No abstract

Objective: In the development of epilepsy, interleukin-1 (IL-1) and interleukin-6 (IL-6) play critical roles. We sought to understand the clinical significance of IL-1 and IL-6 by comparing the blood levels of individuals with left-lateralized focal epilepsy and those with right-lateralized focal epilepsy. Method: Sixty epilepsy patients aged 18–60 with lateralized seizures and 32 healthy controls were included. Clinical and demographic data of patients were collected. We compared the levels of IL-1 and IL-6 of the patients in the interictal period. Results: Nineteen patients (31.7%) had seizures lateralized to the right hemisphere, while 41 (68.3%) were lateralized to the left hemisphere (p < 0.001). Both IL-1 and IL-6 levels were lower in all patients than in controls (p < 0.001). Both interleukin levels did not significantly differ between right and left-lateralized seizures (p = 0.44). In the left-lateralized seizures, IL-1 levels correlated with epilepsy duration (p = 0.006), onset age (p = 0.050), and prenatal risk (p = 0.028). Conclusion: Epilepsy patients had lower IL-1 and IL-6 levels than controls. In terms of these interleukins, there was no differentiation between left-lateralized seizures and right-lateralized. The number of patients with lateralized left hemispheres was higher than with the right hemispheres. IL-1 level was correlated with epilepsy duration, onset age, and prenatal risk in the left-lateralized seizures.

COVID-19 critically ill patients usually require prone positioning for the treatment of respiratory failure caused by Acute Respiratory Distress Syndrome (ARDS). Prone position provides a better ventilation-perfusion compatibility, resulting in a significant improvement in oxygenation and a decrease in mortality, but prolonged prone positioning may cause Meralgia Paresthetica (MP), one of the most common mononeuropathies of the lower limb. The early diagnosis of MP is crucial to avoid a permanent damage with pain and disability, and to start immediately the correct treatment. In this article, we report a rare case of MP in a critically ill COVID-19 patient with ARDS, with the main aim to create awareness for MP among the medical team working.

The varicella-zoster virus (VZV) infection results in varicella (chickenpox) and is generally seen in immunocompromised persons. VZV virus remains latent in the ophthalmic branch in the trigeminal ganglion. When reactivated, herpes zoster ophthalmicus (HZO) develops and sometimes leads to chronic ocular complications, among which cranial nerve palsies are rarely seen. Though the third cranial nerve is most frequently involved, the fourth and sixth nerves may also be involved in some cases. Treatment includes systemic antiviral therapy and steroid administration. The prognosis is generally good when treatment is executed. Improvement can also be observed without treatment. In this article, we would like to highlight two such cases in which these two cranial nerves got involved following an episode of HZO. One is a 67-year-old female patient having diabetes mellitus (DM), hypertension (HT), and coronary heart disease with fourth and sixth cranial nerve complete palsy. The other is a 76-year-old male patient with HT, DM, and heart failure with only sixth cranial nerve complete palsy. Despite adequate treatment, both patients had a poor prognosis. Advanced age and the presence of multiple comorbidities are important factors in predicting poor prognosis in HZO cases.