Multisystem inflammatory syndrome in children emerged as a result of the COVID-19 pandemic and has been reported to cause many different symptoms. We aimed to evaluate the electroencephalographic findings as well as the neurological manifestations of children, followed up with multisystem inflammatory syndrome in children in comparison with healthy controls.Children who were diagnosed with multisystem inflammatory syndrome between March 2020 and 2022 were included. The demographic characteristics of the patients, complaints, electroencephalographic findings, and follow-ups were examined.Seventy patients, with a mean age of 108 (±47.7) months and 44 (62.9%) males, were included in the study. Multisystem inflammatory syndrome in children was divided into three categories based on severity:mild (n=41; 58.5%), moderate (n=24; 34.2%), and severe (n=5; 7.1%). At least one neurological symptom was present in 51 (72%) of cases. Table 1 lists the admission grievances. Electroencephalographic recordings were made for all patients in terms of sleep and wakefulness. Electroencephalographic abnormalities were detected in 20 (28.6%) patients (n=2 generalized and n=18 focal paroxysmal activity). Six weeks later, patients with abnormal electroencephalographic patterns underwent imaging and a control electroencephalography. Generalized epileptiform activity was detected in two patients on electroencephalography, but the patients had normal cranial magnetic resonance imaging and no neurological deficit was found. Of these 20 patients,12 had neurological manifestations, and 8 were asymptomatic. This study provides an in-depth evaluation of neurological findings in multisystem inflammatory syndrome in children and includes one of the largest case series on electroencephalographic findings available in the literature. The results highlight the significance of electroencephalographic abnormalities in multisystem inflammatory syndrome in patients, emphasizing the need for close neurological monitoring.

Objective: This study aimed to evaluate the effect of training teachers using the video simulation method on their knowledge of epileptic seizure management and on their first-aid intervention skills. Methods: A survey was distributed to 250 participating teachers working in both private and public schools. The survey included basic demographic information, teachers' awareness of epilepsy, and their knowledge of first aid measures. Subsequently, the teachers received a training session on general information about epilepsy, first response to epileptic seizures, and emergency procedures using the video simulation training method. Awareness and attitudes were reassessed using the same survey. Results: The study involved 250 participants with an average age of 39.76 years, 62.8% female, and 78.4% working in the public sector. Participants with connections to individuals with epilepsy had significantly higher pre-training correct response scores (p=0.026, p=0.001). 72.8% had received first-aid training, and 26.6% had performed first aid, but only 6.1% considered their knowledge sufficient. Before training, 94.4% recognized epilepsy as a neurological disorder. The awareness of epilepsy being treatable increased from 70.7% to 90.4% (p<0.001). Knowledge of proper seizure interventions significantly improved, with correct responses to questions about safe positioning and jaw clenching rising from 52.4% to 78.4% and 52.4% to 90.8%, respectively (p<0.001). The total number of correct answers significantly increased after training, from 9.38 +/- 4.18 to 11.59 +/- 3.64 (p<0.001). Conclusion: These findings indicate that video simulation training is an effective method for improving teachers' knowledge and first-aid skills in managing epileptic seizures, supporting the integration of structured simulation-based interventions into school-based emergency preparedness programs.

BACKGROUND:Malnutrition is a common but frequently underrecognized comorbidity in children with neurological disorders. Accurate nutritional assessment is often challenging in pediatric neurology practice due to motor impairment, skeletal deformities, and unreliable height and weight measurements. Mid-upper arm circumference Z-score (MUAC-Z) has emerged as a practical anthropometric alternative; however, its age-dependent diagnostic performance in neurologically affected children remains insufficiently defined. OBJECTIVE:To evaluate the age-specific diagnostic accuracy of MUAC-Z for detecting malnutrition in a large pediatric neurology outpatient cohort and in a predefined subgroup of children with cerebral palsy (CP). METHODS:This multicenter, analytical cross-sectional study included 3668 children aged 6 months to 19 years attending pediatric neurology outpatient clinics, including 242 children with CP. Participants were stratified into two age groups (6-60 months and 5-19 years). Malnutrition was defined as weight-for-age Z-score (WAZ) < -2 in children under 5 years and body mass index-for-age Z-score (BMI-Z) < -2 in older children. Anthropometric measurements, laboratory parameters, and enteral feeding status were recorded. Diagnostic performance of MUAC-Z was assessed using receiver operating characteristic (ROC) curve analysis. RESULTS:MUAC-Z demonstrated moderate diagnostic accuracy in children aged 6-60 months (AUC 0.772), with marked variability across early childhood subgroups. In contrast, MUAC-Z showed excellent diagnostic performance in children aged 5-19 years (AUC 0.907). In the CP subgroup, malnutrition prevalence was substantially higher across all indices. MUAC-Z showed limited accuracy in CP children under 5 years (AUC 0.668) but good diagnostic performance in those aged 5-19 years (AUC 0.774). Older malnourished children, particularly those with CP, exhibited more frequent laboratory abnormalities consistent with chronic nutritional impairment. CONCLUSIONS:The diagnostic utility of MUAC-Z in pediatric neurology is strongly age-dependent. MUAC-Z represents a reliable and practical screening tool in school-aged children and adolescents, including those with cerebral palsy, while its use in early childhood should be complementary to conventional anthropometric indices.

This study aimed to investigate the effect of upper respiratory tract infections on serum antiseizure medication levels in children with idiopathic epilepsy and the relationship between that condition and inflammation. Forty-nine patients aged 2–18 years presenting to our paediatric neurology clinic who were under follow-up with a diagnosis of idiopathic epilepsy and who were receiving valproate or carbamazepine therapy were included in this study. All patients were using either valproic acid (n = 31) or carbamazepine (n = 18). Patients were evaluated at the time of presentation with symptoms of upper respiratory tract infection and during the control period one month later. Serum antiseizure medication, interleukin-17 A and interleukin-23 levels, complete blood count, alanine transaminase levels, creatinine levels, albumin levels, erythrocyte sedimentation rates, and C-reactive protein levels were measured during infection and during the control period one month later. Simultaneous electroencephalography examinations were also performed. No provoked seizures occurred in any patient during the infection period. Serum valproic acid levels were higher in patients during the infection period than in those same patients during the control period after one month, although this difference was not statistically significant (p = 0.073). There was also no significant difference in carbamazepine levels (p = 0.484). While no difference was observed in the interleukin-23 values between the two periods in patients receiving valproic acid, these values were greater in the patients who received carbamazepine during the infection period (p = 0.039). The findings of this study suggest that mild upper respiratory tract infections do not cause clinically significant alterations in serum valproate or carbamazepine levels.

Purpose This study aimed to investigate the relationship between ghrelin levels and severity of inflammation in children with epilepsy by evaluating the differences in total ghrelin, High Mobility Group Box 1 (HMGB1), Interleukin-1 Receptor Type 1 (IL1R1), and Interleukin-1 Beta (IL1-β) levels in patients with drug-resistant and non-drug-resistant epilepsy and comparing these parameters with those of healthy controls. Methods We measured total ghrelin, HMGB1, IL1R1, and IL1-β levels—known to play roles in epileptogenesis—in patients with severe (n: 28), mild (n:29) epilepsy, and 31 healthy controls. The severe epilepsy group included patients with treatment-resistant epilepsy, while the mild epilepsy group consisted of patients whose seizures could be controlled with monotherapy. Results Total ghrelin levels, along with HMGB1, IL1R1, and IL1-β, were significantly elevated in children with epilepsy compared to healthy controls. This increase was more pronounced in the drug-resistant epilepsy group, suggesting a potential role for ghrelin in drug-resistant epilepsy. While no direct correlation was found between ghrelin and the inflammatory markers, we observed that ghrelin levels rose significantly when levels of IL1R1, IL1-β, and HMGB1 surpassed their respective cut-off values in epilepsy patients. The biomarkers IL1R1 and IL1-β had the strongest discriminative potential in distinguishing patients with severe epilepsy from healthy controls. Although ghrelin was not as powerful a diagnostic marker as IL1R1 or IL1-β, it still showed moderate diagnostic value. Conclusion Ghrelin could serve as a biomarker reflecting both inflammation and drug resistance in epilepsy. It may be associated with inflammatory responses in epilepsy and could play a potential role in the pathophysiology of the disease.

ObjectivesTo evaluate the demographic, clinical, laboratory, and prognostic data of children with acute disseminated encephalomyelitis with respect to anti-myelin oligodendrocyte glycoprotein (MOG) antibody status.MethodsAcute disseminated encephalomyelitis patients (n = 245) from 24 centers followed up between 2010 and 2022 were evaluated retrospectively. The short- and long-term outcome characteristics (disease severity and course, clinical relapse, and recovery rates) were assessed. Incomplete clinical recovery was defined as modified Rankin Score ≥1 or the presence of epilepsy. Univariant and multivariant analysis were performed for outcome characteristics.ResultsThe mean age at diagnosis was 6.3 ± 3.8 (0.5-17.7) years and the median follow-up was 22 (3-132) months. The outcome characteristics were evaluated in 180 of 245 patients (73.4%) with at least 12 months' follow-up. Twenty-three patients (12.6%) relapsed. The multivariable logistic regression analysis revealed the following clinical parameters as predictors of relapse: sex, visual impairment, and ataxia at initial presentation. Incomplete clinical recovery (n = 42/180, 23.3%) was associated with the presence of seizures on admission and the need for an intensive care unit. Anti-MOG antibody positivity was not associated with an increased risk of relapse (25% vs 13.1%, P = .164) or incomplete clinical recovery (P = .511).ConclusionThe nationwide cohort presented further supports the typically monophasic nature of acute disseminated encephalomyelitis, and a high rate of complete recovery. The presence of certain symptoms in the acute period may assist the clinician in estimating the outcome.

Febrile seizures (FS) are the most common seizures in childhood. In most studies, iron deficiency was associated with FS, whereas serum calcium (Ca) levels were contradictory. This study evaluated the relationships of erythrocyte indices, serum Ca levels, and related factors among children with FS. Prospectively, patients aged six months to five years were included in the complex FS (n = 23), simple FS (n = 22) and febrile without seizure groups (n = 25). Patients with central nervous system infection, previous afebrile seizures, or chronic drug use were excluded. Total and ionized Ca, inorganic phosphate, vitamin D levels, erythrocyte count and indices, hemoglobin, hematocrit, pH, bicarbonate and lactate levels in blood were examined. The cutoff values of variables discriminating between the FS and control groups were established through receiver operating characteristic analysis. In the complex FS group, Ca and mean corpuscular hemoglobin concentration (MCHC) levels were lower than those in the control group (p = 0.004 for both) and albumin levels were lower than those in the simple FS group (p = 0.02). Ca levels were positively correlated with MCHC (r = 0.252, p = 0.039). In the FS group, the proportions of MCHC < 34.1 g/dL, Ca < 9.9 mg/dL, ionized Ca < 1.27 mmol/L and pH < 7.38 were more frequent (p = 0.003, p = 0.005, p = 0.044 and p = 0.035 respectively). Lower Ca and MCHC levels were associated with FS. The positive correlation between Ca and MCHC levels indicates a common pathogenetic mechanism. To our knowledge, the increased proportion of patients with low blood pH level in FS is a novel finding.

Objective: This study aimed to evaluate the relationship between normal brain magnetic resonance imaging (MRI) findings and prognosis in children with focal epileptic disorder on electroencephalography (EEG) without an epileptic syndrome. Material and Methods: Data from patients aged 0-18 years, who were followed up with a diagnosis of epilepsy at the pediatric neurology clinics over the last 5 years, were retrospectively reviewed. Patients with focal epileptic disorder on EEG were selected. Those with an epileptic syndrome were excluded from the study. The patients’ demographic characteristics, seizure types, etiologies, brain MRI findings, seizure focus, treatment methods, and seizure control were analyzed. Patients were divided into two groups based on their brain MRI findings (normal and abnormal) and compared in terms of treatment resistance, number of medications, and seizure control. Results: The mean age of the 100 patients included in the study was 8±4.32 years, with an equal gender distribution (50% female, 50% male). Generalized seizures were observed in 72% of patients, while 28% had focal seizures. Seizure freedom was achieved in 60% of cases, and treatment resistance was noted in 23%. Cranial MRI revealed structural abnormalities in 67% of patients, with the majority (84%) showing sequelae-related changes, including hypoxic-ischemic sequelae (16%), encephalomalacia (12%), and structural malformations (10%). Although treatment resistance (28.8% vs. 12.1%) was higher and seizure freedom (56.7% vs. 66.7%) was lower in patients with abnormal MRI findings compared to those with normal MRI, these differences were not statistically significant (p =0.150 and p=0.310 respectively) . However, perinatal (p=0.013) and postnatal complications (p=0.042) were significantly more frequent in patients with abnormal MRI findings. Conclusion: In children with focal epileptic disorder on EEG, normal brain MRI findings do not predict a better prognosis in terms of seizure control and treatment resistance. Other factors affecting treatment resistance in this population need to be investigated in more detail.

Elevated inflammation, characterized by increased proinflammatory cytokine levels in febrile seizures (FSs), has been well documented; however, the underlying causes and contributing factors remain unclear. This study aimed to investigate the molecular components that may contribute to or protect against inflammation in children with FS. The study involved children aged 6–60 months with FS (FS group, n = 29), afebrile seizures (AS group, n = 17), and febrile controls (FC group, n = 30). Leukocyte count, C-reactive protein, complement C3 and C4, fibrinogen, intercellular and vascular cell adhesion molecules (ICAM-1, VCAM-1), adrenocorticotropic hormone (ACTH), and cortisol levels were measured at onset (T1) and 24 h later (T2) in the seizure groups and at T1 in the FC group, whose samples served as controls for both periods alongside the AS group. At T2 time compared with T1, VCAM-1 levels increased and C3 levels decreased in the FS group, whereas ICAM-1 levels increased in the AS group (p = 0.001, p = 0.048, p = 0.035, respectively). The FS and AS groups had higher leukocyte counts at T1 than T2 (p < 0.001, p = 0.023, respectively). The FS group had higher cortisol levels than the AS group and higher ACTH levels than the FC group at T1 (p < 0.001, p = 0.037, respectively), but at T2, the FS group had lower ACTH levels than the AS and FC groups (p = 0.037, p = 0.006, respectively). In conclusion, VCAM-1 and C3 alterations observed in FS suggest their involvement in inflammation, possibly related to leukocyte migration. Additionally, a higher ACTH peak after FS may be associated with a more benign profile compared with epilepsy.

Introduction: Thisstudyaimsto investigatethe clinical and electroencephalographic characteristics of children diagnosed with SeLECTS (Self-limited epilepsy with centrotemporal spikes), comparing the effectiveness of antiseizure medications (ASMs) based on the presence or absence of Attention Deficit Hyperactivity Disorder (ADHD), and evaluating the prognostic value of the spike-wave index (SWI). Materials and Methods: A retrospective review was conducted on 914 children diagnosed with SeLECTS between 2005-2023. A total of 542 patients who met the inclusion criteria were followed for a minimum of three years with at least three EEG recordings. SWI values were analyzed according to the type of ASM valproic acid (VPA), carbamazepine (CBZ), and levetiracetam (LEV), ADHD status, and age. The predictive power of SWI for EEG improvement and seizure control was assessed using ROC curve analysis. Results: The mean age was 8.18 +/- 3.35 years; the male-to-female ratio was 1.47:1. Onset before age five was associated with more frequent seizures (p=0.003). VPA was more effective for EEG improvement, while LEV provided better seizure control. SWI was significantly higher in children with ADHD. SWI values decreased over time. ADHD prevalence was 19.9%. Conclusion: SWI is a valuable tool for assessing treatment response. Epilepsy burden is higher in patients with ADHD. VPA is superior in EEG normalization, whereas LEV offers more effective seizure control.

Aim: Spinal Muscular Atrophy (SMA) is a rare neuromuscular disorder requiring a multidisciplinary approach. This study aimed to investigatethe clinical, biochemical, and immunological parameters in pediatric SMA patients and to explore their potential associations with quality oflife.Material and Methods: In this study, 16 genetically confirmed SMA patients aged 2–18 years were evaluated. Data on hematologic andbiochemical profiles, including vitamin B12, 25-OH-vitamin D3, and immunoglobulin levels, were recorded. The PedsQL™ 3.0 NeuromuscularModule was administered to assess quality of life.Results: The cohort included 8 patients with SMA type 1, 5 with type 2, and 3 with type 3. Seven (43.75%) were females, with a mean ageof 93±60 months. The mean follow-up period was 36±5 months. Serum vitamin B12 values were 271±66ng/L, and 25-OH-D3 vitamin valueswere 21.14±12.9μg/L. Immunoglobulin (Ig) G levels of 5 (31.25%) were below the normal range for their ages. When SMAtype1, SMA type2,and 3 groups were compared, there was no difference in vitamin B12, vitamin D, and IgE levels. Hemoglobin and transferrin saturation weresignificantly lower in SMA type 1 patients(p

Background: Various etiologies may underlie optic neuritis, including autoantibody-mediated disorders described in the last decade. We re-examined demographic, clinical, laboratory features and prognostic factors in pediatric patients with autoimmune optic neuritis according to current knowledge.Methods: Cases of pediatric ON from 27 centers in Turkiye diagnosed between 2009 and 2022 were included for retrospective evaluation.Results: The study included 279 patients, 174 females and 105 males, with a female-to-male ratio of 1.65. The average age at onset was 12.8 +/- 3.4 years, and mean follow-up, 2.1 years (range: 1-12.1 years). Patients <10 years old were grouped as "prepubertal" and those >= 10 years old as "others". The diagnoses made at the end of follow-up were multiple sclerosis associated optic neuritis (n = 90, 32.3 %), single isolated optic neuritis (n = 86, 31 %), clinically isolated syndrome (n = 41, 14.7 %), myelin oligodendrocyte glycoprotein antibody associated optic neuritis (n = 22, 7.9 %), and relapsing isolated optic neuritis (n = 18, 6.5 %). Predominant diagnoses were myelin oligodendrocyte glycoprotein antibody associated optic neuritis and acute disseminated encephalomyelitis associated optic neuritis in the prepubertal group and multiple sclerosis associated optic neuritis in the older group. Recurrences were observed in 67 (24 %) patients, including 28 with multiple sclerosis associated optic neuritis, 18 with relapsing isolated optic neuritis, 11 with myelin oligodendrocyte glycoprotein antibody associated optic neuritis, 8 with aquaporin-4 antibody related optic neuritis, and 2 with chronic relapsing inflammatory optic neuropathy. Recurrences were more common among female patients. Findings supporting the diagnosis of multiple sclerosis included age of onset >= 10 years (OR=1.24, p = 0.027), the presence of cranial MRI lesions (OR=26.92, p<0.001), and oligoclonal bands (OR=9.7, p = 0.001). Treatment in the acute phase consisted of intravenous pulse methylprednisolone (n = 46, 16.5 %), pulse methylprednisolone with an oral taper (n = 212, 76 %), and combinations of pulse methylprednisolone, plasmapheresis, or intravenous immunoglobulin (n = 21, 7.5 %). Outcome at 12 months was satisfactory, with 247 out of 279 patients (88.5 %) demonstrating complete recovery. Thirty-two patients exhibited incomplete recovery and further combination treatments were applied. Specifically, patients with relapsing isolated optic neuritis and aquaporin-4 antibody related optic neuritis displayed a less favorable prognosis.Conclusion: Our results suggest optic neuritis is frequently bilateral in prepubertal and unilateral in peri- or postpubertal patients. Age of onset 10 or older, presence of oligoclonal bands, and brain MRI findings reliably predict the development of multiple sclerosis. The risk of developing multiple sclerosis increases mostly during the second and third years of follow-up. Relapsing isolated optic neuritis remains a separate group where the pathogenesis and outcome remain unclear. Investigation of predisposing and diagnostic biomarkers and long follow-up could help to define this group.

Background: Neuroin fl ammation induced by systemic in fl ammation is a risk factor for developing chronic neurologic disorders. Oleuropein (OLE) has antioxidant and anti-in fl ammatory properties; however, its effect on systemic in fl ammation-related neuroin fl ammation is unknown. Objectives: This study aimed to determine whether OLE protects against systemic lipopolysaccharide (LPS)-induced neuroin fl ammation in rats. Methods: Six-wk-old Wistar rats were randomly assigned to 1 of the following 5 groups: 1 ) control, 2 ) OLE-only, 3 ) LPS & thorn; vehicle, 4 ) OLE & thorn; LPS (O-LPS), and 5 ) a single-dose OLE & thorn; LPS (SO-LPS group). OLE 200 mg/kg or saline as a vehicle was administered via gavage for 7 d. On the seventh day, 2.5 mg/kg LPS was intraperitoneally administered. The rats were decapitated after 24 h of LPS treatment, and serum collection and tissue dissection were performed. The study assessed astrocyte and microglial activation using glial fi brillary acidic protein (GFAP) and CD11b immunohistochemistry, nod -like receptor protein -3, interleukin (IL)-1 beta , IL -17A, and IL -4 concentrations in prefrontal and hippocampal tissues via enzyme-linked immunosorbent assay, and total antioxidant/oxidant status (TAS/TOS) in serum and tissues via spectrophotometry. Results: In both the O-LPS and SO-LPS groups, LPS-related activation of microglia and astrocytes was suppressed in the cortex and hippocampus ( P < 0.001), excluding cortical astrocyte activation, which was suppressed only in the SO-LPS group ( P < 0.001). Hippocampal GFAP immunoreactivity and IL -17A concentrations in the dentate gyrus were higher in the OLE group than those in the control group, but LPS-related increases in these concentrations were suppressed in the O-LPS group. The O-LPS group had higher cortical TAS and IL -4 concentrations. Conclusions: OLE suppressed LPS-related astrocyte and microglial activation in the hippocampus and cortex. The OLE-induced increase in cortical IL -4 concentrations indicates the induction of an anti-in fl ammatory phenotype of microglia. OLE may also modulate astrocyte and IL -17A functions, which could explain its opposing effects on hippocampal GFAP immunoreactivity and IL -17A concentrations when administered with or without LPS.

Purpose: Multisystem inflammatory syndrome(MIS-C) in children emerged as a result of the COVID-19 pandemic and has been reported to cause many different symptoms. In this study, we aimed to evaluate the electroencephalography(EEG) findings as well as the neurological manifestations of children, followed up with the diagnosis of MIS-C.Methods: Children who were admitted to the pediatric infection service with the diagnosis of MISC between March 2020-2022 were included in the study. The demographic characteristics of the patients, their complaints, EEG findings, and follow-ups were examined.Results: A total of 70 patients, with a mean age of 108(± 47,7) months and 44(62,9%) males, were included in the study. MIS-C was classified according to its severity (n:41(58.5%) mild, n:24(34.2 %) moderate, n:5(7.1%) severe). At least one neurologic symptom was present in 51(72%) of cases. Admission complaints are shown in Table-1. EEG recordings were made for all patients in terms of sleep and wakefulness. EEG abnormalities were detected in 20(28.6%) patients(n:2 generalized, n:18 focal paroxysmal activity). Imaging and control EEG were performed six weeks later in patients who had abnormal EEG patterns. Generalized epileptiform activity was detected in 2 patients on EEG, but the patients had normal cranial magnetic resonance imaging and no neurological deficit was found. Of these 20 patients, 12 had neurologic manifestations, and 8 were asymptomatic.Conclusion: It was the first study with a large number of cases examining neurological findings in MISC. Although the data in the literature about the newly defined MISC is limited, it is increasing exponentially.

Objectives: The use of herbal products/dietary supplements (HP/DS) in the pediatric population is increasing day by day. The interaction of HP/DSs with drugs with a narrow therapeutic index such as phenytoin, phenobarbital, and valproic acid, may cause problems in treatment. In this respect, it is very important to determine the use of HP/DS in children with neurological diseases and/or complaints. In this study, it was aimed to determine the use of HP/DS and the factors affecting the use of these products in individuals with a neurological complaint and/or disease who applied to the pediatric neurology outpatient clinic. Methods: Parents were questioned face-to-face as part of the descriptive questionnaire research. 174 questionnaires with appropriate data quality were included in the study. The statistical software tool SPSS 23.0 was used to analyze the data. Results: 44.6% of the parents stated that they gave HP/DS to their children. The findings of the analysis showed that kids whose parents use HP/DS are more likely to utilize these items themselves (p<0.001). The most commonly used products are linden (70.1%), bee products (26.0%), carob (18.2%), chamomile (13.0%), and lemon (13.0%). It has been determined that the reasons for parents to have their children use HP/DS are to strengthen the immune system (51.9%), improve general health status (40.3%), and supplement normal nutrition (27.3%), respectively. Conclusions: This study revealed a high frequency of HP/DS use in children with pediatric neurological diseases/complaints in Türkiye. The frequency of HP/DS use was higher in children whose parents tended to consume HP/DS. Considering the high use of these products, healthcare professionals need to inform parents to prevent adverse effects caused by HP/DS.

Background: After the pandemic period, the daily routines changed, and this caused a significant decrease in families’ quality of life. We aimed to show how the pandemic period and closure of educational institutions influenced children with autism spectrum disorder (ASD) and their families’ quality of life. Method: The study is a descriptive type of research. The study population consists of families of children aged between 3 and 16 diagnosed with ASD who attended special education and rehabilitation centers and educational practice schools in Trabzon for at least 6 months before the pandemic, registered with the Trabzon Autism Association, and were followed at the Karadeniz Technical University Faculty of Medicine Child and Adolescent Mental Health and Pediatric Neurology Polyclinic. Families were asked to complete the questionnaire we designed. The data was collected face-to-face prospectively. The questionnaire consisted of six parts: sociodemographic and personal characteristics of children and parents; education problems during the pandemic period; the effect of daily routines during the pandemic period on both children and families; the Quality of Life in Autism Questionnaire-Parent Version; and the Parental Burnout Scale. Results: We contacted 169 parents. Mothers were more likely than fathers to complete the questionnaire (73.1% vs. 26.9%). School attendance decreased by 11.9%, while regular education availability fell by 8.1%. The pandemic has caused changes in the daily routines of families and children in many areas of life, such as decreased physical activity, changes in sleep duration and time, and deterioration in regular eating habits (p = 0.035; 0.001; 0.004; 0.001, respectively). The QoL of parents whose daily schedules changed decreased as a result. Our study found that their levels of burnout significantly increased, and the PBS total score and the QoLA scores had a moderately significant correlation (rs = 0.411, p<0.001). Conclusions: In this study, we showed that the COVID-19 epidemic negatively affected the education process of children with ASD. In order to improve the QoL of families and reduce burnout levels, we suggest providing additional service opportunities (parks, playgrounds, hobby centers, etc.) and special psychiatric services for children with ASD during pandemic periods.

Objective: We aimed this study, investigated the changes in pre- and post-treatment hematological parameters, liver and kidney function parameters in children that were diagnosed with epilepsy and initiated on levetiracetam (LEV) therapy. Methodology: The study population consisted of 114 children (6-18 years) had normal growth percentiles, that were treated for new-onset epilepsy with LEV monotherapy. In each patient, hematological parameters, B12, ferritin, liver and kidney function parameters were measured before and one/three years after the initiation of the therapy. Results: The hemoglobin (Hgb) and hematocrit (Htc) levels showed a significant increase and the absolute lymphocyte count (ALC), absolute neutrophil count (ANC) (p=0.000), monocyte percentage (p=0.032), and mean platelet volume (MPV) (p=0.000) levelsshowed a significant decrease. The ALC levels decreased significantly in 6 (5.3%) children. The mean drug dose at three years of treatment was 30.0±5.6 mg/kg/day. No significant difference was found between pre- and post-treatment platelet (PLT) counts and no significant correlation was found between gender and hematological parameters (p>0.05 for both). Conclusion: Although LEV monotherapy led to changes in the hematological parameters of the epilepsy patients, no significant change was observed in liver function. We suggest that when evaluating the hematological parameters in children with epilepsy, the community’s predisposition should be considered and also children should be examined for iron deficiency and vitamin B12 deficiency anemia before initiating the LEV therapy. It was also revealed that long-term LEV monotherapy is a safe treatment in children with epilepsy.

Dünya çapında bitkisel ürün kullanımı giderek yaygınlaşmaktadır. Epilepsi hastaları, tıbbi tedavilerini tamamlamak, epilepsi yönetimini desteklemek ve nöbet sıklığını azaltmak gibi çeşitli amaçlarla bu ürünleri kullanmaya yönelmektedir. Bitkisel ürünlerin konvansiyonel ilaçlarla eş zamanlı kullanılması, bitki-ilaç etkileşimlerine yol açabilir. Bu derlemede, antiepileptik ilaçlar ile bitkisel ürünler ve bitkilerden elde edilen sekonder metabolitlerin farmakokinetik etkileşimi, 1995 ve 2016 yılları arasında gerçekleştirilen 33 klinik çalışmadan hareketle çalışmanın tipi, katılımcıların sayısı ve niteliği, bitkisel ürün ve bitkisel droglardan elde edilen sekonder metabolitler ile antiepileptik ilaçların dozu, kullanım süresi ve bitki-ilaç etkileşimine dair bulgular ele alınarak değerlendirilmiştir. Yapılan araştırmada, antiepileptik ilaçlarla klinik olarak anlamlı farmakokinetik etkileşim gösteren bitkilerin Citrus paradisi Macfad., Echinacea purpurea (L.) Moench, Ginkgo biloba L., Hydrastis canadensis L. ve Hypericum perforatum L.; sekonder metabolitlerin ise diosmin, piperin ve resveratrol olduğu görülmüştür. Çalışmanın devamında, bu bitkilerin ve sekonder metabolitlerin antiepileptik ilaçlarla olası farmakokinetik etkileşim mekanizmaları değerlendirilmiştir. Bitkisel ürünler ve sekonder metabolitler, pregnan X reseptörü aktivasyonu yoluyla sitokrom P450 enzim modülasyonu ve ilaç taşınmasında rol oynayan P-glikoprotein gibi ilaç taşıyıcı proteinleri etkilemek suretiyle antiepileptik ilaçlarla etkileşmektedir. Epilepsi tanılı bireylerde, klinikte terapötik düzeyleri takip edilen antiepileptik ilaçların kan konsantrasyon düzeylerinin subterapötik veya supraterapötik düzeylerde bulunması, durumun bitkisel ürün kullanımıyla ilişkili olduğunu göstermiştir.