<abstract>
<title style='display:none'>Summary</title>
<sec id="j_joepi-2022-0002_s_001">
<title style='display:none'>Introduction</title>
Acute Ischemic Stroke (AIS) is a medical emergency with focal neurological deficits. Todd’s paralysis (TP) is defined as a transient loss of motor ability and weakness that lasts hours to days and typically occurs after a focal seizure. Given the high prevalence of stroke and the rising availability of reperfusion therapies, timely detection of eligible patients is critical. Pre- and early-hospital differential diagnosis of various conditions with comparable clinical presentations is still difficult.
</sec>
<sec id="j_joepi-2022-0002_s_002">
<title style='display:none'>Aim</title>
This review discusses Todd’s post-epileptic paralysis, one of the most common stroke mimics (SM), in pre- and early-hospital settings.
</sec>
<sec id="j_joepi-2022-0002_s_003">
<title style='display:none'>Discussion and Conclusions</title>
The review covers the most critical findings on the TP and its emergency care as a common stroke mimic. Because TP is an excluding diagnosis, the most severe and curable illnesses must be recognised. Since thrombolysis is safe in SM, delaying or withholding medication may be improper when the advantages of treating a stroke mimic outweigh the dangers of treating a stroke mimic.
</sec>
</abstract>

How can we distinguish postictal Todd’s Paralysis from acute ischemic stroke in the prehospital and early hospital setting?

<abstract><title style='display:none'>SUMMARY</title><sec id="j_joepi-2021-003_s_001"><title style='display:none'>Background.</title>Epilepsy is one of the most common pediatric neurological disorders. The knowledge and attitude of teachers toward epileptic students can be crucial.</sec><sec id="j_joepi-2021-003_s_002"><title style='display:none'>Patients and methods.</title>This cross-sectional study was carried on schoolteachers in the city of Ouagadougou during the period from March 02 to July 20, 2020. The schools were chosen randomly among a list of recognized public or private establishments.</sec><sec id="j_joepi-2021-003_s_003"><title style='display:none'>Results.</title>Two hundred and twenty teachers were included in the study. Among them, 35.45% were post-primary teachers. Most of them had already heard of epilepsy (98.6%). For the majority of school teachers, epilepsy was not a contagious disease (74%). Regarding the causes of epilepsy, the majority of participants had listed brain disease (65%) and genetic disorders (18.20%). The majority of schoolteachers (70.9%) believed that students with epilepsy usually had associated mental retardation. For the majority of teachers (73.20%), epilepsy was a stigmatizing disease, and students with epilepsy should benefit from personalized supervision (65%). The majority of schoolteachers (75.9%) had a good knowledge of epilepsy, and 43.6% had good attitudes toward epilepsy. The factor associated with teachers’ knowledge was having witnessed an epileptic seizure (p &lt; 0.05). The factors related to schoolteacher practice was gender (p &lt; 0.05) and having already witnessed an epileptic seizure (p &lt; 0.05)</sec><sec id="j_joepi-2021-003_s_004"><title style='display:none'>Conclusion.</title>Our study found that teachers had a good knowledge of epilepsy, but attitudes and practices were inadequate.</sec></abstract>

Epilepsy knowledge, attitudes, behaviors, and associated factors among primary, post-primary, and secondary school teachers in Ouagadougou (Burkina Faso)

Heinz Gregor Wieser (1943–2018)

<abstract><title style='display:none'>SUMMARY</title><sec id="j_joepi-2018-001_s_001"><title style='display:none'>Background.</title>Planned homebirth is an option available to a small minority of expecting mothers. Compared with hospital births, long-term risks of homebirths are poorly known.</sec><sec id="j_joepi-2018-001_s_002"><title style='display:none'>Aim</title>To study very long-term outcome for death, seizure remission, and other neurological long-term comorbidities</sec><sec id="j_joepi-2018-001_s_003"><title style='display:none'>Material and Methods.</title>A cohort of virtually all children (n = 230) in a geographically defined area with onset of epilepsy in or active epilepsy diagnosed prior to 1961–1964, and prospectively followed-up for 50 years.</sec><sec id="j_joepi-2018-001_s_004"><title style='display:none'>Results.</title>The proportion of homebirths was 16% in blue collar families and 2% in white collar families (p = 0.007). No significant differences between homebirths and hospital births were found in the frequencies of either abnormal pregnancy (27% vs 27%, p &gt; 0.99) or abnormal birth (32% vs 35%, p = 0.82). Premature mortality following homebirths was non-significantly higher than that following hospital births (41% vs 27%, p = 0.13). Homebirth did not significantly affect 5-year (38% vs 40%) or 10-year (38% vs 37%) remission. Neither was homebirth alone associated with neurological morbidity (2.1, 0.82–6.1, p = 0.137).</sec><sec id="j_joepi-2018-001_s_005"><title style='display:none'>Conclusion.</title>Homebirth is an observable but non-significant risk factor of offspring mortality and neurological morbidity of an offspring with epilepsy. Blue collar families preferred homebirth to hospital birth for reasons which are not fully understood. Further research is needed in a prospective setting by applying modern standards of early identification of risk pregnancies and deliveries, carefully monitoring the health of expecting mothers, and anticipating referral to specialist services according to medical needs.</sec></abstract>

Long-term offspring epilepsy outcomes following planned assisted homebirth versus hospital birth

<abstract><title style='display:none'>Summary</title><sec id="j_joepi-2016-0012_s_001"><title style='display:none'>Background</title>Every chronic illness, including epilepsy, has a negative effect on both the quality of life of the sufferer as well as on their relationship with their surroundings.</sec><sec id="j_joepi-2016-0012_s_002"><title style='display:none'>Aims</title>To investigate the quality of life of children suffering from epilepsy and analyse how they assessed and scored their experiences compared to their parents.</sec><sec id="j_joepi-2016-0012_s_003"><title style='display:none'>Materials and methods</title>The study included 209 children with epilepsy and their parents. The research tool was a questionnaire for gathering demographic and clinical data as well as the Pediatric Quality of Life Inventory™ 4.0 Generic Core Scales (PedsQL™ 4.0) questionnaire in two versions, one for 8–12 year olds and one for 13–18 year olds and their parents.</sec><sec id="j_joepi-2016-0012_s_004"><title style='display:none'>Results</title>Cronbach’s alpha coefficient for the entire PedsQL™ 4.0 questionnaire was 0.91 and 0.93 for children with epilepsy and their parents respectively. Children rated their Total Scale Score higher (67.5 points) than their parents (62.5 points). Whilst analyzing children’s functioning in different areas it was observed that girls’ assessments were higher than boys’, except for Emotional Functioning. Both parents and children scored School Functioning the lowest. The greatest agreement of responses was observed in the domain of Physical Functioning, the smallest in the domain of Emotional Functioning.</sec><sec id="j_joepi-2016-0012_s_005"><title style='display:none'>Conclusions</title>Quality of life was rated higher by both age groups of children suffering from epilepsy than by their parents. A statistically significant difference was found when comparing the assessment scores of children and parents in light of the following variables; child age, gender, illness duration, seizure frequency and treatment effectiveness.</sec></abstract>

The quality of life of children with epilepsy in Poland – the opinion of children and their parents

<abstract>
<title style='display:none'>SUMMARY</title>
<sec>
<title style='display:none'>Introduction</title>
Cenobamate (CNB) is a newly approved antiseizure medication in Europe. It is used as an add-on treatment for focal-onset seizures in adult patients with epilepsy that is not responding to other medications.
</sec>
<sec>
<title style='display:none'>Aim</title>
This report discusses the practical aspects of using cenobamate to treat adult patients with epilepsy based on current experiences.
</sec>
<sec>
<title style='display:none'>Discussion and conclusions</title>
Studies have shown that cenobamate is effective in reducing seizure frequency in adult patients with drug-resistant focal onset epilepsy when used as add-on therapy. It also has a high seizure freedom rate, a good treatment retention rate, and a favorable safety profile. The aspects discussed include using cenobamate in special populations and potential interactions with other drugs, management strategies to mitigate the risk of adverse reactions illustrated by a specific clinical case. Further studies involving larger patient groups are necessary to assess the drug’s efficacy and safety profile, particularly in special populations and patients with other types of epileptic seizures.
</sec>
</abstract>

Cenobamate in the management of focal-onset epilepsy in adults – practical considerations for daily practice

<abstract><title style='display:none'>Summary</title>
<sec><title style='display:none'>Background</title>
Epileptic seizure is a transient period of signs and symptoms resulting from the abnormal excessive and synchronous neuronal activity in the brain, resulting in brain damage. To prevent complications, the antiseizure medication is needed. Several agents have a potency of anti-seizure effect, including ibuprofen. Unfortunately, there are few studies regarding the anti-seizure effect of ibuprofen.
</sec>
<sec><title style='display:none'>Aim</title>
To determine the anti-seizure effect of ibuprofen to reduce the symptoms of epileptic seizures.
</sec>
<sec><title style='display:none'>Materials and Methods</title>
A systematic review using the databases ScienceDirect, SpringerLink, Nature, and Pubmed. The article was obtained using the keywords “ibuprofen” and (“epilepsy” or “anticonvulsant” or “antiseizure” or “epileptic” or “neuroinflammation”) in the period 2012 to 2022 and screened with inclusion and exclusion criteria. Out of the 1376 articles screened, there are three studies included in this review. The SYRCLE Risk of Bias Tool was used to assess the risk of bias, and the data was synthesised using SWiM guidelines.
</sec>
<sec><title style='display:none'>Results</title>
Ibuprofen affects seizures by reducing the number, grade, and duration of seizure intensity in the PTZ-induced rats. Despite the risk of bias assessment revealing some potential bias in the studies, our study shows that ibuprofen has potency as an additional agent for epileptic seizures among febrile convulsive patients.
</sec>
<sec><title style='display:none'>Conclusion</title>
In animal models of seizures, ibuprofen has an antiseizure effect by reducing the number, grade, and duration of seizures.
</sec>
</abstract>

The use of ibuprofen as an anti-seizure medication: a systematic review

<abstract>
<title style='display:none'>SUMMARY</title>
<sec>
<title style='display:none'>Background</title>
Between 14% and 20% of cases of drug-resistant epilepsy may be attributed to an impaired cellular or humoral immune response.
</sec>
<sec>
<title style='display:none'>Aim</title>
Our study aimed to assess disorders of the immune response of the humoral or cellular type and their impact on the course of the disease, factors suggesting the diagnosis of an autoimmune etiology. We wanted to analyse these factors, looking for correlations with a history of status epilepticus.
</sec>
<sec>
<title style='display:none'>Materials and methods</title>
This study prospectively analysed 30 patients who were diagnosed with drug-resistant epilepsy. The patients were divided into two groups: those who had previously experienced status epilepticus and those who had not. The study collected and analysed detailed information about the patient’s medical history, routine blood laboratory tests, albumin and immunoglobulin (IgG) levels, neuropsychological evaluations, electroencephalography tests (EEG), general cerebrospinal fluid (CSF) examinations, tests for the presence of oligoclonal bands, IgG index determination, MRZ-reaction (MRZR), chitotriosidase activity, and the presence of anti-herpes type 1 (anti-HSV-1) antibodies and neural autoantibodies. Each patient underwent magnetic resonance imaging (MRI) of the head with intravenous contrast administration using the epileptic protocol.
</sec>
<sec>
<title style='display:none'>Results</title>
There was no statistically significant difference in age, gender, onset and disease duration up to the time of our study. None of the patients showed the presence of the tested antibodies against neuronal surface antigens and oligoclonal bands in the CSF.
</sec>
<sec>
<title style='display:none'>Conclusion</title>
Lack of antibodies against neuronal antigens does not necessarily rule out autoimmune epilepsy. The exact diagnostic criteria are still a subject of debate. A history of SE increases the risk of autoimmune epilepsy.
</sec>
</abstract>

Factors related to possible autoimmune etiology in patients with drug-resistant epilepsy

<abstract>
<title style='display:none'>Summary</title>
<sec id="j_joepi-2022-0003_s_001">
<title style='display:none'>Introduction</title>
Succinic semialdehyde dehydrogenase deficiency (SSADH), also known as 4-hydroxybutyric aciduria (OMIM #271980, 610045), is an ultra-rare neurometabolic disorder inherited in an autosomal recessive pattern. It is usually characterised by a relatively nonprogressive encephalopathy in the first two years of life with hypotonia and developmental delay, associated with mild ataxia and hyporeflexia, as well as delays in language and speech development.
</sec>
<sec id="j_joepi-2022-0003_s_002">
<title style='display:none'>Case report</title>
We report on a case of a four-year-old girl with SSADH deficiency who presented, at the age of 11 months old, with marked hypotonia, global neurodevelopmental delay and epilepsy. The diagnosis of “Succinic semialdehyde dehydrogenase deficiency” was indicated as there was a marked elevation of the levels of 4-hydroxy-butyric and 3,4-dihydroxybutyric acid caused by mutation at the gene ALDH5A1 in the homozygous state, identified with WES technique. Currently, she is four years old and has a severe global psychomotor delay, excessive hypotonia, hyperextensibility, and ataxia and is free of seizures.
</sec>
<sec id="j_joepi-2022-0003_s_003">
<title style='display:none'>Conclusion</title>
At the early stage of clinical presentation, the condition is difficult to differentiate from other encephalopathies. This case report suggests that analysis of urinary organic acids should be performed in all patients at risk to allow early diagnosis. DNA analysis with the WES technique can confirm the diagnosis.
</sec>
</abstract>

Succinic semialdehyde dehydrogenase deficiency (SSADH-D) in an eleven-month-old infant with marked hypotonia and staring episodes: a case report

<abstract>
<title style='display:none'>Summary</title>
<sec id="j_joepi-2022-0001_s_001">
<title style='display:none'>Introduction</title>
Beta-propeller protein-associated neurodegeneration (BPAN) is a neurodegenerative disorder; its estimated prevalence is 2 to 3 per million individuals. All published cases of BPAN have been sporadic, with a clear female predominance and mutations in various exons of the <italic>WDR45</italic> gene.
</sec>
<sec id="j_joepi-2022-0001_s_002">
<title style='display:none'>Case presentation</title>
The study aimed to confirm the diagnosis of BPAN in a 9-year-old girl with a developmental delay since early childhood complicated with intellectual disability, lack of speech and febrile and non-febrile tonic-clonic seizures. The patient also had autistic symptoms as well as some Rett-like symptoms: stereotypical movements of the hands–twisting objects, putting hands in the mouth.
</sec>
<sec id="j_joepi-2022-0001_s_003">
<title style='display:none'>Discussion</title>
Clinical exome analysis and Sanger sequencing of the proband have been performed to confirm the diagnosis. The novel heterozygous missense mutation c.755T&gt;C of the <italic>WDR45</italic> «autophagy» gene was revealed. Sanger sequencing of the trio (proband and parents) proved the <italic>de novo</italic> nature of mutation; its clinical significance has been defined as probably pathogenic. Thus, we report a new missense variant of the <italic>WDR45</italic> gene in a girl with a clinical picture of BPAN. The use of NGS made it possible to get a correct diagnosis during rather a short period before the second debilitating phase of the disease started so that the physicians and the family would have time to prepare and hopefully choose the way to resist.
</sec>
</abstract>

A patient with Beta-Propeller Protein-Associated Neurodegeneration: a new missense mutation of the <italic>WDR45</italic> gene

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