Differences in obsessive-compulsive symptom dimensions between patients with epilepsy with obsessive-compulsive symptoms and patients with OCD.

Clinical correlates of obsessive-compulsive symptoms (OCS) were evaluated in 100 adult consecutive outpatients with epilepsy, using the Obsessive-Compulsive Inventory (OCI-R), Beck Depression Inventory (BDI), Dissociative Experiences Scale (DES-II), and the Schizotypal Personality Questionnaire (SPQ). Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) was applied to determine the types and severity of OCS to the 45 patients with epilepsy who were over 21 points on the OCI-R scale and 30 patients who were with diagnosed obsessive-compulsive disorder (OCD) among the patients in the psychiatry outpatient clinic, as a control group. As a result, it was found that patients with epilepsy with OCS tend to have more symmetry/exactness obsessions and compulsions, whereas patients with OCD had significantly more contamination/cleaning and aggressiveness obsessions and compulsions. In addition, OCS was found to be significantly higher in temporal lobe epilepsy (TLE) and extratemporal epilepsy than generalized epilepsy. However, OCS were correlated with depression, dissociation, and schizotypy in patients with epilepsy, while only depression was predictive when regression analysis was performed for OCS. This study is the first study to compare patients with OCD with patients with epilepsy in terms of the nature of OCS and first identified the differences in OCS dimensions between patients with epilepsy with OCS and patients with OCD.

Gender-Related Differences in Semiology of Psychogenic Non-Epileptic Seizures.

INTRODUCTION: The aim of the study is to detect possible gender-related differences in the semiology of psychogenic non-epileptic seizures (PNES). METHODS: One hundred fifty-five patients (male: female=63:92) aged 13 to 67 years, who were diagnosed with PNES by video-monitoring electroencephalogram (EEG) between 2010 and 2017, were included in this retrospective study. Patients were grouped according to their gender. The primary semiological characteristics of PNES for each case were defined, standardized, and categorized by an epileptologist during video-monitoring EEG. The chi-square test and the Fisher exact test were used statistically. RESULTS: An age histogram showed peaks at ages 20 to 23 and at ages 40 to 43, which were more prominent in the female gender. Whereas major motor activity (p=0.032), lateralizing motor activity (p=0.017), and opisthotonic posture and pelvic thrust motion (p=0.017) were significantly related to the male gender, weeping (p<0.001) was significantly related to the female gender. CONCLUSION: Our study showed that there are some semiological differences between the genders in PNES. In male patients, lateralized motor findings are more prominent and not accompanied by ictal crying in seizures, which may lead to further confusion with epileptic seizures. It is important to know the semiological characteristics for early and accurate diagnosis.

Longitudinal assessment of gray matter volumes and white matter integrity in patients with medication-overuse headache.

Background Medication-overuse headache is a common clinical entity, but neuroimaging studies investigating volumetric and microstructural alterations of the brain in medication-overuse headache are rare. Therefore, in the current longitidunal study we evaluated gray matter volume and white matter integrity in patients with medication-overuse headache before and after drug withdrawal. Methods A prospective study evaluated 27 patients with medication-overuse headache and 27 age-, sex-, and education-matched healthy adults. High-resolution T1-weighted magnetic resonance imaging and diffusion tensor imaging were obtained from the control group and medication-overuse headache patients before and six months after drug withdrawal. Tract-based spatial statistics of multiple diffusivity indices and voxel-based morphometry were employed to investigate white and gray matter abnormalities. Results No correlation was found between age, gender, education and smoking status in both groups. The most commonly overused medications were simple analgesics (96.3%) and combined analgesics (3.7%). The mean duration of the history of medication overuse and headaches was 56.7 ± 63.5 months. White matter diffusional and gray matter morphological alterations including volume, fractional anisotropy, radial diffusivity, and axial diffusivity analyses showed no significant relationship in the patients before and six months after withdrawal of analgesics. Also no difference was observed between the patients versus controls. Conclusion Our data demonstrated no structural alterations within the brain in medication-overuse headache.