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Objective:To investigate the demographic and clinical characteristics of epilepsy in 2 referral hospitals in northern Iran.Methods:In this cross-sectional study, we evaluated 300 patients with the confirmed diagnosis of epilepsy referred to the Neurology clinics of 22-Bahman, and 17-Shahrivar Hospitals, Mashad, Iran, from April 2011 to December 2012. We collected and analyzed demographic and disease information.Results:The mean age of patients was 31.5 ± 15.3 years. The diagnosis of disease had been made approximately 10 months after the onset of symptoms, and the treatment gap was 28%. The most widely used anticonvulsants were sodium valproate, carbamazepine, and phenobarbital. Generalized seizure was seen in 78%, partial seizure in 22%, and a combination of them in 11% of patients. Tonic-colonic seizure (72%) was the most common type of generalized epilepsy, and secondarily generalized seizure was the most frequent type of partial epilepsy.Conclusion:The epidemiological features of epilepsy in our region with regard to age and gender are the same as other parts of the world. The generalized type is the most common form of epilepsy, with tonic-colonic seizures being the most frequent type in our area.

Objective: Some patients with migraine headache still experience severe migraine attacks despite use of proper prophylactic treatments. There are several treatments for refractory migraine (RM), one of which is abobotulinum toxin A (Dysport). This study aimed to investigate the efficacy of abobotulinum toxin A in the prophylactic treatment of RM. Materials and Methods:In this prospective single-arm clinical trial, 18 patients with RM were included. Patients completed a questionnaire including migraine characteristics one month before the study. Each patient received an injection of 150 U abobotulinum toxin A in the specific head and neck regions. Before and 3 months after treatment, migraine severity was evaluated. Results:The average number of attacks per month before injection was 7.56±4.06, which decreased to 1.89±1.32 3 months after injection (p<0.0001). The average duration of attacks also decreased significantly after 3 months of injection (from 20.33 hrs to 2.56 hrs per month) (p=0.0001). Three patients (16.6%) had no attacks during the follow-up period. Eleven patients (61.1%) reported mild attacks and four patients (22.2%) reported moderate pain. Conclusion:Abobotulinum toxin A (Dysport) can reduce frequency, duration, and severity of migraine attacks in patients with RM and it can be used as a prophylactic treatment in this group of patients. Keywords: Refractory migraine, abobotulinum toxin A, headacheAmaç: Migren hastalarının bir kısmı uygun profilaktik tedavi kullanımına rağmen ciddi migren atakları yaşamaya devam etmektedirler. Dirençli migrende kullanılan çeşitli tedaviler vardır ve bunlardan birisi abobotulinum toksin A'dır (Dysport). Bu çalışmada dirençli migrenin profilaktik tedavisinde abobotulinum toksin A'nın etkinliğinin araştırılması hedeflenmiştir. Gereç ve Yöntem:Bu prospektif tek kollu klinik çalışmaya 18 dirençli migren hastası dahil edildi. Hastalar çalışmadan 1 ay önce migren karakteristiklerini içeren bir anketi tamamladılar. Her hastanın spesifik baş ve boyun bölgelerine 150 U abobotulinum toksin A enjeksiyonu uygulandı. Tedavi öncesi ve 3 ay sonrasında migren şiddeti değerlendirildi. Bulgular: Enjeksiyon öncesi aylık ortalama atak sayısı 7,56±4,06 iken, enjeksiyondan 3 ay sonra bu sayı 1,89±1,32'ye geriledi (p<0,0001). Ortalama atak süresinin de enjeksiyondan 3 ay sonra anlamlı olarak azaldığı görüldü (ayda 20,33 saatten 2,56 saate) (p=0,0001). İzlem süresince üç hastada (%16,6) hiç atak gözlenmezken, 11 hasta (%61,1) hafif, dört hasta ise (%22,2) orta şiddette ataklar bildirdi.