Seizure symptoms and ambulatory EEG findings: incidence of epileptiform discharges.

AIMS: Ambulatory video-EEG monitoring has been utilized as a cost-effective alternative to inpatient video-EEG monitoring for non-surgical diagnostic evaluation of symptoms suggestive of epileptic seizures. We aimed to assess incidence of epileptiform discharges in ambulatory video-EEG recordings according to seizure symptom history obtained during clinical evaluation. METHODS: This was a retrospective cohort study. We queried seizure symptoms from 9,221 consecutive ambulatory video-EEG studies in 35 states over one calendar year. We assessed incidence of epileptiform discharges for each symptom, including symptoms that conformed to a category heading, even if not included in the ILAE 2017 symptom list. We report incidences, odds ratios, and corresponding p values using Fisher's exact test and univariate logistic regression. We applied multivariable logistic regression to generate odds ratios for the six symptom categories that are controlled for the presence of other symptoms. RESULTS: History that included motor symptoms (OR=1.53) or automatisms (OR=1.42) was associated with increased occurrence of epileptiform discharges, whereas history of sensory symptoms (OR=0.76) predicted lack of epileptiform discharges. Patient-reported symptoms that were associated with increased occurrence of epileptiform discharges included lip-smacking, moaning, verbal automatism, aggression, eye-blinking, déjà vu, muscle pain, urinary incontinence, choking and jerking. On the other hand, auditory hallucination memory deficits, lightheadedness, syncope, giddiness, fibromyalgia and chronic pain predicted absence of epileptiform discharges. The majority of epileptiform discharges consisted only of interictal sharp waves or spikes. CONCLUSIONS: Our study shows that the use of ILAE 2017 symptom categories may help guide ambulatory video-EEG studies.

Knowledge of modifiable risk factors of cardiovascular diseases among patients with acute myocardial infarction.

BACKGROUND: Cardiovascular disease is a major cause of mortality and morbidity in Pakistan. Knowledge regarding any disease is an important pre-requisite for implementation of preventive and control measures. This study aimed to evaluate the knowledge of modifiable risk factors of cardiovascular diseases in acute myocardial infarction (MI) patients admitted to Ayub Teaching Hospital, Abbottabad, Pakistan. METHODS: It was a hospital based cross sectional descriptive study carried out in cardiology unit of Ayub Teaching Hospital, on 150 patients with first attack of acute MI. knowledge of four modifiable risk factors; fatty food consumption, smoking, physical activities and obesity, was assessed. RESULTS: Among 150 subjects, 103 (68.7%) were males while 47 (31.3%) were females. Forty three (28.7%) of the patients were having good level of knowledge. Male gender and educational status were associated with good level of knowledge. CONCLUSION: There is a lack of good level of knowledge among patients admitted with acute MI. Implementing aggressive educational strategies is of utmost importance in Pakistani population for preventing the rising prevalence of this disease to combat the burdeni of MI.