World Congress on Epilepsy and Brain Disorders November 22-23, 2018 Cape Town, South Africa

Biography:

Abstract:

Biography:

Claire Lownie graduated with her medical degree (MBBCh) from Wits University in 2003. She completed her internship at Groote Schuur Hospital (2004) and her community service at a district hospital in Kokstad (2005). In 2006, she was diagnosed with a Stage-4 Malignant Melanoma. Thereafter, Dr Lownie worked for several years as a clinical trial coordinator, research programme manager and ultimately Trauma Programme Manager at Milpark Hospital. She completed a Master of Science in Emergency Medicine degree (MSc Med Emergency Medicine) and worked clinically in various private Emergency Departments. In 2012 Dr Lownie left Netcare to work in the corporate pharmaceutical environment. The combination of personal and professional experiences piqued her interest in Psychiatry and mental health. She subsequently completed her specialist training in the Department of Psychiatry at Wits Universit and obtained her specialist fellowship (FC Psych SA) through the Colleges of Medicine of South Africa in May 2018. Dr Lownie currently runs her private practice in Bryanston. She treats a variety of mental illnesses and is passionate about working with children and adolescents.

Abstract:

Aim & Objective: Conduct Disorder is a serious psychiatric disorder with onset in childhood and adolescence and antisocial behaviour which may continue into adulthood. Characteristic externalising behaviours have the potential to negatively impact

on the wellbeing of the individual as well as on societal interactions. Th e aim of this study was to review the records of children and adolescents with a diagnosis of Conduct Disorder at a local specialised psychiatric hospital to identify possible associated factors.

Method: Clinical fi les at Th e Tara, H. Moross Centre’s Child and Adolescent Clinic were reviewed and those with Conduct Disorder were identifi ed. Variables in the dataset included gender, referral source, age at symptom onset, age when diagnosis was made, schooling, co-morbid diagnoses, pregnancy/ birth history, perinatal complications, attachment, primary caregiver, milestones, discipline style, exposure to violence/ abuse/ neglect, social circumstances, other conditions that may be a focus of clinical attention (“V” or “Z” codes), family psychiatric history and interventions. Descriptive and comparative statistical analyses of the data were performed.

Result: A total of 953 fi les were reviewed, of which 107 (11.2%) of the mental health care users were diagnosed with having Conduct Disorder. Associated factors included: (1) having a parent as the primary caregiver seemed to have been a protective

factor; while (2) exposure to violence, abuse or neglect, having a family history of Antisocial Personality Disorder, or having 2 or more “V” or “Z” codes, were signifi cantly more oft en associated with severe conduct disordered features.

Conclusion: Considering these factors associated with an increased risk, may help to develop strategies for earlier detection and intervention in children and adolescents at risk.

Biography:

Temitope Farombi MD, FMCP (Neurology), is a graduate of University of Ibadan. She trained in internal medicine at the University College Hospital (UCH) and Neurology at UCH Ibadan Nigeria. Obtained a master’s degree in Clinical Neuroscience at King’s College London. Temitope is a Consultant Neurologist at the Chief Tony Anenih Geriatric center University college hospital, the first geriatric center in West Africa sub-region. The Temitope practice specializes in the critical care neurology of the elderly, movement disorders, Dementia, and headaches. Temitope was a visiting scholar to the Northwestern University Chicago, USA and has published articles in scientific journals.

Abstract:

Aim: Th e uncommon occurrence of peri-menstrual (C1) catamenial epilepsy in our routine epilepsy clinic, and the absence of a statistical diff erence in the frequency of clinically signifi cant sexual dysfunction between female with epilepsy (FEW) and their matched controls informed this study. We compared the sex hormones between FWE and their age-matched controls. We postulated that a diff erence in etiology, with a higher prevalence of structural etiology in sub-Saharan Africa, may be associated with an unexpected hormonal profi le.

Method: An observational study carried out at the University College Hospital, Oyo State – a tertiary hospital in South- Western Nigeria involving seventy-five FWE and forty-five age-matched controls. Samples for hormonal evaluation at preovulatory phase – on the 10th–13th day of the cycle and luteal phase – on the 21st–24th day were taken

Result: FWE had lower FSH levels when compared to controls, p: 0.012. In the pre-ovulatory phase, Further stratification shows a higher FSH level among FWE on medication, p: 0.003. Controls had similar LH/FSH ratio with FWE on medication while FWE not on medication having a higher LH/FSH ratio, p: 0.026. In the mid-luteal phase, FSH level was lowest in FEW not on medication), FWE on medication had higher levels but lower when compared to the control group, p: 0.002. FEW had lower progesterone levels when compared with the control group, p: 0.004 with no difference with the use of AEDs. The E/P ratio showed a reverse picture with FWE having higher values when compared to controls, p: 0.002. There was no significant difference in the levels of LH, LH/FSH ratio, estrogen, E/P ratio, and testosterone between FWE and controls.

Conclusion: Menstrual abnormalities and abnormal FSH and progesterone are commoners in FWE than controls in our population.

Biography:

Abstract:

Vagus nerve Stimulation (VNS) has been shown to be effective in reducing seizure frequency. Traditionally, the left Vagus nerve is stimulated in ongoing cycles along with user-initiated stimulation by passing a magnet across the implanted device at the time of the perceived seizure onset. However, manual application of the magnet at the time of the perceived seizure may not be feasible for a variety of reasons. An automated method to initiate stimulation at the start of the seizure would be beneficial in these circumstances. Approximately 70% of focal onset seizures are associated with tachycardia. One method of delivering stimulation is to use the detected tachycardia to initiate automated stimulation. A prospective, unblinded, single-center study was performed. Ten subjects all of whom were younger than twelve years of age, who could not perform manual stimulation were treated using the AspireSR VNS therapy device. Baseline seizure frequency data was collected along with postbaseline seizure frequency data. Quantitative seizure severity, pre and post insertion, was collected, using the Hague Seizure Severity Scale. Baseline and postbaseline quality of life data, using the QOLCE-55 questionnaire were obtained. Responder rate, along with the Engel and McHugh classification of outcomes were collected. Adverse events were systematically collected and reported. Our minimum period of six months follow up data is reported.

Biography:

Abstract:

The Ketogenic Diet (KD) is a high fat, adequate protein and low carbohydrate diet. Th e hallmark of the KD is the production of ketone bodies by the liver which becomes the brain’s primary source of energy. Th e KD has been applied in individuals with refractory or also known as drug-resistant epilepsy since the 1920s. Th e diet was discovered by the observation of decreased seizure frequency during episodes of fasting. In 1921, Dr. Wilder at Mayo clinic suggested the KD for the long-term management of epilepsy. In terms of this suggestion, it was stated that the benefi ts of fasting could be recreated through the implementation of a KD. Additionally, the KD could be sustained for a much longer period as it compensates for the clear disadvantages associated with a prolonged period of fasting. Initial anti-seizure drug (as standalone therapy) control seizures in approximately half of patients with newly diagnosed epilepsy. Th e remaining half of the patients, normally those suff erring from drug-resistant/refractory/intractable epilepsy, may benefi t from the KD. Systemic reviews of KD therapies in children with refractory epilepsy suggest that 33 - 56% of children achieve ≥50% seizure reduction and approximately 16% achieve seizure freedom. Th e KD and variants thereof has shown promising results in those (from infancy to adulthood) suff erring from refractory epilepsy and should be recommended by medical professionals aft er two trials of anti-seizure medication has proven to be unsuccessful.