Giorgi Lomidze - Academia.edu (original) (raw)

Papers by Giorgi Lomidze

John Libbey Eurotext, Dec 8, 2021

Infantile spasms syndrome is a severe epileptic encephalopathy. Management of infantile spasms re... more Infantile spasms syndrome is a severe epileptic encephalopathy. Management of infantile spasms remains challenging because of pharmacoresistant forms and relapsing seizures. A high number of patients with this syndrome have neurodevelopmental delay. The main objective of our study was to determine predictors to measure the neurodevelopmental outcome of patients with infantile spasms. We prospectively evaluated 31 patients with infantile spasms from 2014 to 2017 at three hospitals in Tbilisi, Georgia. Various demographic data were evaluated at the first visit; video-EEG, brain MRI and neurodevelopmental evaluation were performed upon admission. A diary to record spasms was provided and completed by all parents/caregivers. Seizures were recorded on video and the phenomenology of infantile spasms was studied. Children were followed for one and two years after the first assessment. Neurodevelopmental deterioration was revealed in 61.1% on the second and 53% on the third evaluation in patients with onset of spasms before seven months of age. The mean score on the ASQ communication domain was low among structural cases. Eleven patients with pre-existing delay had developmental regression based on the second evaluation (Fisher's exact test: 7.2; df 1; p=0.01). Our study reveals that age at onset of infantile spasms at less than seven months, pre-existing developmental delay, low ASQ scores and structural abnormalities on MRI are predictors of poor developmental outcome. Our data suggest that clinicians should inform parents at the first clinical evaluation about prognosis, and intervention should be started as early as possible in order to improve development.

Journal of Child and Family Studies, 2017

Low- and middle-income countries need simple, technically sound developmental screening tools. Th... more Low- and middle-income countries need simple, technically sound developmental screening tools. The Ages and Stages Questionnaires, 3rd edition (ASQ-3) is widely accepted as a scientifically reliable and valid, user-friendly, and easy-to-learn and administer tool. This study documents the cultural adaptation, validation, and standardization of the Georgian ASQ-3 for children 1–66 months. The parents of 2974 children from one to 66 months completed the Georgian ASQ-3. We compared mean domain scores to the US normative sample, and performed multivariate analyses to detect variables associated with ASQ-3 cutoff scores. Cronbach's alpha values for all age groups varied from 0.643 to 0.824 across areas. We found significant differences in cutoff points between the Georgian ASQ-3 and US reference population in most domains across age groups. Child gender was associated with Communication (B, 0.453; p = 0.01), Fine Motor (B, 0.457; p = 0.01) and Personal–Social (B, 0.576; p = 0.001) with scores for girls more frequently distributed above the cutoff. We found administration of the Georgian ASQ-3 was easy after adaptation. We recommend additional research to investigate sensitivity and specificity and gender differences.

Epilepsy & Behavior, 2020

Neuroimmunology and Neuroinflammation, 2017

Epilepsy & Behavior, 2017

European Neuropsychopharmacology, 2014

Clinical Neurophysiology, 2010

EEG recording. Three patients were recorded with sphenoidal electrodes and 128 ch dEEG and anothe... more EEG recording. Three patients were recorded with sphenoidal electrodes and 128 ch dEEG and another 3 patients were recorded with intracranial electrodes simultaneously. We applied electrical source analysis for interictal epileptiform discharge and dipole location was visualized in a standard MRI using by the cortically constrained linear inverse method of local autoregressive average. We evaluated the electrical source analysis comparing with (1) sphenoidal electrodes and 128ch dEEG, (2) 128ch and 256ch and (3) mesial and lateral lesional cases with dEEG and (4) 256ch dEEG and intracranial electrodes. Results: In all cases, electrical source analysis of interictal discharges with dEEG was localized in temporal lobe. dEEG detected sphenoidal discharges simultaneously and estimated mesial temporal sources in patients with mesial temporal lesion. Compared to the results from 128ch dEEG, the interictal electrical source by 256ch dEEG was estimated in more mesial location in patients with mesial temporal lesion. dEEG interictal source analysis estimated lateral and mesial temporal separately. Conclusions: Dense array EEG and its source analysis for interictal discharge can provide more reliable localization of the epileptiform discharge compared to conventional EEG recording. dEEG also has a potential to avoid the evaluation by sphenoidal electrodes.

Epilepsy Research, 2013

Mortality in people with epilepsy has not previously been estimated in Georgia. We identified a p... more Mortality in people with epilepsy has not previously been estimated in Georgia. We identified a prevalent cohort of people with epilepsy from a tertiary referral centre in Tbilisi, Georgia and attempted to establish survivorship status for all. One-way sensitivity analysis estimating mortality rates in those lost to follow-up was also used. Of 1952 people, 1250 (64%) were located; 93 (7%) had died over a median of 11 years follow up. The main cause specific Proportional Mortality Ratios were: underlying diseases (39%) and accidental death (9%). One SUDEP was confirmed with a further 4 possible, but the cause of death was unknown in 47%. The overall SMR was 1.4, with much higher SMRs (up to 12) in young people. The sensitivity analysis suggested an SMR of 3.0.

Journal of Pediatric Neurology

Stroke is an important cause of mortality and morbidity in children. The aim of the study was to ... more Stroke is an important cause of mortality and morbidity in children. The aim of the study was to evaluate long-term neurological outcome in children with arterial ischemic stroke (AIS) and explore predictive factors that affect poor outcome. Fifty-six patients aged between 1 month and 17 years who were treated at M. Iashvili Children's Central Hospital, Tbilisi, Georgia, with an onset of stroke from 2007 to 2017 were included. To explore predictive factors of outcome, the following data were collected: demographic characteristics, risk factors, he presenting signs, radiological features, and presence of stroke recurrence. Neurological status at discharge and long-term neurological outcome at least 1 year after stroke was evaluated according to Pediatric Stroke Outcome Measure subscale. The reported outcome after childhood stroke was variable with long-term neurological deficits in one-third of patients (30.4%). The neurological outcome was worse in males, in patients with multip...

Epilepsy Behav 27 315 318, Mar 21, 2013

We conducted a survey to assess public awareness of epilepsy and stigma expression in different s... more We conducted a survey to assess public awareness of epilepsy and stigma expression in different social groups in Tbilisi, Georgia. Respondents were divided into those from a medical or paramedical background, those with a nonmedical professional background, and a group with unskilled workers or unemployed individuals. One thousand and sixteen people completed a Knowledge, Attitude and Perception questionnaire. Medical and paramedical professionals had a better general knowledge about epilepsy, its possible causes, and its nature, but their views on treatment and attitudes towards epilepsy were the same or worse when compared to the other groups. Of the respondent, 14% would not let their children play with people with epilepsy, and 75% would not allow their children to marry a person with epilepsy. Nearly a third of teachers considered epilepsy a psychiatric disorder. This suggests a high degree of stigma towards epilepsy in Georgia. Increasing awareness is crucial to ameliorate this.

Epilepsy & Behavior, 2013

Epileptic disorders : international epilepsy journal with videotape, 2015

Convulsive status epilepticus is the most common childhood neurological emergency in developing c... more Convulsive status epilepticus is the most common childhood neurological emergency in developing countries, where poor healthcare organisation could play a negative role in the management of the condition. Unavailability of second-line injectable anticonvulsants is an additional hindering factor in Georgia. This report reflects the results of the first study aimed at evaluating the epidemiological features of convulsive status epilepticus, as well as identifying obstacles influencing the management of patients with convulsive status epilepticus in Georgia. A prospective, hospital-based study was performed. Paediatric patients with convulsive status epilepticus, admitted to the emergency department of a referral academic hospital from 2007 to 2012, were included in the study. Forty-eight paediatric patients admitted to hospital met the criteria for convulsive status epilepticus. Seizure duration was significantly shorter among the group with adequate and timely pre-hospital interventi...

Clinical Neurophysiology, 2015

To investigate the characteristics of focal EEG features in patients with juvenile absence epilep... more To investigate the characteristics of focal EEG features in patients with juvenile absence epilepsy (JAE) and juvenile myoclonic epilepsy (JME), and to assess their possible influence on therapeutic response. Focal EEG features were prospectively scored in 168 consecutive patients. Ninety-six patients were drug-naïve and 72 patients were already on antiepileptic drugs (AEDs): 38 on adequate medication and 34 on inadequate medication. Therapeutic response was assessed one year after starting adequate therapy. One-hundred-eighteen patients (70.2%) had focal EEG features: 89 patients (53%) had focal epileptiform discharges, and 80 patients (47.6%) had focal slowing. Most often, these were multifocal and localized in frontal and temporal regions. Among patients already on AEDs, patients with focal EEG features were more often treated with inadequate medication due to misdiagnosis, than patients without focal features. Data on therapeutic response were available for 118 patients; most of them (90.7%) were seizure free. None of the focal EEG features affected therapeutic response. Focal EEG features are common in patients with JME and JAE, but they do not influence the therapeutic response. It is important that physicians are aware of the focal EEG features in order to avoid misdiagnosis and inadequate therapy.