Objective:To study types and etiologies of epilepsy in Jordanian pediatric epileptic patients maintained on antiepileptic drugs using customized classification scheme of International League Against Epilepsy (ILAE) (2010) report.Methods:This is a cross-sectional, multi-centre study on paediatric epileptic patients on antiepileptic drugs, who were managed in the pediatric neurology clinics at 6 teaching public hospitals in Jordan.Results:Out Of the 663 patients included in the study, (90.2%) had one seizure type, (53%) of this type were focal seizures followed by generalized seizures (41.5%) and spasms (5.5%). Distinctive constellations were found in 11/663 (1.7%) patients. Benign epilepsies with centrotemporal spikes were the most common electro clinical syndromes 60/221 (27.1%). Epilepsies attributed to structural-metabolic causes were documented in 278/663 (41.9%) patients, unknown causes 268/663(40.4%) and genetic causes in 117/663(17.7%). Most common causes of structural-metabolic group were due to perinatal insults (32%) and most common causes of the genetic group were the presumed genetic electro clinical syndromes (93.1%).Conclusion:Our study is on pediatric epilepsy, using customized classification scheme from the ILAE 2010 report which showed interesting results about type and etiology of epileptic seizures from developing country with potential impact on the international level.

The introduction of a rotavirus vaccine makes it important to determine the need for vaccination in a population. This study in Jordan in 2007-08 determined the incidence and clinical features of rotavirus gastroenteritis among children aged under 5 years admitted to hospital with diarrhoea. Of 148 children, 59 (39.9%) were ELISA-positive for rotavirus in stool samples, predominantly in the age group < 2 years. There was a marginally higher rate of fever in the rotavirus cases than the non-rotavirus cases. The lowest rate of infection was in winter. No deaths were recorded among the rotavirus or non-rotavirus groups. Rotavirus vaccine was not in use in Jordan at the time of the study.

BACKGROUNDLate infantile ceroid lipofuscinosis is a rare neurodegenerative disorder that appears between the ages of 2 and 4 years and is difficult to diagnose. In this report we present two sisters with this condition, and the clinical course consisted of delayed developmental skills initially and later regression of previously acquired skills. The cases were initially considered as childhood disintegrative disorder (CDD); however, when whole exome sequencing (WES) genetic testing was done, they proved to be variant late infantile ceroid lipofuscinosis. This is the first report from Jordan.CASE SUMMARYClinical presentation included developmental delay and initially speech delay, followed by lose of sphincter control. Motor development was normal until 4 years of age, then they developed ataxia (fear of going downstairs) and weakness while walking. Atonic and myoclonic seizures become intractable, and this was followed by inability to stand or sit and loss of expressive language. In addition to complete blood count test, liver function test, kidney function test, serum electrolyte test, and blood sugar test, serum amino acid profile, B12 level test, thyroid function test, and a brain computed tomography scan were also normal. An electroencephalogram showed a generalized spike and wave pattern, and magnetic resonance imaging showed little to no abnormalities. After dealing with the cases as CDD, WES testing proved a final diagnosis of variant late infantile ceroid lipofuscinosis. Current treatment is anti-epileptic drugs and supportive care at home, and they are now in vegetative state.CONCLUSIONThis report highlights the importance of WES for the identification of genetic diseases, especially neurodegenerative disorders.

This study sheds an important light on the current knowledge status and attitudes of parents of children with epilepsy, and is an invaluable tool for tailoring the delivery of information and support resources for families in our region.

Conclusions MMD is commonly found in the Asian area, including Japan, Korea and Taiwan. However, the outcomes of patients with MMD are unpredictable. In this study, we found that the severity of MMD might be correlated with the scores of modified Suzuki's grading system. Therefore, the more the scores patients with MMD acquire, the higher risks of infarction will possibly occur in them.