Faculty of Medicine
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Item type:Publication, BEYOND SEIZURES: BONE MINERAL DISORDERS IN CHRONIC EPILEPSY-A CROSSSECTIONAL STUDY(Macedonian Neurological Society, 2025-10); ; Kostovska, Irena - Some of the metrics are blocked by yourconsent settings
Item type:Publication, DOUBLE TROUBLE: DCX MUTATION-ASSOCIATED SUBCORTICAL BAND HETEROTOPIA – A CASE REPORT(Macedonian Neurological Society, 2025-10); ; Kostovska, IrenaBackground: Patients with epilepsy have an increased risk of fractures, partly due to antiepileptic therapy (AET) through reduced bone mineral density (BMD). Although bone loss is multifactorial, AET may play a significant role, but the exact mechanisms remain unclear. Aim: To investigate the association between AET use and decreased BMD in an unselected population of Macedonian patients with epilepsy. Internationally accepted guidelines for bone health monitoring in epilepsy are lacking, and in our country there are no standardized recommendations. Identifying highrisk groups is essential for the prevention of osteoporosis and fractures. Methods: A cross-sectional study was conducted on 95 patients older than 20 years, treated with AET for more than 2 years, who attended the Epilepsy Outpatient Department at the University Clinic of Neurology between January 1st, 2021 and January 31st, 2024. Data included DXA scan results and demographic information. Logistic regression and other statistical analyses were applied. Results: Osteopenia was present in 50.5% and osteoporosis in 20.0% of patients. Independent risk factors for reduced BMD were female sex, polytherapy with AET, comorbidities, menopause, older age, and longer epilepsy duration. Age >50 years and depression were significant in univariate analysis but not confirmed in multivariate analysis. Conclusion: Independent risk factors such as female sex, menopause, older age, lower BMI, polytherapy, epilepsy duration, and comorbidity were associated with decreased BMD in epilepsy patients. These findings emphasize the importance of using known risk factors as guidance to identify patients at high risk of osteoporosis and fractures. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Fractures in people with epilepsy: A nationwide population-based cohort study https://doi.org/10.1002/epi4.12776(Wiley, 2023-06-19); Objective: The objective of this study was to determine the age, gender, and site-specific prevalence of fractures in people with epilepsy (PWE) and matched general population comparators in a nationwide study in North Macedonia between 2015 and 2018.Methods: PWE and matched controls were selected through a systematic search of the electronic National Health System (eNHS). We determined the period prevalence (PP) of all site- specific fractures. We also calculated gender and age- specific incidence rate ratios (IRR) for various fractures. Odds ratios (ORs) and risk ratios(RR) were estimated for the number and type of ASM as well as comorbid conditions.Results: Out of 13 818 prevalent epilepsy cases, 6383 (46.2%) were females, and7435 (53.8%) were males. 109 PWE out of 1000 had at least one fracture during thestudy period and ~8 people out of 1000 in the general population. The most frequentsites in terms of PP both in PWE and controls, were fractures of the lower arm, hipand femur, and lower leg. Significant differences in PP for all fracture locationswere observed between PWE and controls (P < 0.001). The noticeable differences of ∼100 times higher PP were observed for fractures of the skull and jaw in PWE.IRR of any fracture in PWE was 272.84/10000 person-years; higher in the older age groups and among people who received >2 ASM. Fracture risk was increased with the use of >2 ASM (OR: 1.56; 95% CI: 1.32-1.84 and RR: RR: 1.32). The presence of comorbidities also increased fractures risk (OR: 1.24; 95% CI: 1.10-1.38).Significance: This population-based study depicts a higher fracture prevalence in PWE compared to the general population. A higher number of ASM and the presence of comorbidities increase the risk of fractures and targeted prevention might be needed in those subgroups of PWE - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Atrial fibrillation and risk for ischemic stroke(League against epilepsy of Macedonia, 2017); ; Cheperganova Changovska, TatjanaAbstract Objective: To investigate the frequency of atrial fibrillation in patients who develope acute ischemic stroke, associated risk factors and their outcome. Material and methods: A retrospective study was conducted at the University Clinic of Neurology Clinic, Department for Urgent Neurology.We analyzed medical records of acute ischemic stroke patients hospitalized between April 2014 and April 2016. Statistical analysis was performed with the programme Statistica for Windows 12. Results: Of the 1102 patients in the study,219 (19.8%) had atrial fibrillation. Of them, 109 (49,8%) were males and 110 (50,2%) were females. The mean age of those patients was 65±14 years compared to 60±16 years for the rest. Patients with AF had higher modified Rankin Scale(mRS) score on admission and at discharge from the hospital and had lethal outcome in higher percentage, compared to the rest (p<0.05). Conclusion: AF significantly increases the risk of stroke and affects its prognosis and outcome.