Background: Sleep disturbances in the multiple sclerosis (MS) population are increasingly recognized, but the factors driving this association remain understudied. This study aimed to determine the prevalence and associations of poor sleep quality in the relapsing–remitting MS (RRMS) population receiving disease-modifying therapy (DMT). Methods: We conducted a cross-sectional study that enrolled 399 individuals diagnosed with RRMS on DMT. Data on patient demographics, clinical presentation, and treatment were systematically evaluated. Sleep-related outcomes were assessed using validated questionnaires—the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), STOP-Bang questionnaire, and Hamilton Anxiety Rating Scale (HAM-A). Independent associations of poor sleep were examined using log-binomial regression to estimate risk ratios (RR). Results: Poor sleep was reported in 42% of the participants in our cohort. In multivariable analysis, only insomnia severity (RR = 1.07; 95% CI 1.05–1.09, p < 0.001) and anxiety (RR = 1.02; 95% CI 1.01–1.04, p = 0.001) remained independently associated with poor sleep. Conclusions: Sleep disturbances are common among patients with RRMS. Insomnia severity and anxiety, rather than demographic or disease-related characteristics, showed independent associations with impaired sleep. Routine screening and targeted interventions addressing insomnia and anxiety may improve sleep quality and, consequently, overall quality of life in this population.

Epilepsy is common in children with cerebral palsy (CP). In a group of 521 children with cerebral palsy it was found that 58% (n = 303) of the affected had epilepsy and 74.5% (n = 388) had mental retardation. We found ahigher percentage of symptomatic epilepsy in a combination of CP with mental retardation – 84.2% (n = 255), while only 15.8% (n = 48) of children with normal intellect had epilepsy. In our CP patients, the focal seizures were the most common – 34.7% (n = 181), followed by the secondary generalized 29.6% (n = 154) and the generalized seizures (tonic, clonic and generalized tonicclonic) 25.3% (n = 132), most often with early onset, with 43.5% (n = 132) of them with onset in the first year of life. The earlier onset of the epileptic seizures correlated with a more severe mental retardation. We found that symptomatic epilepsy and severe mental retardation are most common in children with spastic quadriparesis.

Neuroimaging plays a key role in the diagnosis of cerebral palsy (CP), as it helps to understand the etiology and pathogenesis of neurological impairment. The aim of the study is to demonstrate the role of neuroimaging in assessing the risk for epilepsy in children with CP with various lesions in CT and MRI with a focus on neuroimaging findings in full-term and premature children and their risk for epilepsy. The study includes 521 children with CP, diagnosed in the Clinic of Child Neurology, UMHATNP “St. Naum” between 2008 and 2018. Two hundred and twenty children underwent MRI of the brain, 464 of the cases had CT, and 127 had both MRI and CT. Various pathological lesions in MRI (brain malformations, lesions in the white or gray matter, lesions in the basal ganglia, cystic lesions, cortical atrophy, ventriculomegaly) were found in all patients with CP and symptomatic epilepsy, while 5.8% of those children with CP without epilepsy had normal MRI. Normal findings were observed in CT in 7.5% of the children with CP and epilepsy, while this result reached 12.1% when children did not have epilepsy. Among the abnormal findings in MRI with the highest relative risk for symptomatic epilepsy were ventriculomegaly RR – 1.296 (95% CI 1.149–1.463), cortical atrophy RR – 1.235 (95% CI 1.082–1.410) and lesions in the gray matter RR – 1.210 (95% CI 1.056–1.387). When comparing the types of the lesions in MRI in full-term and premature children with CP, we observed that white matter lesions predominated in premature children, while grey matter lesions in full-term children, which explains the higher incidence of epilepsy in full-term children. We found a higher incidence of pathological lesions in neuroimaging studies in patients with CP and concomitant epilepsy compared to those without epilepsy, as well as a high relative risk for epilepsy in patients with ventriculomegaly, cortical atrophy, and gray matter lesions.

Malformations of cortical development (MCD) are a heterogeneous group of diseases, that cause epileptic seizures, motor deficit and mental retardation. We analysed the clinical course, seizure characteristics and neuroimaging data in patients with cortical malformations, treated between 2006 and 2021 in the Clinic of Child Neurology of MHATNP “St. Naum”. We studied 205 patients with MCD, 94 girls (45.9%) and 111 boys (54.1%), with a mean age of 7.7 years, ranging from one month to 18 years of age. Ac- cording to the type of cortical malformation, patients were divided into five groups: 31 patients (15.12%) with heterotopia, 52 (25.3%) – with polymicro- gyria, 47 (22.9%) – with lissencephaly, 59 (28.9%) – with cortical dysplasia and 16 (7.8%) – with schizencephaly. Ninety-five (46.3%) of our patients were with intellectual disability. Mo- tor deficit was reported in 122 children (59.5%) and 173 patients (84.4%) had epileptic seizures. The seizures were focal in 42 (20.57%) of the cases, with mo- tor manifestation in 20 and secondary generalisation – in 7 of them. Forty-six patients experienced generalised seizures. Mixed type of seizures were regis- tered in 83 patients. In two children, the seizures could not be classified. The seizures frequency varied significantly, but patients with cortical dysplasia had the highest rate of daily seizures – 52.5% (n = 31), followed by patients with polymicrogyria – 25% (n = 13). Malformations of cortical development are a heterogeneous group of dis- orders, associated with mental retardation, epilepsy and motor deficit in childhood. Our study provides phenotypic information that would be useful for future genotype-phenotype correlations.

Intracerebral hemorrhage (ICH) is a life-threatening condition associated with high mortality and morbidity. This study aimed to identify the predictors of in-hospital mortality in patients with spontaneous ICH based on initial evaluation. We conducted a retrospective study of patients admitted with ICH between January 2019 and January 2024, collecting demographic, clinical, laboratory, and computed tomographic data. A total of 98 patients were included, with 31 (31.6%) deaths occurring during the hospital stay. Univariate regression analysis identified several potential independent predictors of in-hospital mortality, including lower Glasgow Coma Scale score (GCS), higher National Institutes of Health Stroke Scale (NIHSS) and ICH scores, elevated white blood cell (WBC) count and blood glucose levels, higher hematoma volume, the presence of midline shift, subarachnoid and intraventricular expansions, island sign, satellite sign and irregular shape. However, multivariate regression analysis revealed that only NIHSS score (OR = 1.24, 95% CI = 1.12–1.42, p ≤ 0.001) and GCS score (OR = 0.15, 95% CI = 0.02–0.67, p = 0.02) were independent predictors of in-hospital mortality. In conclusion, our results suggest that lower GCS and higher NIHSS on admission are significant predictors for in-hospital mortality in ICH patients, highlighting their importance for clinical early decision-making.