Seizure

An 88-year-old man was admitted to the Emergency Department presenting with sudden and persistent jaw movements over the last 10 hours. The patient remained alert, but was unable to voluntarily stop the movements. No prior history of similar episodes was reported, and the patient had no relevant medical history.

Functional seizures (FS), also known as psychogenic non-epileptic seizures (PNES) and non-epileptic attack disorder (NEAD), manifest as clinically observable, paroxysmal changes in behaviour or consciousness that mimic epileptic seizures, but unlike the latter, they are not associated with electrophysiological brain abnormalities [1]. While these seizure-like events are believed to be caused by psychological factors [2], their resemblance to epileptic convulsions, especially to healthcare providers who have little experience in dealing with FS, often results in the incorrect diagnosis of epilepsy ...

Photosensitivity is present in 2-14% of patients with epilepsy and characterized by the photoparoxysmal response (PPR), an abnormal electrophysiologic response to visual stimuli. PPR is defined as a 2-5 Hz generalized spike, spike/slow wave pattern, usually more pronounced in the frontal and paracentral regions, observed during intermittent photic stimulation (IPS) [1]. Clinical photosensitivity refers to the triggering of seizures by flashing lights from natural or artificial light sources [2].

Clinical practice guidelines for managing Infantile Epileptic Spasms Syndrome (IESS) vary based on local experts’ opinions, local patient demographics, genetic, and clinical characteristics, as well as medication availability and accessibility challenges [1]. However, there is currently a lack of specific guidance tailored to the Gulf Cooperation Council (GCC) countries. As such, consensus established by experienced specialists is urgently needed. An expert panel was convened by the Saudi Pediatric Neurology Society (SPNS) to discuss and debate issues related to the management ...

Epilepsy is one of the most common and serious brain diseases, affecting more than 700,000 people worldwide; its incidence is bimodal and higher in infants and old adults [1]. Seizures are transient signs and/or symptoms resulting from abnormally excessive or synchronised neuronal activity in the brain [2]. Additionally, epilepsy often results in oxidative stress and brain damage [3]. Drug therapy is the most important treatment for epilepsy, and currently, anti-seizure medication (ASM) completely eliminate seizures without side effects in approximately ...

We read with interest Jose et al’s article about a single-center cohort study on the frequency and etiology of metabolic disorders in 385 pediatric patients with developmental epileptic encephalopathy (DEE) and treatment-refractory epilepsy [1]. A probable or possible metabolic disorder was suspected in 89/385 patients [1]. A pathogenic or likely pathogenic variant in genes associated with metabolic disorder was detected in 39/89 patients, and a variant of unknown significance in 28/89 patients [1].

Approximately 30% of pediatric patients with epilepsy do not achieve adequate seizure control when given standard medication. Dietary changes are frequently regarded as a viable alternative therapy option in the case for these patients, with a growing body of evidences supporting their efficacy (1-3). Research has demonstrated that the traditional ketogenic diet (KD), which restricts carbohydrate consumption to less than 4% of total calorie intake, shows efficacy in improving seizure management in newborns and young children.

Epilepsy is a common chronic neurological disorder that affects more than 50 million people worldwide [1]. Antiseizure medications are effective in approximately two-thirds of cases, leaving a third of patients with uncontrolled epileptic seizures [2]. If patients do not qualify for resective epilepsy surgery, neuromodulation strategies, such as vagus nerve stimulation (VNS) or deep-brain stimulation (DBS), are effective options to be considered [3]. The use of VNS was approved for epilepsy by European Union in 1994, followed by the United ...

Phosphoglycerate kinase (PGK) deficiency is an extremely rare X-linked recessive genetic disorder with a wide range of phenotypes, which typically present as either a syndrome of moderate to severe hemolytic anemia accompanied by nervous system manifestations, or a mostly myopathic syndrome.[1,2] Here, we reported a novel PGK1 missense variant from a patient with atypical presentations of PGK deficiency, including mild hemolytic anemia, global developmental delay, and seizures, without apparent myopathies.

We thank the author for the positive and critical comments in the letter titled “Whole exome sequencing is the method of choice to determine the etiology of developmental epileptic encephalopathy”. The data published in our paper is from a prospectively maintained database of developmental-epileptic encephalopathies (DEE). Some children may have had normal prior development without any significant medical issues before onset of their illness and psychomotor regression along with medical comorbidities may only have developed after evolution of the epilepsy ...