Recurrent catamenial status epilepticus: Is it rare or an under recognized phenomenon in women with epilepsy?

•Recurrent catamenial status epilepticus may occur in generalized and focal epilepsy.•Documenting the menstrual cycles and perimenstrual video-EEG help the diagnosis.•Hormonal treatment including menstrual suppressive therapies may be used.

Referral practice, reporting standards, and the impact of dopamine transporter scans done in a tertiary hospital.

AIMS: We studied the referral practice, reporting standards, and the impact of 123 ioflupane single photon emission computed tomogram dopamine transporters (DAT-SPECT) scans conducted for the diagnosis and clinical management of patients. SETTINGS AND DESIGNS: The present study was a retrospective, non-interventional study. MATERIALS AND METHODS: We assessed the DAT scan referral and the official reports available from the Nuclear Medicine Department of the Mater Misericordiae University Hospital over 1 year (2013). We also assessed the impact of the DAT scan result on the management of patients by analyzing patient records. The European Association of Nuclear Medicine Neuroimaging (EANM) 2010 and the Federal Drug Administration (FDA) 2012 guidelines were taken as the standard against which the quality of our DAT scans reporting was assessed. STATISTICAL METHODS: Microsoft Excel 2010 and graphpad software were used for statistical analysis. RESULTS: Twenty five (56.2%) out of a total of 48 DAT scans were performed to confirm early Parkinson's disease, 5 (8.9%) were done to exclude drug-induced parkinsonism, and 8 (14.3%) to distinguish essential tremor from parkinsonism; 2 scans were performed to distinguish Lewy body diseases from Alzheimer's dementia, and 4 indications were outside the recommended guidelines. Twelve out of the 26 (46%) abnormal scans had bilateral abnormalities. Twenty one out of the 25 DAT scans proved the clinical diagnosis of degenerative parkinsonism to be correct. CONCLUSION: The overall compliance of the DAT imaging with the existing standard guidelines was good. DAT scan can be very useful in clinical practice because it influences the clinical diagnosis and management in 23% of the patients.