Displaying publications 1 - 20 of 236 in total

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  1. Fulltext Macrodactyly and poliosis in tuberous sclerosis complex
    Sasongko TH, Ismail NF, Nik Mohd Ariff NA, Zabidi-Hussin ZA
    Jpn J Clin Oncol, 2014 Nov;44(11):1130.
    PMID: 25320338 DOI: 10.1093/jjco/hyu157
    Matched MeSH terms: Epilepsy
  2. Clinical characteristics and outcome of children with febrile convulsions
    Abdul Wahab Jantan, Zabidi Azhar Mohd Husin
    Malaysian Journal of Child Health, 1997;9(1):73-82.
    MyJurnal
    Objective: The clinical characteristics and out-come offebrile convulsions in children admitted to the University Hospital in Kubang Kerian were analysed in this retrospective study.

    Method: The medical records of 244 children aged between 6 months to 5 years who presented with their first convulsions between January 1989 to December 1990 were reviewed. Patients were followed till one year after their first febrile convulsions.

    Results: The mean age of presentation was 18.26 (s.d. 11.83) months. One hundred and thirty (54.5%) were males. Complex febrile convulsions were noted in 47.5% and simple febrile convulsions in 52.5%. Seventy-two children (29.5%) were less than one year old at the time offirst febrile convulsions. A family history offebrile convulsions was significantly higher in the complexfebrile convulsions group. Ten children (4.1%) presented with prolonged first febrile convulsions. Data on 117 children on follow-up were available for analysis. Recurrence of febrile convulsions occurred in fifty children (46.7%) with mean interval of 6.53 (s.d. 5.25) months. There was significant difference in children who presented with febrile convulsions at age of less than one year old and having family history offebrile convulsions with regard to recurrence. Three children developed epilepsy at a mean age of 31.56 months. Identifiable causes of febrile convulsions were upper respiratory infection, presumed viral infection (fever with rashes) and acute gastro-enteritis. Laboratory investiga-tions that were done were not helpful.

    Conclusions: Children with a family history of febrile convulsions were more likely to develop complex febrile convulsions. Routine investi-gations were rarely helpful. The recurrence rate is significantly influenced by the age of presentation and family history of febrile convulsions in siblings or either parent. The types offebrile convulsions did not significantly influence the recurrent rate.
    Matched MeSH terms: Epilepsy
  3. Fulltext NMDA receptor antagonism with novel indolyl, 2-(1,1-Dimethyl-1,3-dihydro-benzo[e]indol-2-ylidene)-malonaldehyde, reduces seizures duration in a rat model of epilepsy
    Rothan HA, Amini E, Faraj FL, Golpich M, Teoh TC, Gholami K, et al.
    Sci Rep, 2017 03 30;7:45540.
    PMID: 28358047 DOI: 10.1038/srep45540
    N-methyl-D-aspartate receptors (NMDAR) play a central role in epileptogensis and NMDAR antagonists have been shown to have antiepileptic effects in animals and humans. Despite significant progress in the development of antiepileptic therapies over the previous 3 decades, a need still exists for novel therapies. We screened an in-house library of small molecules targeting the NMDA receptor. A novel indolyl compound, 2-(1,1-Dimethyl-1,3-dihydro-benzo[e]indol-2-ylidene)-malonaldehyde, (DDBM) showed the best binding with the NMDA receptor and computational docking data showed that DDBM antagonised the binding sites of the NMDA receptor at lower docking energies compared to other molecules. Using a rat electroconvulsive shock (ECS) model of epilepsy we showed that DDBM decreased seizure duration and improved the histological outcomes. Our data show for the first time that indolyls like DDBM have robust anticonvulsive activity and have the potential to be developed as novel anticonvulsants.
    Matched MeSH terms: Epilepsy/complications; Epilepsy/prevention & control*
  4. Fulltext A cross-sectional study on the rate of non-adherence to anti-seizure medications and factors associated with non-adherence among patients with epilepsy
    Teh KX, Henien NPB, Wong LS, Wong ZKH, Raja Ismail RZ, Achok HN, et al.
    PLoS One, 2020;15(7):e0235674.
    PMID: 32649723 DOI: 10.1371/journal.pone.0235674
    BACKGROUND: Non-adherence to anti-seizure medication (ASM) therapy is an important contributing factor to the higher mortality rate and treatment failure of epilepsy. This study aimed to determine the rate and factors associated with non-adherence to ASM therapy through the WHO five dimensions of medication adherence framework.

    METHODS: We conducted a cross-sectional study at an outpatient Neurology Clinic of a tertiary government hospital in Malaysia. Between March and July 2019, we identified 217 patients with a confirmed diagnosis of epilepsy, receiving oral ASM therapy and able to administer their medications. We performed a semi-structured interview to gather information on sociodemographic background, clinical and medication history, and perceptions on healthcare services. Adherence to ASM therapy was evaluated using the Medication Compliance Questionnaire (MCQ). Patient's illness perception was assessed by the Brief Illness Perception Questionnaire (B-IPQ).

    RESULTS: 208 patients participated in this study. The median age of the study participants was 35 years (IQR 26-44). 58.2% were females and majority, 55.8%, were from the Malay ethnic group. Based on the MCQ scoring, 89 patients (42.8%) were non-adherent. Multiple logistic regression demonstrated that being employed or students (adjusted odds ratio [aOR] 2.26, 95%CI: 1.19-4.29 p = 0.012) and having an average or below average perceived access to pharmacy services (aOR 2.94, 95%CI: 1.38-6.24, p = 0.005) were significant contributors to non-adherence.

    CONCLUSION: Being employed or students and having an average or below average perceived access to pharmacy services were associated with ASM non-adherence Efforts to improve ASM adherence should adopt a comprehensive approach considering the success of adherence is contingent on the interrelationship of multiple dimensions.

    Matched MeSH terms: Epilepsy
  5. Complementary treatment of psychotic and epileptic patients in malaysia
    Razali SM, Yassin AM
    Transcult Psychiatry, 2008 Sep;45(3):455-69.
    PMID: 18799643 DOI: 10.1177/1363461508094676
    The objective of this article is to describe and compare the use of traditional/complementary medicine (T/CM) among psychotic (schizophrenia and schizophreniform disorder) and epileptic Malay patients in peninsular Malaysia. There were 60 patients in each group. T/CM consultation was uniformly spread across all levels of education and social status. We could not find a single over-riding factor that influenced the decision to seek T/CM treatment because the decision to seek such treatment was complex and the majority of decisions were made by others. Fifty-three patients (44.2%), consisting of 37 (61.7%) psychotic and 16 (26.7%) epileptic patients had consulted Malay traditional healers (bomoh) and/or homeopathic practitioners in addition to modern treatment; of these, only three had consulted bomoh and homeopathic practitioners at the same time. The use of T/CM was significantly higher in psychotic than in epileptic Malay patients.
    Matched MeSH terms: Epilepsy/ethnology*; Epilepsy/therapy
  6. A case series of super-refractory status epilepticus successfully treated with electroconvulsive therapy
    Tan HJ, Tee TY, Husin M, Khoo CS, Woon LS
    Epileptic Disord, 2020 Dec 01;22(6):828-833.
    PMID: 33337333 DOI: 10.1684/epd.2020.1233
    Super-refractory status epilepticus (SRSE) is a neurocritical emergency, associated with significant morbidity and mortality. The precise pathophysiology is still not completely understood. The likelihood of spontaneous seizure termination reduces with time, and it is of paramount importance to abort status in order to prevent permanent long-term neurological sequelae and death. A few neuroprotective strategies, such as general anaesthesia, steroids, ketogenic diet and hypothermia, have been used to treat SRSE, however, the clinical outcome remains inconclusive. We herein present two cases of SRSE, which were successfully treated with electroconvulsive therapy (ECT) after failing all pharmacological measures.
    Matched MeSH terms: Drug Resistant Epilepsy/physiopathology; Drug Resistant Epilepsy/therapy*
  7. Fulltext Lack of meaningful genotype-phenotype association in SCN1A-related infantile-onset epileptic encephalopathies
    Siti Aishah Abdul Wahab, Yusnita Yakob, Khoo,Teik-Beng, Sangita Dharshini Terumalay, Vigneswari Ganesan, Teh,Chee-Ming, et al.
    Neurology Asia, 2017;22(2):99-111.
    MyJurnal
    Background & Objective: SCN1A gene which encodes for sodium channel alpha 1 subunit has been
    found to be the most common mutated gene in patients with epilepsy. This study aims to characterize the
    SCN1A mutations as well as to describe genotype and phenotype association in children with SCN1Arelated
    infantile-onset epileptic encephalopathies in Malaysia.

    Methods: Children with infantile-onset
    epileptic encephalopathy mostly suspected to have Dravet syndrome who had mutational analysis for
    SCN1A gene from hospitals all over Malaysia were included in the study. Their epilepsy syndrome
    diagnosis was classified into severe myoclonic epilepsy in infancy and its variants. Polymerase chain
    reaction and bidirectional sequencing were used to identify SCN1A mutations.

    Results: A total of 38
    children with heterozygous mutations were analysed, 22 (57.9%) of which were novel mutations.
    Truncated mutations were the most common mutation type (19, 50%). Other mutation types were
    missense mutations (14, 36.8%), splice site mutations (4, 10.5%) and in-frame deletion (1, 2.6%). The
    mean age of seizure onset was 4.7 months. Seizure following vaccination was observed in 26.3% of
    the children. All of them had drug resistant epilepsy. There was no significant association between
    the type of mutation with the syndromic diagnosis, age of seizure onset, tendency of the seizures to
    cluster or having status epilepticus, mean age when developmental delay was observed and response
    to various antiepileptic drugs.

    Conclusion: This study expands the spectrum of SCN1A mutations and proves the importance of
    SCN1A gene testing in diagnosing infantile-onset epileptic encephalopathies patients. Although, our
    study does not support any clinically meaningful genotype-phenotype association for SCN1A-related
    infantile-onset epileptic encephalopathies, the clinical characteristics of our cohort are similar to those
    that have been described in previous studies.
    Matched MeSH terms: Drug Resistant Epilepsy; Epilepsy; Epilepsy, Generalized
  8. Fulltext Successful epilepsy surgery for tuberous sclerosis complex evaluated by stereoelectroencephalography
    Fong CY, Bleasel A, Dexter MA, Lawson JA, Wong CH
    Epileptic Disord, 2020 Oct 01;22(5):633-641.
    PMID: 33146141 DOI: 10.1684/epd.2020.1211
    Evaluating the candidacy for epilepsy surgery in patients with tuberous sclerosis can be challenging, particularly when non-invasive investigations do not show a clear epileptogenic zone. Stereoencephalography may be useful in such cases. We present a case in which the primary epileptogenic tuber was successfully identified by stereoencephalography, which resulted in seizure freedom following epilepsy surgery. [Published with video sequences].
    Matched MeSH terms: Epilepsy/complications; Epilepsy/diagnosis; Epilepsy/surgery*
  9. Fulltext The EEG and epilepsy in Kelantan--a hospital/laboratory-based study
    Win MN
    Med J Malaysia, 1993 Jun;48(2):153-9.
    PMID: 8350790
    Five hundred and ninety three cases of clinically diagnosed and suspected epilepsy were analysed as regards to the EEG (standard scalp electrode recording) features for confirmation and typing. Fifty-five per cent of all clinically diagnosed adult epileptics were confirmed by the EEG with the initial record, and the EEG confirmatory rate in children was higher at 92%. The frequency of generalised epilepsy as confirmed by the EEG was found to be 86% in adults and 92% in children, reflecting a higher proportion of generalised epilepsy in the population than reported elsewhere. Clinical diagnosis of partial epilepsy was often subsequently shown to be of generalised type on EEG.
    Matched MeSH terms: Epilepsy, Generalized/classification; Epilepsy, Generalized/diagnosis*
  10. Bone Mineral Changes in Epilepsy Patients During Initial Years of Antiepileptic Drug Therapy
    Shiek Ahmad B, O'Brien TJ, Gorelik A, Hill KD, Wark JD
    J Clin Densitom, 2016 Oct;19(4):450-456.
    PMID: 27553750 DOI: 10.1016/j.jocd.2016.07.008
    Antiepileptic drug (AED) therapy is associated with decreased bone mineral density; however, the time course for this development is unclear. The aim of this study was to evaluate bone mineral changes during the initial years of AED therapy in AED-naive, newly diagnosed epilepsy patients compared with non-AED users. In 49 epilepsy patients newly started on AEDs and in 53 non-AED users of both genders, bone mineral density (BMD) and bone mineral content were measured using dual-energy X-ray absorptiometry at baseline (within the first year of therapy) and at least 1 yr later. Bone changes between the 2 assessments, adjusted for age, height, and weight, were calculated as the annual rate of change. The median duration of AED therapy was 3.5 mo at baseline and 27.6 mo at follow-up. No overall difference was found in mean BMD and bone mineral content measures between user and nonuser cohorts in both cross-sectional baseline and the annual rate of change (p > 0.05). However, users on carbamazepine monotherapy (n = 11) had an increased annual rate of total hip (-2.1% vs -0.8%, p = 0.020) and femoral neck BMD loss (-2.1% vs -0.6%, p = 0.032) compared to nonusers. They also had a marginally higher rate of femoral neck BMD loss (-2.1%, p = 0.049) compared with valproate (-0.1%, n = 13) and levetiracetam users (+0.6%, n = 13). During the initial years of AED treatment for epilepsy, no difference was found in bone measures between AED users as a group and nonuser cohorts. However, the data suggested that carbamazepine monotherapy was associated with increased bone loss at the hip regions, compared to users of levetiracetam or valproate and nonusers. Larger studies of longer duration are warranted to better delineate the bone effects of specific AEDs, with further consideration of the role of early dual-energy X-ray absorptiometry scanning and careful AED selection in potentially minimizing the impact on bone health in these patients.
    Matched MeSH terms: Epilepsy/drug therapy*
  11. Bone loss with antiepileptic drug therapy: a twin and sibling study
    Shiek Ahmad B, Petty SJ, Gorelik A, O'Brien TJ, Hill KD, Christie JJ, et al.
    Osteoporos Int, 2017 Sep;28(9):2591-2600.
    PMID: 28589417 DOI: 10.1007/s00198-017-4098-9
    Changes in areal bone mineral density (aBMD) and other predictors of bone loss were evaluated in 48 same-sex twin/age-matched sibling pairs discordant for antiepileptic drug (AED) use. AED users had reduced BMD at the hip regions. Prolonged AED users had greater aBMD loss, predicting a higher risk of bone fragility.

    INTRODUCTION: To investigate the longitudinal associations of bone mineral measures with antiepileptic drug (AED) use, including enzyme-inducing (EIAED) and non-enzyme-inducing (NEIAED) types, and other predictors of bone loss in a study of 48 same-sex twin/age-matched sibling pairs (40 female, 8 male) discordant for AED use.

    METHODS: Using dual-energy X-ray absorptiometry (DXA), areal bone mineral density (aBMD) and content (BMC) at the hip regions, forearm, lumbar spine, and whole body were measured twice, at least 2 years apart. The mean within-pair difference (MWPD), MWPD%, and mean annual rate of aBMD change were adjusted for age, weight, and height. Predictors of bone loss were evaluated.

    RESULTS: AED users, compared to non-users, at baseline and follow-up, respectively, had reduced aBMD at the total hip (MWPD% 3.8, 4.4%), femoral neck (4.7, 4.5%), and trochanter regions (4.1, 4.6%) (p  0.05) regions did not differ within pairs. Nevertheless, EIAED users had greater aBMD loss than non-users (n = 20 pairs) at the total hip (1.7 vs. 0.3%, p = 0.013) and whole body regions (0.7% loss vs. 0.1% BMD gain, p = 0.019), which was not found in NEIAED-discordant pairs (n = 16). AED use >20 years predicted higher aBMD loss at the forearm (p = 0.028), whole body (p = 0.010), and whole body BMC (p = 0.031).

    CONCLUSIONS: AED users had reduced aBMD at the hip regions. Prolonged users and EIAED users had greater aBMD loss, predicting a higher risk of bone fragility. Further prospective studies of AED effects on bone microarchitecture are needed.

    Matched MeSH terms: Epilepsy/drug therapy*; Epilepsy/physiopathology
  12. Quantitative HPLC analysis of gallic acid in benincasa hispida prepared with different extraction techniques
    Fatariah Z, Zulkhairuazha TT, Wan Rosli W
    Sains Malaysiana, 2014;43:1181-1187.
    Ash gourd (Benincasa hispida, Bh) is traditionally claimed useful in treating asthma, cough, diabetes, haemoptysis and hemorrhages from internal organs, epilepsy, fever and balancing of the body heat. One of the major phenolic acids presented in Benincasa hispida is gallic acid, a phenolic compound which is linked with its ability in reducing Type II diabetes. The aim of the present study was to investigate the effect of different extraction techniques on the concentration of gallic acid in Bh. The Bh extracts were prepared with three different techniques namely; fresh extract (FE), low heating (LH) and drying and heating (DH). The gallic acid has been detected and quantified using high performance liquid chromatography (HPLC) coupled with uv-Vis detector. The amount of gallic acid detected in FE, LH and DH were 0.036, 0.050 and 0 272 mg1100 g, respectively. The limits of detection was 0.75 liglmL while the limit of quantification and recovery were 2.50 liglmL and 95 .53% , respectively. In summary, HPLC technique coupled with vv detector systems able to quantify gallic acid in Bh extracts. The gallic acid were present at higher concentration in Bh extracted using drying and heating, followed by low heating and fresh extract methods.
    Matched MeSH terms: Epilepsy
  13. Fulltext Epilepsy with myoclonic absences
    Manonmani V, Wallace SJ
    Arch Dis Child, 1994 Apr;70(4):288-90.
    PMID: 8185360
    The cases are described of eight children, five of them girls, who had epilepsy with myoclonic absences. The mean age of onset was 4.9 years. Brief episodes of loss of awareness with bilateral clonic jerking of the upper limbs were associated with rhythmic 3 cycles/second spike-wave discharges on electroencephalogram. Generalised tonic-clonic or astatic seizures, or both, also occurred in seven patients. All now have learning difficulties, and seven have behavioural problems. Conventional treatment for absences was effective in only two children. Of six patients treated with lamotrigine, five have improved substantially, but only one is in sustained complete remission. One recently diagnosed patient continues to have frequent myoclonic absences. As the response to treatment and long term outcome are much poorer, it is important to differentiate myoclonic absences from typical childhood absence epilepsy.
    Matched MeSH terms: Epilepsy, Absence/diagnosis*; Epilepsy, Absence/drug therapy; Epilepsy, Absence/psychology
  14. Ethnic differences in Singapore's dementia prevalence: the stroke, Parkinson's disease, epilepsy, and dementia in Singapore study
    Sahadevan S, Saw SM, Gao W, Tan LC, Chin JJ, Hong CY, et al.
    J Am Geriatr Soc, 2008 Nov;56(11):2061-8.
    PMID: 19016940 DOI: 10.1111/j.1532-5415.2008.01992.x
    To study the prevalence of dementia in Singapore among Chinese, Malays, and Indians.
    Matched MeSH terms: Epilepsy/ethnology
  15. Fulltext Exploring Changes in Thalamus Metabolites as Diagnostic Biomarkers in Idiopathic Generalised Epilepsy Patients Using Magnetic Resonance Spectroscopy
    Abedi-Firouzjah R, Rostamzadeh A, Banaei A, Shafiee M, Moghaddam ZM, Vafapour H
    Malays J Med Sci, 2020 Feb;27(1):78-86.
    PMID: 32158347 DOI: 10.21315/mjms2020.27.1.8
    Introduction: Idiopathic generalised epilepsy (IGE) refers to a group of epilepsies resulting from the activation of neurons in the whole brain. This study aimed to evaluate the metabolite changes in thalamus as diagnostic biomarkers in IGE patients compared to healthy individuals using magnetic resonance spectroscopy (MRS) technique.

    Methods: The MRS was performed on 35 IGE patients (26 women and 11 men) with average age of 32 (ranged from 18 to 43) and 35 healthy individuals (13 women and 22 men) with average age of 31 (ranged from 21 to 50) as the control group. The levels of N-acetylaspartate (NAA), creatine (Cr) and choline (Cho) were measured using MRS. The NAA/Cr and NAA/Cho ratios were calculated for all participants. These values were statistically compared using t-test between the groups.

    Results: The NAA had significant lower values in IGE patients, 9.6 (SD = 0.8) and 9.9 (SD = 0.7) for right and left thalamus, respectively, compared to 10.9 (SD = 0.9) and 10.7 (SD = 0.9) in control group. The Cr values in the left side of thalamus were significantly higher in IGE patients (6.7 [SD = 0.8] versus 5.8 [SD = 0.5]); however, there was no difference in right thalamus. Measurements showed no difference for amounts of Cho between the groups in both sides of thalamus. The NAA/Cr ratio was 1.48 (SD = 0.14) and 1.48 (SD = 0.16) for right and left thalamus, respectively, in IGE patients in comparison with 1.83 (SD = 0.2) and 1.86 (SD = 0.26) in controls. There was no meaningful variation between the NAA/Cho ratio of the right and left thalamus among the groups.

    Conclusion: Thalamic NAA, Cr and NAA/Cr ratio values in IGE patients showed statistical differences compared to healthy individuals. Evaluating metabolites variations in thalamus using MRS is suggested for differentiating IGE patients from healthy individuals.

    Matched MeSH terms: Epilepsy, Generalized
  16. Fulltext Self-perception of stigma among epilepsy patients in Malaysia
    Yousuf, R.M., Shahar, M.A., Marzuki, O.A., Azarisman, S.M.S., Rosle, C., Tin, M.H.
    International Medical Journal Malaysia, 2018;17(1):113-120.
    MyJurnal
    Introduction: Epilepsy remains a stigmatised disease across geographical and temporal boundaries. Very little is known about epileptic stigma (ES) in cross-cultural settings. The aim of this study was to assess the prevalence of perceived stigma and factors associated with it, among patients with epilepsy (PWE) at a tertiary care referral hospital in East Coast of Malaysia. Methods: A cross sectional survey among 132 consenting PWE using pre-tested, semi-structured questionnaire in Malay/English language to assess their knowledge, attitude and practices (KAPs). Results: Among 132 respondents, 51.5% were male and 48.5 % were female. Their age ranged from 14 to 70 years (mean=31.6±13.41). Majority (53.8%) of them were aged 30 years or younger. The median number of years they had epilepsy was 8.0 (IQR 4.0-18.8) years and average duration of seizure prior to seeking medical attention was 1.0 (IQR 0.3 - 4.5) year. Most of them (90.9%) did not know the cause of epilepsy; however nearly all (91.7%) believed that it was a disease of the
    brain. Higher education level respondents possessed significantly higher KAP scores compared to lower education level respondents (p
    Matched MeSH terms: Epilepsy
  17. Fulltext Migraine with aura complicated by “migraine triggered seizures” and “occipital lobe infarction”: A case report
    Juliena Muhammed, Sanihah Abdul Halim, Wan Hazabbah Wan Hitam, Tharakan, John
    Neurology Asia, 2014;19(3):323-326.
    MyJurnal
    Migraine with aura is one of the major subtypes of migraine, and can be associated with ischaemic brain infarction. Use of oral contraceptive pills (OCPs) increases the risk of infarction in this type of migraine. Seizures and migraine also have a complex relationship, one element of which is migraine- triggered seizures. We report a case of bilateral occipital lobe infarction and migraine-triggered seizures, most likely precipitated by oral contraceptive pills (OCPs) in a patient with migraine with visual aura. OCPs, triptans and ergotamines should be used cautiously in these patients. Methods of birth control other than OCPs should be considered.
    Matched MeSH terms: Epilepsy
  18. The psychiatric aspects of epilepsy
    Teoh JI
    Med J Malaysia, 1973 Sep;28(1):8-15.
    PMID: 4273788
    Matched MeSH terms: Epilepsy/classification*; Epilepsy/complications
  19. Fulltext Epilepsy stigma in Asia: the meaning and impact of stigma
    Lim, Kheng-Seang, Tan, Chong-Tin
    Neurology Asia, 2014;19(1):1-10.
    MyJurnal
    Stigma is conceptually broad and culturally variable. Understanding stigma from the conceptual theories, culturally application based on the word stigma in other languages, the definition of stigma and its synonyms, as well as the medical implications in other stigmatized disease such as AIDS, will help us to understand the complexity of stigma in epilepsy. This review investigated the meaning and types of stigma from different perspectives, leading to staging stigma into 5 levels, i.e. social identity, stereotype, prejudice, discrimination and social disability. In addition to the conventional categorization of stigma into social, felt, self-perceived or internalized stigma, new categories of stigma i.e. personal and general attitudes towards epilepsy based on a newly developed Public Attitudes Toward Epilepsy (PATE) scale was introduced. Courtesy stigma was further elaborated in related to Asian culture. Based on well-established and recently developed theories, the causation and impact of epilepsy stigma was discussed in an Asian context, especially from the aspects of language and society values which are culturally specific. Integrating these theories of causation, illness and stereotype perceptions were proposed to be the mediating mechanism of stigma, which led to the development of a practical and multi-dimensional stigmatization model, aiming to guide, widen and deepen the scope of future stigma research in epilepsy. Using the established model, together with review of related studies, research priorities in epilepsy stigma research especially in Asia focusing on five aspects, i.e. expanding population studies especially on significant others, understanding stigma from personal attitude perspective, investigating the cultural and social causation of stigma, and the impacts of stigma on patients as well as the family members, were proposed.
    Matched MeSH terms: Epilepsy
  20. Fulltext Level 4 comprehensive epilepsy program in Malaysia, a resource-limited country
    Lim, Kheng-Seang, Sherrini Ahmad Bazir Ahmad, Vairavan Narayanan, Kartini Rahmat, Norlisah Mohd Ramli, Mun, Kein-Seong, et al.
    Neurology Asia, 2017;22(4):299-305.
    MyJurnal
    Background and Objective: There is a great challenge to establish a level 4 epilepsy care offering
    complete evaluation for epilepsy surgery including invasive monitoring in a resource-limited country.
    This study aimed to report the setup of a level 4 comprehensive epilepsy program in Malaysia and the
    outcome of epilepsy surgery over the past 4 years.

    Methods: This is a retrospective study analyzing
    cases with intractable epilepsy in a comprehensive epilepsy program in University Malaya Medical
    Center (UMMC), Kuala Lumpur, from January 2012 to August 2016.

    Results: A total of 92 cases
    had comprehensive epilepsy evaluation from January 2012 till August 2016. The mean age was 35.57
    years old (range 15-59) and 54 (58.7%) were male. There were 17 cases having epilepsy surgery
    after stage-1 evaluation. Eleven cases had mesial temporal sclerosis and 81% achieved Engel class
    I surgical outcome. Six cases had lesionectomy and 60% had Engel class I outcome. A total of 16
    surgeries were performed after stage-2 evaluation, including invasive EEG monitoring in 9 cases.
    Among those with surgery performed more than 12 months from the time of data collection, 5/10
    (50%) achieved Engel I outcome, whereas 2 (20%) had worthwhile improvement (Engel class III)
    with 75% and 90% seizure reduction.

    Conclusion: Level 4 epilepsy care has an important role and is possible with joint multidisciplinary
    effort in a middle-income country like Malaysia despite resource limitation.
    Matched MeSH terms: Drug Resistant Epilepsy; Epilepsy; Epilepsy, Temporal Lobe
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