Background: we evaluated the diagnostic value of Electroencephalography (EEG), video-EEG monitoring (VEM) and Magnetic resonance imaging (MRI) of the brain with epilepsy protocol in patients with complex partial epilepsy.Methods: Forty-two consecutive patients underwent complete neurological examination, EEG, and MRI with a modified epilepsy protocol. A subset of these patients (n=29) also underwent VEM. Data were presented using descriptive statistics and were analyzed using Chi square and McNemar tests.

We conducted a retrospective study to evaluate the efficacy of levetiracetam as adjunctive therapy in patients with refractory partial onset seizures, and in particular to assess effects following failed epilepsy surgery. Eighty-two patients with uncontrolled partial-onset seizures treated with levetiracetam were identified, of whom 21 failed prior epilepsy surgery (Group I) and 61 had no prior surgery (Group II). Group I patients (11 female, 10 male) ranged in age from 20 to 80 years (mean=40.7); mean age at onset of seizures was 14.4 years. The 61 patients in Group II (37 female, 24 male) ranged in age from 18 to 80 years (mean=41.5) and had mean age of onset of seizures 18.2 years. Patients who had ≥50 % reduction in seizure frequency were considered responders; the remaining patients were considered non-responders. In Group I, responder rate was 76.1 %: 10 patients (47.6 %) were seizures - free, and 6 patients (28.5 %) had ~ 50 % reduction in seizure frequency. In Group II, responder rate was 34.3 %: 9 patients (14.7 %) were seizure - free and 12 patients (19.6 %) had ≥ 50 %  reduction. In Group I, 11 of 12 temporal resection patients (91.6 %) were responders, of whom 8 were seizure-free; of the remaining 9 operated patients, 5 (55.5 %) were responders and 2 patients were seizure-free. Three responders (14.2 %) in Group I developed a severe, delayed psychotic syndrome 4 9 months following levetiracetam introduction, leading to its discontinuation. This impressive data shows adjunctive levetiracetam therapy should be considered early following failed epilepsy surgery (especially temporal resection), and may have implications for its use before surgical intervention. Patients should be under close psychiatric observation in this clinical setting.    

Introduction: Epilepsy is one of the most prominent problems in pediatrics. Statistics show that 5 to 8 persons out of 1000 suffer from seizure disorders, and about 300.000 children in Iran have epilepsy, 40% of whom have partial seizure. This investigation was conducted to study the effectiveness and side effects of primidone, as the standard first line treatment of partial seizure and to compare it with carbamazepine. Method and Material: In this clinical trial study, 30 patients (<18 years old) including 20 boys and 10 girls, with newly diagnosed and previously untreated partial epileptic seizure from Bandar Abbas childrens hospital were enrolled. Subjects were randomly divided into two equal groups. Carbamazepine 15-25 mg/kg/day and primidone 10-25 mg/kg/day were administered to each of the patients during a 6- months period. Data analysis was performed using paired t-test and p<0.05 was considered as significant. Results: Mean seizure frequency in carbamazepine group was reduced from 2.5 times to 0.3 during the study period. In the primidone group, this figure reduced from 2 times to 0.07 times. The differences were statistically significant (p<0.05). The mean time of seizure in carbamazepine group was reduced from 5 minutes to 1.6 minutes. In primidone group, the mean time of seizure was reduced from 4.1 minutes to 0.37 minute. These differences were also significant (p<0.05). Discussion: Primidone and carbamazepine show similar efficacy against partial seizures in newly diagnosed epilepsy in children. Primidone, however, had better effect on EEG outcome. In conclusion, we suggest that after some more extensive studies, primidone can be used as the first choice of therapy for pediatric partial seizure.

Background & Objective: Benign Rolandic epilepsy is one of the most common epileptic syndrome in children with an excellent outcome. The pattern of inheritance is autosomal dominant and usually started between 3-14 years. The purpose of this study was to show clinical manifestation, outcome and good recovery of these patients after treatment.Methods: In this descriptive and prospective study between 2000-2001in Isfahan University of medical science, 21 patients according to clinical and electroencephalographic findings of Rolandic epilepsy were evaluated. Results: 17 patients were male and 4 female. The range of patients age was between 4-18. positive family history of Rolandic epilepsy were seen in 7 patients. There is not any recurrence of attacks after treatment with carbamazepin (18 patients) and sodium valproate (3 patients).Conclusion: Clinical diagnosis with EEG findings are very important in patients with Rolandic epilepsy. Physicians must inform patients and their parents about excellent outcome of this type of epilepsy.

Objective: Psychoses of epilepsy usually have an acute onset, accompanied by brief symptom duration and a risk of recurrence. Managing these conditions can be challenging due to the potential for seizures associated with certain antipsychotic medications, as well as exacerbating psychosis resulting from some antiepileptic medications. Our objective in this study was to assess the occurrence of psychosis among patients with epilepsy, as well as identify the factors linked to the presence and severity of psychosis in this population. Method: In this study, we included a total of 514 subjects diagnosed with epilepsy referring to our neuropsychiatry clinic affiliated with Tehran University of Medical Sciences from April 2011 to December 2021, among whom 57 patients showed psychotic presentations. We compared baseline and clinical characteristics between patients with psychosis of epilepsy and non-psychosis patients who also had epilepsy. Results: Marital status was the sole demographic factor that displayed a statistically significant difference between the psychosis and non-psychosis groups (P = 0. 019). There was no significant difference observed between the two groups regarding family history of epilepsy and age at the onset of the epilepsy. Patients with psychosis experienced significantly more frequent seizures and generalized type (P < 0. 001). Participants were matched for demographics and other clinical factors between the refractory and controlled psychosis groups, except for the psychosis frequency (P = 0. 007). The type of epilepsy was significantly associated with psychosis when adjusted for the covariates (P < 0. 001). Conclusion: Patients with psychosis of epilepsy experienced more episodes of epilepsy than non-psychotics. We identified generalized epilepsy as an independent risk factor for the development of psychosis. Additional cohorts are warranted to explore the factors associated with epilepsy-related psychosis across diverse populations.

Objective: Epilepsy is a chronic neurological disorder that affects 0. 5%–, 1% of children. 30%–, 40% of patients are resistant to current anti‑, epileptic drugs. Lacosamide (LCM) appeared to be effective, safe, and well tolerated in children and adolescents. This study was aimed to evaluate whether LCM could be an effective add‑, on therapy in children with refractory focal epilepsies. Methods: This study was conducted from April 2020 to April 2021 in Imam Hossein Children Hospital, Isfahan, Iran. We included 44 children aged 6 months to 16 years with refractory focal epilepsy (based on International League Against Epilepsy criteria). LCM was given in divided doses of 2 mg/kg/day, increasing by 2 mg/kg every week. The first follow‑, up visit was 6 weeks later, when all patients had reached the therapeutic dose. Findings: The average age of the patients was 89. 9 months. 72. 5% of children had focal motor seizures. Evaluation of percent change in seizure frequency and duration before and after treatment showed a 53. 22% reduction in seizure frequency and 43. 72% reduction in seizure duration after treatment. Our study group tolerated LCM well, with few side effects. Headache, dizziness, and nausea were common side effects. In line with other studies, none of the suspected risk factors could predict response to LCM treatment. Conclusion: LCM appears to be an effective, safe, and well‑, tolerated medication in children with uncontrolled drug‑, resistant focal epilepsy.

Background: Epilepsy is defined as recurrent unprovoked febrile seizures, which cause disability in patients. This study aims to assess the health-related quality-of-life (QOL) in epileptic patients in Fars Province, southern Iran.Methods: One-hundred epileptic patients, above 18 years, referred to Shiraz University of Medical Sciences affiliated clinics, were included. The QOL of patients with generalized and partial seizure were assessed using the Iranian valid and reliable Sf-36 questionnaire. Patients’socio-demographic and their disease features were also compared with each other using a questionnaire.Results: In partial epilepsy group (n=24), the married patients in social functioning (SF) aspect of QOL (64.42±14.29) (P=0.024), the patients on antiepileptic drugs (AEDs) monotherapy in both physical functioning (PF) (88.75±11.57) (P=0.030) and SF (75.00±6.68) (P=0.022) aspects, the employed patients in PF aspect of QOL (P=0.023) (91.87±8.83) and those with high income in mental health aspect of QOL (P=0.036 and correlation coeDcient=0.413) got better scores compared with the partial epileptic patients who were single, on polytherapy, unemployed and had low to moderate income. In generalized epilepsy group (n=76), patients on AEDs monotherapy in PF aspect of QOL (P=0.025) (78.33±24.36) and employed patients in vitality aspect (P=0.023) (57.00±28.25) had better scores. Data were analyzed using SPSS for windows.Conclusion: Epilepsy can affect patient’s life in a number of ways such as their lives, marriage, occupation, and education. We can encourage patients to find a partner, continue higher education and try to find a job.