Study Results
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Basic Information
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UNKNOWN
180 participants
OBSERVATIONAL
2019-11-01
2020-11-01
Brief Summary
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Detailed Description
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Subjects:
Inclusion criteria:
1. Patient with diagnosis of epilepsy (idiopathic or cryptogenic/symptomatic), according to the International League Against Epilepsy classification confirmed by electroencephalogram.
2. Treatment with at least one AED, long enough to achieve the optimal dose; drug-resistance and drug-responsiveness, according to the criteria ILAE 2010.
3. Written consent obtained from a patient or legal guardian.
Exclusion criteria:
1. Patient with severe adverse anti epileptic drug reactions.
2. Patient with unreliable records of seizure frequency.
3. Patient with poor compliance with AEDs,.
4. Patient with significant psychiatric comor- bidity,
5. Patient with progressive systemic disorders .
6. Patient with history of alcohol or drug abuse.
7. Epileptic patients in clinical remission or with gradual withdrawal of therapy.
8. Epileptic patients with therapy titration phase.
Methods:
After an informed consent, all participants will be subjected to the following;
1. A detailed history taking; including age, sex, age of onset , type of seizure, duration of epilepsy, pretreatment and post treatment seizure frequency , and drugs (antiepileptic drugs, others).
2. Full laboratory investigation including (complete blood count, liver function test, serum creatinine, electrolyte assay, thyroid profile, blood sugar test).
3. Serum level of antiepileptic drug.
4. Electroencephalogram in order to localize site of paroxysmal activity.
5. MRI brain: T1, T2 and FLAIR: axial and coronal cuts to detect any structural abnormalities,
6. Both control and epileptic patient will underwent genetic study for SCN1A c.3184 A/G and CCL2-2518G\>A polymorphism:
* DNA analysis:
Genomic DNA will be extracted from EDTA-anticoagulated peripheral blood (QIAamp DNA Blood mini kit,QIAGEN).
Conditions
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Study Design
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CASE_CONTROL
RETROSPECTIVE
Study Groups
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Drug responders
60 patients are drug responders
Genetic study for SCN1A c.3184 A/G and CCL2-2518G>A polymorphism:
DNA analysis: Genomic DNA will be extracted from EDTA-anticoagulated peripheral blood (QIAamp DNA Blood mini kit,QIAGEN).
Genotyping of SCN1A c.3184 A/G(rs2298771) polymorphism
Drug resistant
60 patients are drug resistant
Genetic study for SCN1A c.3184 A/G and CCL2-2518G>A polymorphism:
DNA analysis: Genomic DNA will be extracted from EDTA-anticoagulated peripheral blood (QIAamp DNA Blood mini kit,QIAGEN).
Genotyping of SCN1A c.3184 A/G(rs2298771) polymorphism
The control
The control consists of 60 Age and gender matched healthy individual with negative past and family history of epilepsy and febrile convulsion.
Genetic study for SCN1A c.3184 A/G and CCL2-2518G>A polymorphism:
DNA analysis: Genomic DNA will be extracted from EDTA-anticoagulated peripheral blood (QIAamp DNA Blood mini kit,QIAGEN).
Genotyping of SCN1A c.3184 A/G(rs2298771) polymorphism
Interventions
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Genetic study for SCN1A c.3184 A/G and CCL2-2518G>A polymorphism:
DNA analysis: Genomic DNA will be extracted from EDTA-anticoagulated peripheral blood (QIAamp DNA Blood mini kit,QIAGEN).
Genotyping of SCN1A c.3184 A/G(rs2298771) polymorphism
Eligibility Criteria
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Inclusion Criteria
* Treatment with at least one AED, long enough to achieve the optimal dose; drug-resistance and drug-responsiveness, according to the criteria ILAE 2010.
Exclusion Criteria
* Patient with unreliable records of seizure frequency.
* Patient with poor compliance with AEDs,.
* Patient with significant psychiatric comorbidity,
* Patient with progressive systemic disorders .
* Patient with history of alcohol or drug abuse.
* Epileptic patients in clinical remission or with gradual withdrawal of therapy.
* Epileptic patients with therapy titration phase.
6 Years
16 Years
ALL
Yes
Sponsors
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Mansoura University Hospital
OTHER
Responsible Party
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Ahmed Esmael
Assistant Prof of Neurology
Principal Investigators
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Esmael M Ahmed, MD
Role: PRINCIPAL_INVESTIGATOR
Assistant Prof of Neurology
Locations
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Mansoura University Hospital
Al Mansurah, , Egypt
Countries
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Central Contacts
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Facility Contacts
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References
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He X, Li Y, Liu Z, Yue X, Zhao P, Hu J, Wu G, Mao B, Sun D, Zhang H, Song X, Wang Y, Shao J. The association between CCL2 polymorphisms and drug-resistant epilepsy in Chinese children. Epileptic Disord. 2013 Sep;15(3):272-7. doi: 10.1684/epd.2013.0603.
Kumari R, Lakhan R, Garg RK, Kalita J, Misra UK, Mittal B. Pharmacogenomic association study on the role of drug metabolizing, drug transporters and drug target gene polymorphisms in drug-resistant epilepsy in a north Indian population. Indian J Hum Genet. 2011 May;17 Suppl 1(Suppl 1):S32-40. doi: 10.4103/0971-6866.80357.
Kasperaviciute D, Sisodiya SM. Epilepsy pharmacogenetics. Pharmacogenomics. 2009 May;10(5):817-36. doi: 10.2217/pgs.09.34.
Kwan P, Arzimanoglou A, Berg AT, Brodie MJ, Allen Hauser W, Mathern G, Moshe SL, Perucca E, Wiebe S, French J. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia. 2010 Jun;51(6):1069-77. doi: 10.1111/j.1528-1167.2009.02397.x. Epub 2009 Nov 3.
Lakhan R, Kumari R, Misra UK, Kalita J, Pradhan S, Mittal B. Differential role of sodium channels SCN1A and SCN2A gene polymorphisms with epilepsy and multiple drug resistance in the north Indian population. Br J Clin Pharmacol. 2009 Aug;68(2):214-20. doi: 10.1111/j.1365-2125.2009.03437.x.
Lorigados Pedre L, Morales Chacon LM, Orozco Suarez S, Pavon Fuentes N, Estupinan Diaz B, Serrano Sanchez T, Garcia Maeso I, Rocha Arrieta L. Inflammatory mediators in epilepsy. Curr Pharm Des. 2013;19(38):6766-72. doi: 10.2174/1381612811319380009.
Manna I, Gambardella A, Bianchi A, Striano P, Tozzi R, Aguglia U, Beccaria F, Benna P, Campostrini R, Canevini MP, Condino F, Durisotti C, Elia M, Giallonardo AT, Iudice A, Labate A, La Neve A, Michelucci R, Muscas GC, Paravidino R, Zaccara G, Zucca C, Zara F, Perucca E. A functional polymorphism in the SCN1A gene does not influence antiepileptic drug responsiveness in Italian patients with focal epilepsy. Epilepsia. 2011 May;52(5):e40-4. doi: 10.1111/j.1528-1167.2011.03097.x.
Marchi N, Granata T, Freri E, Ciusani E, Ragona F, Puvenna V, Teng Q, Alexopolous A, Janigro D. Efficacy of anti-inflammatory therapy in a model of acute seizures and in a population of pediatric drug resistant epileptics. PLoS One. 2011 Mar 28;6(3):e18200. doi: 10.1371/journal.pone.0018200.
Pohlmann-Eden B, Weaver DF. The puzzle(s) of pharmacoresistant epilepsy. Epilepsia. 2013 May;54 Suppl 2:1-4. doi: 10.1111/epi.12174.
Sanchez MB, Herranz JL, Leno C, Arteaga R, Oterino A, Valdizan EM, Nicolas JM, Adin J, Armijo JA. Genetic factors associated with drug-resistance of epilepsy: relevance of stratification by patient age and aetiology of epilepsy. Seizure. 2010 Mar;19(2):93-101. doi: 10.1016/j.seizure.2009.12.004. Epub 2010 Jan 12.
Tellez-Zenteno JF, Hernandez-Ronquillo L, Buckley S, Zahagun R, Rizvi S. A validation of the new definition of drug-resistant epilepsy by the International League Against Epilepsy. Epilepsia. 2014 Jun;55(6):829-34. doi: 10.1111/epi.12633. Epub 2014 May 14.
Wirrell EC. Predicting pharmacoresistance in pediatric epilepsy. Epilepsia. 2013 May;54 Suppl 2:19-22. doi: 10.1111/epi.12179.
Walker L, Sills GJ. Inflammation and epilepsy: the foundations for a new therapeutic approach in epilepsy? Epilepsy Curr. 2012 Jan;12(1):8-12. doi: 10.5698/1535-7511-12.1.8.
Other Identifiers
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Mansoura University Hospital 6
Identifier Type: -
Identifier Source: org_study_id
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