Knowledge and Attitude About Epilepsy Among School Teachers in Madinah, Saudi Arabia

BACKGROUND AND OBJECTIVE

Epilepsy is one of the most common chronic neurological disorders affecting school-age children. School teachers play an essential role in the life and development of patients with epilepsy. Hence, adequate knowledge of and positive attitudes toward epilepsy among school teachers are critical. This study assessed the knowledge of and attitude toward epilepsy among primary, middle, and high school teachers in Madinah, Saudi Arabia.

METHOD

This cross-sectional study was conducted using a self-administered electronic questionnaire to assess the knowledge and attitude about epilepsy among 394 teachers from local schools.  Results: Most of the participants were female (64.7%). About 32.2% of the participants had experience teaching children with epilepsy. The mean score for knowledge about epilepsy was 8.2 out of 13. Regarding attitudes toward epilepsy, most participants (93.4%) had positive attitudes toward students with epilepsy. There is a strong correlation between experience and attitude toward epilepsy. Most of the participants lacked adequate first aid training and felt unprepared to deal with a child with a seizure.

CONCLUSION

Most school teachers in Madinah had positive attitudes toward epilepsy patients. Although they had a basic understanding of epilepsy, there were gaps in their knowledge, and they lacked adequate training and confidence in assisting a child with a seizure. Therefore, it is essential to implement education and training programs aimed at improving their knowledge and confidence in dealing with students with epilepsy.

Neuropathy associated with IgA monoclonal Gammopathy. A harbinger of AL amyloidosis

Peripheral neuropathy is seen in 15% of patients with IgA monoclonal gammopathy. Treatment and prognosis of dysproteinemic neuropathy is usually guided by the underlying plasma cell disorders, which could be either benign or malignant. The true incidence of hematologic malignancy in patients with neuropathy associated with IgA monoclonal gammopathy is not known. However, patients with IgA M-protein are generally at increased risk for malignant transformation. Since neuropathy may be the first and only organ involvement, neurologists are key contributors in identifying each patient's plasma cell dyscrasia. We report two patients who presented with severe progressive polyneuropathy, had a detectable low-level IgA lambda paraproteinemia dismissed as incidental. Both were diagnosed later with a combination of malignant plasma cell dyscrasia and AL amyloidosis resulting in multiorgan failure and death. Both patients demonstrated red flags for malignant progression including abnormal serum free light chain, rapidly progressive debilitating neuropathy refractory to immunotherapy, prominent autonomic dysfunction, and weight loss. In summary, patients with IgA monoclonal gammopathy presenting with polyneuropathy can be at risk for malignant transformation. Failure to investigate for hematologic malignancy and AL amyloidosis may cause significant delays in treatment and result in fatal outcomes.