Kabeer K A

Abstract

Background: Epileptic patients suffer from multiple comorbidities resulting in a poor quality of life. Depression is one of the most important and often under-recognized comorbidity among epileptic patients. We aimed to study the prevalence of depression among epileptic adults and also tried to identify potential risk factors predisposing to depression in epilepsy. Materials and Methods: This was a cross-sectional study on the consecutive epilepsy patients (>18 years) attending our Neurology department between January-2018 to December-2018. All the demographic and clinical details were recorded in the predefined study proforma. Patient Health Questionnaire-9(PHQ-9) was used to screen for depression among epileptic patients. Statistical analysis was done using SPSS software and risk factors associated with depression were considered significant if the p-value 0.05. Results: A total of 300epileptic adults were enrolled in this study. The mean age of the study subjects was 38-years (range:18-85 years) with a male predominance (M:F-1.7:1). Majority in the epileptic cohort (62%) had secondary education and 14% had primary education. Only 3%(8/300) were postgraduates. Almost half of these epileptic patients were unmarried and one third remained unemployed. Eighty-five percent of the study patients had generalized epilepsy while the rest 15%had focal epilepsy. The mean PHQ score was 8.76 (SD-5.99; Range:0-24) with more than two-thirds of the patient (69%) screened positive for depression. Age>50-years (p-0.004), frequent breakthrough seizures(p-0.000), patients on polytherapy(p-0.000), and poor compliance to anticonvulsants (p-0.000) were found to be significant risk factors for depression in epileptic patients. Conclusion: Depression is common in epilepsy and awareness among clinicians about this comorbidity is important. Active screening for depression in epilepsy can lead to early interventions resulting in a better quality of life. Keywords: Depression, Epilepsy, Patient Health Questionnaire9.

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Abstract

Introduction and Objectives: Painful ophthalmoplegia is a clinical syndrome due to various underlying causes. The objective of the study is to determine the underlying pathological entities responsible for this potentially fatal condition. Various primary headache syndromes, facial pain syndromes and post traumatic and postsurgical pain syndromes were ruled out clinically. Materials and Methods: 107 patients satisfying our research definition of painful opthalmoplegia were enrolled in this study. The data was collected and analyzed systematically. Results and Interpretation: The common etiological causes for painful ophthalmoplegia are idiopathic inflammation of orbit (22 patients /20.5%), Tolosa hunt syndrome (13 patients /11.21%) followed by orbital cellulitis (11 patients /10.28%) fungal granuloma and mononeuritis multiplex (10 patients each /9.34%) granulomatosis with polyangiitis and tuberculous granuloma (5patients each/4.67%). Conclusions: most cases of painful opthalmoplegia are amenable to medical management provided an early and prompt diagnosis is made using appropriate diagnostic tools. Keywords: Opthalmoplegia, Periorbital pain, Tolosa hunt syndrome, Superior orbital fissure, Cavernous sinus, Orbital apex, Fungal granuloma, Tuberculous granuloma.

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