Day 1 :
- Neurological disorder
Dr. Nirmal Surya, MBBS, MD , DNB (Neurology), FIAN , working as Hon. Ass. Consultant Neurologist at Bombay Hospital and research Centre, Saifee Hospital and Mumbai. Chairman of Surya Neurocentre, Mumbai. I am the Founder Trustee and Chairman of Epilepsy Foundation India(2009 onwards). I have been at various posts for neurological societies in India, Founder President of Indian Federation of Neurorehabilitation, Past President (2013-14) of BNA- Bombay Neuroscience Association, Treasurer(2014-2020) IAN- Indian Academy of Neurology, Founder Secretary (2005-10) MAN- Maharashtra Association of Neurology. I am the Regional Vice President of World Federation for NeuroRehabilitation (Since 2006) Chairperson, Developing world Forum, SIG, WFNR and president of the recently concluded 10th World Congress of Neurorehabilitation in Mumbai.
Epilepsy is a major public health concern affecting an estimated 50 million people worldwide. Developing countries are the one most affected by the consequences of epilepsy, with treatment gap of over 60%. The life time prevalence rate for epilepsy in developing countries varies from 1.5 - 14 per 1000 in Asia. to 5.1 - 57.0 per 1000 in Latin America and 5.2 - 74.4 per 1000 in sub Sahara Africa. The increased occurrence of birth trauma, traumatic head injury and neuro-infection are responsible for higher prevalence of epilepsy. Approximately 30% patient with epilepsy have significant neurological co-morbidity (ID, CP, Autism, ADHD, Stroke, Head injury and Encephalitis. In developing world epilepsy is associated with many disability particularly in children, in Children with Epilepsy 30 - 40% have ID and 7 - 42% with autism. In population based study 38% of children with CP has epilepsy. ADHD, ASD are more common with epilepsy. The more serious the neurological co-morbidity, higher the incidence of epilepsy, each disability needs to be addressed separately besides the disability related to epilepsy itself.
Epilepsy is often misunderstood, leading to fear, stigmatization and the risk of social discrimination. In some patients, social stigma can pose a greater challenge than the epilepsy itself. People with epilepsy have an increased risk of poor self-esteem, depression, and suicide. Many people with epilepsy live in fear that they will have another seizure. Our experience of epilepsy and disability during the epilepsy camp in Maharashtra with NHM Govt. of Maharashtra in past 7 years has been as follows: In 69 camps from 2011-2018 the total no. of patient with epilepsy are 26606, No. of patients evaluated by the Physiotherapist: 1724, Speech Therapist: 2574, Occupational Therapist: 2724 and Clinical Psychologist: 1896. I shall be discussing our experience and highlight the need of recognizing this hidden devil in people with epilepsy.
Pedaitric Neurologist , India
I am Dr. Amit Vatkar, MBBS,DCH,DNB(Ped) working as a Pediatric Neurologist in Mumbai.
I have completed my DNB in pediatrics in 20011, I have been working in Pediatrics for last 4 years. I have completed Fellowship in Pediatric Neurology (Mumbai) under the guidance of Vrajesh Udani, in India.. I was part of the Hinduja Pediatric Neurology speciality center from 2011 to 2013. I has also been trained in Epilepsy & neurophysiology at Case western Reserve University at Cleveland under the guidance of Dr. Hans Luders.
I am currently associated with few hospitals as an expert in Pediatric Neurology field and has been treating their patients.
Statement of the Problem: Neonatal seizures include those critical events whose onset has occurred during the first 28 days of life and till date, phenobarbital and phenytoin remain the most common anticonvulsive drugs administered in this age group. When administered apart, these drugs result in resolution of <50% of neonatal seizures. When used in combination, the percentage of seizure resolution rises up to 60% of all treated cases. Neonatal seizures are often refractory to treatment with initial antiseizure medications. Consequently, clinicians turn to alternatives such as levetiracetam, despite the lack of published data regarding its safety, tolerability, or efficacy in the neonatal population.
Methodology: The aim of this study is to evaluate the efficacy of Phenobarbitone and levetiracetam (LEV) as first-line treatment of neonatal seizures admitted in NICU.This study was conducted in patients of Neonatal Intensive Care Unit of Satyam Hospital Raebareli. A total of 200 neonates with convulsions not associated with major syndromes, which required anticonvulsant therapy, were analysed for the use of IV Leviteracetam or IV phenobarbitone at standard doses.
Findings: All patients responded to treatment, with a variety range of seizure resolution. The number of patients required a second anticonvulsant therapy. Regarding safety of LEV, no major side-effects were observed.
- Dynamic Disease
Head of Epilepsy Research at UNEEG medical, Denmark
Dr Jonas Duun-Henriksen received the M.S. in Biomedical Engineering and industrial Ph.D. degrees from DTU Electrical Engineering, Technical University of Denmark, in 2008 and 2013, respectively. His Ph.D. was in collaboration with the company HypoSafe A/S now called UNEEG medical A/S and Copenhagen University Hospital. After he finished the Ph.D. he continued in the company as a scientific researcher. In 2017 he won the People’s Choice award at the annual Epilepsy Foundation Shark tank competition. He is now the Head of Epilepsy Research at UNEEG medical A/S and has special responsibility within EEG data quality. In August 2018 he started as Visiting Researcher in the Richardson Lab at King’s College London.
Statement of the Problem: Unawareness of seizures complicates precise reporting of seizures, making it difficult for physicians to evaluate the effect of the treatment. Long-term video-EEG during admission can remedy this problem, but it is costly, inconvenient and sometimes just not the right tool for the job. Various research groups have recently outlined the future within portable EEG equipment. They agree that small, portable and convenient systems for instantaneous and continuous EEG monitoring are essential. We present a novel subcutaneous monitoring system developed for unobtrusive, continuous, ultra-long-term EEG applications able to record for weeks, months or years in an outpatient setting.
The device consists of two parts: a subcutaneously placed device with three electrodes implanted during a 15 minutes procedure under local anesthesia and an external device for power supply and data storage. The parts are small enough to be wearable during everyday activities, making the device truly mobile. The electrodes can be implanted over a wide area, however, the three electrodes give a limited spatial coverage which necessitates selection of subjects with e.g. a known seizure focus.
30 subjects have worn the system for at least six weeks. No device related serious adverse events have been observed. The signal is comparable to closely located scalp recordings but with significant fewer movement artefacts. For subjects having temporal lobe epilepsy, the seizures seem to be reliably detectable from the subcutaneous EEG, especially when they show a significant rhythmic component.
The novel EEG recorder presents a solution to an unmet clinical need. It provides a method of ultra-long-term EEG recording where a small number of EEG electrodes are sufficient. Results are encouraging, and we continue to recruit patients. When more knowledge and data are obtained the system might even provide a solution to seizure prediction.
- Prevention and Management
Head - Neurologist & Epileptologist, India
Dr Madhusudhan B.K. completed his MBBS from AIMS in 2002 and pursed his MD in General Medicine and DM Neurology from M.S Ramaiah Medical College and Hospitals. Later, he underwent training in epilepsy and epilepsy surgery workup with video EEG and intracranial electrode EEG monitoring at Toronto Western Hospital, UHN, Canada.He holds a good experience in treating patients with epilepsy, pre-surgical evaluation of medically refractory epilepsy, Vagus Nerve Stimulation (VNS), stroke, Parkinson disease, spondylosis, neuropathy and neuromuscular disorders, Acute neurological conditions such as ADEM, meningitis, GBS, headache , migraine etc.
Epilepsy refers to a disorder of brain function characterized by the periodic and unpredictable occurrence of seizure. It is 2nd most common neurological disorder after stroke and Common neurological disorder affecting 0.5-1.0 % population in India. Rochester epilepsy study also found that the prevalence of epilepsy was slightly higher in males than females (6.5 vs 6.0 per 1000 persons). Although most epilepsy syndromes are equally or more commonly found in males than in females, childhood absence epilepsy and the syndrome of photosensitive epilepsy are more common in females. In addition, some genetic disorders with associated epilepsy (eg, Rett syndrome and Aicardi syndrome) and eclamptic seizures in pregnancy can only occur in females. Few factors around epilepsy and its treatment are specific to women and do not apply in the same way to men. These include links between epilepsy and hormones, puberty, contraception, pregnancy and the menopause.
The efficacy of hormonal contraception diminishes in women who are taking CYP-450 enzyme inducing AEDs. Antiepileptic drugs (AEDs) reduce the efficacy of contraception methods and increase the risk of fetal malformations. Women with epilepsy have a higher risk of reproductive dysfunction, including polycystic ovarian syndrome, multiple ovarian cysts, anovulatory cycles and infertility. Women with epilepsy who are on AEDs and pregnant have an increased risk of fetal malformations. Prenatal exposure to AEDs is known to increase this risk to 4-9%. However, the vast majority of women with epilepsy deliver healthy babies. Breastfeeding in women taking AEDs is safe, providing that there is close monitoring of the baby for potential side effects.
Thus, Management of women with epilepsy is challenging. The treating clinician should be thoughtful about the correct choice of antiepileptic medications as it may create problems in reproductive planning and metabolic health. Thus, regular assessments need to be made from menarche onward.
Founder trustee & Chairman of Epilepsy Foundation, India
Dr Nirmal Surya has his expertise in Epilepsy care and rehabilitation. He hasbeen a prominent figure in India in terms of treatment for the poor andneglected society of India for epilepsy care. His ideology of removing thestigma of Epilepsy and Spreading knowledge among the patients and societyhas been helpful in a developing country.
According to WHO, approximately 50 million peoplesuffer from epilepsy around the world, out of whichapproximately 12 million patients with epilepsy reside inIndia and Maharashtra has a approximately 1 millionpeople with epilepsy. It’s one of the major neurologicaldisability present which affects all age, sex, religion andcaste alike.In Rural India the treatment gap is up to 85%largely due to poverty, lack of awareness, myths andtaboo associated with the illness & stigma of disease itselfwith unavailability of specialist to treat this disease.Epilepsy Foundation of india in association with NationalHealth Mission (NHM), state health society, Government ofMaharashtra has founded a public-private partnership anddeveloped a Maharashtra model of epilepsy which is beenworking successfully for past 7 years. The model includes-1. Training of medical & paramedical byCME/SEMINAR/HANDS on Training/Telemedicine.2.Sensitisation of medical officer, health worker andsociety.3.Awareness in society by audio-visual, movie,street play, pamphlets, radio and other modes ofbroadcasting.4. Rural Epilepsy Camps- Organised inDistrict, Sub- District level hospital- across Maharashtraevery Month. Evaluation and Management by Neurologistor Paediatric Neurologist. EEG/CT/MRI/Drug level free ofcost for the required patients. Neuropsychologicalevaluation and Counselling. 3 Months free medication toall. Data entry of all patients for future follow ups and forfeedbacks. Evaluation and treatment of disabilityassociated with epilepsy during the camp Follow upthrough telemedicine/ at district hospital/ at EF centre inMumbai. Set up of 10 Regional Epilepsy Centres indifferent districts of Maharashtra. In the last 7 years atotal of 69 camps have been organized by Epilepsyfoundation in association with NHM, Gov. Of Maharashtra,which saw a total of 26137 patients. 3340 free EEG havebeen done, 640 free CT scans and MRI, 1876 patientshave been counselled, Drug level and Bera were done of502 and 118 patients respectively. 125 Neurologist and25 Paediatrician/ Paediatric Neurologist rendered theirservices during these camps. These camps has reduced thetreatment gap to 25%, this model can be used in all therural setup for various conditions across India. This Modelcan be considered on a larger scale for other developingcountries as well.
- Disorders of Epilepsy
- Advanced Diagnosis
Jinnah Postgraduate Medical Centre, Pakistan
Introduction: Vitamin D deficiency is linked to poor treatment response in patients with MS. The aim of this study is to define the frequency of Vitamin D deficiency for early detection and timely intervention leading to improved morbidity rates.
Objective: To determine the frequency of vitamin D deficiency in Multiple sclerosis patients present at neurology ward of a tertiary care hospital in Larkana
Outcome measure: frequency of vitamin D deficiency
Duration of study: 26 November 2016 to 28 May 2017
Study design: Cross-sectional study
Setting: Neurology Ward Chandka Medical College Hospital, Larkana
Subjects: Ages of 18 and 60 years, either gender, diagnosis of MS for > 3 months, sun exposure for at least 30 minutes and give written informed consent were included in this study. Patients that have other co-morbidities like heart failure determined by echo as EF>25 renal disease determined by serum Cr > 3mg/dl), endocrine disorders like hyperparathyroidism determined by blood PTH levels > 10 ng/dl, any patient on long-term steroid treatment for < 3 months, determined by physician prescription slip, patients already on vitamin D therapy for > 3 months were excluded.
Methods: This study was approved by an ethical review committee of the institute. Patients fulfilling inclusion criteria were enrolled in this study after taking written informed consent. The demographic variables like name, age, gender, duration of sun exposure & duration of disease were collected by the researcher. Blood Sample for a vitamin D level blood sample of these patients was drawn on the same day and sent to a laboratory for vitamin D level in the pathological lab of CMCH. Blood Vitamin D levels in this study were measured by radioimmunoassay. The data was analyzed using SPSS version 19.
Results: Mean age of enrolled participants was 43.6±11 years. Of 85 enrolled participants, 36 (42.4%) were male and 49 (57.6%) were female, the mean duration of disease was 6.2±1.4 months, 70 (82.4%) participants were married and 15 (17.6%) were unmarried, 49 (57.6%) were employed, 43 (50.6%) were exposed to the sun for < 40 minutes a day. The frequency of vitamin D deficiency among patients with multiple sclerosis was 17 (20%) cases.
Conclusions: It is concluded from this study that the frequency of vitamin D deficiency among patients with multiple sclerosis was 20%.
Keywords: Multiple sclerosis, vitamin D deficiency, sun exposure
M.Sc. "Scientific Computing" in FU Berlin, working on field Brain- Computer Interfacing with focus on Machine Learning and Statistical Mathematics (Data Science). Detection of Epilepsy by ML and Deep learning Working as Student Assistant in FU Berlin, Heisenberg
Brain-computer interface (BCI) is a fairly fresh and developing field , Research on BCIs began in the 1970s at the University Of California (UCLA). Although the history of (BCIs) started with Hans Berger's discovery of the electrical activity of the human brain and the development of electroencephalography (EEG). Furthermore, William Grey Walter developed an adjunct to EEG called EEG topography, this enjoyed a brief period of popularity in the 1980s and seemed especially promising for psychiatry. EEG as a non-invasive recording of electrical activity from the scalp has become one of the most useful tools for studying the cognitive processes and the physiology/pathology of the brain . The combined effect of fundamental results about neurocognitive processes and advancements in decoding mental states from ongoing brain signals has brought forth a whole range of potential neuro-technological applications . From an engineering point of view, the task of a BCI is to decode brain activity as reliably and as fast as possible. Clearly, the interface must identify neurophysiological activity that is associated with a subject’s choices or decisions . I believe these points play an important rolls in my PHD thesis; interpreting brain activity as quick as possible for biomedical usage mainly by EEG and fMRI.
Pointedly, I believe BCIs attract more interest in near future with combination of new mathematical methods of dimensionality reduction and data compression specifically manifold learning and compressed sensing(CS) which is crucial for decreasing computational cost. For these reasons my research interests lie in its encouraging application in the traverse through these fields
- Epilepsy Therapeutics
Neurovascular Interventionist, Saudi Arabia
Up to 30% of patients with cerebral arteriovenous malformation (AVM) present with seizure as first presentation. Complete seizure remission is achieved in 70% of those patients with AVM who underwent successful endovascular occlusion of AVM. However, high complication rate limits endovascular management in non-ruptured AVM. Other non-vascular epileptogenic pathologies can be treated endovascularly, as well, some endovascular procedures can be an effective alternate for epilepsy surgery, such as balloon occlusion hemispherectomy.
One center experience, literature review for outcome of different procedures to treat epilepsy endovascularly, and discussion of ARUBA trial results vs real life practice.
Endovascular Management is an effective method to treat intractable seizure in general and vascular seizures in specific. Endovascular management can replace epilepsy surgery in different lesional epilepsy pathologies.
The purpose of this study was to investigate the effectiveness of nursing care in epilepsy. In this experimental study, 120 nurses from hospitals in Isfahan were randomly divided into control and experimental groups (60 each). The data collection tool was a questionnaire based on nursing care in epilepsy. The case group received an educational program for one month and 3 months after the educational intervention, both groups completed the questionnaire and the data was analyzed. The findings of the study indicated that there was no significant difference between the two groups in terms of professional behavior, communication, personal approach, empathy and respect before the educational intervention, while after the intervention, the mentioned factors significantly increased in the experimental group, in comparison to the control group (p=0.001). Based on this study, the designed nursing care education program is effective in promoting nurses' professional behaviors, communication, personal approach, empathy and respect. In addition, educational control, monitoring and follow up are recommended in the implementation of these programs.
Baylor College of Medicine, USA
Dr. Montier recently completed her doctoral dissertation on Dravet syndrome at the University of Houston under the mentorship of Dr. JokÅ«bas Å½iburkus. She is passionate about improving the lives of children diagnosed with this devastating disorder and is continuing her research in the field with Dr. Alica Goldman at Baylor College of Medicine in the Houston Medical Center. Her postdoctoral work involves examining the genetics of families of patients with Dravet-like epilepsy disorders. In addition to her dedication to epilepsy research, Dr. Montier seizes every opportunity to encourage the aspirations of students striving to become scientists or medical professionals. She has six years of teaching experience, and has mentored research projects for three undergraduate students. Dr. Montier is eager to pursue interdisciplinary approaches to the complex problems found in the field of epilepsy.
Statement of the Problem: More than 30% of patients diagnosed with Dravet syndrome (DS) suffer from intractable epilepsy that put them at high risk for premature death. About 20% of DS patients die from sudden unexplained death in epilepsy (SUDEP). In addition, all DS patients experience at least some degree of autistic-like impairments, and about 25% are diagnosed with full Autism Spectrum disorder (ASD). The goal of this study is to test the long-term effects of a novel pharmaceutical approach that targets excitation, instead of inhibition, in a DS mouse model.
Methodology: Mice were administered N6-cyclopentyladenosine (CPA), an A1R agonist, twice daily by i.p. injection during early development. Two regimens were tested: a short-course from P11-20 and a long-course from P11-30. The long-term effects on viability, behavioral comorbidities, and the astroglial environment were assessed for each regimen. Anxiety (open field), sociability (3-chamber), and long-term memory (contextual-fear conditioning) were quantified at 8, 9, and 10 weeks, respectively. Confocal microscopy was employed to image brains of adult mice that had been labeled with anti-GFAP immunofluorescent staining techniques. Three-dimensional assessment of the astroglial environment was carried out with FarSight image analysis software. Findings: A short-course with CPA improved viability, while a long-course showed initial protection, but continued treatment reinstated decline in survival. The short-course improved sociability, restored long-term memory, and blocked astrogliosis in adult mice.
Conclusion & Significance: Currently, no anti-epileptic drug (AED) effectively controls seizures for one third of DS patients, and these children can experience hundreds of seizures every day. The novel pharmaceutical therapy with A1R agonist CPA presented here protected against premature death and showed long-term improvements in comorbidities in a DS mouse model, making a case for exploring adenosine therapy during early development clinically.
Day 2 :
- Epilepsy Therapeutics
International Institute of Medicine & Science, U.S.A.
Dr. Alain L. Fymat is a medical-physical scientist and an educator who was educated at the Universities of Bordeaux and Paris-Sorbonne, France, and the University of California at Los Angeles. He is the current President/CEO and Professor at the International Institute of Medicine & Science. He was formerly Professor of Radiology, Radiological Sciences, Radiation Medicine (Oncology), Critical Care Medicine, and Physics at several U.S. and European Universities. His current research interests lie at the interface between science and medicine (neurological disorders; precision medicine; nanobiotechnology; nanomedicine; genetics/epigenetics/ecogenetics; and drug delivery across the brain protective barriers). He has extensively published (~425 scholarly publications) and lectured in several national and international academic, professional, governmental and industrial venues. He is a a Board member of several institutions, and Editor-in-Chief, Honorable Editor or Editor of 35 scientific Journals.
There are approximately 400 known neurological disorders (including some which may be better classified as mental disorders). Some of these disorders may be due to a disruption or failure of the blood brain barrier (BBB) such as, importantly, epilepsy (a group of neurological disorders characterized by chronic or acute seizures caused by inflammation). Epileptic seizures are the result of excessive and abnormal nerve cell activity in the brain cortex. As of 2015, about 39 million people have epilepsy with nearly 80% of the cases occurring in the developing world and 125,000 having died of it. Common among older people, epilepsy will become more prevalent as a result of the growing aging population.
The cause of most cases of epilepsy is still unknown through a process known as epileptogenesis. Nonetheless, there are both genetic and acquired causes, with interaction of these factors in many cases. To date, nearly all the genes discovered to be involved in human epilepsies encode subunits of ion channels, both voltage-gated and ligand-gated. Known genetic mutations are directly linked to a small proportion of cases. Established acquired causes include serious brain trauma, stroke, tumors, infective lesions, and birth defects. Seizures are controllable with medication in about 70% of cases. Inexpensive options are often available. In those whose seizures do not respond to medication, surgery, neurostimulation, or dietary changes may be considered.
In its integral form, the BBB is a selective filter that allows passage of essential nutrients, water, some gases, lipid-soluble molecules, hydrophobic molecules (O2, CO2, hormones) and also allows transport of metabolic products to the brain (glucose with specific proteins). It restricts diffusion of microscopic objects (e.g. bacteria) and large hydrophilic molecules and prevents entry of polar and lipid-insoluble substances, and lipophilic neurotoxins. Of interest here are those epileptic treatments rendered possible by the delivery of therapeutic drugs through the disrupted blood brain barrier.
Sylvain Haba was born on the seventh of October 1963 in Kpoulo (Region N'Zerekore). He obtained his bachelor's degree in 1984, then completed his orientation with school nurses. After that, he began his internship in a medical post at the prefecture of Sèbètèrè Gaoual where he underwent a distance training on medical semiology. In 1998, he admitted the public service test and later training in traditional medicine in DR Congo for his return Guinea led in 2006 to the establishment of the Center Medico-Spiritual Tradi koumi Talitha (Marc5: 41-42) To (Labe) Guinea 2008 and transferred to the center of Conakry.
Epilepsy is a neurological disease characterized by abnormal functioning of brain activity. This results in the repetition of unexpected and often very brief crises. These attacks can take many forms and vary in intensity. This long disease considered as composed of demons. - The devil of the water (it kills the patient in the water in the crisis) - The devil's fire (he kills the patient in the fire during the crisis) - The devil at the top of the palms and the legs The victims climbs on the palm trees or Choosing oranges or mangoes) Thanks to modern medicine, it has been defined. The causes are usually malaria, meningitis, syphilis, HIV and others. It is treated with a vegetable and animal origin.
Maceration composed of three (3) plants: 1) Newbouldia Leavis. F: 10g Bignoniacée 2) Akeben 5g 3) 5g Balanbiline All packed in a container placed diluted with one liter of water per day for four days during these 60 days with control elements check. Decoction made: 1) Raphiostilis benénien icacinacé 10g 2) V.canne 10g 3) Nauclea latifolia rubiaccé 2g 4) Koyalakele (10g of root) All boiled with the viscera of a wild animal. After the control, he recommended that the patient drink 3 to 5 liters of decoction in the interval of one hour (1), which causes vomiting and causes diarrhea, but effective against convulsions. Nasal strain: 1) Microglossa pyrifolia 1g leaf 2) Citrus Medica fruit juice 1ml 3) Oecophylla smaragdina F: Formicidae (yellow ant 20) 6 nasal costs and deposit 3 times a day for 3 days for a period of three weeks In the case of small epilepsy.
An ant nest containing ants, larvae, crushed eggs, roasted, mixed with seed oil Elaeis guineensis (palmaceae) preserved in the form of pasta and stored in a snail shell
The dosage is a pinch of dough on the tongue and two foreheads pinched 3 times a day after meals.
Recent research has shown that the bile of the fish called captain (lethrinus, fish of the family Lethrinidae) was to be used by nose drop of a drop in each nostril at bedtime for a week, according to many fisherman healers this substance Helps effectively against dizziness, convulsions.
The prohibition of the recipe:
The hoax for research; The pan used to grill ants, larvae, eggs and nest must not touch the ground and even the wooden spoon; These instruments were placed on a chair in the ceiling of his house to this is added a small poison of fresh water called gbongo in Guerzé (language of my ethnic origin)
Isfahan University of Medical Sciences, Isfahan, Iran
Background: Epilepsy is an abnormality in the central nervous system which characterized in recurrent or
unprovoked seizures. Nurse care is one of the important specialists for management of the patients. The aims of this
study was evaluating role of nurse care on management of patients with epilepsy.
Method: This study is a brief review to evaluate role of nurses in management of patients with epilepsy.
Conclusion: Nurses should improve the quality of patient care: 1- We need to have a plan for increasing the
knowledge of ESNS, 2- Government should make a new course in Faculty of Nursing and Midwifery, 3- Develop guide lines for ESNS and prepare appropriate programs
- Epilepsy Case Study
Founder of Epilepsy Footprint, United Kingdom.
Tanya has been an epilepsy patient since the age of one and has always had to face many challenges in education, employment and socially. This lead her to start campaigning in the United Kingdom and join the international campaign to bring epilepsy "Out of the Shadows". This work has been ongoing for 35 years during which time Tanya has been an Accredited Volunteer for Epilepsy Action, a Governor of Epilepsy Society (2006-2012), Patron of the Gambia Epilepsy Association (2006 - date), Founder of Epilepsy Footprint and recipient of two BT Chairman's Awards for her work in epilepsy.
In the United Kingdom people take everything for granted because we always have an NHS with access to specialist hospitals, doctors, surgeons, medicines and medical machines for performing neurological tests.
In comparison there is an extreme lack of services available in Africa especially The Gambia. This is due to a lack of facilities, medical services, trained medical staff, medicines, funding and the general understanding of epileptic seizures.
In my role as Patron of the Gambia Epilepsy Association, the aim now is to bring countries together in different ways to aid those in sub-Saharan Africa who have less neurological services and facilities. This can be achieved by assisting general doctors in those countries, working together with traditional healers, training new epilepsy nurses, provision of neurological services and equipment, providing more epilepsy education and change the general attitudes towards epilepsy.
There are many ways of achieving these goals which starts by building up good relations with other medical organisations worldwide, negotiations with political leaders, media publicity and finding potential sponsors or donors.
My son is named NAMAN. Started his first convulsion in the age of 3. Convulsions were in the intervals of every 15-20 days lasting for 4-5minutes. Started the treatment and kept on LEVIPIL 250 BID, and Sodium Valproic acid 300mg HS. There were no convulsions noted Age 3rd to Age 13. The dosage kept till today was the same aforementioned dosage. Existing problems: 1) Less schoolatrics.---early morning when he wakes up, he wants me to assist him, I mean I need to talk with him meanwhile he does all his morning works by his own but I need to talk with him. Now a days he is developing his interest towords school. Started writing slowly, but interest lasts for 10minutes, (2)Childish talks and behaviors-being at the age 13 years, pronunciation and the voice is like a child (3)Attention deficit Attention stays for 5-10 minutes, and wants to change the routine after some minutes of concentration. (4)Pinching and lip biting started when he was at the age of 4, and still continues to do so. He wants me to sleep beside him while sleeping pinching my arm simultaneously bites his lip, Pinching my arm and lip biting lasts until he gets sleep. (5)Interesting matter of his life was - he started speaking and understanding HINDI LANGUAGE by watching TV by his own although our mother tongue is KANNADA. He learnt riding bicycle by his own, and rides a motor bike for a short distance. EEG still observes epileptic waves. As we being parents not a single dose of medicine was missed till today. We make sure that one takes the required tablets regularly. When I heard and read about the Epilepsy conference, I thought it would be the best chance to seek attention of all eminent neurologist present here in this conference.
- Neurological disorder
University of Nairobi School of nursing sciences, Kenya.
Mr. Mathieu Nemerimana, MSN, BSN, RN, is a clinical pediatric nurse with master’s degree from the University of Nairobi School of nursing sciences, Kenya.
Background. Many of the nongenetic causal risk factors of intellectual disability (ID) can be prevented if they are identified early. There is paucity on information regarding potential risk factors associated with this condition in Kenya. This study aimed to establish risk factors associated with severity of nongenetic intellectual disability (ID) among children presenting with this condition at Kenyatta National Hospital (KNH).
Methods. A hospital-based cross-sectional study was conducted over the period between March and June 2017 in pediatric and child/youth mental health departments of Kenyatta National Hospital (KNH), Kenya. It included children aged 2–18 years diagnosed with ID without underlying known genetic cause.
Results. Of 97 patients with nongenetic ID, 24% had mild ID, 40% moderate, 23% severe-profound, and 10% unspecified ID. The mean age of children was 5.6 (±3.6) years. Male children were predominant (62%). Three independent factors including “labor complications” [AOR = 9.45, 95% CI = 1.23–113.29, P=0.O36], “admission to neonatal intensive care unit” [AOR = 8.09, 95% CI = 2.11–31.07, P=0.002], and “cerebral palsy” [AOR =21.18, CI = 4.18–107.40, P≤0.001] were significantly associated with increased risk of severe/profound nongenetic ID.
Conclusion. The present study findings suggest that perinatal complications as well as postnatal insults are associated with increased risk of developing severe-profound intellectual disability, implying that this occurrence may be reduced with appropriate antenatal, perinatal, and neonatal healthcare interventions.
Key words: Children, non-genetic Intellectual disability, risk factors, Kenya