Displaying publications 81 - 100 of 236 in total

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  1. Mukhtar AA, Ibrahim LS, Khairil AO
    Nepal Med Coll J, 2007 Dec;9(4):289-91.
    PMID: 18298025
    A 20 year old male presented to the emergency department with generalized tonic clonic convulsions and up rolling of eye balls. He had history of seizure disorder for three years and on regular medical treatment and is compliant to medication. A non-contrast CT scan of the head was only done on 14th day of admission which showed hypodense areas in the right and left cerebellar hemisphere. MR imaging was performed four days later revealed high signal intensity in the both cerebellar hemispheres, both external capsules, both occipital and right parietal regions on fluid-attenuated inversion recovery (FLAIR). The post contrast MR imaging revealed diffuse cerebral and cerebellar hypervascularity in the similar region. This change of diffuse hypervascularity of both cerebral and cerebellar associated with seizure activity on post-contrast magnetic resonance imaging (MRI) has not been reported in any literature.
    Matched MeSH terms: Epilepsy/diagnosis*; Epilepsy/pathology
  2. Sayuthi S, Tharakan J, George J, Pieter MS, Salmah WM, Madhavan M, et al.
    Med J Malaysia, 2006 Aug;61(3):374-6.
    PMID: 17240596 MyJurnal
    Two rare cases of intractable epilepsy caused by Dysembryoplastic Neuroepithelial Tumours (DNET) are reported and their different management discussed. The first case required vagal nerve stimulation and radiosurgery while the later was operated with the help of neuronavigation. Both had good outcome according to Engel classification after a one year follow up.
    Matched MeSH terms: Epilepsy, Temporal Lobe/etiology*; Epilepsy, Temporal Lobe/surgery*
  3. Ab Rahman AF
    Seizure, 2005 Dec;14(8):593-6.
    PMID: 16246597
    University students represent a better-educated group of society and it is important that they possess the correct knowledge and attitude towards healthcare issues. The aim of this study was to determine the current level of awareness and knowledge of epilepsy among students at a public university in Malaysia.
    Matched MeSH terms: Epilepsy/epidemiology; Epilepsy/psychology*
  4. Vigneswari G, Sofiah A, Hussain IHMI
    Med J Malaysia, 2001 Sep;56(3):359-64.
    PMID: 11732083
    An observational study of all children with intractable epilepsy at the Paediatric Institute prescribed Lamotrigine as an add-on therapy between January 1994 and November 1998 was conducted. A total of 30 children were recruited. Three had adverse effects to the drug and it was withdrawn. Of the remaining 27, there were 20 boys and 7 girls, ranging from 2 to 17 years. Fifteen children had generalised epilepsy, 6 had partial epilepsy, 2 had West syndrome and 4 had Lennox Gastaut syndrome. Six children (20%) became seizure free, and 14 (54%) had a greater than 50% reduction in seizure frequency. However 7 children (23%) did not respond and 3 experienced a deterioration in seizure severity. Nine children were noted to have an improvement in alertness and behaviour. Our small series suggests that Lamotrigine is useful as add-on therapy in childhood intractable epilepsy.
    Matched MeSH terms: Epilepsy/drug therapy*; Epilepsy/physiopathology*
  5. 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*
  6. Tan EH, Razak SA, Abdullah JM, Mohamed Yusoff AA
    Epilepsy Res, 2012 Dec;102(3):210-5.
    PMID: 22944210 DOI: 10.1016/j.eplepsyres.2012.08.004
    Generalized epilepsy with febrile seizures plus (GEFS+) comprises a group of clinically and genetically heterogeneous epilepsy syndrome. Here, we provide the first report of clinical presentation and mutational analysis of SCN1A gene in 36 Malaysian GEFS+ patients. Mutational analysis of SCN1A gene revealed twenty seven sequence variants (missense mutation and silent polymorphism also intronic polymorphism), as well as 2 novel de-novo mutations were found in our patients at coding regions, c.5197A>G (N1733D) and c.4748A>G (H1583R). Our findings provide potential genetic insights into the pathogenesis of GEFS+ in Malaysian populations concerning the SCN1A gene mutations.
    Matched MeSH terms: Epilepsy, Generalized/complications; Epilepsy, Generalized/genetics*
  7. Wo MC, Lim KS, Choo WY, Tan CT
    Epilepsy Res, 2016 Dec;128:6-11.
    PMID: 27792885 DOI: 10.1016/j.eplepsyres.2016.10.003
    PURPOSE: People with epilepsy (PWE) are negatively prejudiced in their ability to work. This study aimed to examine demographic, clinical and psychological factors associated with employability in PWE.

    METHODS: This study recruited epilepsy patients from a neurology clinic in Malaysia. Employability was measured using employment ratio, with a ratio ≥90% (ER90) classified as high employability. Basic demographic data such as age, gender, marital status, religion, education level and household income was collected. Clinical measures consisted of age of seizure onset, seizure frequency, type of epilepsy, aura, polytherapy, nocturnal seizures and seizure control. Psychological measures included Work Self-Determination Index (WSDI), Rosenberg Self-Esteem Scale (SES), and Multidimensional Scale of Perceived Social Support (MSPSS).

    RESULTS: Of 146 PWE, 64.4% had high employability. The participants were predominantly female (52%), Chinese (50.7%), single (50%), having tertiary education (55.5%) and focal epilepsy (72.6%). Clinically, only type of epilepsy was significantly correlated to employability of PWE. Employability of PWE was associated with ability to work (indicated by education level, work performance affected by seizures, ability to travel independently and ability to cope with stress at work) and family overprotection. The high employability group was found to have lower self-perceived stigma (ESS), higher self-determined motivation (WSDI), self-esteem (SES) and perceived social support (MSPSS), than the low employability group. Logistic regression analysis showed that tertiary education level (AOR 3.42, CI: 1.46-8.00), higher self-determination (WSDI, AOR 1.09, CI: 1.012-1.17), lower family overprotection (AOR 0.76, CI: 0.61-0.95), and generalised epilepsy (AOR 4.17, CI: 1.37-12.70) were significant predictors for higher employability in PWE.

    CONCLUSION: Ability to work (education level), clinical factor (type of epilepsy) and psychological factor (self-determined motivation and family overprotection) were important factors affecting employability in PWE.

    Study site: neurology clinic Universiti Malaya Medical Centre (UMMC)
    Matched MeSH terms: Epilepsy/epidemiology*; Epilepsy/psychology*
  8. H S N, Paudel YN, K L K
    Life Sci, 2019 Sep 15;233:116686.
    PMID: 31348946 DOI: 10.1016/j.lfs.2019.116686
    Epilepsy is a neurological disorder characterized by an enduring predisposition to generate and aggravate epileptic seizures affecting around 1% of global population making it a serious health concern. Despite the recent advances in epilepsy research, no disease-modifying treatment able to terminate epileptogenesis have been reported yet reflecting the complexity in understanding the disease pathogenesis. To overcome the current treatment gap against epilepsy, one effective approach is to explore anti-epileptic effects from a drug that are approved to treat non-epileptic diseases. In this regard, Metformin emerged as an ideal candidate which is a first line treatment option for type 2 diabetes mellitus (T2DM), has conferred neuroprotection in several in vivo neurological disorders such as Alzheimer's diseases (AD), Parkinson's disease (PD), Stroke, Huntington's diseases (HD) including epilepsy. In addition, Metformin has ameliorated cognitive alteration, learning and memory induced by epilepsy as well as in animal model of AD. Herein, we review the promising findings demonstrated upon Metformin treatment against animal model of epilepsy however, the precise underlying mechanism of anti-epileptic potential of Metformin is not well understood. However, there is a growing understanding that Metformin demonstrates its anti-epileptic effect mainly via ameliorating brain oxidative damage, activation of AMPK, inhibition of mTOR pathway, downregulation of α-synuclein, reducing apoptosis, downregulation of BDNF and TrkB level. These reflects that Metformin being non-anti-epileptic drug (AED) has a potential to ameliorate the cellular pathways that were impaired in epilepsy reflecting its therapeutical potential against epileptic seizure that might plausibly overcome the limitations of today epilepsy treatment.
    Matched MeSH terms: Epilepsy/drug therapy*; Epilepsy/etiology
  9. Paudel YN, Angelopoulou E, Jones NC, O'Brien TJ, Kwan P, Piperi C, et al.
    ACS Chem Neurosci, 2019 10 16;10(10):4199-4212.
    PMID: 31532186 DOI: 10.1021/acschemneuro.9b00460
    Emerging findings point toward an important interconnection between epilepsy and Alzheimer's disease (AD) pathogenesis. Patients with epilepsy (PWE) commonly exhibit cognitive impairment similar to AD patients, who in turn are at a higher risk of developing epilepsy compared to age-matched controls. To date, no disease-modifying treatment strategy is available for either epilepsy or AD, reflecting an immediate need for exploring common molecular targets, which can delineate a possible mechanistic link between epilepsy and AD. This review attempts to disentangle the interconnectivity between epilepsy and AD pathogenesis via the crucial contribution of Tau protein. Tau protein is a microtubule-associated protein (MAP) that has been implicated in the pathophysiology of both epilepsy and AD. Hyperphosphorylation of Tau contributes to the different forms of human epilepsy and inhibition of the same exerted seizure inhibitions and altered disease progression in a range of animal models. Moreover, Tau-protein-mediated therapy has demonstrated promising outcomes in experimental models of AD. In this review, we discuss how Tau-related mechanisms might present a link between the cause of seizures in epilepsy and cognitive disruption in AD. Untangling this interconnection might be instrumental in designing novel therapies that can minimize epileptic seizures and cognitive deficits in patients with epilepsy and AD.
    Matched MeSH terms: Epilepsy/complications; Epilepsy/metabolism*
  10. Chia ZJ, Lim KS, Fong SL, Sim RS, Rajahram GS, Narayanan V, et al.
    Epilepsy Behav, 2020 09;110:107158.
    PMID: 32512367 DOI: 10.1016/j.yebeh.2020.107158
    BACKGROUND: Epilepsy stigma is an important issue affecting people with epilepsy (PWE) in various social aspects of life. Most studies on stigma were among the metropolitan population but rarely on indigenous people. Hence, this study aimed to understand the attitudes toward epilepsy of the East Malaysians, comparing with the West Malaysians previously reported.

    METHOD: This study was performed among the indigenous people in Kuching and Sibu (Sarawak) and Kota Kinabalu (Sabah) using the Public Attitudes Toward Epilepsy (PATE) scale. A higher score indicates poorer attitude.

    RESULT: A total of 360 respondents (41.7% Kadazan-Dusun, 30.6% Bidayuh, and 24.7% Iban) aged 34.6 ± 12.6 years completed the questionnaire. They were predominantly females and had lower education level and income compared with the West Malaysians. The Sabah population had significantly lower mean scores (better attitudes) than those in Sarawak, in both personal and general domains (p 

    Matched MeSH terms: Epilepsy/ethnology*; Epilepsy/psychology
  11. Aktürk T, Tanık N, Saçmacı H, Chia ZJ, Lim KS
    Epilepsy Behav, 2020 10;111:107245.
    PMID: 32693372 DOI: 10.1016/j.yebeh.2020.107245
    OBJECTIVE: This study was conducted to test the validity and reliability of the Turkish version of the Public Attitudes Toward Epilepsy (PATE) scale, which aims to understand public perceptions of seizures and epilepsy.

    METHODS: The scale was translated following the standard procedures. For psychometric validation, the Turkish version of the PATE scale was administered to 201 native Turkish speakers above the age of 18 who had no history of seizures or epilepsy. It was found that the respondents were able to fill out the scale quickly and without difficulty in understanding the translated items on the scale.

    RESULTS: Cronbach's alpha coefficient was found to be 0.843 for the overall scale and above 0.7 for each individual item. Cronbach's alpha was 0.78 for the general domain and 0.792 for the personal domain. Exploratory and confirmatory factor analyses were carried out and showed that the scale had a structure similar to that of the original scale, with the 14 items grouped under two dimensions, similar to the original scale.

    CONCLUSION: The Turkish version of the PATE scale was a valid and reliable tool to measure the attitudes toward epilepsy in Turkish society.

    Matched MeSH terms: Epilepsy/epidemiology*; Epilepsy/psychology*
  12. Akyuz E, Polat AK, Eroglu E, Kullu I, Angelopoulou E, Paudel YN
    Life Sci, 2021 Jan 15;265:118826.
    PMID: 33259863 DOI: 10.1016/j.lfs.2020.118826
    Epilepsy is a neurologicaldisorder characterized by persistent predisposition to recurrent seizurescaused by abnormal neuronal activity in the brain. Epileptic seizures maydevelop due to a relative imbalance of excitatory and inhibitory neurotransmitters. Expressional alterations of receptors and ion channelsactivated by neurotransmitters can lead to epilepsy pathogenesis.

    AIMS: In this updated comprehensive review, we discuss the emerging implication of mutations in neurotransmitter-mediated receptors and ion channels. We aim to provide critical findings of the current literature about the role of neurotransmitters in epilepsy.

    MATERIALS AND METHODS: A comprehensive literature review was conducted to identify and critically evaluate studies analyzing the possible relationship between epilepsy and neurotransmitters. The PubMed database was searched for related research articles.

    KEY FINDINGS: Glutamate and gamma-aminobutyric acid (GABA) are the main neurotransmitters playing a critical role in the pathophysiology of this balance, and irreversible neuronal damage may occur as a result of abnormal changes in these molecules. Acetylcholine (ACh), the main stimulant of the autonomic nervous system, mediates signal transmission through cholinergic and nicotinic receptors. Accumulating evidence indicates that dysfunction of nicotinic ACh receptors, which are widely expressed in hippocampal and cortical neurons, may be significantly implicated in the pathogenesis of epilepsy. The dopamine-norepinephrine-epinephrine cycle activates hormonal and neuronal pathways; serotonin, norepinephrine, histamine, and melatonin can act as both hormones and neurotransmitters. Recent reports have demonstrated that nitric oxide mediates cognitive and memory-related functions via stimulating neuronal transmission.

    SIGNIFICANCE: The elucidation of the role of the main mediators and receptors in epilepsy is crucial for developing new diagnostic and therapeutic approaches.

    Matched MeSH terms: Epilepsy/genetics; Epilepsy/physiopathology*
  13. Paudel YN, Angelopoulou E, Akyuz E, Piperi C, Othman I, Shaikh MF
    Pharmacol Res, 2020 10;160:105172.
    PMID: 32871246 DOI: 10.1016/j.phrs.2020.105172
    Understanding the interplay between the innate immune system, neuroinflammation, and epilepsy might offer a novel perspective in the quest of exploring new treatment strategies. Due to the complex pathology underlying epileptogenesis, no disease-modifying treatment is currently available that might prevent epilepsy after a plausible epileptogenic insult despite the advances in pre-clinical and clinical research. Neuroinflammation underlies the etiopathogenesis of epilepsy and convulsive disorders with Toll-like receptor (TLR) signal transduction being highly involved. Among TLR family members, TLR4 is an innate immune system receptor and lipopolysaccharide (LPS) sensor that has been reported to contribute to epileptogenesis by regulating neuronal excitability. Herein, we discuss available evidence on the role of TLR4 and its endogenous ligands, the high mobility group box 1 (HMGB1) protein, the heat shock proteins (HSPs) and the myeloid related protein 8 (MRP8), in epileptogenesis and post-traumatic epilepsy (PTE). Moreover, we provide an account of the promising findings of TLR4 modulation/inhibition in experimental animal models with therapeutic impact on seizures.
    Matched MeSH terms: Epilepsy/pathology; Epilepsy/physiopathology*
  14. Lee HS
    Ther Drug Monit, 1984;6(2):182-8.
    PMID: 6740737
    In a study with 113 Asian children in which phenobarbitone was used as the sole antiepileptic drug in 75 children, including Chinese, Malays, and Indians, the mean phenobarbitone dosage required to produce a plasma level of 15 micrograms/ml was 5.2 mg/kg/day. While the mean plasma level/dose ratio varied, the differences between the three ethnic groups were not statistically significant. Also of little difference were the ratios between the male and female groups. For those patients with poor seizure control, however, the mean plasma level/dose ratio was significantly lower than in those whose seizures were controlled. Using additional anticonvulsant drugs concurrently with phenobarbitone in 40 children raised the mean plasma level/dose ratios significantly in each ethnic group. Further, the greater age level in those given additional antiepileptic drugs might have contributed slightly to a higher mean plasma level/dose ratio.
    Matched MeSH terms: Epilepsy/blood*; Epilepsy/drug therapy
  15. Nurs Stand, 2016 Jul 20;30(47):17.
    PMID: 27440341 DOI: 10.7748/ns.30.47.17.s20
    Children with epilepsy need targeted strategies to ensure they get sufficient vitamin D, say researchers in Malaysia.
    Matched MeSH terms: Epilepsy/complications; Epilepsy/drug therapy*
  16. 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
  17. Fong SL, Lim KS, Tan L, Aris T, Khalid RA, Ali RA, et al.
    Epilepsy Behav, 2019 08;97:206-211.
    PMID: 31252280 DOI: 10.1016/j.yebeh.2019.05.033
    INTRODUCTION: Prevalence studies of epilepsy in Asia revealed a prevalence ranging from 1.5 to 14.0 per 1000 among Asian populations. However, the prevalence of epilepsy in Malaysia is not available for comparison with other countries. This study aimed to translate and validate a Malay brief screening instruments for ascertainment of epilepsy.

    METHOD: We translated into Malay a brief screening instrument for ascertainment of epilepsy designed and validated by Ottman et al., using the three-stage cross-cultural adaptation process developed by the International Quality of Life Assessment (IQOLA) project. We then administered the translated questionnaire via online survey to 162 cases (patients with epilepsy under follow-up care at the neurology clinic in University of Malaya Medical Centre, Kuala Lumpur) and 146 controls with no known history of epilepsy for validation.

    RESULTS: Applying the most liberal definition for a positive screen, we obtained a sensitivity of 96.3% (95% confidence interval [CI]: 91.8-98.5%), with a specificity of 66.4% (95% CI: 58.1-73.0%) and positive predictive value (PPV) of 2.0%. The most stringent definition for a positive screen (only epilepsy) resulted in a sensitivity of 97.4% (95% CI: 62.0-72.6%), specificity of 98.6% (95% CI: 94.6-99.7%), and PPV of 26.6%. Narrowing the definition of a positive screen decreased sensitivity but improved PPVs. When compared to the original English questionnaire, the sensitivities were similar for all four definitions of a positive screen.

    CONCLUSION: This is the first validated epilepsy screening questionnaire in the Malay language and represents a useful tool for the ascertainment of epilepsy in population-based studies.

    Matched MeSH terms: Epilepsy/diagnosis*; Epilepsy/psychology
  18. Khoo CS, Lee D, Park KM, In Lee B, Kim SE
    BMC Neurol, 2019 Dec 30;19(1):348.
    PMID: 31888520 DOI: 10.1186/s12883-019-1575-0
    BACKGROUND: Chest pain as the primary manifestation of epilepsy is extremely rare and has only been reported once to date.

    CASE PRESENTATION: We herein describe a 47-year-old woman with recurrent chest pain for 3 years. The cause of her chest pain remained elusive despite extensive investigations including comprehensive cardiac work-up. She was referred to the neurology clinic for one episode of confusion. Video-electroencephalographic monitoring detected unequivocal ictal changes during her habitual chest pain events. She has remained chest pain (seizure) free with a single antiseizure drug.

    CONCLUSIONS: This case underlines the importance of epilepsy as a rare yet treatable cause of recurrent chest pain. Further studies are required to determine the pathophysiology of ictal chest pain.

    Matched MeSH terms: Epilepsy/complications*; Epilepsy/drug therapy
  19. Lai ST, Lim KS, Tang V, Low WY
    Epilepsy Behav, 2018 03;80:90-97.
    PMID: 29414564 DOI: 10.1016/j.yebeh.2017.12.019
    BACKGROUND: Positive psychological interventions (PPI) are increasingly employed as a coping strategy with physical and mental conditions, including neurological diseases. Its effectiveness on improving wellbeing in people with epilepsy (PWE) has been shown in a few studies. This study aimed to explore factors related to participants' willingness to engage in psychological interventions from the perspective of patients with epilepsy.

    METHODS: Participants answered a needs assessment questionnaire eliciting information about their illness perception (Brief Illness Perception Questionnaire (Brief-IPQ)), emotions (Hospital Anxiety and Depression Scale (HADS)), willingness to participate in psychological interventions, preferences in types of PPI and intervention designs, as well as barriers in seeking mental health services.

    RESULTS: A total of 154 patients with epilepsy participated, with a mean age of 37.3years (range 16-86years). Most patients had focal epilepsy (68.2%), and drug-resistant (59.1%). Majority (71.4%) of them indicated a strong willingness to participate in PPI. Out of nine types of PPI, character strengths, mindfulness-based and expressive-based interventions were highly preferred. Those with negative illness perception (p=0.001), anxiety (p=0.004), and being unemployed (p=0.048) were more willing to participate in PPI. Most participants preferred group rather than individual session, and a shorter duration (30min) was favored by most.

    CONCLUSION: This study captured the self-report willingness to participate in psychological interventions. Findings suggested that psychological interventions delivered in short-group session were highly preferred. Future study is required to determine the feasibility of such design for patients with epilepsy.

    Matched MeSH terms: Epilepsy/psychology; Epilepsy/therapy*
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