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PURPOSE: Nationwide studies on public knowledge of epilepsy have been undertaken in several countries, but not in Jordan. The purpose of this study was to evaluate knowledge of the management of epilepsy in Jordan. METHODS: A cross-sectional study was performed during the period February-June 2005 on 16,044 individuals selected randomly to represent all regions of Jordan. Respondents were interviewed and asked to complete a five-item questionnaire testing their knowledge of the management of epilepsy. RESULTS: Most of the individuals (77.9%) agreed that patients with epilepsy are best treated in a specialized hospital for neurological diseases. Although the largest percentage of the sample (86.7%) agreed that the best person to treat epilepsy is a neurologist, others believed that a hypnotherapist (25.4%) or a religious healer (22.6%) is. As an immediate measure during an attack of epilepsy, most respondents (82.6%) agreed that protecting the patient's head is most important. During the postseizure period, 45.8% of respondents believed that offering the patient water or a cold or hot drink is appropriate. Two-thirds of the respondents (66.2%) agreed that epilepsy can be treated with drugs. Responses of the participants to the five items significantly differed with respect to age, gender, level of education, and occupation. CONCLUSION: Jordanians are reasonably well informed about most aspects of the management of epilepsy, but there is still a need for public education about this disorder.

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We have previously evaluated veratridine as an in vitro model of seizure using conventional electrophysiological recordings in rat hippocampal CA1 pyramidal neurones. The aim of this investigation is to further characterize this convulsant as an in vivo model of seizure. Veratridine was administered intraperitoneally to male Fisher rats in a dose range of 100-400 mug/kg. Within 5 min. after the injections, the animals entered a quiescent period which was followed 10-15 min. later by facial automatism (washing), grooming, masticatory jaw movement and profuse salivation. This phenomenon was followed by the development of wet dog shake and forelimb clonus. The time (mean+/-S.E.M.) for the onset of induction of these shakes for all tested doses was 31.65+/-2.85 min. and the number of shakes (mean+/-S.E.M.) 30 min. after the onset was 17.2+/-2.85. The onset and number of wet dog shakes induced by veratridine was dose-dependent. No rat death was recorded until 2 weeks after the experiments. Histopathological studies of animals 2 weeks after veratridine administration showed evidence of apoptosis in the hippocampus. Our results indicate that veratridine produced a behavioural pattern of a limbic seizure which mimics temporal lobe epilepsy in man. Based on our previous findings in vitro and of this investigation in vivo, veratridine can be used as an experimental tool to evaluate potential antiepileptic drugs effective against this type of limbic behaviour.

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Knowledge of population distribution of blood pressure is useful for predicting blood pressure related health burden as well as for planning prevention strategy. The aim of this investigation is to determine the distribution of systolic blood pressure (SBP), diastolic blood pressure (DBP), arterial blood pressure (ABP), and heart rate among normotensive adults resident from all regions of Jordan. This study is the first detailed description of these parameters in Jordan at a national level. A total of 14,310 adult males (7,400) and females (6,910) were selected randomly in various regions of Jordan. For each individual, the SBP, DBP, and heart rate were measured three times with 10-15-minute intervals in the sitting position and at the resting state. The ABP was calculated from the measured SBP and DBP. The mean values were distributed according to age and sex. Student's t-test was used for statistical analysis. Males had significantly higher SBP, DBP, ABP, and heart rate values than females. There also was an increase of these values with advancing age. Moreover, cases of hypotension and bradycardia were higher in the female population than in males, whereas cases of hypertension and tachycardia were higher in males. Distribution of blood pressure and heart rate among adults in Jordan was determined. Cases of undiagnosed hypertension, hypotension, and an increase or a decrease in heart rate were detected through our random screening in the target population. Individuals with these abnormalities require further clinical investigations to confirm or exclude these findings.

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Propofol was reported to exhibit an antiepileptic activity. This study was performed to investigate the effect of propofol on evoked and spontaneous seizure-like activity induced by the convulsant veratridine. Studies were performed on rat brain slices using conventional electrophysiological intracellular techniques. The alteration of sodium channel function by veratridine (0.3 microM) induced an evoked and spontaneous seizure-like activity in the hippocampal CA1 pyramidal neurons. Therapeutic concentrations of propofol (10 microM) were ineffective in inhibiting veratridine-induced seizure-like activity. However, higher concentrations (50-100 microM, n=6) inhibited both evoked and spontaneous bursting, induced by veratridine. The inhibitory effect of propofol (100 microM) was associated with membrane hyperpolarization [after veratridine, -66+/-0.71 mV (mean+/-S.E.M.), and after propofol, -77+/-2.15 mV] and with an increase in input resistance [after veratridine (37.8+/-1.2 MOmega) and after propofol (43+/-1.3 MOmega)]. The drug also produced an increase in current threshold. Results from this study are valuable in solving critical questions regarding the antiepileptic activity of propofol and strengthen the validity of the veratridine model in testing for potential antiepileptic drugs.

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After a gap of approximately 20 years, a new generation of antiepileptic drugs (AEDs) has recently been developed. More than 8 drugs have been licensed in at least one country during the 1990s. While lamotrigine, gabapentin, vigabatrin and oxcarbazepine are widely used in some countries, felbamate, topiramate, tiagabine, levetiracetam, and zonisamide are still used on a narrow scale. A feeling of optimism occurs after the development of these drugs, although only a small number of epileptic patients become free of seizures after the addition of these new AEDs to their regimen. Generally, the safety profile of the new AEDs is only slightly better than that of established drugs and their efficacy is strongly associated with the use of high doses. This article reviews new AEDs by studying their clinical pharmacological effects, mechanisms of action as antiepileptic agents, side effects, drug-drug interactions and the appropriate regimen of their use.

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OBJECTIVE: Guanosine 3`,5` monophosphate (cGMP) can be used as a marker of the epileptogenicity of proconvulsant drugs. As valproic acid (VPA), at certain concentrations, acts as a proconvulsant agent in hippocampal pyramidal neurons when tested in the veratridine model, this investigation was conducted to study the effect of proconvulsant concentrations of VPA on the basal level of cGMP in hippocampal tissue. METHODS: Experiments were performed using standard radioimmuonassay techniques in hippocampal tissues from rats. This study was carried out at the Department of Pharmacological and Pharmaceutical Sciences, University of Houston, Houston, Texas, United States of America between 1996-1997. RESULTS: We found that veratridine (0.3, 1 and 2 uM, n=3) increased the level of cGMP in hippocampal tissue in a concentration dependent manner. However, VPA at proepileptic concentrations (0.1, 2, 5 uM, n=3), did not significantly affect the basal level of cGMP when added alone or with veratridine (0.3 uM). CONCLUSION: Guanosine 3`,5` monophosphate is not a marker of the proepileptic activity of VPA in brain tissues.