Keywords : epilepsy

Patterns and Prognosis of Epileptic seizures in Children with Cerebral Palsy

Kawes O.Zangana; Muhi Kadhem Al-Janabi; Abdulla F. Ahmad; Zaher T. Gardi

Iraqi Postgraduate Medical Journal, 2017, Volume 16, Issue 1, Pages 64-71

Cerebral palsy (CP) is the result of non-progressive damage to the developing brain and consists of a number of clinical neurological syndromes of heterogeneous etiology. Epilepsy is known to have a higher association with cerebral palsy; 15–60% of children with cerebral palsy have been reported to have epilepsy.
This study was performed to determine and assess the characteristics of cerebral palsy and explore the relationship between type of cerebral palsy and patterns of epileptic seizures and to determine the associated factors, nature and prognosis of epilepsy in children with cerebral palsy.
Design:A prospective, hospital-based, case-control study.
Setting: RaparinPediatric Teaching Hospital, Rizgary Teaching Hospital-Neurology Department and Helina Handicap Care Centre during the period of January 2013- July 2015, Erbil, KRG, Iraq.
One hundred and twelve children had CP and seizures were studied (group1). Two control groups included 70 children had CP without seizures (group2), and 50 children had seizures without CP (group3).
The following data were ascertained: Type of CP, pattern of seizures, age, gender, age at onset of seizures, mode of delivery, history of hypoxic ischemic encephalopathy in the neonatal period, neonatal seizures, history of status epilepticus, family history of seizures, developmental delay, EEG data, image findings, use of anti-epileptic drugs, seizures control and seizures outcome. Children with febrile convulsion were excluded from this study.
Spastic tetraplegia wasthe most common type of CP (29.46%, 35.71%) in group 1 and 2 respectively.Generalized tonic, clonic or tonic clonic seizures were the most common types of seizures in both groups. Unlike those who had epilepsy without CP,themajority; 57(50.89%) of patients who had epilepsy and CPdeveloped seizures in the first year of life. Twenty eight percent of caseswith epilepsy and cerebral palsy, and 88% of cases with epilepsies alone showed good seizure control by antiepileptic therapy. Children who had epilepsy and CPhad a higher frequency of; neonatal seizures44 (39.28%), developmental delay98 (87.5), abnormal brain CT scan 91(81.25%) and family history of seizures47 (41.69%). Large number of patients who had epilepsy and CP 81(72.32%) needed poly therapy while majority ofthose who had epilepsy without CP needed single therapy 60(90%).
Cerebral palsy is associated with a higher incidence of seizure disorders, whichin a majority has its onset in the first year life.Brain imaging showed abnormal pathology in most affected children and needed poly therapy and even difficult to control.

Common Ictal Patterns in Patients with Documented Epileptic Seizures

Ghaieb Bashar ALJandeel

Iraqi Postgraduate Medical Journal, 2013, Volume 12, Issue 0, Pages 637-642

The ictal EEG patterns are the electrical triggers of 'epileptic seizures' and they are different from the familiar 'inter-ictal' discharges that are encountered during the normal 'non-seizing' states of epileptic patients. This study concentrates on the 'seizing discharges' among in-patients with documented seizures through a 'simultaneous EEG-Video' monitoring (telemetry) facility
To identify the common ictal patterns in patients with documented epileptic seizures
Two hundred consecutive telemetries at King's College Hospital in London over the period of nine months starting from Jan 2007 back to May 2006 were reviewed and the common ictal patterns were evaluated by using 'simultaneous EEG-Video' monitoring (telemetry) facility
Three main ictal patterns were observed in the 81 patients with documented epileptic seizures. 'Rhythmic theta ictal pattern' was observed in 46.9% of patients, all showed focal seizures whereas 26.1% of patients showed the 'decremental ictal pattern' (fast activity). Focal seizures were presented in 81.8% and 18.2% with generalized ones. 'Polyspike-wave' activity was observed in 9.8% of patients and all of them have genrralized seizures
At least three commonly encountered ictal patterns were identified. They are distinct, may be readily recognizable and showed their prevalence in King's telemetry.

The Role of Telemetry (Simultaneous Video and EEG Monitoring) in the Proper Management of Epilepsy

Ghaieb B Aljandeel; Gonzalo Alarcon

Iraqi Postgraduate Medical Journal, 2011, Volume 10, Issue 3, Pages 408-413

Telemetry is defined as simultaneous video and EEG monitoring of presumably epileptic patients while they are hospitalized in telemetry ward so that one or more of the habitual seizures or funs are captured and recorded; these events would be visualized and analyzed later by expert epileptologists for the sake of proper diagnosis, classification, presurgical evaluation or else.
To define and evaluate simultaneous Video –EEG monitoring in epilepsy management.
Two hundreds consecutive telemetries at King's College Hospital in London over the period of nine months starting from Jan 2007 back to May 2006 were reviewed and the conclusive yields were evaluated.
It showed that the three main indications for referral were to be ’the diagnosis' in a proportion of 56.5% 'presurgical evaluation ' in 19.8% and ' classification' in 15.2% whereas other application like assessment for vagal nerve stimulation (VNS) candidacy , sleep studies , follow up and frequency estimation constitute the remaining 8.5 % . It was conclusive in 63% for 'classification', 60 % for 'diagnosis', and only 34%for presurgical evaluation, whereas categorically was conclusive in 56.55 of all referrals.
The study shows that telemetry is a crucial and probably an indispensable tool if the proper understanding of the problem, and consequently proper handling and management are to be considered.

Etiologies of Adult Onset Epilepsy: Clinical and Paraclinical Study in the Governorate of Babylon.

Kareem Al-Tameemi

Iraqi Postgraduate Medical Journal, 2010, Volume 9, Issue 4, Pages 555-561

Adult onset epilepsy (AOE) is considered the epilepsy that start after the age of 18 years. It is a
common disorder, and it’s etiology is variable from one place to another.
to study the etiologies, diagnosis and treatment of AOE in one governorate of Iraq and to compare
it’s different clinical and paraclinical abnormalities in different age groups.
106 patients with AOE were enrolled in this prospective study, and included all patients who
developed seizure after the age 18. The study was done in a heavy neurological clinic in north of
Babylon governorate, Iraq, for 3 years from Sept. 2007 to Sept. 2010.
A total of 102 patients met the criteria. Brain tumors were found in 24 (23.5%). No cause could be
found in 25 (24.5%) of cases. Generalized tonic clonic seizure was registered in 47 patients (46%).
EEG was positive in (57.3%) of cases and the MRI was conclusive in 63.7% of them.
Brain tumors, CVD, post traumatic and inflammatory disease are the four major causes of AOE in
Iraq. The most common type of seizure among different groups of etiologies of AOE is focal

Correlation of Angiographic Findings and Clinical Presentations in Unstable Angina

Ali Abdulamir Mohammad AL.Mossawi; Kasim Abbas Ismail; Majid Hameed AL Maini; Adil Siwan Aqabi; Azher Sabih Zubaidy; Jawad K. mnuti; Fadhil A. AL- Abbudi; Amira H. Shubbar; DEFINITION GERD is described as any symptomatic or histopathological alteration resulting from episodes of gastroesophageal reflux; Layth Rafea Taqa; INTRODUCTION; Reflux esophagitis describes the subset of GERD patient with histopathological changes of; Sawsan Sati; Najat Abul; Razak; Noor Mustafa; Razeqa Abd Ali; Suhaila Saadallah; Raji H AL-Hadithi; Darya Akram Faqe Mahmood; Ari R. Qader; Kurdo A. Mohmmad; Dawood Salman Hameed Alazzawi; Entissar Hadi AL- Shimery; Jaafar Muhamed Hassan; AL- Ghabban; Haider Abdul Muhsin; Huda Adnan Habib; Maysaloun Muhammed Abdulla; Selwa Elias Yacoub; Abdulrazak H. Alnakash; Shaema Jafar; Yousef Abdul-Raheem; Alaa Hussein Ali; Montadhar Hameed Nima; Rasha Abbas Azeez; Jassim Mohammad Alkhazraji; Hussein Mahmood Gazi; Mohammed Shafik Tawfeek; Nabeel Ghazi Hashim; Hayder Hadi Lazim; Maysoon Mohammad Najeeb Mohammad Saleem; Arieg Abdul Wahab Mohammad; Majid Syki Jabir; Kareem Al-Tameemi; Malak A. Al-Yawer; Adel Rabea Alsaadawi; ABSTRACT; Issraa A. Hussein; Osama E. Hudder; Thukaa T. Yahya

Iraqi Postgraduate Medical Journal, 2010, Volume 9, Issue 4, Pages 449-455

Unstable angina is usually related to acute thrombosis superimposed on a disrupted plaque. The highest;
level of Braunwald classification of unstable angina can be used to assess the severity of clinical
presentation. However the highest classes have not been directly correlated with thrombotic and complex
The study was done to clarify the correlation between angiographic findings and the most acute and / or
severe clinical presentation in unstable angina.
We conducted a prospective study of 110 patients of unstable angina at Ibn-Albitar Center for Cardiac
Surgery. All of these patients underwent cardiac catheterization, culprit lesion was identified in 80
patients and in 30 patients there was no an identifiable culprit lesion .Complex lesions including complex
morphology, intracoronary thrombus, or total occlusion were also quantitatively analyzed and
Thrombolysis in Myocardial Infarction (TIMI) flow grade was assessed. Patients were classified
according to Braunwald classification in instable angina .We compared patients with and those with no
culprit lesions in regarding Braunwald classification. We sequentially compared the highest Braunwald
classes II, C, 3 with classes


braunwald classification
unstable angina

Drug Compliance In Epileptic Children In Sulaymani Governate

Salem Rahma; Ibrihem khasro

Iraqi Postgraduate Medical Journal, 2010, Volume 9, Issue 2, Pages 158-162

Compliance behavior depends on the specific clinical situation, the nature of the illness, and the treatment program.
Determine the rate of drug compliance in families caring for a child or adolescent with epilepsy and to describe some associated factors.
Two hundred patients with epilepsy under 18 years of age, who were attending the pediatric clinic for a twelve month period (August 2007-August 2008) and their families, were interviewed.
Drug compliance was satisfactory in 123(62.5%) and was poor in 77(37.5%) of the patients according to their self or parental report. Age of the patient, gender, residence, etiology of epilepsy, and monotherapy versus polytherapy did not significantly influence the drug compliance but duration of the disease, parental education, family size and positive family history of epilepsy were more significantly associated with drug non compliance.
In this study, drug compliance was satisfactory in 62.5% of the patients. There was a significant association between drug non compliance and socioeconomic status (large family size, family history of epilepsy, low parental education