The aim of the study was to investigate the neurobiological and psychosocial factors that influence neuropsychological test performance in children with epilepsy from a non-Western rural background. The sample comprised 100 children with tonic-clonic seizures and 100 children with simple partial seizures between the ages of eight to twelve years. A third group of 100 children with chronic renal problems was used as a comparison to control for the effects of having a chronic illness. The findings of the present study indicate that in the epilepsy groups, seizure variables such as the age of onset, frequency of seizures and duration of seizures have an impact on self-esteem, adjustment and NEPSY scores. However, psychosocial and emotional factors appear to have a greater impact than neurobiological variables on the measured neuropsychological domains (attention/executive, language, sensorymotor and learning/memory functions). These findings are consistent with the theoretical perspectives used, combining the view of Piaget (1955) that cognitive development proceeds as a result of the child’s own activities, with Luria’s (1973) model of brain functioning and the stance of Vygotsky (1978) that development is a socially mediated process. The findings regarding the influence of neurobiological and psychosocial factors on neuropsychological test performance in children with epilepsy from non-Western backgrounds are similar to those of Western studies. Epilepsy presents with unique problems relative to other chronic illnesses. The three groups are separated according to differences in psychosocial (maternal attitudes), emotional (adjustment and self-esteem) as well as neuropsychological functioning (attention/executive, language and visual-spatial skills). The renal group is characterised by the highest levels of psychosocial, emotional and neuropsychological functioning, while the simple partial seizure group have lower levels of psychosocial and emotional functioning, and the tonic-clonic seizure group have the lowest levels of neuropsychological functioning and adjustment. / Psychology / D.Litt et Phil. (Psychology)

Epilepsia e cefaleia são doenças neurológicas comuns. A epilepsia atinge cerca de 1% da população mundial, enquanto a cefaleia têm prevalência muito mais elevada, ocorrendo em 38-50% das pessoas. As duas condições dividem mecanismos fisiopatogênicos comuns. Relatos de cefaleia em pacientes neuropediátricos com epilepsia correm, mas são pouco estudados devido ao pequeno número de pacientes e dificuldade de diagnóstico de cefaleia nessa população. Nesse estudo avaliamos a prevalência e as características de cefaleia em pacientes com epilepsia focal de início na infância, na idade adulta e após os 50 nos de idade. Foram analisados 167 pacientes com epilepsia focal. Cento e vinte e cinco destes pacientes (74.8%) apresentaram cefaleia. No primeiro grupo, a idade de início da epilepsia variou de 0-17 anos, no segundo de 18-50 anos e no terceiro acima de 50 anos. Para cada paciente entrevistado, foi utilizado um questionário padronizado, verificando a existência de epilepsia e cefaleia, idade de início, frequência, intensidade, classificação e resposta ao tratamento. No nosso estudo, quanto mais precoce o início da epilepsia, maior a chance de do paciente ser refratário e de apresentar cefaleia. Todos os tipos de cefaleia foram mais comuns em pacientes que iniciaram ainda jovens com epilepsia. A cefaleia foi mais comum em mulheres que iniciaram com epilepsia até 50 anos. Após essa idade, a cefaleia em epilepsia foi mais frequentemente observada em pacientes masculinos. Quando a epilepsia iniciou na infância, a cefaleia ocorreu mais frequentemente associada às crises, sendo predominantemente observada no período pós-ictal e ocorrendo mais comumente na região occipital. Esses achados podem sugerir que ocorre maior sobreposição fisiopatológica entre epilepsia e cefaleia quando a epilepsia inicia na infância. No conjunto, nosso estudo demonstrou que a cefaleia observada em epilepsia tem características dependentes da idade de início das crises. Parece ocorrer uma sobreposição de mecanismos de doença entre cefaleia e epilepsia quando a epilepsia inicia na infância. Essa associação é menos observada quando a epilepsia ocorre após os 50 anos de idade, sugerindo diferentes mecanismos fisiopatogênicos para ocorrência da cefaleia em epilepsia, de acordo com a época de início da epilepsia. / Epilepsy and headache are common neurological diseases. Epilepsy affects around 1% of the world population, while headache prevalence is much higher, occurring in 38-50% of people. Both conditions share mutual physiopathogenic mechanisms. Reports of headache in neuropediatric patients with epilepsy occur, but they are poorly studied due to the small number of patients and difficulty of headache diagnosis on this population. This study evaluated the prevalence and characteristics of headache in patients with focal epilepsy of childhood onset, adulthood and after 50 years old. We analyzed 167 patients with focal epilepsy. One hundred twenty five of those patients (74.8%) had headache. In the first group, the age at onset of epilepsy varied between 0-17 years; in the second group, from 18-50 years; and in the third group above 50 years. For each patient interviewed, a standardized survey was used to verify the occurrence of epilepsy and headache, the age at onset, frequency, intensity, classification and response to treatment. In this study, the earlier the onset of headache, the greater the chances of the patient is refractory and to present headache. All kinds of headache were more common in patients who started at a young age with epilepsy. Headache was more common in women who started until 50 years old with epilepsy. After this age, headache in epilepsy was more often observed in male patients. When epilepsy started at childhood, headache occurred more often related to the crises, being predominantly observed during post-ictal period and most commonly occurring in the occipital region. These findings may suggest that physiopathologic superposition between epilepsy and headache occurs more often at childhood. As a whole, the study demonstrated that the headache observed in epilepsy has characteristics dependent on the onset age of crises. There seems to be a superposition of disease mechanisms between headache and epilepsy when epilepsy starts during childhood. This association is less observed when epilepsy occurs after 50 years old, suggesting different physiopathogenic mechanisms for headache occurrence in epilepsy, according to the time of onset of epilepsy.

Epilepsia e cefaleia são doenças neurológicas comuns. A epilepsia atinge cerca de 1% da população mundial, enquanto a cefaleia têm prevalência muito mais elevada, ocorrendo em 38-50% das pessoas. As duas condições dividem mecanismos fisiopatogênicos comuns. Relatos de cefaleia em pacientes neuropediátricos com epilepsia correm, mas são pouco estudados devido ao pequeno número de pacientes e dificuldade de diagnóstico de cefaleia nessa população. Nesse estudo avaliamos a prevalência e as características de cefaleia em pacientes com epilepsia focal de início na infância, na idade adulta e após os 50 nos de idade. Foram analisados 167 pacientes com epilepsia focal. Cento e vinte e cinco destes pacientes (74.8%) apresentaram cefaleia. No primeiro grupo, a idade de início da epilepsia variou de 0-17 anos, no segundo de 18-50 anos e no terceiro acima de 50 anos. Para cada paciente entrevistado, foi utilizado um questionário padronizado, verificando a existência de epilepsia e cefaleia, idade de início, frequência, intensidade, classificação e resposta ao tratamento. No nosso estudo, quanto mais precoce o início da epilepsia, maior a chance de do paciente ser refratário e de apresentar cefaleia. Todos os tipos de cefaleia foram mais comuns em pacientes que iniciaram ainda jovens com epilepsia. A cefaleia foi mais comum em mulheres que iniciaram com epilepsia até 50 anos. Após essa idade, a cefaleia em epilepsia foi mais frequentemente observada em pacientes masculinos. Quando a epilepsia iniciou na infância, a cefaleia ocorreu mais frequentemente associada às crises, sendo predominantemente observada no período pós-ictal e ocorrendo mais comumente na região occipital. Esses achados podem sugerir que ocorre maior sobreposição fisiopatológica entre epilepsia e cefaleia quando a epilepsia inicia na infância. No conjunto, nosso estudo demonstrou que a cefaleia observada em epilepsia tem características dependentes da idade de início das crises. Parece ocorrer uma sobreposição de mecanismos de doença entre cefaleia e epilepsia quando a epilepsia inicia na infância. Essa associação é menos observada quando a epilepsia ocorre após os 50 anos de idade, sugerindo diferentes mecanismos fisiopatogênicos para ocorrência da cefaleia em epilepsia, de acordo com a época de início da epilepsia. / Epilepsy and headache are common neurological diseases. Epilepsy affects around 1% of the world population, while headache prevalence is much higher, occurring in 38-50% of people. Both conditions share mutual physiopathogenic mechanisms. Reports of headache in neuropediatric patients with epilepsy occur, but they are poorly studied due to the small number of patients and difficulty of headache diagnosis on this population. This study evaluated the prevalence and characteristics of headache in patients with focal epilepsy of childhood onset, adulthood and after 50 years old. We analyzed 167 patients with focal epilepsy. One hundred twenty five of those patients (74.8%) had headache. In the first group, the age at onset of epilepsy varied between 0-17 years; in the second group, from 18-50 years; and in the third group above 50 years. For each patient interviewed, a standardized survey was used to verify the occurrence of epilepsy and headache, the age at onset, frequency, intensity, classification and response to treatment. In this study, the earlier the onset of headache, the greater the chances of the patient is refractory and to present headache. All kinds of headache were more common in patients who started at a young age with epilepsy. Headache was more common in women who started until 50 years old with epilepsy. After this age, headache in epilepsy was more often observed in male patients. When epilepsy started at childhood, headache occurred more often related to the crises, being predominantly observed during post-ictal period and most commonly occurring in the occipital region. These findings may suggest that physiopathologic superposition between epilepsy and headache occurs more often at childhood. As a whole, the study demonstrated that the headache observed in epilepsy has characteristics dependent on the onset age of crises. There seems to be a superposition of disease mechanisms between headache and epilepsy when epilepsy starts during childhood. This association is less observed when epilepsy occurs after 50 years old, suggesting different physiopathogenic mechanisms for headache occurrence in epilepsy, according to the time of onset of epilepsy.

Submitted in fulfilment of the requirements for the Degree in Masters of Technology: Nursing, Durban University of Technology, 2013. / Epilepsy is one of the world’s most common neurological disorders of the brain. It is a condition that affects individuals in most countries worldwide. However, there is still stigma attached to epilepsy, and the condition is often misunderstood. However, there are people who understand the condition and the care that PWE need. Aim of the study : The aim of the study was to describe the lived experiences of people with epilepsy. Methodology : A descriptive phenomenological methodology was used. This study is guided by Parse’s Theory of Human Becoming. In-depth interviews were conducted with eight participants. The main research question that was asked in this study was: What are experiences of people living with epilepsy? Results : The findings of this study revealed that people with epilepsy still face challenges unique to their lifestyles. The lack of knowledge among communities has led to negative experiences of people with epilepsy. Family members often provide support to people with epilepsy; especially female partners support their husbands.

Taurine (2-aminoethane sulfonic acid) is one of the most abundant inhibitory amino acids in the mammalian central nervous system (CNS). Substantial evidence exists to suggest that this amino acid is a physiological modulator of neuronal excitability. Taurine is also a potent anticonvulsant in a variety of animal epilepsies and in certain human epileptics. The mechanisms of these neuromodulatory and anticonvulsant actions of taurine are not known. I have investigated a proposed relationship between altered amino acid metabolism, seizure-susceptibility and the anticonvulsant action of taurine. The findings of the work presented in this dissertation indicate that in the genetically seizure-susceptible rat there are alterations in the subcellular concentration and transport of taurine. Furthermore, the data presented here indicate that these alterations in the CNS handling of taurine are not a consequence of seizure activity but rather may be contributing to the seizure-susceptibility. This supports the hypothesis that taurine is a physiological modulator of neuronal excitability and that defects in this neuromodulatory process may contribute to seizure-susceptibility. The action of taurine was found to not be mediated by a redistribution of glutamate in the brain but instead may be by increasing the conversion of glutamate to GABA.

No description available.

No description available.

No description available.

Galanin is a 29/30 amino acid long bioactive peptide discovered over 30 years ago when C-terminally amidated peptides were isolated from porcine intestines. The name galanin originates from a combination of the first and last amino acids - G from glycine and the rest from alanine. The first 15 amino acids are highly conserved throughout species, which indicates that the N-terminus is important for receptor recognition and binding. Galanin exerts its effects by binding to three different G protein-coupled receptors, which all differ according to regional distribution, the affinity for shortened galanin fragments, as well as the intracellular G-protein signaling cascade used. When first discovered, galanin was found to cause muscle contraction as well as hyperglycemia.  Over the years, galanin has been reported to be involved in a wide variety of biological functions, for example food intake and neurogenesis, and pathological functions, for example epilepsy and depression. Determining the specific involvement of the three different galanin receptors in biological and pathological processes is limited by the small amount of galanin receptor selective/specific ligands available as research tools. Furthermore, the fast degradation of peptides limits the administration routes in animal studies. This thesis aims at developing new galanin receptor-selective ligands to help delineate the involvement of the three different galanin receptors. Paper 1 presents the shortest galanin fragment with a galanin receptor 2 specific binding preference where only a single amino acid substitution was made, Ala5Ser in galanin (2-11). In addition, G-protein coupled receptor signaling were evaluated through both a classical second messenger assay and a real-time label-free technique in cells overexpressing the receptor as well as low receptor expression. Paper 2 demonstrates that the neuroprotective effects of galanin in a kainic acid-induced excitotoxic animal model were mediated through galanin receptor 1. Furthermore, a new robust protocol for evaluating G-protein signaling using a label-free real time impedance technique was presented and compared to two different classical second-messenger assays. Paper 3 presents a series of systemically active galanin receptor 2 selective ligands subsequently evaluated in two different depression-like animal models. Paper 4 investigates a mutated form of human galanin which was found in epilepsy patients and binding and signaling properties of the mutated associated ligand p.(A39E) was examined. In conclusion, this thesis presents the discovery of eight new galanin ligands, which can be used to evaluate the galaninergic system as well as to help investigate the possible use of peptides as pharmaceuticals in different diseases.

University of Macau / Institute of Chinese Medical Sciences