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Open access

Dorota Talarska, Michał Michalak and Patrycja Talarska

Summary

Background. Every chronic illness, including epilepsy, has a negative effect on both the quality of life of the sufferer as well as on their relationship with their surroundings.

Aims. To investigate the quality of life of children suffering from epilepsy and analyse how they assessed and scored their experiences compared to their parents.

Materials and methods. The study included 209 children with epilepsy and their parents. The research tool was a questionnaire for gathering demographic and clinical data as well as the Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL 4.0) questionnaire in two versions, one for 8–12 year olds and one for 13–18 year olds and their parents.

Results. Cronbach’s alpha coefficient for the entire PedsQL 4.0 questionnaire was 0.91 and 0.93 for children with epilepsy and their parents respectively. Children rated their Total Scale Score higher (67.5 points) than their parents (62.5 points). Whilst analyzing children’s functioning in different areas it was observed that girls’ assessments were higher than boys’, except for Emotional Functioning. Both parents and children scored School Functioning the lowest. The greatest agreement of responses was observed in the domain of Physical Functioning, the smallest in the domain of Emotional Functioning.

Conclusions. Quality of life was rated higher by both age groups of children suffering from epilepsy than by their parents. A statistically significant difference was found when comparing the assessment scores of children and parents in light of the following variables; child age, gender, illness duration, seizure frequency and treatment effectiveness.

Open access

Vladimir V. Kalinin, Daniya M. Nazmetdinova and Alexander V. Basamygin

Summary

Introduction. The current knowledge of significance of some neurobiological and clinical variables for the development of cognitive deterioration in patients with epilepsy remains sparse and controversial.

Aim. The current study has been carried out in order to elucidate the role of handedness in terms of influence on cognitive processing and intelligence in patients with epilepsy.

Material and methods. One hundred and thirty two patients (62 males, 70 females, aged 27.8 ± 8.9 years) with epilepsy participated in the study. Patients were divided into two groups. The first group included 112 patients that were characterized by intelligence and cognitive impairment while the second group (20 patients) had no mental deterioration and was regarded as controls. The two diagnostic categories accorded with ICD-10 criteria. The diagnosis of Dementia (F-02.8) was confirmed in 54 patients, while the diagnosis of Mild Cognitive Impairment (F-06.7) was confirmed in 58 patients.

Results. Our results show that the level of left-handers among patients with cognitive Impairment achieved 14.2%, whilst in the group without cognitive deterioration there were no left-handers, and this difference was statistically significant (p = 0.051). An analysis of possible influence of motor lateralization on degree of cognitive deterioration, revealed that left-handedness determines the higher degrees of intelligence deterioration compared with right-handedness (χ2 = 6.64; p < 0,05). These data were confirmed by use of Wechsler Adult Intelligence Scale (WAIS) and the Mini Mental State Examination (MMSE) tests, and all left-handed epilepsy patients achieved lower scores on MMSE, total WAIS, as well as verbal and nonverbal WAIS scores.

Conclusion. Our data confirm a role of some neurobiological variables, with emphasis on cerebral motor lateralization, in their influence upon intelligence level and cognitive deterioration in epilepsy. These data may be used for predictive purposes of intelligence assessment in patients with epilepsy.

Open access

Evangelina E. Ballini, Edward Helmes and Bruce K. Schefft

SUMMARY

Introduction. The traditional view of cognition in idiopathic or genetic generalized epilepsy (GGE) is that “one size fits all” i.e. only very mild generalized impairment might be detected, if any. This paper describes four case studies of cognitive functioning in GGE patients with photosensitivity and reflexive seizures.

Aim. The aim was to discover whether each individual’s set of cognitive deficits varied in accordance with his/her other clinical phenomena such as photosensitivity and kinds of reflexive seizures.

Method. Neurological and cognitive performance was assessed by comprehensive evaluation of each patient based on interviews, neurologist’s EEG reports and neuropsychological tests. Assessment of cognitive domains included estimated pre-morbid I.Q. based on reading ability and demographic norms, current I.Q., attention factors, verbal memory, visual memory and executive functions.

Results. Clinical signs and investigative studies indicated that two cases typically began reflexive seizure episodes with facial myoclonia which evolved into tonic-clonic convulsions or generalized myoclonic seizures. These patients had widespread attention and working memory deficits, some severe, together with lowered intelligence scores. In contrast, two other cases (with no history of myoclonus) had generalized reflexive seizures originating in the occipital lobes, very mild localized visual dysfunction and high intelligence.

Conclusions. The systematic variation in extent and nature of cognitive dysfunction illustrated in these cases with reflexive seizures (preceded by myoclonia or visual phenomena) would be explained by a more recent conceptualization of GGE as encompassing regional differences in variable hyperexcitability located at cortical levels or functional neural networks.

Open access

Matti Sillanpää

with partial complex seizures. Brain, 2013, 136: 593-600. Camfield C.S., Camfield P.R.: Long-term social outcomes for children with epilepsy. Epilepsia, 2007, 48: 3-5. Camfield C., Camfield P., Gordon K., Smith B., Dooley J.: Outcome of childhood epilepsy: a population-based study with a simple predictive scoring system for those treated with medication. J. Pediatr., 1993, 122: 861-868. Camfield P.R., Camfield C.S., Gordon K., Dooley J.M.: If a first antiepileptic drug fails to control a child’s epilepsy, what are the

Open access

Shigeaki Kobayashi and Akio Morita

, Aoki N, Fukuhara S, et al. The natural course of unruptured cerebral aneurysms in a Japanese cohort. N Engl J Med. 2012;366(26):2474-82. 31. Greving JP, Wermer MJ, Brown RJ, Morita A, Juvela S, Yonekura M, et al. Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies. Lancet Neurol. 2014;13(1):59-66. 32. Shojima M, Oshima M, Takagi K, Torii R, Hayakawa M, Katada K, et al. Magnitude and role of wall shear stress on cerebral aneurysm: computational

Open access

Tetsuya Goto, Chika Ndubuisi, Tatsuya Kobayashi, Takafumi Kiuchi, Kunihiko Kodama, Keiichi Sakai and Kazuhiro Hongo

lesion (upper). Functional MRI by moving foot joint showing that hot spot of lower left and lower right looks almost as a mirror image. Four months later, the tumor rapidly extended to the pyramidal tract, basal ganglia and corpus callosum four months after the fourth surgery ( Figure 3 , upper). She had mild motor aphasia and right hemiparesis: proximal U/E MMT 2, distal U/E MMT 4, lower extremity (L/E) MMT 2. Her Karnofsky performance state score was 70%. Figure 3 MRI before fifth operation revealing that the enhanced lesion invades to the basal