Sample records for acid-induced epileptic seizures

  1. Increase in α-tubulin modifications in the neuronal processes of hippocampal neurons in both kainic acid-induced epileptic seizure and Alzheimer’s disease

    Vu, Hang Thi; Akatsu, Hiroyasu; Hashizume, Yoshio; Setou, Mitsutoshi; Ikegami, Koji


    Neurodegeneration includes acute changes and slow-developing alterations, both of which partly involve common cellular machinery. During neurodegeneration, neuronal processes are impaired along with dysregulated post-translational modifications (PTMs) of cytoskeletal proteins. In neuronal processes, tubulin undergoes unique PTMs including a branched form of modification called glutamylation and loss of the C-terminal tyrosine residue and the penultimate glutamic acid residue forming Δ2-tubulin. Here, we investigated the state of two PTMs, glutamylation and Δ2 form, in both acute and slow-developing neurodegenerations, using a newly generated monoclonal antibody, DTE41, which had 2-fold higher affinity to glutamylated Δ2-tubulin, than to unmodified Δ2-tubulin. DTE41 recognised glutamylated Δ2-tubulin preferentially in immunostaining than in enzyme-linked immunosorbent assay and immunoblotting. In normal mouse brain, DTE41 stained molecular layer of the cerebellum as well as synapse-rich regions in pyramidal neurons of the cerebral cortex. In kainic acid-induced epileptic seizure, DTE41-labelled signals were increased in the hippocampal CA3 region, especially in the stratum lucidum. In the hippocampi of post-mortem patients with Alzheimer’s disease, intensities of DTE41 staining were increased in mossy fibres in the CA3 region as well as in apical dendrites of the pyramidal neurons. Our findings indicate that glutamylation on Δ2-tubulin is increased in both acute and slow-developing neurodegeneration. PMID:28067280

  2. Long-Term Intake of Uncaria rhynchophylla Reduces S100B and RAGE Protein Levels in Kainic Acid-Induced Epileptic Seizures Rats

    Nou-Ying Tang


    Full Text Available Epileptic seizures are crucial clinical manifestations of recurrent neuronal discharges in the brain. An imbalance between the excitatory and inhibitory neuronal discharges causes brain damage and cell loss. Herbal medicines offer alternative treatment options for epilepsy because of their low cost and few side effects. We established a rat epilepsy model by injecting kainic acid (KA, 12 mg/kg, i.p. and subsequently investigated the effect of Uncaria rhynchophylla (UR and its underlying mechanisms. Electroencephalogram and epileptic behaviors revealed that the KA injection induced epileptic seizures. Following KA injection, S100B levels increased in the hippocampus. This phenomenon was attenuated by the oral administration of UR and valproic acid (VA, 250 mg/kg. Both drugs significantly reversed receptor potentiation for advanced glycation end product proteins. Rats with KA-induced epilepsy exhibited no increase in the expression of metabotropic glutamate receptor 3, monocyte chemoattractant protein 1, and chemokine receptor type 2, which play a role in inflammation. Our results provide novel and detailed mechanisms, explaining the role of UR in KA-induced epileptic seizures in hippocampal CA1 neurons.

  3. Neuroprotective Effect of Uncaria rhynchophylla in Kainic Acid-Induced Epileptic Seizures by Modulating Hippocampal Mossy Fiber Sprouting, Neuron Survival, Astrocyte Proliferation, and S100B Expression

    Chung-Hsiang Liu


    Full Text Available Uncaria rhynchophylla (UR, which is a traditional Chinese medicine, has anticonvulsive effect in our previous studies, and the cellular mechanisms behind this are still little known. Because of this, we wanted to determine the importance of the role of UR on kainic acid- (KA- induced epilepsy. Oral UR for 6 weeks can successfully attenuate the onset of epileptic seizure in animal tests. Hippocampal mossy fiber sprouting dramatically decreased, while neuronal survival increased with UR treatment in hippocampal CA1 and CA3 areas. Furthermore, oral UR for 6 weeks significantly attenuated the overexpression of astrocyte proliferation and S100B proteins but not γ-aminobutyric acid A (GABAA receptors. These results indicate that oral UR for 6 weeks can successfully attenuate mossy fiber sprouting, astrocyte proliferation, and S100B protein overexpression and increase neuronal survival in KA-induced epileptic rat hippocampus

  4. Predicting epileptic seizures in advance.

    Negin Moghim

    Full Text Available Epilepsy is the second most common neurological disorder, affecting 0.6-0.8% of the world's population. In this neurological disorder, abnormal activity of the brain causes seizures, the nature of which tend to be sudden. Antiepileptic Drugs (AEDs are used as long-term therapeutic solutions that control the condition. Of those treated with AEDs, 35% become resistant to medication. The unpredictable nature of seizures poses risks for the individual with epilepsy. It is clearly desirable to find more effective ways of preventing seizures for such patients. The automatic detection of oncoming seizures, before their actual onset, can facilitate timely intervention and hence minimize these risks. In addition, advance prediction of seizures can enrich our understanding of the epileptic brain. In this study, drawing on the body of work behind automatic seizure detection and prediction from digitised Invasive Electroencephalography (EEG data, a prediction algorithm, ASPPR (Advance Seizure Prediction via Pre-ictal Relabeling, is described. ASPPR facilitates the learning of predictive models targeted at recognizing patterns in EEG activity that are in a specific time window in advance of a seizure. It then exploits advanced machine learning coupled with the design and selection of appropriate features from EEG signals. Results, from evaluating ASPPR independently on 21 different patients, suggest that seizures for many patients can be predicted up to 20 minutes in advance of their onset. Compared to benchmark performance represented by a mean S1-Score (harmonic mean of Sensitivity and Specificity of 90.6% for predicting seizure onset between 0 and 5 minutes in advance, ASPPR achieves mean S1-Scores of: 96.30% for prediction between 1 and 6 minutes in advance, 96.13% for prediction between 8 and 13 minutes in advance, 94.5% for prediction between 14 and 19 minutes in advance, and 94.2% for prediction between 20 and 25 minutes in advance.

  5. [Epileptic seizures in childhood: from seizure type to diagnosis].

    Milh, M; Ticus, I; Villeneuve, N; Hugonencq, C; Mancini, J; Chabrol, B


    Epileptic seizures can be difficult to recognize in infancy and childhood because the semeiology can be misleading. Already, in the acute phase, precise assessment of the seizure is required, with active questioning about circumstances of occurrence, clinical manifestations and postictal symptoms. Laboratory tests and toxicologic screening should only be performed according to the circumstances and clinical examination in order to distinguish between symptomatic seizure and epilepsy at the beginning. Epilepsy consists in repetition of several unprovoked epileptic seizure. Assessment of the age of onset, type of seizures, interictal EEG and the neuropsychological profile are instrumental for both the diagnosis of epileptic syndrome and the choice of the right treatment. Epileptic seizures cause distress to parents and the fear they experience of death must always be taken into account.

  6. Ambroxol-induced focal epileptic seizure.

    Lapenta, Leonardo; Morano, Alessandra; Fattouch, Jinane; Casciato, Sara; Fanella, Martina; Giallonardo, Anna Teresa; Di Bonaventura, Carlo


    It is well known that in epileptic patients some compounds and different drugs used for the treatment of comorbidities can facilitate or provoke seizures, this evidence regarding a wide spectrum of pharmacological categories. The potential facilitating factors usually include direct toxic effects or pharmacological interactions of either active ingredients or excipients. We report the case of a patient with drug-resistant epilepsy who experienced focal epileptic seizures, easily and constantly reproducible, after each administration of a cough syrup. This is, to our knowledge, the first electroencephalogram-documented case of focal epileptic seizures induced by cough syrup containing ambroxol as active ingredient.

  7. Automated differentiation between epileptic and non-epileptic convulsive seizures

    Beniczky, Sándor; Conradsen, Isa; Moldovan, Mihai


    Our objective was the clinical validation of an automated algorithm based on surface electromyography (EMG) for differentiation between convulsive epileptic and psychogenic nonepileptic seizures (PNESs). Forty-four consecutive episodes with convulsive events were automatically analyzed...... with the algorithm: 25 generalized tonic-clonic seizures (GTCSs) from 11 patients, and 19 episodes of convulsive PNES from 13 patients. The gold standard was the interpretation of the video-electroencephalographic recordings by experts blinded to the EMG results. The algorithm correctly classified 24 GTCSs (96......%) and 18 PNESs (95%). The overall diagnostic accuracy was 95%. This algorithm is useful for distinguishing between epileptic and psychogenic convulsive seizures....

  8. Long-term electrical stimulation at ear and electro-acupuncture at ST36-ST37 attenuated COX-2 in the CA1 of hippocampus in kainic acid-induced epileptic seizure rats.

    Liao, En-Tzu; Tang, Nou-Ying; Lin, Yi-Wen; Liang Hsieh, Ching


    Seizures produce brain inflammation, which in turn enhances neuronal excitability. Therefore, anti-inflammation has become a therapeutic strategy for antiepileptic treatment. Cycloxygenase-2 (COX-2) plays a critical role in postseizure brain inflammation and neuronal hyperexcitability. Our previous studies have shown that both electrical stimulation (ES) at the ear and electro-acupuncture (EA) at the Zusanli and Shangjuxu acupoints (ST36-ST37) for 6 weeks can reduce mossy fiber sprouting, spike population, and high-frequency hippocampal oscillations in kainic acid (KA)-induced epileptic seizure rats. This study further investigated the effect of long-term ear ES and EA at ST36-ST37 on the inflammatory response in KA-induced epileptic seizure rats. Both the COX-2 levels in the hippocampus and the number of COX-2 immunoreactive cells in the hippocampal CA1 region were increased after KA-induced epileptic seizures, and these were reduced through the 6-week application of ear ES or EA at ST36-ST37. Thus, long-term ear ES or long-term EA at ST36-ST37 have an anti-inflammatory effect, suggesting that they are beneficial for the treatment of epileptic seizures.

  9. Localizing epileptic seizure onsets with Granger causality

    Adhikari, Bhim M.; Epstein, Charles M.; Dhamala, Mukesh


    Accurate localization of the epileptic seizure onset zones (SOZs) is crucial for successful surgery, which usually depends on the information obtained from intracranial electroencephalography (IEEG) recordings. The visual criteria and univariate methods of analyzing IEEG recordings have not always produced clarity on the SOZs for resection and ultimate seizure freedom for patients. Here, to contribute to improving the localization of the SOZs and to understanding the mechanism of seizure propagation over the brain, we applied spectral interdependency methods to IEEG time series recorded from patients during seizures. We found that the high-frequency (>80 Hz) Granger causality (GC) occurs before the onset of any visible ictal activity and causal relationships involve the recording electrodes where clinically identifiable seizures later develop. These results suggest that high-frequency oscillatory network activities precede and underlie epileptic seizures, and that GC spectral measures derived from IEEG can assist in precise delineation of seizure onset times and SOZs.

  10. [Semiology and propagation of epileptic seizures].

    Gellner, A-K; Fritsch, B


    The evaluation of episodic seizure-like symptoms is a common challenge in the neurologist's daily routine. The clinical signs (semiology) are the most important puzzle pieces to distinguish epileptic seizures from other episodic entities. Due to the often far-reaching health and social consequences of the diagnosis of epilepsy, the early and rigorous assessment of episodic symptoms by means of the patient history is important. This assessment is based on knowledge of the association of certain semiologies with epileptic syndromes and brain regions; however, certain limitations and pitfalls have to be considered. Typical propagation pathways of seizure activity determine the serial occurrence of semiological features and provide supplementary information.

  11. Nonlinear analysis of EEG for epileptic seizures

    Hively, L.M.; Clapp, N.E.; Daw, C.S.; Lawkins, W.F. [Oak Ridge National Lab., TN (United States); Eisenstadt, M.L. [Knoxville Neurology Clinic, St. Mary`s Medical Center, Knoxville, TN (United States)


    We apply chaotic time series analysis (CTSA) to human electroencephalogram (EEG) data. Three epoches were examined: epileptic seizure, non-seizure, and transition from non-seizure to seizure. The CTSA tools were applied to four forms of these data: raw EEG data (e-data), artifact data (f-data) via application of a quadratic zero-phase filter of the raw data, artifact-filtered data (g- data) and that was the residual after subtracting f-data from e-data, and a low-pass-filtered version (h-data) of g-data. Two different seizures were analyzed for the same patient. Several nonlinear measures uniquely indicate an epileptic seizure in both cases, including an abrupt decrease in the time per wave cycle in f-data, an abrupt increase in the Kolmogorov entropy and in the correlation dimension for e-h data, and an abrupt increase in the correlation dimension for e-h data. The transition from normal to seizure state also is characterized by distinctly different trends in the nonlinear measures for each seizure and may be potential seizure predictors for this patient. Surrogate analysis of e-data shows that statistically significant nonlinear structure is present during the non-seizure, transition , and seizure epoches.

  12. Childhood masturbation simulating epileptic seizures: A report of ...

    Childhood masturbation simulating epileptic seizures: A report of two cases ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search ... Background: Childhood masturbation (self-gratification) may mimic epileptic seizures, and is ...

  13. Childhood epileptic seizures imitating migraine and encephalitis

    Kravljanac Ružica


    Full Text Available Introduction. Paroxismal events can resemble epileptic seizures, however, some epileptic seizures, especially benign occipital childhood epilepsies can imitate migraine, cycling vomiting or encephalitis. Objective. The aim of this study was evaluation of clinical and electroencephalographic (EEG features and outcome in children with benign occipital childhood epilepsies. Methods. Investigation included 18 patients with benign occipital childhood epilepsies hospitalized in the period from 2007 to 2010. The diagnosis was based on clinical and EEG characteristics of seizures, while treatment included acute therapy for seizures and chronic antiepileptic drugs. Prognosis was analyzed in terms of neurological outcome and seizure recurrence rate. Results. Benign occipital childhood epilepsy with early onset was diagnosed in 15 children. Vegetative symptoms, mostly ictal vomiting (13, eye deviation and loss of consciousness (13 dominated in the clinical presentation. The most frequent EEG findings showed occipital epileptic discharges. Benign occipital childhood epilepsy with late onset was diagnosed in three cases. Seizures were manifested by visual hallucinations, headache and secondary generalized convulsions. All three patients were administered chronic antiepileptic drugs and had good outcome. Conclusion. In our patients, clinical manifestations of benign occipital epilepsies had some similarities with clinical features of migraine and encephalitis. It could explain misdiagnosis in some of them. Knowledge about main features and differences between each of these disorders is crucial for making appropriate diagnosis.

  14. Do oral contraceptives increase epileptic seizures?

    Reddy, Doodipala Samba


    Hormonal contraceptives are used by over 100 million people worldwide. Recently, there has been an emerging interest in studying the potential impact of oral contraceptives (OCs) on certain neurological conditions. It has been suspected for some time that hormonal birth control increases seizure activity in women with epilepsy, but there is little supportive data. Areas covered: Literature from PubMed and online sources was analyzed with respect to hormonal contraception and epilepsy or seizures. New evidence indicates that OCs can cause an increase in seizures in women with epilepsy. The epilepsy birth control registry, which surveyed women with epilepsy, found that those using hormonal contraceptives self-reported 4.5 times more seizures than those that did not use such contraceptives. A preclinical study confirmed these outcomes wherein epileptic animals given ethinyl estradiol, the primary component of OCs, had more frequent seizures that are more likely to be resistant. Expert commentary: OC pills may increase seizures in women with epilepsy and such refractory seizures are more likely to cause neuronal damage in the brain. Thus, women of child bearing age with epilepsy should consider using non-hormonal forms of birth control to avoid risks from OC pills. Additional research into the mechanisms and prospective clinical investigation are needed.

  15. Epileptic Seizures: Quakes of the brain?

    Osorio, Ivan; Sornette, Didier; Milton, John; Lai, Ying-Cheng


    The concept of universality proposes that dynamical systems with the same power law behaviors are equivalent at large scales. We test this hypothesis on the Earth's crust and the epileptic brain, and discover that power laws also govern the distributions of seizure energies and recurrence times. This robust correspondence is extended over seven statistics, including the direct and inverse Omori laws. We also verify in an animal seizure model the earthquake-driven hypothesis that power law statistics co-exist with characteristic scales, as coupling between constitutive elements increases towards the synchronization regime. These observations point to the universality of the dynamics of coupled threshold oscillators for systems even as diverse as Earth and brain and suggest a general strategy for forecasting seizures, one of neurosciences' grails.

  16. Epileptic seizures in patients with glioma: A single centrebased ...

    Epileptic seizures in patients with glioma: A single centrebased study in China. ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search · USING AJOL ... Fisher's exact and Chi square tests were used for analysis of seizure ...

  17. Effects of kindling and epileptic seizures during pregnancy on ...

    Effects of kindling and epileptic seizures during pregnancy on cerebellar expression ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search ... were randomly divided into five groups: A) Kindle+/Seizure+; pregnant kindled rats ...

  18. Serum prolactin for differentiating epileptic seizures in children

    Harry Mangunsong


    Full Text Available Background Serum prolactin level has been used as a marker to differentiate epileptic from non-epileptic seizures in adults. Electroencephalogram (EEG examination is the primary diagnostic tool used to assess seizures. However, EEGs are quite difficult to perform in children and have sensitivity of only 50%-55%, with 96% specificity. Objective To assess the diagnostic potential of serum prolactin level as an alternative tool for children for differentiating between epileptic and non-epileptic seizures. Methods This diagnostic study was performed between January 2013 and December 2013. Thirty patients aged 3 months to 15 years with seizures and without fever who visited the Emergency Department of Arifin Ahmad Hospital, Pekanbaru, Riau, were included. Blood specimens were collected within 2 hours after seizure. Subjects underwent serum prolactin measurements and EEG examinations. Results Fifteen subjects had normal EEGs and 15 subjects had abnormal EEGs. Post-ictal serum prolactin levels were significantly higher in the epileptiform EEG group. The mean serum prolactin levels were 23.78 (SD 21.86 ng/mL and 10.57 (SD 5.62ng/mL in patients with epileptic and non-epileptic patients, respectively. Using a prolactin cut-off point of 17.2 ng/mL, serum prolactin had a 73.3% sensitivity and 93.3% specificity for differentiating between epileptic and non-epileptic seizures. Conclusion Our findings suggest that serum prolactin level increases after an epileptic seizure, but not after a non-epileptic seizure. Post-ictal prolactin elevation within 2 hours may be useful in differentiating epileptic seizures from non-epileptic seizures.

  19. Serum prolactin for differentiating epileptic seizures in children

    Harry Mangunsong


    Full Text Available Background Serum prolactin level has been used as a marker to differentiate epileptic from non-epileptic seizures in adults. Electroencephalogram (EEG examination is the primary diagnostic tool used to assess seizures. However, EEGs are quite difficult to perform in children and have sensitivity of only 50%- 55%, with 96% specificity. Objective To assess the diagnostic potential of serum prolactin level as an alternative tool for children for differentiating between epileptic and non-epileptic seizures. Methods This diagnostic study was performed between January 2013 and December 2013. Thirty patients aged 3 months to 15 years with seizures and without fever who visited the Emergency Department of Arifin Ahmad Hospital, Pekanbaru, Riau, were included. Blood specimens were collected within 2 hours after seizure. Subjects underwent serum prolactin measurements and EEG examinations. Results Fifteen subjects had normal EEGs and 15 subjects had abnormal EEGs. Post-ictal serum prolactin levels were significantly higher in the epileptiform EEG group. The mean serum prolactin levels were 23.78 (SD 21.86 ng/mL and 10.57 (SD 5.62ng/mL in patients with epileptic and non-epileptic patients, respectively. Using a prolactin cut-off point of 17.2 ng/mL, serum prolactin had a 73.3% sensitivity and 93.3% specificity for differentiating between epileptic and non-epileptic seizures. Conclusion Our findings suggest that serum prolactin level increases after an epileptic seizure, but not after a non-epileptic seizure. Post-ictal prolactin elevation within 2 hours may be useful in differentiating epileptic seizures from non-epileptic seizures.

  20. Detection of Epileptic Seizures with Multi-modal Signal Processing

    Conradsen, Isa

    and alarm whenever a seizure starts is of great importance to these patients and their relatives, in the sense, that the alert of the seizure will make them feel more safe. Thus the objective of the project is to investigate the movements of convulsive epileptic seizures and design seizure detection...... convulsive seizures tested. Another study was performed, involving quantitative parameters in the time and frequency domain. The study showed, that there are several differences between tonic seizures and the tonic phase of GTC seizures and furthermore revealed differences of the epileptic (tonic and tonic...

  1. [Psychogenic non epileptic seizures: a review].

    Auxéméry, Y; Hubsch, C; Fidelle, G


    This paper summarizes the recent literature on the phenomena of psychogenic non epileptic seizures (PNES). DEFINITION AND EPIDEMIOLOGY: PNES are, as altered movement, sensation or experience, similar to epilepsy, but caused by a psychological process. Although in the ICD-10, PNES belong to the group of dissociative disorders, they are classified as somatoform disorders in the DSM-IV. That represents a challenging diagnosis: the mean latency between manifestations and diagnosis remains as long as 7 years. It has been estimated that between 10 and 30% of patients referred to epilepsy centers have paroxysmal events that despite looking like epileptic episodes are in fact non-epileptic. Many pseudo epileptic seizures have received the wrong diagnosis of epilepsy being treated with anticonvulsants. The prevalence of epilepsy in PNES patients is higher than in the general population and epilepsy may be a risk factor for PNES. It has been considered that 65 to 80% of PNES patients are young females but a new old men subgroup has been recently described. POSITIVE DIAGNOSIS AND PSYCHIATRIC COMORBIDITIES: Even if clinical characteristics of seizures were defined as important in the diagnosis algorithm, this point of view could be inadequate because of its lack of sensitivity. Because neuron-specific enolase, prolactin and creatine kinase are not reliable and able to validate the diagnosis, video electroencephalography monitoring (with or without provocative techniques) is currently the gold standard for the differential diagnosis of ES, and PNES patients with pseudoseizures have high rates of psychiatric disorders such as depression, anxiety, somatoform symptoms, dissociative disorders and post-traumatic stress disorder. We found evidence for correlations between childhood trauma, history of childhood abuse, PTSD, and PNES diagnoses. PNES could also be hypothesized of a dissociative phenomena generated by childhood trauma. Some authors report that PNES can be associated with

  2. Emergence of semiology in epileptic seizures.

    Chauvel, Patrick; McGonigal, Aileen


    Semiology, the manifestation of epilepsy, is dependent upon electrical activity produced by epileptic seizures that are organized within existing neural pathways. Clinical signs evolve as the epileptic discharge spreads in both time and space. Studying the relation between these, of which the temporal component is at least as important as the spatial one, is possible using anatomo-electro-clinical correlations of stereoelectroencephalography (SEEG) data. The period of semiology production occurs with variable time lag after seizure onset and signs then emerge more or less rapidly depending on seizure type (temporal seizures generally propagating more slowly and frontal seizures more quickly). The subset of structures involved in semiological production, the "early spread network", is tightly linked to those constituting the epileptogenic zone. The level of complexity of semiological features varies according to the degree of involvement of the primary or associative cortex, with the former having a direct relation to peripheral sensory and motor systems with production of hallucinations (visual and auditory) or elementary sensorimotor signs. Depending on propagation pattern, these signs can occur in a "march" fashion as described by Jackson. On the other hand, seizures involving the associative cortex, having a less direct relation with the peripheral nervous system, and necessarily involving more widely distributed networks manifest with altered cognitive and/or behavioral signs whose neural substrate involves a network of cortical structures, as has been observed for normal cognitive processes. Other than the anatomical localization of these structures, the frequency of the discharge is a crucial determinant of semiological effect since a fast (gamma) discharge will tend to deactivate normal function, whereas a slower theta discharge can mimic physiological function. In terms of interaction between structures, the degree of synchronization plays a key role in

  3. Analysis of brain changes before epileptic seizures

    Escarre Pons, Bernat


    [ANGLÈS] This study analyse EEG signals from different patients who suffer from epilepsy by means of mathematic algorithms in order to see what happens in the brain minutes before epileptic seizures. [CASTELLÀ] Este estudio analiza las señales EEG de diferentes pacientes epilépticos mediante algoritmos matemáticos para poder ver que sucede en el cerebro minutos antes de sufrir un ataque epiléptico. [CATALÀ] Aquest estudi analitza les senyals EEG de diferents pacients epilèptics mitjança...

  4. Epileptic seizures precipited by eating: a case report

    Fernando Carlos Aleixo Sepulveda


    Full Text Available The case of one 23 year-old girl who had epileptic manifestations is reported. At first, generalized tonic seizures; afterwards, epileptic seizures precipited by eating. The electroencephalograms showed left temporal lobe disfunctions. Different types of drugs were used with no sucess. The best results were obtained by association of sodium valproate, clonazepan and phenobarbital. Comments are made about clinic and etiopathogenesis, believing the authors in the hipothesis of nervous structures chronic hiperactivity. To Walker8 the hiperactivity was reached by hormones production under neural control of specific cerebral centers. The continuous bombardment of epileptic discharges to hypothalamic centers is the probably responsible by epileptic seizures precipited by eating.

  5. Pathophysiology of Tonic Muscle Activation During Epileptic Seizures

    Beniczky, S.; Conradsen, Isa; Wolf, P.


    , quantitative analysis of the sEMG during the epileptic seizures has received surprisingly little attention. The aim of our study was to elucidate the pathophysiology of the tonic muscle activation during seizures. SEMG was recorded from the deltoid muscles, during 58 seizures from 18 patients (9...

  6. The Role of Emotions in Psychogenic Non-Epileptic Seizures

    Mikkelsen, Mai Bjørnskov; Rask, Charlotte Ulrikka

    Dysregulated emotions have been implied as factors contributing to psychogenic non-epileptic seizures (PNES). The present study explored patients with PNES’ inclusion of emotions in their narratives of their seizures. Results revealed that patients focus more on their physical experience than...... their emotional experience of their seizures....

  7. Ontology and Knowledge Management System on Epilepsy and Epileptic Seizures

    Almeida, Pedro; Sales, Francisco; Nogueira, Ana; Dourado, António


    A Knowledge Management System developed for supporting creation, capture, storage and dissemination of information about Epilepsy and Epileptic Seizures is presented. We present an Ontology on Epilepsy and a Web-based prototype that together create the KMS.

  8. The neural correlates of altered consciousness during epileptic seizures.

    Cavanna, Andrea E; Bagshaw, Andrew P; McCorry, Dougall


    Epileptic seizures are characterized by a multifaceted spectrum of alterations in the general level of awareness and/or the subjective contents of consciousness. Complete loss of consciousness occurs when epileptic activity involves both cortical and subcortical structures, as in generalized seizures. On the other hand, simple partial seizures can spare both the level and contents of consciousness. Finally, complex partial seizures associated with medial temporal lobe discharges can selectively impair the patient's subjective experiences with variable degrees of responsiveness. The differences in ictal semiology between patients with epilepsy offer unique avenues for understanding the relationship between pathological brain function and altered conscious states.

  9. Brain mechanisms of altered conscious states during epileptic seizures.

    Cavanna, Andrea Eugenio; Monaco, Francesco


    Impaired consciousness has long been considered the hallmark of epileptic seizures. Both generalized seizures and complex partial seizures are characterized by a multifaceted spectrum of altered conscious states, in terms of the general level of awareness and the subjective contents of consciousness. Complete loss of consciousness occurs when epileptic activity involves both cortical and subcortical structures, as in tonic-clonic seizures and absence seizures. Medial temporal lobe discharges can selectively impair experience in complex partial seizures (with affected responsiveness) and certain simple partial seizures (with unaffected responsiveness). Electrical stimulation of temporal lobe structures has been shown to evoke similar subjective experiences. Findings from neurophysiological and brain-imaging studies in epilepsy have now demonstrated that involvement of the bilateral thalamus and upper brainstem leads to selective impairment of frontoparietal association cortices and midline 'default mode' networks, which results in ictal loss of consciousness. The spread of epileptic discharges from the medial temporal lobe to the same subcortical structures can ultimately cause impairment in the level of consciousness in the late ictal and immediate postictal phase of complex partial seizures. This paper reviews novel insights into the brain mechanisms that underlie alterations of consciousness during epileptic seizures and the implications for clinical practice in terms of diagnosis and management.

  10. Analysis of Seizure EEG in Kindled Epileptic Rats

    A. K. Sen


    Full Text Available Using wavelet analysis we have detected the presence of chirps in seizure EEG signals recorded from kindled epileptic rats. Seizures were induced by electrical stimulation of the amygdala and the EEG signals recorded from the amygdala were analyzed using a continuous wavelet transform. A time–frequency representation of the wavelet power spectrum revealed that during seizure the EEG signal is characterized by a chirp-like waveform whose frequency changes with time from the onset of seizure to its completion. Similar chirp-like time–frequency profiles have been observed in newborn and adult patients undergoing epileptic seizures. The global wavelet spectrum depicting the variation of power with frequency showed two dominant frequencies with the largest amounts of power during seizure. Our results indicate that a kindling paradigm in rats can be used as an animal model of human temporal lobe epilepsy to detect seizures by identifying chirp-like time–frequency variations in the EEG signal.

  11. Temporal epileptic seizures and occupational exposure to solvents

    Jacobsen, M; Bælum, Jesper; Bonde, J P


    exposure to a mixture of organic solvents (mainly cyclohexanone, white spirit, and isopropanol). Epileptic seizures of temporal type were occurring in relation to solvent exposure. The seizures disappeared shortly after stopping exposure but returned just after a short term re-exposure to cyclohexanone...

  12. [Neurophysiological markers of generalized and focal epileptic seizures].

    Kravtsova, E Yu; Shulakova, K V

    To identify neurophysiological markers of focal and generalized epileptic seizures in the inter-epileptic period. Sixty-four patients, including 36 with isolated generalized tonic-clonic seizures and 28 with focal seizures, were examined. The control group consisted of 27 healthy people. EEG-video monitoring and bioelectric activity analysis of the brain during wakefulness and day sleep, spectral EEG analysis, quantitative and quality indicators of sleep were used. In generalized epileptic seizures, alpha rhythm is predominantly recorded in the left hemisphere. In wakefulness, the focal epileptiform activity develops during the first two stages of day sleep. In focal epileptic seizures, delta and beta-2 rhythms were recorded in the left hemisphere, regional epileptiform changes are aggravated during the 1st and 2nd stages of slow sleep initiated in the frontal regions. A focal component of the epileptiform activity in the inter-epileptic period in patients with different types of seizures should be taken into account in examination and treatment planning of patients who had difficulties with the diagnosis of epilepsy type.

  13. A novel genetic programming approach for epileptic seizure detection.

    Bhardwaj, Arpit; Tiwari, Aruna; Krishna, Ramesh; Varma, Vishaal


    The human brain is a delicate mix of neurons (brain cells), electrical impulses and chemicals, known as neurotransmitters. Any damage has the potential to disrupt the workings of the brain and cause seizures. These epileptic seizures are the manifestations of epilepsy. The electroencephalograph (EEG) signals register average neuronal activity from the cerebral cortex and label changes in activity over large areas. A detailed analysis of these electroencephalograph (EEG) signals provides valuable insights into the mechanisms instigating epileptic disorders. Moreover, the detection of interictal spikes and epileptic seizures in an EEG signal plays an important role in the diagnosis of epilepsy. Automatic seizure detection methods are required, as these epileptic seizures are volatile and unpredictable. This paper deals with an automated detection of epileptic seizures in EEG signals using empirical mode decomposition (EMD) for feature extraction and proposes a novel genetic programming (GP) approach for classifying the EEG signals. Improvements in the standard GP approach are made using a Constructive Genetic Programming (CGP) in which constructive crossover and constructive subtree mutation operators are introduced. A hill climbing search is integrated in crossover and mutation operators to remove the destructive nature of these operators. A new concept of selecting the Globally Prime offspring is also presented to select the best fitness offspring generated during crossover. To decrease the time complexity of GP, a new dynamic fitness value computation (DFVC) is employed to increase the computational speed. We conducted five different sets of experiments to evaluate the performance of the proposed model in the classification of different mixtures of normal, interictal and ictal signals, and the accuracies achieved are outstandingly high. The experimental results are compared with the existing methods on same datasets, and these results affirm the potential use of

  14. Assortative mixing in functional brain networks during epileptic seizures

    Bialonski, Stephan


    We investigate assortativity of functional brain networks before, during, and after one-hundred epileptic seizures with different anatomical onset locations. We construct binary functional networks from multi-channel electroencephalographic data recorded from 60 epilepsy patients, and from time-resolved estimates of the assortativity coefficient we conclude that positive degree-degree correlations are inherent to seizure dynamics. While seizures evolve, an increasing assortativity indicates a segregation of the underlying functional network into groups of brain regions that are only sparsely interconnected, if at all. Interestingly, assortativity decreases already prior to seizure end. Together with previous observations of characteristic temporal evolutions of global statistical properties and synchronizability of epileptic brain networks, our findings may help to gain deeper insights into the complicated dynamics underlying generation, propagation, and termination of seizures.

  15. Neurogenesis in a young dog with epileptic seizures.

    Borschensky, C M; Woolley, J S; Kipar, A; Herden, C


    Epileptic seizures can lead to various reactions in the brain, ranging from neuronal necrosis and glial cell activation to focal structural disorganization. Furthermore, increased hippocampal neurogenesis has been documented in rodent models of acute convulsions. This is a report of hippocampal neurogenesis in a dog with spontaneous epileptic seizures. A 16-week-old epileptic German Shepherd Dog had marked neuronal cell proliferation (up to 5 mitotic figures per high-power field and increased immunohistochemical expression of proliferative cell nuclear antigen) in the dentate gyrus accompanied by microglial and astroglial activation. Some granule cells expressed doublecortin, a marker of immature neurons; mitotically active cells expressed neuronal nuclear antigen. No mitotic figures were found in the brain of age-matched control dogs. Whether increased neurogenesis represents a general reaction pattern of young epileptic dogs should be investigated.

  16. Immune response in the eye following epileptic seizures

    Ahl, Matilda; Avdic, Una; Skoug, Cecilia; Ali, Idrish; Chugh, Deepti; Johansson, Ulrica Englund; Christine T Ekdahl


    Background: Epileptic seizures are associated with an immune response in the brain. However, it is not known whether it can extend to remote areas of the brain, such as the eyes. Hence, we investigated whether epileptic seizures induce inflammation in the retina.Methods: Adult rats underwent electrically induced temporal status epilepticus, and the eyes were studied 6 h, 1, and 7 weeks later with biochemical and immunohistochemical analyses. An additional group of animals received CX3CR1 anti...

  17. Automatic Epileptic Seizure Onset Detection Using Matching Pursuit

    Sorensen, Thomas Lynggaard; Olsen, Ulrich L.; Conradsen, Isa


    An automatic alarm system for detecting epileptic seizure onsets could be of great assistance to patients and medical staff. A novel approach is proposed using the Matching Pursuit algorithm as a feature extractor combined with the Support Vector Machine (SVM) as a classifier for this purpose....... The combination of Matching Pursuit and SVM for automatic seizure detection has never been tested before, making this a pilot study. Data from red different patients with 6 to 49 seizures are used to test our model. Three patients are recorded with scalp electroencephalography (sEEG) and three with intracranial...... electroencephalography (iEEG). A sensitivity of 78-100% and a detection latency of 5-18s has been achieved, while holding the false detection at 0.16-5.31/h. Our results show the potential of Matching Pursuit as a feature xtractor for detection of epileptic seizures....

  18. Epileptic seizures in patients with a posterior circulation infarct

    Yüksel Kaplan


    Full Text Available OBJECTIVE: The aim of this study was to investigate the frequency of seizures and the clinical features of patients with seizures related to a posterior circulation infarct (POCI. METHODS: We reviewed all ischemic stroke patients admitted to our clinic between January 2011 and January 2012. The patients’ database information was retrospectively analyzed. Fifty-five patients with a POCI were included in the study. We reviewed all patients with epileptic seizures related to a POCI. Age, gender, recurrent stroke, risk factors, etiology, radiographic localization, the seizure type and onset time, and the electroencephalographic findings of patients were evaluated. We excluded all patients who had precipitating conditions during seizures such as taking drugs, acid-base disturbances, electrolyte imbalance, and history of epilepsy. RESULTS: Seizures were observed in four patients (3 male, 1 female with a POCI related epileptic seizures (7.2%. The etiology of strokes was cardiac-embolic in 3 patients and vertebral artery dissection in 1 patient. Seizures occurred in 2 patients as presenting finding, in 1 patient within 7 days, and 1 patient within 28 days. Primary generalized tonic-clonic seizures occurred in 3 patients and simple partial seizures with secondary generalization in 1 patient. Three patients had cerebellum infarction at the left hemisphere. One patient had lateral medullary infarction at the right side. The electroencephalographic findings of patients were normal. CONCLUSION: Studies involving patients with seizures related to a POCI are novel and few in number. Three patients with seizure had cerebellum infarction. The cerebellum in these patients may contribute via different mechanisms over seizure activity.

  19. Recognition of psychogenic non-epileptic seizures: a curable neurophobia?

    O'Sullivan, S S


    Diagnosing psychogenic non-epileptic seizures (PNES) remains challenging. The majority of \\'PNES status\\' cases are likely to be seen in the emergency department or similar non-specialised units, where patients are initially assessed and managed by physicians of varying expertise in neurology.

  20. [Focal epileptic seizures ipsilateral to the tumor: case report].

    Gusmão, Sebastião Silva; Mendes, Mirian Fabíola Studart; Silveira, Roberto Leal


    Focal somatosensory epileptic seizures ipsilateral to a brain tumor is reported and the literature reviewed. It is an exceptional occurrence, having been described only six cases, with several mechanisms being proposed. The proximity of the lesions with the low cerebral convexity (perisylvian) suggests the compromising of the secondary somatosensorial area, seeming to prove the experimental observation of somatosensorial crises originating in this area.

  1. Detection and Prediction of Epileptic Seizures

    Duun-Henriksen, Jonas

    monitoring of their brain waves. More specifically, three issues were investigated: The feasibility of automatic seizure prediction, optimization of automatic seizure detection algorithms, and the link between intra- and extracranial EEG. Regarding feasibility of automatic seizure prediction, neither...... seizure prediction algorithms. More promising results were obtained in the investigating of possible use of an outpatient EEG monitoring device for idiopathic generalized epilepsy patients. Combined with an automatic seizure detection algorithm such a device can give an objective account of the paroxysm...... frequency, duration, and time of occurrence. Based on standard EEG data from 20 patients recorded in the clinic, the log-sum of wavelet transform coefficients were used as feature input to a classifier consisting of a support vector machine. 97% of paroxysms lasting more than two seconds were correctly...

  2. Voltage synchronizations between multichannel electroencephalograms during epileptic seizures

    Tuncay, Caglar


    The underlying dynamics for the electroencephalographic (EEG) recordings from humans but especially epilepsy patients are usually not completely known. However, the ictal activity is claimed to be characterized by synchronous oscillations in the brain voltages in the literature. These time dependent interdependencies (synchronization, coupling) between the EEG voltages from epileptogenic and non epileptogenic brain sites of nineteen focal epileptic patients are investigated in this work. It is found that strong synchronizationdesynchronization events occur in alternation during most of the investigated seizures. Thus, these seizures are detected with considerable sensitivity (71 of the 79 seizures).

  3. Canine and feline epileptic seizures and the lunar cycle: 2,507 seizures (2000-2008).

    Browand-Stainback, Laura; Levesque, Donald; McBee, Matthew


    Epileptic seizures in 211 canine and feline patients diagnosed with idiopathic epilepsy were evaluated for temporal significance in relation to the lunar cycle. Seizure counts were compared among each of the eight individual lunar phases, among each of eight exact lunar phase dates, and by percent of lunar illumination using generalized estimating equations. No statistical significance was found in any of these comparisons excluding a relationship between the onset of epileptic seizures and the phases of the moon. Alteration in anticonvulsant treatment or monitoring of canine and feline patients with idiopathic epilepsy at large was not warranted based on the lunar cycle.

  4. Unsupervised EEG analysis for automated epileptic seizure detection

    Birjandtalab, Javad; Pouyan, Maziyar Baran; Nourani, Mehrdad


    Epilepsy is a neurological disorder which can, if not controlled, potentially cause unexpected death. It is extremely crucial to have accurate automatic pattern recognition and data mining techniques to detect the onset of seizures and inform care-givers to help the patients. EEG signals are the preferred biosignals for diagnosis of epileptic patients. Most of the existing pattern recognition techniques used in EEG analysis leverage the notion of supervised machine learning algorithms. Since seizure data are heavily under-represented, such techniques are not always practical particularly when the labeled data is not sufficiently available or when disease progression is rapid and the corresponding EEG footprint pattern will not be robust. Furthermore, EEG pattern change is highly individual dependent and requires experienced specialists to annotate the seizure and non-seizure events. In this work, we present an unsupervised technique to discriminate seizures and non-seizures events. We employ power spectral density of EEG signals in different frequency bands that are informative features to accurately cluster seizure and non-seizure events. The experimental results tried so far indicate achieving more than 90% accuracy in clustering seizure and non-seizure events without having any prior knowledge on patient's history.

  5. Serum Prolactin in Diagnosis of Epileptic Seizures

    J Gordon Millichap


    Full Text Available The results of studies in databases and references concerning serum prolactin levels (PRL in patients with suspected seizures were rated for quality and analyzed by members of the Therapeutics Subcommittee of the American Academy of Neurology.

  6. Focal epileptic seizures mimicking sleep paralysis.

    Galimberti, Carlo Andrea; Ossola, Maria; Colnaghi, Silvia; Arbasino, Carla


    Sleep paralysis (SP) is a common parasomnia. The diagnostic criteria for SP, as reported in the International Classification of Sleep Disorders, are essentially clinical, as electroencephalography (EEG)-polysomnography (PSG) is not mandatory. We describe a subject whose sleep-related events fulfilled the diagnostic criteria for SP, even though her visual hallucinations were elementary, repetitive and stereotyped, thus differing from those usually reported by patients with SP. Video/EEG-PSG documented the focal epileptic nature of the SP-like episodes.

  7. Epileptic seizures in Neuro-Behcet disease: why some patients develop seizure and others not?

    Kutlu, Gulnihal; Semercioglu, Sencer; Ucler, Serap; Erdal, Abidin; Inan, Levent E


    Behcet disease (BD) is a chronic relapsing inflammatory disorder. Neuro BD (NBD) is seen in approximately 5% of all patients. The aim of this study is to investigate the frequency, type and prognosis of epileptic seizures in different forms of NBD. All files of 42 patients with NBD were evaluated between 2006 and 2012, retrospectively. The demographic data, the presentation of NBD, clinical findings including seizures, EEG and neuroimaging findings were reviewed. The mean age of patients was 35.02±8.43 years. Thirty (71.4%) patients were male; the remaining 12 of them were female. Twenty-four patients had brainstem lesions; 16 patients had cerebral venous thrombosis. Spinal cord involvement was seen in two patients. Seven patients had epileptic seizures (six partial onset seizures with or without secondary generalization). Six of them had cerebral sinus thrombosis (CVT). Four patients had a seizure as the first symptom of the thrombosis. One patient had late onset seizure due to chronic venous infarct. The other patient with seizure had brainstem involvement. The remaining was diagnosed as epilepsy before the determination of NBD. CVT seen in BD seems to be the main risk factor for epileptic seizures in patients with NBD. The prognosis is usually good especially in patients with CVT. Epileptic seizures in patients with brainstem involvement may be an indicator for poor prognosis. Superior sagittal thrombosis or cortical infarct would be predictor of seizures occurrence because of the high ratio in patients with seizures. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  8. The quantitative measurement of consciousness during epileptic seizures.

    Nani, Andrea; Cavanna, Andrea E


    The assessment of consciousness is a fundamental element in the classification of epileptic seizures. It is, therefore, of great importance for clinical practice to develop instruments that enable an accurate and reliable measurement of the alteration of consciousness during seizures. Over the last few years, three psychometric scales have been specifically proposed to measure ictal consciousness: the Ictal Consciousness Inventory (ICI), the Consciousness Seizure Scale (CSS), and the Responsiveness in Epilepsy Scale--versions I and II (RES-I and RES-II). The ICI is a self-report psychometric instrument which retrospectively assesses ictal consciousness along the dimensions of the level/arousal and contents/awareness. The CSS has been used by clinicians to quantify the impairment of consciousness in order to establish correlations with the brain mechanisms underlying alterations of consciousness during temporal lobe seizures. The most recently developed observer-rated instrument is the RES-I, which has been used to assess responsiveness during epileptic seizures in patients undergoing video-EEG. The implementation of standardized psychometric tools for the assessment of ictal consciousness can complement clinical observations and contribute to improve accuracy in seizure classification.

  9. Hyperspherical Manifold for EEG Signals of Epileptic Seizures

    Tahir Ahmad


    Full Text Available The mathematical modelling of EEG signals of epileptic seizures presents a challenge as seizure data is erratic, often with no visible trend. Limitations in existing models indicate a need for a generalized model that can be used to analyze seizures without the need for apriori information, whilst minimizing the loss of signal data due to smoothing. This paper utilizes measure theory to design a discrete probability measure that reformats EEG data without altering its geometric structure. An analysis of EEG data from three patients experiencing epileptic seizures is made using the developed measure, resulting in successful identification of increased potential difference in portions of the brain that correspond to physical symptoms demonstrated by the patients. A mapping then is devised to transport the measure data onto the surface of a high-dimensional manifold, enabling the analysis of seizures using directional statistics and manifold theory. The subset of seizure signals on the manifold is shown to be a topological space, verifying Ahmad's approach to use topological modelling.

  10. [Classification of epileptic seizures and syndromes].

    Noachtar, S; Rémi, J


    Advances in diagnostic and therapeutic options require a revision of the current classification of seizures and epilepsies. Recently, a classification proposal was introduced which reflects the ambivalence of the Internationalen Liga gegen Epilepsie (ILAE). We suggest that epileptology should utilize the same established systematic approach used in clinical neurology.

  11. Cardiac arrhythmias during or after epileptic seizures

    van der Lende, Marije; Surges, Rainer; Sander, Josemir W; Thijs, Roland D


    Seizure-related cardiac arrhythmias are frequently reported and have been implicated as potential pathomechanisms of Sudden Unexpected Death in Epilepsy (SUDEP). We attempted to identify clinical profiles associated with various (post)ictal cardiac arrhythmias. We conducted a systematic search from the first date available to July 2013 on the combination of two terms: ‘cardiac arrhythmias’ and ‘epilepsy’. The databases searched were PubMed, Embase (OVID version), Web of Science and COCHRANE Library. We attempted to identify all case reports and case series. We identified seven distinct patterns of (post)ictal cardiac arrhythmias: ictal asystole (103 cases), postictal asystole (13 cases), ictal bradycardia (25 cases), ictal atrioventricular (AV)-conduction block (11 cases), postictal AV-conduction block (2 cases), (post)ictal atrial flutter/atrial fibrillation (14 cases) and postictal ventricular fibrillation (3 cases). Ictal asystole had a mean prevalence of 0.318% (95% CI 0.316% to 0.320%) in people with refractory epilepsy who underwent video-EEG monitoring. Ictal asystole, bradycardia and AV-conduction block were self-limiting in all but one of the cases and seen during focal dyscognitive seizures. Seizure onset was mostly temporal (91%) without consistent lateralisation. Postictal arrhythmias were mostly found following convulsive seizures and often associated with (near) SUDEP. The contrasting clinical profiles of ictal and postictal arrhythmias suggest different pathomechanisms. Postictal rather than ictal arrhythmias seem of greater importance to the pathophysiology of SUDEP. PMID:26038597

  12. Cardiac arrhythmias during or after epileptic seizures.

    van der Lende, Marije; Surges, Rainer; Sander, Josemir W; Thijs, Roland D


    Seizure-related cardiac arrhythmias are frequently reported and have been implicated as potential pathomechanisms of Sudden Unexpected Death in Epilepsy (SUDEP). We attempted to identify clinical profiles associated with various (post)ictal cardiac arrhythmias. We conducted a systematic search from the first date available to July 2013 on the combination of two terms: 'cardiac arrhythmias' and 'epilepsy'. The databases searched were PubMed, Embase (OVID version), Web of Science and COCHRANE Library. We attempted to identify all case reports and case series. We identified seven distinct patterns of (post)ictal cardiac arrhythmias: ictal asystole (103 cases), postictal asystole (13 cases), ictal bradycardia (25 cases), ictal atrioventricular (AV)-conduction block (11 cases), postictal AV-conduction block (2 cases), (post)ictal atrial flutter/atrial fibrillation (14 cases) and postictal ventricular fibrillation (3 cases). Ictal asystole had a mean prevalence of 0.318% (95% CI 0.316% to 0.320%) in people with refractory epilepsy who underwent video-EEG monitoring. Ictal asystole, bradycardia and AV-conduction block were self-limiting in all but one of the cases and seen during focal dyscognitive seizures. Seizure onset was mostly temporal (91%) without consistent lateralisation. Postictal arrhythmias were mostly found following convulsive seizures and often associated with (near) SUDEP. The contrasting clinical profiles of ictal and postictal arrhythmias suggest different pathomechanisms. Postictal rather than ictal arrhythmias seem of greater importance to the pathophysiology of SUDEP.

  13. [Portable Epileptic Seizure Monitoring Intelligent System Based on Android System].

    Liang, Zhenhu; Wu, Shufeng; Yang, Chunlin; Jiang, Zhenzhou; Yu, Tao; Lu, Chengbiao; Li, Xiaoli


    The clinical electroencephalogram (EEG) monitoring systems based on personal computer system can not meet the requirements of portability and home usage. The epilepsy patients have to be monitored in hospital for an extended period of time, which imposes a heavy burden on hospitals. In the present study, we designed a portable 16-lead networked monitoring system based on the Android smart phone. The system uses some technologies including the active electrode, the WiFi wireless transmission, the multi-scale permutation entropy (MPE) algorithm, the back-propagation (BP) neural network algorithm, etc. Moreover, the software of Android mobile application can realize the processing and analysis of EEG data, the display of EEG waveform and the alarm of epileptic seizure. The system has been tested on the mobile phones with Android 2. 3 operating system or higher version and the results showed that this software ran accurately and steadily in the detection of epileptic seizure. In conclusion, this paper provides a portable and reliable solution for epileptic seizure monitoring in clinical and home applications.

  14. Aspirin attenuates spontaneous recurrent seizures in the chronically epileptic mice.

    Zhu, Kun; Hu, Ming; Yuan, Bo; Liu, Jian-Xin; Liu, Yong


    Neuroinflammatory processes are pathologic hallmarks of both experimental and human epilepsy, and could be implicated in the neuronal hyperexcitability. Aspirin represents one of the non-selective nonsteroidal anti-inflammatory drugs with fewer side effects in long-term application. This study was carried out to assess the anti-epileptic effects of aspirin when administered during the chronic stage of temporal lobe epilepsy [TLE] in mice. The alteration of hippocampal neurogenesis was also examined for raising a possible mechanism underlying the protective effect of anti-inflammatory treatment in the TLE. Two months after pilocarpine-induced status epilepticus, the chronically epileptic mice were treated with aspirin (20 mg, 60 mg or 80 mg/kg) once a day for 10 weeks. Spontaneous recurrent seizures were monitored by video camera for 2 weeks. To evaluate the profile of hippocampal neurogenesis, the newly generated cells in the dentate gyrus were labeled by the proliferation marker BrdU. The newborn neurons that extended axons to CA3 area were visualized by cholera toxin B subunit retrograde tracing. Administration of aspirin with a dosage of 60 mg or 80 mg/kg initiated at 2 months after pilocarpine-induced status epilepticus significantly reduced the frequency and duration of spontaneous recurrent seizures. Aspirin treatment also increased the number of newborn neurons with anatomic integration through improving the survival of the newly generated cells. Aspirin treatment during the chronic stage of TLE could attenuate the spontaneous recurrent seizures in mice. Promotion of hippocampal neurogenesis and inhibition of COX-PGE2 pathway might partly contribute to this anti-epileptic effect. Highlights • Aspirin attenuates spontaneous recurrent seizures of chronically epileptic mice • Aspirin increases neurogenesis of chronically epileptic hippocampus by improving the survival of newly generated cells • Promotion of hippocampal neurogenesis and inhibition

  15. Epileptic Seizures from Abnormal Networks: Why Some Seizures Defy Predictability


    are provoked (e.g. medications and alcohol) and less than half of these patients have recurrent seizures. The life- time cumulative risk of developing... microwire and clinical macroelectrode recordings. Brain 131 (Pt 4), 928—937. Worrell, G.A., Parish, L., Cranstoun, S.D., Jonas, R., Bal- tuch, G., Litt

  16. Epileptic Seizure, Postictal Hemiparesis, and Hyperleukocytosis

    Martin Olivieri MD


    Full Text Available Introduction: Acute ischemic stroke (AIS is a rare event in infancy. Besides vasculopathy, thrombophilia, or cardiac disorders, cancer and chemotherapy are known predisposing factors for AIS. Leukemia can be associated with different abnormal coagulation parameters, but severe bleeding or thrombosis occurs rarely. Clinical Course: We report the case of a 2-year-old boy who was presented to our emergency ward after a prolonged seizure with right sided postictal hemiparesis. Cranial computed tomography scan revealed a large infarction and edema due to thrombosis of the left carotid artery, the middle cerebral artery, and the anterior cerebral artery. Laboratory workup showed 196 g/L leukocytes with 75% myeloid blast cells. Immediate exchange transfusion, hydration, and chemotherapy with cytarabine were started. During the hospital course intracranial pressure increased and the patient developed a unilateral dilated pupil unresponsive to light. Cranial computed tomography scan revealed a new infarction in the right middle cerebral artery territory. Refractory increased intracranial pressure and brain stem herniation developed, and the child died 3 days after admission to hospital. Conclusion: Seizures with postictal hemiparesis due to cerebral infarction can be a rare manifestation of acute myeloid leukemia. Leukocytosis and cancer-induced coagulopathy are main reasons for thrombosis and/or hemorrhage. High leukocyte counts need immediate interventions with hydration, careful chemotherapy, and perhaps exchange transfusion or leukapharesis. In the presence of thrombosis, anticoagulation must be discussed despite the risk of bleeding due to hyperfibrinolysis and low platelet counts. Mortality may be reduced by awareness of this rare presentation of leukemia and prompt institution of leucoreductive treatment.

  17. Migraine with aura and photosensitive epileptic seizures: a case report.

    de Carolis, P; Tinuper, P; Sacquegna, T


    An 18-year-old female presented with two seizures induced by photic stimulation. She had a positive family history for migraine and a history of febrile convulsions. Since the age of 13 she had suffered from migraine attacks with aura. A brain computerized tomography with contrast enhancement was negative and several electroencephalograms showed a photoparoxysmal response. At the age of 18 she had a partial secondary generalized seizure after photic stimulation during routine electroencephalogram. The onset of seizure was in the occipital region. Two days later, the patient presented with a typical migrainous attack with aura. Interictal apomorphine test (1.5 mg s.c.) blocked the photoparoxysmal response. According to Quesnay, dopaminergic failure of the occipital cortex may account for both epileptic and migraine features.

  18. A Case of Lung Cancer with Brain Metastases Diagnosed After Epileptic Seizure

    Murat Eroglu


    Full Text Available    Epileptic seizures can accompany benign diseases, also can be the first sign of malign tumors. In brain metastasis, epileptic seizures can be seen before the symptoms of the primary lesion. Brain metastasis is bad prognostic factor in all malignancies and it is determined that lung cancers are the most metastatic tumors to the brain. Especially in new onset epileptic seizures in elderly patients, metastatic brain tumors are frequent in etiology. We aimed to present a lung cancer patient with brain metastasis who admitted emergency department with first epileptic seizure.

  19. A Spectral Based Forecasting Tool of Epileptic Seizures

    Hedi Khammari


    Full Text Available A new approach to recognize and predict succedent epileptic seizure by using single channel electroencephalogram (EEG analysis is proposed. Spectral analysis of a brain time series of the left frontal FP1-F7 (LF scalp location signal is devoted for seizure prediction and analysis. Important findings showing the presence of preictal spectral changes in studied brain signal are described. Spectral features occurring during the preictal epoch are extracted from the application of sliding spectral windows of raw EEG at different moments in time preceding the seizure onset. The same method is then applied to a couple of Intrinsic Mode Functions (IMF1 and IMF2 of the raw EEG (FP1-F7 decomposed by the algorithm of empirical mode decomposition. The main prediction features are derived from the changes of amplitudes, frequency and the number of spikes which are of diagnostic values. The sliding spectral windows were computed to trace the amplitude changes of higher harmonics during time interval preceding the seizure onset. Choosing different moments in time aims to identify the best prediction time of seizure onset. Obviously an early prediction time is always desirable but the seizure may result from an abrupt change and so the spectral 'signs of an imminent seizure occur during a very short prediction time. From another viewpoint, it may be advantageous to consider a successive prediction times showing the increase of spike numbers and the predominance of certain waves rather than others when approaching seizure onset. The common prediction features extracted from the analysis of FP1-F7 signal for both patients were mainly the increasing number of spikes of low frequency waves namely delta and theta waves.

  20. Clinical Microbiological Aspects of Epileptic Seizures in the Tropical Countries with Specific Focus on Nigeria

    Ijeoma Kanu


    Full Text Available Epilepsy is a common neurological disorder; however, in Nigeria and other tropical regions, the causes of epileptic seizures differ greatly in etiology. This paper is an attempt to highlight some possible microbiological aspects of epileptic seizures. A literature review was carried out to identify the extent to which microbial infections were involved in the elicitation of epileptic seizures. Data were collected from several clinics in the community and hospitals in Nigeria and correlated with the evidence from the literature review. It was found that different microbial agents including viral, bacterial, protozoa, and fungal agents were involved in several aspects of epileptic seizures. Malaria was found to cause more than 88% of childhood epileptic seizures and 12% of adult seizures. Generalized tonic-clonic seizures occurred in more than 40% of adult patients. Partial seizures were uncommon. Cases of epileptic seizures associated with bacteria (e.g., brucellosis, viral, fungal, and protozoa infections were frequently reported. Malaria, tapeworm, and cysticercosis were some of the common infectious causes of epilepsy; however, in some cases, the cause remained unknown. From these findings, it was evident that microbiological aspects of epilepsies are possible research areas that might be developed. It is believed that the unraveling of the various microbiological factors in epileptic seizures would have important implications for understanding the underlying neurobiology, evaluating treatment strategies, and perhaps planning health-care resources for the affected. It will also help to improve the prognostic factors in initial seizure symptomatic etiology and presence of any structural cerebral abnormalities.

  1. Epileptic Seizures Induced by a Spontaneous Carotid Cavernous Fistula

    Güner Koyuncu Çelik


    Full Text Available A 79-year-old woman was admitted to our emergency department with complaints of fainting and loss of consciousness three times during the past month. She was diagnosed with epilepsy and started to be treated with antiepileptic drug. Physical examination showed, in the left eye, chemosis, limited eye movements in all directions, and minimal exophthalmos as unexisting symptoms on admission developed on the sixth day. Orbital magnetic resonance imaging (MRI and digital subtraction angiography (DSA imaging revealed a carotid cavernous fistula (CCF. Epileptic attacks and ophthalmic findings previously present but diagnosed during our examinations were determined to ameliorate completely after performing the coil embolization. Based on literature, we present the first case with nontraumatic CCF manifesting with epileptic seizures and intermittent eye symptoms in the present report.

  2. Epileptic Seizures Induced by a Spontaneous Carotid Cavernous Fistula

    Yildirim, Erkan


    A 79-year-old woman was admitted to our emergency department with complaints of fainting and loss of consciousness three times during the past month. She was diagnosed with epilepsy and started to be treated with antiepileptic drug. Physical examination showed, in the left eye, chemosis, limited eye movements in all directions, and minimal exophthalmos as unexisting symptoms on admission developed on the sixth day. Orbital magnetic resonance imaging (MRI) and digital subtraction angiography (DSA) imaging revealed a carotid cavernous fistula (CCF). Epileptic attacks and ophthalmic findings previously present but diagnosed during our examinations were determined to ameliorate completely after performing the coil embolization. Based on literature, we present the first case with nontraumatic CCF manifesting with epileptic seizures and intermittent eye symptoms in the present report. PMID:28077946

  3. Similarities in precursory features in seismic shocks and epileptic seizures

    Kapiris, P. G.; Polygiannakis, J.; Li, X.; Yao, X.; Eftaxias, K. A.


    Theoretical studies suggest that the final earthquake (EQ) and neural-seizure dynamics should have many similar features and could be analyzed within similar mathematical frameworks. Herein, by monitoring the temporal evolution of the fractal spectral characteristics in EEG time series and pre-seismic electromagnetic (EM) time series we show that many similar distinctive symptoms (including common alterations in associated scaling parameters) emerge as epileptic seizures (ES) and EQs are approaching. These alterations reveal a gradual reduction of complexity as the catastrophic events approach. The transition from anti-persistent to persistent behaviour may indicate that the onset of a severe crisis is imminent. The observations find a unifying explanation within the school of the "Intermittent Criticality".

  4. Do energy drinks cause epileptic seizure and ischemic stroke?

    Dikici, Suber; Saritas, Ayhan; Besir, Fahri Halit; Tasci, Ahmet Hakan; Kandis, Hayati


    Energy drinks are popular among young individuals and marketed to college students, athletes, and active individuals between the ages of 21 and 35 years. We report a case that had ischemic stroke and epileptic seizure after intake of energy drink with alcohol. To the best of our knowledge, the following case is the first report of ischemic stroke after intake of energy drink. A previously healthy 37-year-old man was brought to the emergency department after a witnessed tonic-clonic seizure. According to his wife's testimony, just before loss of consciousness, the patient had been drinking 3 boxes of energy drinks (Redbull, Istanbul, Turkey, 250 mL) with vodka on an empty stomach. He did not have a history of seizures, head trauma, or family history of seizures or another disease. In cranial diffusion magnetic resonance imaging, there were hyperintense signal changes in bilateral occipital area (more pronounced in the left occipital lobe), right temporal lobe, frontal lobe, and posterior parietal lobe. All tests associated with possible etiologic causes of ischemic stroke in young patients were negative. Herein, we want to attract attention to adverse effect of energy drink usage.

  5. Similar semiology of epileptic and psychogenic nonepileptic seizures recorded during stereo-EEG.

    Ostrowsky-Coste, Karine; Montavont, Alexandra; Keo-Kosal, Pascale; Guenot, Marc; Chatillon, Claude-Edouard; Ryvlin, Philippe


    We report two adolescents with refractory seizure disorders in whom both epileptic and psychogenic nonepileptic seizures (PNES) were recorded with intracerebral EEG. The ictal phenomenology of epileptic seizures (ES) and PNES, consisting of hypermotor attacks in the first patient and left-sided painful episodes in the second patient, proved remarkably similar in both cases, highlighting the difficulties which can arise with the distinction of epileptic seizures and PNES based on ictal phenomenology alone. Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  6. Reliable epileptic seizure detection using an improved wavelet neural network

    Zarita Zainuddin


    Full Text Available BackgroundElectroencephalogram (EEG signal analysis is indispensable in epilepsy diagnosis as it offers valuable insights for locating the abnormal distortions in the brain wave. However, visual interpretation of the massive amounts of EEG signals is time-consuming, and there is often inconsistent judgment between experts. AimsThis study proposes a novel and reliable seizure detection system, where the statistical features extracted from the discrete wavelet transform are used in conjunction with an improved wavelet neural network (WNN to identify the occurrence of seizures. Method Experimental simulations were carried out on a well-known publicly available dataset, which was kindly provided by the Epilepsy Center, University of Bonn, Germany. The normal and epileptic EEG signals were first pre-processed using the discrete wavelet transform. Subsequently, a set of statistical features was extracted to train a WNNs-based classifier. ResultsThe study has two key findings. First, simulation results showed that the proposed improved WNNs-based classifier gave excellent predictive ability, where an overall classification accuracy of 98.87% was obtained. Second, by using the 10th and 90th percentiles of the absolute values of the wavelet coefficients, a better set of EEG features can be identified from the data, as the outliers are removed before any further downstream analysis.ConclusionThe obtained high prediction accuracy demonstrated the feasibility of the proposed seizure detection scheme. It suggested the prospective implementation of the proposed method in developing a real time automated epileptic diagnostic system with fast and accurate response that could assist neurologists in the decision making process.

  7. Interleukin-6 deficiency reduces the brain inflammatory response and increases oxidative stress and neurodegeneration after kainic acid-induced seizures

    Penkowa, M; Molinero, A; Carrasco, J


    , the immunoreactivity for inducible nitric oxide synthase, peroxynitrite-induced nitration of proteins and byproducts of fatty acid peroxidation were dramatically increased, as was that for metallothionein I+II, Mn-superoxide dismutase and Cu/Zn-superoxide dismutase. In accordance, a significant neuronal apoptosis...... was caused by kainic acid, as revealed by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling and interleukin-1beta converting enzyme/Caspase-1 stainings. In kainic acid-injected interleukin-6 null mice, reactive astrogliosis and microgliosis were reduced, while......The role of interleukin-6 in hippocampal tissue damage after injection with kainic acid, a rigid glutamate analogue inducing epileptic seizures, has been studied by means of interleukin-6 null mice. At 35mg/kg, kainic acid induced convulsions in both control (75%) and interleukin-6 null (100%) mice...

  8. Phase-Synchronization Early Epileptic Seizure Detector VLSI Architecture.

    Abdelhalim, K; Smolyakov, V; Genov, R


    A low-power VLSI processor architecture that computes in real time the magnitude and phase-synchronization of two input neural signals is presented. The processor is a part of an envisioned closed-loop implantable microsystem for adaptive neural stimulation. The architecture uses three CORDIC processing cores that require shift-and-add operations but no multiplication. The 10-bit processor synthesized and prototyped in a standard 1.2 V 0.13 μm CMOS technology utilizes 41,000 logic gates. It dissipates 3.6 μW per input pair, and provides 1.7 kS/s per-channel throughput when clocked at 2.5 MHz. The power scales linearly with the number of input channels or the sampling rate. The efficacy of the processor in early epileptic seizure detection is validated on human intracranial EEG data.

  9. Non Epileptic Seizures Among School Going Children And Adolescents

    Dhanaraj M


    Full Text Available Non epileptic seizures were diagnosed in 20 (F:15, M:5 school children and adolescents by a positive provocative test consisting of induction and termination of the attack with suggestions and saline injection and normal ictal EEG. Patients were followed up for a period of two years. The major provocating factors were (a family problems, mainly conflict between the parents in 25%, (b problems in schooling in 20%, (c combination of both in 30%, (d sexual and physical abuse in 10% and (e undetectable in 15%. The frequency of the attacks were > 1/day in 55%, 1 - 6 / week in 25%, 1 - 3 / month in 15% and occasional in 5%. During follow up, 55% were free from attacks, 10% had recurrence occasionally for one year and free from it during the second year, 10% continued to get attacks and 25% were lost to follow up. In those free from attacks, multiple somatic complaints were reported by 30% of patients.

  10. [Preditive clinical factors for epileptic seizures after ischemic stroke].

    Fukujima, M M; Cardeal, J O; Lima, J G


    Preditive clinical factors for epileptic seizures after ischemic stroke. Clinical features of 35 patients with ischemic stroke who developed epilepsy (Group 1) were compared with those of 35 patients with ischemic stroke without epilepsy (Group 2). The age of the patients did not differ between the groups. There were more men than women and more white than other races in both groups. Diabetes melitus, hypertension, transient ischemic attack, previous stroke, migraine, Chagas disease, cerebral embolism of cardiac origin and use of oral contraceptive did not differ between the groups. Smokers and alcohol users were more frequent in Group 1 (p < 0.05). Most patients of Group 1 presented with hemiparesis; none presented cerebellar or brainstem involvement. Perhaps strokes in smokers have some different aspects, that let them more epileptogenic than in non smokers.

  11. Dynamical characteristics of pre-epileptic seizures in rats with recurrence quantification analysis

    Li, Xiaoli; Ouyang, Gaoxiang; Yao, Xin; Guan, Xinping


    Understanding the transition of brain activity towards an epileptic seizure, called pre-epileptic seizure, is a challenge in epilepsy. In this Letter, a recurrence quantification analysis (RQA) is proposed to describe dynamical characteristics of EEG (electroencephalograph) recordings on rat experiments, which is helpful to predict seizures. One of the advantages of this method does not require any assumptions to EEG data, such as linear, stationary, noiseless and so on. A series of experimental tests in this study show that the dynamical characteristics of EEG data with RQA can identify the differences among inter-ictal, pre-ictal and ictal phases; and support the hypothesis that complexity of brain electrical activity has a significant decrease prior to an epileptic seizure. This change could be useful in predicting epileptic seizures.

  12. Psychogenic non-epileptic seizures and psychoanalytical treatment: results

    Niraldo de Oliveira Santos


    Full Text Available Background: the occurrence of psychogenic non-epileptic seizures (PNES is estimated to be between 2 to 33 cases in every 100,000 inhabitants. The number of patients with PNES reaches 19% of those treated as epileptics. Patients with PNES are treated as if they had intractable epilepsy, with unsatisfactory results even after medication treatment is used to its maximum. The aim of this study is to present the effects of individual psychoanalytical treatment in patients with PNES, assessing its impact in the evolution of the clinical picture and its association with sex, time of disease, social, psychological and professional harm, as well as going through with treatment. Methods: The case base was composed of 37 patients with PNES. The diagnosis was reached with video-EEG monitoring. Psychoanalytical treatment was carried out through 12 months of weekly sessions timed for around 50-minutes each, in a total of 48 individual sessions. Results: This study found a high rate of success in the treatment of PNES patients. 29.7% (n=11 of patients had cessation or cure of symptoms and 51.4% (n=19 had a decrease in the number of episodes. There is an association between cessation or decrease in the number of episodes and sex (p<0.01, religion (p<0.01 and concluding treatment (p<0.01. Conclusion: Individual psychoanalytical treatment applied to patients with PNES is considered effective and can be an essential form of assistance for the reduction or cessation of episodes.


    Balogh, Attila; Balogh, Attila


    The developing of diagnostical examinations in epileptology provides new challenges in seizure semiology. On the analysis of seizures it is important to examine the mechanisms of their propagation. The brain connectivity (based on the neuroimaging), the shadowing of the movement of excessive neuronal activity (based on computerized EEG and MEG methods), the cognition of the physiological and pathological brain networks are the footstone of the epileptic seizure propagation. The investigators prove, by means of case demonstrations of the role of the network nodes and the role of the epileptic hubs in the seizure symptomatology. The preoperative, intra and postoperative data are analised of three insular and one parietal epileptic patients in point of view of their seizure symptomes. Complex neuroimaging, noninvasive and invasive electrophysiology, intensive long-term video-EEG monitoring, computerized EEG analysis, fuctional mapping, intraoperative corticography were used. The etiology were confirmed with hystology. It is observed that on seizure semiology our patients plays the insula a double role. In some cases, it is the focus of insular seizures with their symptoms difficult to identify. However, in the majority of cases and as a consequence of its rich neural connections, the insula has a peculiar property in the evolution of the symptomatogenic features of seizures. This observations are developing new relationships between the mechanism of seizure propagation and its semiological consequences. On epileptological point of view there are brain structures which has peculiar role in the "designe" of propagation of the epileptic excitement. The numerous new methods in neuroimaging and neurophysiology allowed the connectomical examination of the epileptic networks. The role of the epileptic diathesis is approachable with the metholdology of the brain connectivity. Theoretically the node of the epileptic network consist of the potential pathes where the localised

  14. Multidimensional assessment of personality in patients with psychogenic non-epileptic seizures

    Reuber, M; Pukrop, R; Bauer, J.; Derfuss, R; Elger, C


    Objectives: To determine whether patients with psychogenic non-epileptic seizures (PNES) have evidence of maladaptive personality, and whether they have a single or several different typical pathological personality profiles.

  15. Classification of EEG signals for detection of epileptic seizures based on wavelets and statistical pattern recognition

    Gajic, D.; Djurovic, Z.; Di Gennaro, S.; Gustafsson, Fredrik


    The electroencephalogram (EEG) signal is very important in the diagnosis of epilepsy. Long-term EEG recordings of an epileptic patient contain a huge amount of EEG data. The detection of epileptic activity is, therefore, a very demanding process that requires a detailed analysis of the entire length of the EEG data, usually performed by an expert. This paper describes an automated classification of EEG signals for the detection of epileptic seizures using wavelet transform and statistical pat...

  16. Prediction of Epileptic Seizure by Analysing Time Series EEG Signal Using k-NN Classifier

    Md. Kamrul Hasan


    Full Text Available Electroencephalographic signal is a representative signal that contains information about brain activity, which is used for the detection of epilepsy since epileptic seizures are caused by a disturbance in the electrophysiological activity of the brain. The prediction of epileptic seizure usually requires a detailed and experienced analysis of EEG. In this paper, we have introduced a statistical analysis of EEG signal that is capable of recognizing epileptic seizure with a high degree of accuracy and helps to provide automatic detection of epileptic seizure for different ages of epilepsy. To accomplish the target research, we extract various epileptic features namely approximate entropy (ApEn, standard deviation (SD, standard error (SE, modified mean absolute value (MMAV, roll-off (R, and zero crossing (ZC from the epileptic signal. The k-nearest neighbours (k-NN algorithm is used for the classification of epilepsy then regression analysis is used for the prediction of the epilepsy level at different ages of the patients. Using the statistical parameters and regression analysis, a prototype mathematical model is proposed which helps to find the epileptic randomness with respect to the age of different subjects. The accuracy of this prototype equation depends on proper analysis of the dynamic information from the epileptic EEG.

  17. Clinical evolution of epileptic seizures in children with perinatal brain pathology

    E. A. Morozova


    Full Text Available The complex mechanism of epileptogenesis has not been adequately explored. Perinatal brain pathology is one of the most important triggers of epilepsy in children. The paper gives data on the course and transformation of epileptic seizures in children who have verified perinatal problems. A study of 66 children with perinatally induced epileptic seizures has provided evidence for the evolution of impairments in cerebral hemodynamics and neuroimaging phenomena in the examined contingent of patients.

  18. Weather as a risk factor for epileptic seizures: A case-crossover study.

    Rakers, Florian; Walther, Mario; Schiffner, Rene; Rupprecht, Sven; Rasche, Marius; Kockler, Michael; Witte, Otto W; Schlattmann, Peter; Schwab, Matthias


    Most epileptic seizures occur unexpectedly and independently of known risk factors. We aimed to evaluate the clinical significance of patients' perception that weather is a risk factor for epileptic seizures. Using a hospital-based, bidirectional case-crossover study, 604 adult patients admitted to a large university hospital in Central Germany for an unprovoked epileptic seizure between 2003 and 2010 were recruited. The effect of atmospheric pressure, relative air humidity, and ambient temperature on the onset of epileptic seizures under temperate climate conditions was estimated. We found a close-to-linear negative correlation between atmospheric pressure and seizure risk. For every 10.7 hPa lower atmospheric pressure, seizure risk increased in the entire study population by 14% (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.01-1.28). In patients with less severe epilepsy treated with one antiepileptic medication, seizure risk increased by 36% (1.36, 1.09-1.67). A high relative air humidity of >80% increased seizure risk in the entire study population by up to 48% (OR 1.48, 95% CI 1.11-1.96) 3 days after exposure in a J-shaped association. High ambient temperatures of >20°C decreased seizure risk by 46% in the overall study population (OR 0.54, 95% CI 0.32-0.90) and in subgroups, with the greatest effects observed in male patients (OR 0.33, 95% CI 0.14-0.74). Low atmospheric pressure and high relative air humidity are associated with an increased risk for epileptic seizures, whereas high ambient temperatures seem to decrease seizure risk. Weather-dependent seizure risk may be accentuated in patients with less severe epilepsy. Our results require further replication across different climate regions and cohorts before reliable clinical recommendations can be made. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  19. Protective effect of hispidulin on kainic acid-induced seizures and neurotoxicity in rats.

    Lin, Tzu Yu; Lu, Cheng Wei; Wang, Su Jane; Huang, Shu Kuei


    Hispidulin is a flavonoid compound which is an active ingredient in a number of traditional Chinese medicinal herbs, and it has been reported to inhibit glutamate release. The purpose of this study was to investigate whether hispidulin protects against seizures induced by kainic acid, a glutamate analog with excitotoxic properties. The results indicated that intraperitoneally administering hispidulin (10 or 50mg/kg) to rats 30 min before intraperitoneally injecting kainic acid (15 mg/kg) increased seizure latency and decreased seizure score. In addition, hispidulin substantially attenuated kainic acid-induced hippocampal neuronal cell death, and this protective effect was accompanied by the suppression of microglial activation and the production of proinflammatory cytokines such as interleukin-1β, interleukin-6, and tumor necrosis factor-α in the hippocampus. Moreover, hispidulin reduced kainic acid-induced c-Fos expression and the activation of mitogen-activated protein kinases in the hippocampus. These data suggest that hispidulin has considerable antiepileptic, neuroprotective, and antiinflammatory effects on kainic acid-induced seizures in rats.

  20. Patterns of muscle activation during generalized tonic and tonic–clonic epileptic seizures

    Conradsen, Isa; Wolf, Peter; Sams, Thomas


    was recorded from the deltoid muscles, on both sides, during 63 seizures from 20 patients with epilepsy (10 with generalized tonic and 10 with tonic–clonic seizures). Twenty age‐ and gender‐matched normal controls simulated 100 generalized tonic seizures. To characterize the signal properties we calculated...... the root mean square (RMS) of the amplitudes, the median frequency (MF), and the coherence. Based on the spectrograms of both epileptic and simulated seizures, we chose to determine the relative spectral power (RP) in the higher (100–500 Hz) frequency domain. Key Findings: During the tonic seizures...

  1. Medical management of epileptic seizures: challenges and solutions

    Sarma AK


    Full Text Available Anand K Sarma,1 Nabil Khandker,1 Lisa Kurczewski,2 Gretchen M Brophy2 1Department of Neurology, 2Departments of Pharmacotherapy & Outcomes Science and Neurosurgery, Virginia Commonwealth University, Richmond, VA, USA Abstract: Epilepsy is one of the most common neurologic illnesses. This condition afflicts 2.9 million adults and children in the US, leading to an economic impact amounting to $15.5 billion. Despite the significant burden epilepsy places on the population, it is not very well understood. As this understanding continues to evolve, it is important for clinicians to stay up to date with the latest advances to provide the best care for patients. In the last 20 years, the US Food and Drug Administration has approved 15 new antiepileptic drugs (AEDs, with many more currently in development. Other advances have been achieved in terms of diagnostic modalities like electroencephalography technology, treatment devices like vagal nerve and deep-brain stimulators, novel alternate routes of drug administration, and improvement in surgical techniques. Specific patient populations, such as the pregnant, elderly, those with HIV/AIDS, and those with psychiatric illness, present their own unique challenges, with AED side effects, drug interactions, and medical–psychiatric comorbidities adding to the conundrum. The purpose of this article is to review the latest literature guiding the management of acute epileptic seizures, focusing on the current challenges across different practice settings, and it discusses studies in various patient populations, including the pregnant, geriatric, those with HIV/AIDS, comatose, psychiatric, and “pseudoseizure” patients, and offers possible evidence-based solutions or the expert opinion of the authors. Also included is information on newer AEDs, routes of administration, and significant AED-related drug-interaction tables. This review has tried to address only some of these issues that any practitioner who

  2. Classification of clinical semiology in epileptic seizures in neonates.

    Nagarajan, Lakshmi; Palumbo, Linda; Ghosh, Soumya


    The clinical semiology of 61 neonatal seizures with EEG correlates, in 24 babies was analysed. Most seizures (89%) had multiple features during the EEG discharge. The seizures were classified using the prominent clinical feature at onset, and all features seen during the seizure, using an extended classification scheme. Orolingual features occurred most frequently at onset (30%), whereas ocular phenomena occurred most often during the seizure (70%). Orolingual, ocular and autonomic features were seen at onset in 55% of the seizures. Seizure onsets with clonic, tonic and hypomotor features were seen in 20%, 8% and 18% respectively. Clinico-electrical correlations were as follows. The EEG discharge involved both hemispheres in 54% of all seizures, in clonic seizures this was 93%. Focal clonic seizures were associated with EEG seizure onset from the contralateral hemisphere. Majority of the clonic and hypomotor seizures had a left hemisphere ictal EEG onset. Orolingual seizures frequently started from the right hemisphere, whereas ocular and autonomic seizures arose from either hemisphere. There was no significant difference in mortality, morbidity, abnormal neuroimaging and EEG background abnormalities in babies with or without clonic seizures. This study provides insights into neuronal networks that underpin electroclinical seizures, by analysing and classifying the obvious initial clinical features and those during the seizure. Copyright © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  3. Wavelet-based texture analysis of EEG signal for prediction of epileptic seizure

    Petrosian, Arthur A.; Homan, Richard; Pemmaraju, Suryalakshmi; Mitra, Sunanda


    Electroencephalographic (EEG) signal texture content analysis has been proposed for early warning of an epileptic seizure. This approach was evaluated by investigating the interrelationship between texture features and basic signal informational characteristics, such as Kolmogorov complexity and fractal dimension. The comparison of several traditional techniques, including higher-order FIR digital filtering, chaos, autoregressive and FFT time- frequency analysis was also carried out on the same epileptic EEG recording. The purpose of this study is to investigate whether wavelet transform can be used to further enhance the developed methods for prediction of epileptic seizures. The combined consideration of texture and entropy characteristics extracted from subsignals decomposed by wavelet transform are explored for that purpose. Yet, the novel neuro-fuzzy clustering algorithm is performed on wavelet coefficients to segment given EEG recording into different stages prior to an actual seizure onset.

  4. Changes in physiological tremor associated with an epileptic seizure: a case report

    Duval Christian


    Full Text Available Abstract Introduction Epileptic seizures are associated with motor, sensory, somatosensory or autonomic symptoms that have all been described in varying detail over the years. Of interest in the present report is a case of normal physiological tremor, which to date has never been evaluated prior to and during an epileptic seizure. In fact, there is only anecdotal mention of pre-ictal and ictal changes in clinically noticeable tremor in the literature. Case presentation Our patient was a left-handed, 27-year-old Caucasian woman diagnosed seven years previously with partial epileptic seizures, secondarily generalized. Physiological tremor was measured simultaneously on the index finger of both hands of our patient. Electromyography as well as heart rate and respiration were also monitored. A previously performed electroencephalography examination revealed abnormal oscillations focalized to the left primary somatosensory cortex. She was also diagnosed with left frontal neuronal heterotopias. We detected subclinical changes in tremor characteristics, such as amplitude, median power frequency and power dispersion, contralateral to the localization of epileptic activity. Tremor characteristics remained relatively steady ipsilateral to the localization of the epileptic activity. Conclusions Changes in physiological tremor characteristics should be considered as another possible pre-ictal or ictal manifestation. We propose that the network associated with physiological tremor might be more sensitive to abnormal oscillations generated within the central nervous system by epileptic activity from certain structures.

  5. Emperor Napoleon Bonaparte: did he have seizures? Psychogenic or epileptic or both?

    Hughes, John R


    Napoleon Bonaparte was a general in the French army at 24 years of age, later conquering most of Europe. He was one of the greatest military geniuses the world has ever known, but also an extremely intelligent individual. Did he have seizures? The evidence shows that he had both psychogenic and epileptic attacks. The psychogenic attacks were likely related to the tremendous stress in his life, and the epileptic seizures were the result of chronic uremia from a severe urethral stricture caused by gonorrhea that was transmitted from his wife, Empress Josephine.

  6. PRRT2 Mutations Are Related to Febrile Seizures in Epileptic Patients

    Zheng-Wen He


    Full Text Available Previous studies reported that the proline-rich transmembrane protein 2 (PRRT2 gene was identified to be related to paroxysmal kinesigenic dyskinesia (PKD, infantile convulsions with PKD, PKD with migraine and benign familial infantile epilepsy (BFIE. The present study explores whether the PRRT2 mutation is a potential cause of febrile seizures, including febrile seizures plus (FS+, generalized epilepsy with febrile seizures plus (GEFS+ and Dravet syndrome (DS; thus, it may provide a new drug target for personalized medicine for febrile seizure patients. We screened PRRT2 exons in a cohort of 136 epileptic patients with febrile seizures, including FS+, GEFS+ and DS. PRRT2 genetic mutations were identified in 25 out of 136 (18.4% febrile seizures in epileptic patients. Five loss-of-function and coding missense mutations were identified: c.649delC (p.R217Efs*12, c.649_650insC (p.R217Pfs*8, c.412C>G (p.Pro138Ala, c.439G>C (p.Asp147His and c.623C>A (p.Ser208Tyr. PRRT2 variants were probably involved in the etiology of febrile seizures in epileptic patients.

  7. Rapidly Learned Identification of Epileptic Seizures from Sonified EEG

    Psyche eLoui


    Full Text Available Sonification refers to a process by which data are converted into sound, providing an auditory alternative to visual display. Currently, the prevalent method for diagnosing seizures in epilepsy is by visually reading a patient’s electroencephalogram (EEG. However, sonification of the EEG data provides certain advantages due to the nature of human auditory perception. We hypothesized that human listeners will be able to identify seizures from EEGs using the auditory modality alone, and that accuracy of seizure identification will increase after a short training session. Here we describe an algorithm we have used to sonify EEGs of both seizure and non-seizure activity, followed by a training study in which subjects listened to short clips of sonified EEGs and determine whether each clip was of seizure or normal activity, both before and after a short training session. Results show that before training subjects performed at chance level in differentiating seizures vs. non-seizures, but there was a significant improvement of accuracy after the training session. After training, subjects successfully distinguished seizures from non-seizures using the auditory modality alone. Further analyses using signal detection theory demonstrated improvement in sensitivity and reduction in response bias as a result of training. This study demonstrates the potential of sonified EEGs to be used for the detection of seizures. Future studies will attempt to increase accuracy using novel training and sonification modifications, with the goals of managing, predicting, and ultimately controlling seizures using sonification as a possible biofeedback-based intervention for epilepsy.

  8. Epileptic seizure in a patient with an implantable cardioverter-defibrillator: Quo vadis right ventricular lead?

    Wedekind, Horst; Rozhnev, Andrey; Kleine-Katthöfer, Peter; Kranig, Wolfgang


    The case of a 77-year-old man admitted for suspected epileptic seizure is reported. Patient history showed implantation of a single-chamber implantable cardioverter-defibrillator (ICD) after cardiac arrest in 2007 with replacement in 2012 due to battery depletion; the patient reported no previous syncope, unconsciousness or seizures. Interrogation records of the ICD showed five ventricular tachyarrhythmia episodes that corresponded to the "seizure". Further examination revealed incorrect position of the RV-lead. Diagnosis was a provoked epileptic seizure due to undersensing of ventricular tachycardia because of improper ICD lead implantation in the coronary sinus. Treatment consisted of implantation of a new device with an additional ICD lead into the right ventricle.

  9. Are Epileptic Seizures Quakes of the Brain? An Approach by Means of Nonextensive Tsallis Statistics

    Eftaxias, K; Athanasopoulou, L; Kalimeri, M; Potirakis, S M; Balasis, G


    The field of study of complex systems holds that the dynamics of complex systems are founded on universal principles that may used to describe a great variety of scientific and technological approaches of different types of natural, artificial, and social systems. Authors have suggested that earthquake dynamics and neurodynamics can be analyzed within similar mathematical frameworks, a claim further supported by recent evidence. The purpose of this paper is to suggest a shift in emphasis from the large to the small in the search for a dynamical analogy between seizure and earthquake. Our analyses focus on a single epileptic seizure generation and the activation of a single fault (earthquake) and not on the statistics of sequences of different seizures and earthquakes. A central property of the epileptic seizure / earthquake generation is the occurrence of coherent large-scale collective behaviour with very rich structure, resulting from repeated nonlinear interactions among the constituents of the system, res...

  10. [The microglial activation and the expression of heat shock protein 27 through the propagation pathway of kainic acid-induced hippocampal seizure in the rat].

    Taniwaki, Y


    We studied activation of microglia and expression of the 27 kDa heat shock protein (HSP27) in the brain during kainic acid-induced acute hippocampal seizures in rats. The microglial activation was observed at 6 hrs after seizure induction, but the expression of HSP27 was delayed until 3 days after seizure induction. The gross anatomical distributions of the two phenomena in the brain structures were almost identical, being localized not only in the primary focus at the dorsal hippocampus ipsilateral to the kainic acid injection, but also in selected remote brain structures that was highly consistent with the propagation pathways of the hippocampal seizure as detected previously by metabolic mapping. These structures included the hippocampus, amygdala, entorhinal cortex, piriform cortex, sensorimotor cortex, hypothalamus and thalamus. A close observation, however, revealed a difference in distribution of the two phenomena in the layers of the contralateral hippocampus: The HSP27 expression showed a layer-specific distribution, being localized selectively in the molecular layer and hilus of the dentate gyrus, and the radiatum and molecular layers of the CA-3 subfield suggesting the expression in the neuropil. On the other hand, the distribution of the microglial activation was non-specific to the layers, being scattered in the whole regions of the dorsal hippocampus. There were no apparent morphological changes in the neurons in these structures except for the ipsilateral dorsal hippocampus, by light microscopic examinations with hematoxylin-eosin staining. These findings thus indicate that activation of microglial cells and expression of HSP27 occur transsynaptically by epileptic activities through the propagation pathways of hippocampal seizure and suggest that these phenomena may reflect a part of early microenvironmental alterations in epileptic brain.

  11. Local cerebral blood flow and glucose metabolism during seizure in spontaneously epileptic El mice

    Hosokawa, Chisa; Ochi, Hironobu; Yamagami, Sakae; Kawabe, Joji; Kobashi, Toshiko; Okamura, Terue; Yamada, Ryusaku [Osaka City Univ. (Japan). Faculty of Medicine


    Local cerebral blood flow and glucose metabolism were examined in spontaneously epileptic El mice using autoradiography with {sup 125}I-IMP and {sup 14}C-DG in the interictal phase and during seizure. El (+) mice that developed generalized tonic-clonic convulsions and El (-) mice that received no stimulation and had no history of epileptic seizures were examined. The seizure non-susceptible, maternal strain ddY mice were used as control. Uptake ratios for IMP and DG in mouse brain were calculated using the autoradiographic density. In the interictal phase, the pattern of local cerebral blood flow of El (+) mice was similar to that of ddY and El (-) mice, and glucose metabolism in the hippocampus was higher in El (+) mice than in El (-) and ddY mice, but flow and metabolism were nearly matched. During seizure, no significant changed blood flow and increased glucose metabolism in the hippocampus, the epileptic focus, and no markedly changed blood flow and depressed glucose metabolism in other brain regions were observed and considered to be flow-metabolism uncoupling. These observations have never been reported in clinical or experimental studies of epilepsy. Seizures did not cause large regional differences in cerebral blood flow. Therefore, only glucose metabolism is useful for detection of the focus of secondary generalized seizures in El mice, and appeared possibly to be related to the pathophysiology of secondary generalized epilepsy in El mice. (author).

  12. Surface acoustic wave probe implant for predicting epileptic seizures

    Gopalsami, Nachappa [Naperville, IL; Kulikov, Stanislav [Sarov, RU; Osorio, Ivan [Leawood, KS; Raptis, Apostolos C [Downers Grove, IL


    A system and method for predicting and avoiding a seizure in a patient. The system and method includes use of an implanted surface acoustic wave probe and coupled RF antenna to monitor temperature of the patient's brain, critical changes in the temperature characteristic of a precursor to the seizure. The system can activate an implanted cooling unit which can avoid or minimize a seizure in the patient.

  13. Topographic movie of intracranial ictal high-frequency oscillations with seizure semiology: epileptic network in Jacksonian seizures.

    Akiyama, Tomoyuki; Chan, Derrick W; Go, Cristina Y; Ochi, Ayako; Elliott, Irene M; Donner, Elizabeth J; Weiss, Shelly K; Snead, O Carter; Rutka, James T; Drake, James M; Otsubo, Hiroshi


    We developed a technique to produce images of dynamic changes in ictal high-frequency oscillations (HFOs) >40 Hz recorded on subdural electroencephalography (EEG) that are time-locked to the ictal EEG and ictal semiology video. We applied this technique to Jacksonian seizures to demonstrate ictal HFO propagation along the homunculus in the primary sensory-motor cortex to visualize the underlying epileptic network. We analyzed intracranial ictal EEGs from two patients with intractable Jacksonian seizures who underwent epilepsy surgery. We calculated the degrees of increase in amplitude within 40-80, 80-200, and 200-300 Hz frequency bands compared to the interictal period and converted them into topographic movies projected onto the brain surface picture. We combined these data with the ictal EEGs and video of the patient demonstrating ictal semiology. The ictal HFOs began in the sensory cortex and appeared concomitantly with the sensory aura. They then propagated to the motor cortex at the same time that focal motor symptoms evolved. As the seizure progressed, the ictal HFOs spread or reverberated in the rolandic region. However, even when the seizure became secondarily generalized, the ictal HFOs were confined to the rolandic region. In both cases, there was increased amplitude of higher frequency bands during seizure initiation compared to seizure progression. This combined movie showed the ictal HFO propagation corresponding to the ictal semiology in Jacksonian seizures and revealed the epileptic network involved in seizure initiation and progression. This method may advance understanding of neural network activities relating to clinical seizure generation and propagation. Wiley Periodicals, Inc. © 2010 International League Against Epilepsy.

  14. Epileptic Seizure Prediction Using a New Similarity Index for Chaotic Signals

    Niknazar, Hamid; Nasrabadi, Ali Motie

    Epileptic seizures are generated by abnormal activity of neurons. The prediction of epileptic seizures is an important issue in the field of neurology, since it may improve the quality of life of patients suffering from drug resistant epilepsy. In this study a new similarity index based on symbolic dynamic techniques which can be used for extracting behavior of chaotic time series is presented. Using Freiburg EEG dataset, it is found that the method is able to detect the behavioral changes of the neural activity prior to epileptic seizures, so it can be used for prediction of epileptic seizure. A sensitivity of 63.75% with 0.33 false positive rate (FPR) in all 21 patients and sensitivity of 96.66% with 0.33 FPR in eight patients were achieved using the proposed method. Moreover, the method was evaluated by applying on Logistic and Tent map with different parameters to demonstrate its robustness and ability in determining similarity between two time series with the same chaotic characterization.

  15. Detecting and localizing the foci in human epileptic seizures

    Ben-Jacob, E; Pomyalov, A; Procaccia, I; Towle, V L; Ben-Jacob, Eshel; Boccaletti, Stefano; Pomyalov, Anna; Procaccia, Itamar; Towle, Vernon L.


    We consider the electrical signals recorded from a subdural ECoG grid of electrodes placed on the pial surface of the brain for chronic evaluation of epileptic patients before surgical resection. A simple and computationally fast method to analyze the inter-ictal phase synchrony between such electrodes is introduced and developed with the aim of detecting and localizing the foci of the epileptic events. We evaluate the method by comparing the results of surgery to the localization predicted here. We find an indication of good correspondence between the success or failure in the surgery and the agreement between our identification and the regions actually operated on.

  16. Epileptic seizure detection in EEG signal with GModPCA and support vector machine.

    Jaiswal, Abeg Kumar; Banka, Haider


    Epilepsy is one of the most common neurological disorders caused by recurrent seizures. Electroencephalograms (EEGs) record neural activity and can detect epilepsy. Visual inspection of an EEG signal for epileptic seizure detection is a time-consuming process and may lead to human error; therefore, recently, a number of automated seizure detection frameworks were proposed to replace these traditional methods. Feature extraction and classification are two important steps in these procedures. Feature extraction focuses on finding the informative features that could be used for classification and correct decision-making. Therefore, proposing effective feature extraction techniques for seizure detection is of great significance. Principal Component Analysis (PCA) is a dimensionality reduction technique used in different fields of pattern recognition including EEG signal classification. Global modular PCA (GModPCA) is a variation of PCA. In this paper, an effective framework with GModPCA and Support Vector Machine (SVM) is presented for epileptic seizure detection in EEG signals. The feature extraction is performed with GModPCA, whereas SVM trained with radial basis function kernel performed the classification between seizure and nonseizure EEG signals. Seven different experimental cases were conducted on the benchmark epilepsy EEG dataset. The system performance was evaluated using 10-fold cross-validation. In addition, we prove analytically that GModPCA has less time and space complexities as compared to PCA. The experimental results show that EEG signals have strong inter-sub-pattern correlations. GModPCA and SVM have been able to achieve 100% accuracy for the classification between normal and epileptic signals. Along with this, seven different experimental cases were tested. The classification results of the proposed approach were better than were compared the results of some of the existing methods proposed in literature. It is also found that the time and space

  17. Neuroethological approach to frontolimbic epileptic seizures and parasomnias: The same central pattern generators for the same behaviours.

    Tassinari, C A; Cantalupo, G; Högl, B; Cortelli, P; Tassi, L; Francione, S; Nobili, L; Meletti, S; Rubboli, G; Gardella, E


    The aim of this report is not to make a differential diagnosis between epileptic nocturnal seizures and non-epileptic sleep-related movement disorders, or parasomnias. On the contrary, our goal is to emphasize the commonly shared semiological features of some epileptic seizures and parasomnias. Such similar features might be explained by the activation of the same neuronal networks (so-called 'central pattern generators' or CPG). These produce the stereotypical rhythmic motor sequences - in other words, behaviours - that are adaptive and species-specific (such as eating/alimentary, attractive/aversive, locomotor and nesting habits). CPG are located at the subcortical level (mainly in the brain stem and spinal cord) and, in humans, are under the control of the phylogenetically more recent neomammalian neocortical structures, according to a simplified Jacksonian model. Based on video-polygraphic recordings of sleep-related epileptic seizures and non-epileptic events (parasomnias), we have documented how a transient "neomammalian brain" dysfunction - whether epileptic or not - can 'release' (disinhibition?) the CPG responsible for involuntary motor behaviours. Thus, in both epileptic seizures and parasomnias, we can observe: (a) oroalimentary automatisms, bruxism and biting; (b) ambulatory behaviours, ranging from the classical bimanual-bipedal activity of 'frontal' hypermotor seizures, epileptic and non-epileptic wanderings, and somnambulism to periodic leg movements (PLM), alternating leg muscle activation (ALMA) and restless legs syndrome (RLS); and (c) various sleep-related events such as ictal fear, sleep terrors, nightmares and violent behaviour.

  18. Epileptic seizures in patients with glioma: A single centre- based ...

    Pharmacotherapy Group, Faculty of Pharmacy, University of Benin, Benin City, 300001 Nigeria. All rights ... Results: Preoperative seizures were noted in 33.8 % of glioma patients. ..... adverse effects and in any case, it is important to ... data or proper documentation. .... brain tumour-related epilepsy: seizure control, safety,.

  19. Detection of tonic epileptic seizures based on surface electromyography

    Larsen, Sigge N.; Conradsen, Isa; Beniczky, Sandor


    , median frequency, zero crossing rate and approximate entropy. These features were used as input in the random forest classifier to decide if a data segment was from a seizure or not. The goal was to develop a generic algorithm for all tonic seizures, but better results were achieved when certain...

  20. Early presentation of de novo high grade glioma with epileptic seizures: electroclinical and neuroimaging findings.

    Rossi, Rosario; Figus, Andrea; Corraine, Simona


    We report the clinical, EEG and neuroradiologic findings from three adult patients who developed new-onset seizure disorders as early clinical manifestations of de novo high grade glioma. The malignancies could not be recognised at the time of the first epileptic seizure because of minimal non-specific brain abnormalities, which showed no signs of necrosis or significant contrast enhancement on computed tomography and magnetic resonance imaging. Focal EEG abnormalities were recorded in all cases and appeared consistent with the neuroradiologic findings. The patients regained normal neurological status after the first seizure but rapidly developed space-occupying necrotic lesions. Two patients underwent surgery and received histological diagnoses of the tumours. Another patient was finally diagnosed with a malignant glioma based on the neuroradiologic picture and rapid progression of the cerebral lesion. It should be noted that in adult patients, new-onset epileptic seizures might reveal the presence of malignant gliomas at a very early stage in the tumour formation process. This report indicates that typical anatomoradiologic features of de novo high grade glioma, such as necrosis and rim-contrast enhancement, could be absent at the time of the first epileptic seizure but become clear within a short period after clinical presentation.

  1. Do seizures and epileptic activity worsen epilepsy and deteriorate cognitive function?

    Avanzini, Giuliano; Depaulis, Antoine; Tassinari, Alberto; de Curtis, Marco


    Relevant to the definition of epileptic encephalopathy (EE) is the concept that the epileptic activity itself may contribute to bad outcomes, both in terms of epilepsy and cognition, above and beyond what might be expected from the underlying pathology alone, and that these can worsen over time. The review of the clinical and experimental evidence that seizures or interictal electroencephalography (EEG) discharges themselves can induce a progression toward more severe epilepsy and a regression of brain function leads to the following conclusions: The possibility of seizure-dependent worsening is by no means a general one but is limited to some types of epilepsy, namely mesial temporal lobe epilepsy (MTLE) and EEs. Clinical and experimental data concur in indicating that prolonged seizures/status epilepticus (SE) are a risky initial event that can set in motion an epileptogenic process leading to persistent, possibly drug-refractory epilepsies. The mechanisms for SE-related epileptogenic process are incompletely known; they seem to involve inflammation and/or glutamatergic transmission. The evidence of the role of recurrent individual seizures in sustaining epilepsy progression is ambiguous. The correlation between high seizure frequency and bad outcome does not necessarily demonstrate a cause-effect relationship, rather high seizure frequency and bad outcome can both depend on a particularly aggressive epileptogenic process. The results of EE studies challenge the idea of a common seizure-dependent mechanism for epilepsy progression/intellectual deterioration.

  2. Real-time Detection of Precursors to Epileptic Seizures: Non-Linear Analysis of System Dynamics.

    Nesaei, Sahar; Sharafat, Ahmad R


    We propose a novel approach for detecting precursors to epileptic seizures in intracranial electroencephalograms (iEEG), which is based on the analysis of system dynamics. In the proposed scheme, the largest Lyapunov exponent of the discrete wavelet packet transform (DWPT) of the segmented EEG signals is considered as the discriminating features. Such features are processed by a support vector machine (SVM) classifier to identify whether the corresponding segment of the EEG signal contains a precursor to an epileptic seizure. When consecutive EEG segments contain such precursors, a decision is made that a precursor is in fact detected. The proposed scheme is applied to the Freiburg dataset, and the results show that seizure precursors are detected in a time frame that unlike other existing schemes is very much convenient to patients, with sensitivity of 100% and negligible false positive detection rates.

  3. Quantitative analysis of surface electromyography during epileptic and nonepileptic convulsive seizures

    Beniczky, Sándor; Conradsen, Isa; Moldovan, Mihai


    OBJECTIVE: To investigate the characteristics of sustained muscle activation during convulsive epileptic and psychogenic nonepileptic seizures (PNES), as compared to voluntary muscle activation. The main goal was to find surface electromyography (EMG) features that can distinguish between...... convulsive epileptic seizures and convulsive PNES. METHODS: In this case-control study, surface EMG was recorded from the deltoid muscles during long-term video-electroencephalography (EEG) monitoring in 25 patients and in 21 healthy controls. A total of 46 clinical episodes were recorded: 28 generalized...... tonic-clonic seizures (GTCS) from 14 patients with epilepsy, and 18 convulsive PNES from 12 patients (one patient had both GTCS and PNES). The healthy controls were simulating GTCS. To quantitatively characterize the signals we calculated the following parameters: root mean square (RMS) of the amplitude...

  4. Increased number of febrile seizures in children born very preterm: relation of neonatal, febrile and epileptic seizures and neurological dysfunction to seizure outcome at 16 years of age.

    Herrgård, Eila A; Karvonen, Marjo; Luoma, Laila; Saavalainen, Pia; Määttä, Sara; Laukkanen, Eila; Partanen, Juhani


    In prematurely born population, a cascade of events from initial injury in the developing brain to morbidity may be followed. The aim of our study was to assess seizures in prematurely born children from birth up to 16 years and to evaluate the contribution of different seizures, and of neurological dysfunction to the seizure outcome. Pre- and neonatal data and data from neurodevelopmental examination at 5 years of 60 prospectively followed children born at or before 32 weeks of gestation, and of 60 matched term controls from the 2 year birth cohort were available from earlier phases of the study. Later seizure data were obtained from questionnaires at 5, 9, and 16 years, and from hospital records and parent interviews. In the preterm group, 16 children (27%) exhibited neonatal seizures, 10 children (17%) had seizures during febrile illness and 5 children had epilepsy. Eight children had only febrile seizures, and 3 of these had both multiple simple and complex febrile seizures and neurodevelopmental dysfunction. None of the 8 children had experienced neonatal seizures, 6 had a positive family history of seizures, but none developed epilepsy. The children with epilepsy had CP and neurocognitive problems, and all but one had experienced neonatal seizures; two of them had also had fever-induced epileptic seizures. In controls 3 children (5%) had simple febrile seizures. Children born very preterm have increased rate of febrile seizures compared to the controls. However, no cascade from initial injury via febrile seizures to epilepsy could be shown during the follow-up of 16 years. Symptomatic epilepsy in prematurely born children is characterised by neonatal seizures, major neurological disabilities and early onset of epilepsy.

  5. Seizure, Fit or Attack? The Use of Diagnostic Labels by Patients with Epileptic or Non-Epileptic Seizures

    Plug, Leendert; Sharrack, Basil; Reuber, Markus


    We present an analysis of the use of diagnostic labels such as "seizure", "attack", "fit", and "blackout" by patients who experience seizures. While previous research on patients' preferences for diagnostic terminology has relied on questionnaires, we assess patients' own preferences and their responses to a doctor's use of different labels…

  6. Serodiagnosis of neurocysticercosis in patients with epileptic seizure using ELISA and immunoblot assay.

    Ishida, Maria M I; Peralta, Regina Helena S; Livramento, José A; Hoshino-Shimizu, Sumie; Peralta, José M; Vaz, Adelaide J


    Sera from 88 patients from Santa Catarina and São Paulo states of Brazil, with epileptic seizures who underwent cerebral computed tomography (CT) were analyzed for the detection of antibodies to T. solium cysticercus by ELISA and Immunoblot (IB) with the following antigens: Taenia solium cysticercus total saline (Tso), Taenia crassiceps cysticercus vesicular fluid (Tcra-vf) and T. crassiceps cysticercus glycoproteins (Tcra-gp). ELISA carried out with Tso, Tcra-vf and Tcra-gp antigens showed 95%, 90% and 80% sensitivities, respectively, and 68%, 85% and 93% specificities, respectively. In the epileptic patients group, ELISA positivity was 30%, 51% and 35% with Tso, Tcra-vf and Tcra-gp antigens respectively. Considering the IB as the confirmatory test, the positivity was 16% (14/88) in the epileptic patients total group and 22% (12/54) in the epileptic patients with positive CT and signals of cysticercosis. We found a significant statistical correlation among ELISA or IB results and the phase of the disease when any antigens were used (p neurocysticercosis (NC) in patients presenting with epileptic seizures because of the high risk of acquiring NC in our region and its potential cause of epilepsy.

  7. Gaussian mixture model for the identification of psychogenic non-epileptic seizures using a wearable accelerometer sensor.

    Kusmakar, Shitanshu; Muthuganapathy, Ramanathan; Yan, Bernard; O'Brien, Terence J; Palaniswami, Marimuthu


    Any abnormal hypersynchronus activity of neurons can be characterized as an epileptic seizure (ES). A broad class of non-epileptic seizures is comprised of Psychogenic non-epileptic seizures (PNES). PNES are paroxysmal events, which mimics epileptic seizures and pose a diagnostic challenge with epileptic seizures due to their clinical similarities. The diagnosis of PNES is done using video-electroencephalography (VEM) monitoring. VEM being a resource intensive process calls for alternative methods for detection of PNES. There is now an emerging interest in the use of accelerometer based devices for the detection of seizures. In this work, we present an algorithm based on Gaussian mixture model (GMM's) for the identification of PNES, ES and normal movements using a wrist-worn accelerometer device. Features in time, frequency and wavelet domain are extracted from the norm of accelerometry signal. All events are then classified into three classes i.e normal, PNES and ES using a parametric estimate of the multivariate normal probability density function. An algorithm based on GMM's allows us to accurately model the non-epileptic and epileptic movements, thus enhancing the overall predictive accuracy of the system. The new algorithm was tested on data collected from 16 patients and showed an overall detection accuracy of 91% with 25 false alarms.

  8. Epileptic seizure detection in EEGs signals based on the weighted visibility graph entropy.

    Mohammadpoory, Zeynab; Nasrolahzadeh, Mahda; Haddadnia, Javad


    Epileptic seizure detection has been a complex task for both researchers and specialist in that the assessment of epilepsy is difficult because, electroencephalogram (EEG) signals are chaotic and non-stationary. This paper proposes a new method based on weighted visibility graph entropy (WVGE) to identify seizure from EEG signals. Single channel EEG signals are mapped onto the WVGs and WVGEs are calculated from these WVGs. Then some features are extracted of WVGEs and given to classifiers to investigate the performance of these features to classify the brain signals into three groups of normal (healthy), seizure free (interictal) and during a seizure (ictal) groups. Four popular classifiers namely Support Vector Machine (SVM), K-Nearest Neighbor (KNN), Decision tree (DT) and, Naïve Bayes (NB) are used in this work. Experimental results show that the proposed method can classify normal, ictal and interictal groups with a high accuracy of 97%. This high accuracy index, which is obtained using just three features, is higher than those obtained by several previous works in which more nonlinear features were employed. Also, our method is fast and easy and may be helpful in different applications of automatic seizure detection such as online epileptic seizure detection. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  9. The correlation of small spikes in Rolandic area and epileptic seizures

    KUANG Xiao-jun


    Full Text Available The correlation between small spikes in Rolandic area and epileptic seizures was investigated. In this thesis, small spikes in Rolandic area were found in 118 cases recorded by video electroencephalogram (VEEG monitoring. And the 118 patients were chose to be studied in our research. Among the 118 cases, 62 were male and 56 were female. The youngest was only 3-month-old, and the eldest was 4 years and 5 months old. Eighty-five cases were between 3 months and 2 years old which accounted for 72.03%. There were 101 patients (85.59% having seizures: 42 cases (35.59% of febrile convulsion, 35 (29.66% of benign infantile convulsions with mild gastroenteritis (BICG and 24 (20.34% of epilepsy; 17 cases (14.41% of non-epileptic seizures. Hence, there is high correlation between infantile small spikes in Rolandic area and epileptic seizures. But it does not indicate any specificity. Whether small spikes in Rolandic area can be used as certain evidence to diagnose epilepsy and locate the onset of lesions requires further study to confirm.

  10. Characteristics of Children Admitted to the Emergency Department with Convulsive Epileptic Seizures: A Single-Center Study

    Emel Ataş Berksoy


    Full Text Available Introduction: To evaluate the etiology and characteristics of children admitted to the emergency department with an acute convulsive epileptic seizure. Methods: Data of patients who were admitted to the emergency department with a convulsive epileptic seizure were reviewed. The patients were divided into febrile seizure, first idiopathic non-febrile seizure, idiopathic epilepsy, symptomatic epilepsy, and symptomatic seizure groups. Results: A total of 335 children were included in the study. Febrile seizures were the most common cause of convulsive seizure (38.5% of all visits, followed by idiopathic epilepsy-related seizures (35.8%, symptomatic epilepsy-related seizures (8.1%, first non-febrile seizures (17.6%, and symptomatic seizures (1.5%. The mean age of the patients was 4.73 years, and it was significantly lower in patients with febrile seizures when compared to the other groups (p<0.001. Conclusion: Knowing the characteristics of children admitted to the emergency department with a convulsive epileptic seizure is important to guide appropriate management and individualized follow-up.

  11. Dynamic imaging of coherent sources reveals different network connectivity underlying the generation and perpetuation of epileptic seizures.

    Lydia Elshoff

    Full Text Available The concept of focal epilepsies includes a seizure origin in brain regions with hyper synchronous activity (epileptogenic zone and seizure onset zone and a complex epileptic network of different brain areas involved in the generation, propagation, and modulation of seizures. The purpose of this work was to study functional and effective connectivity between regions involved in networks of epileptic seizures. The beginning and middle part of focal seizures from ictal surface EEG data were analyzed using dynamic imaging of coherent sources (DICS, an inverse solution in the frequency domain which describes neuronal networks and coherences of oscillatory brain activities. The information flow (effective connectivity between coherent sources was investigated using the renormalized partial directed coherence (RPDC method. In 8/11 patients, the first and second source of epileptic activity as found by DICS were concordant with the operative resection site; these patients became seizure free after epilepsy surgery. In the remaining 3 patients, the results of DICS / RPDC calculations and the resection site were discordant; these patients had a poorer post-operative outcome. The first sources as found by DICS were located predominantly in cortical structures; subsequent sources included some subcortical structures: thalamus, Nucl. Subthalamicus and cerebellum. DICS seems to be a powerful tool to define the seizure onset zone and the epileptic networks involved. Seizure generation seems to be related to the propagation of epileptic activity from the primary source in the seizure onset zone, and maintenance of seizures is attributed to the perpetuation of epileptic activity between nodes in the epileptic network. Despite of these promising results, this proof of principle study needs further confirmation prior to the use of the described methods in the clinical praxis.


    Jiao, Jianhang

    parameters regarding their ability to inhibit seizures. The present thesis hypothesized that the antiepileptic effects of vagus nerve stimulation and spinal cord stimulation could be improved by using higher stimulation frequencies than those that are currently used in clinic or proposed in the literature....

  13. Childhood masturbation simulating epileptic seizures: A report of ...



    Mar 1, 2013 ... Danfodiyo University Teaching. Hospital, Sokoto ... from a private clinic as a case of seizure disorder with poor response ... She was having 2-3 episodes per week ini- tially, but the ... up and unnecessary drug prescriptions may occur (as in ... parental inattention are some of the risk factors consid- ered for ...

  14. Dynamical analogy between epileptic seizures and seismogenic electromagnetic emissions by means of nonextensive statistical mechanics

    Eftaxias, Konstantinos; Potirakis, Stelios M; Balasis, George


    The field of study of complex systems considers that the dynamics of complex systems are founded on universal principles that may be used to describe a great variety of scientific and technological approaches of different types of natural, artificial, and social systems. Several authors have suggested that earthquake dynamics and neurodynamics can be analyzed within similar mathematical frameworks. Recently, authors have shown that a dynamical analogy supported by scale-free statistics exists between seizures and earthquakes, analysing populations of different seizures and earthquakes, respectively. The purpose of this paper is to suggest a shift in emphasis from the large to the small scale: our analyses focus on a single epileptic seizure generation and the activation of a single fault (earthquake) and not on the statistics of sequences of different seizures and earthquakes. We apply the concepts of the nonextensive statistical physics to support the suggestion that a dynamical analogy exists between the tw...

  15. Advantages of respiratory monitoring during video-EEG evaluation to differentiate epileptic seizures from other events

    Pavlova, Milena; Abdennadher, Myriam; Singh, Kanwaljit; Katz, Eliot; Llewellyn, Nichelle; Zarowsly, Marcin; White, David P.; Dworetzky, Barbara A.; Kothare, Sanjeev V.


    Distinction between epileptic (ES) and seizure-like events of non-epileptic nature(SLNE) is often difficult using descriptions of seizure semiology. Cardiopulmonary dysfunction is frequent in ES but has not been objectively examined in relationship to SLNE. Our purpose was to compare cardiopulmonary dysfunction between ES and SLNE. We prospectively recorded cardio-pulmonary function using pulse-oximetry, EKG and respiratory inductance plethysmography (RIP) in 52 ES and 22 SLNE. Comparison of cardiopulmonary complications between ES and SLNE was done using two-sample t-tests and logistic regression. Ictal bradypnea and pre-ictal bradycardia were more frequent in ES than SLNE (p1.0). Cardio-respiratory dysfunction, specifically bradypnea, apnea, pre-ictal bradycardia, and oxygen desaturation, is more frequently seen in ES than in SLNE. Tachycardia was not discriminant between ES and SLNE. PMID:24561659

  16. Quantitative analysis of surface electromyography during epileptic and nonepileptic convulsive seizures.

    Beniczky, Sándor; Conradsen, Isa; Moldovan, Mihai; Jennum, Poul; Fabricius, Martin; Benedek, Krisztina; Andersen, Noémi; Hjalgrim, Helle; Wolf, Peter


    To investigate the characteristics of sustained muscle activation during convulsive epileptic and psychogenic nonepileptic seizures (PNES), as compared to voluntary muscle activation. The main goal was to find surface electromyography (EMG) features that can distinguish between convulsive epileptic seizures and convulsive PNES. In this case-control study, surface EMG was recorded from the deltoid muscles during long-term video-electroencephalography (EEG) monitoring in 25 patients and in 21 healthy controls. A total of 46 clinical episodes were recorded: 28 generalized tonic-clonic seizures (GTCS) from 14 patients with epilepsy, and 18 convulsive PNES from 12 patients (one patient had both GTCS and PNES). The healthy controls were simulating GTCS. To quantitatively characterize the signals we calculated the following parameters: root mean square (RMS) of the amplitude, median frequency (MF), coherence, and duration of the seizures, of the clonic EMG discharges, and of the silent periods between the cloni. Based on wavelet analysis, we distinguished between a low-frequency component (LF 2-8 Hz) and a high-frequency component (HF 64-256 Hz). Duration of the seizure, and separation between the tonic and the clonic phases distinguished at group-level but not at individual level between convulsive PNES and GTCS. RMS, temporal dynamics of the HF/LF ratio, and the evolution of the silent periods differentiated between epileptic and nonepileptic convulsive seizures at the individual level. A combination between HF/LF ratio and RMS separated all PNES from the GTCS. A blinded review of the EMG features distinguished correctly between GTCS and convulsive PNES in all cases. The HF/LF ratio and the RMS of the PNES were smaller compared to the simulated seizures. In addition to providing insight into the mechanism of muscle activation during convulsive PNES, these results have diagnostic significance, at the individual level. Surface EMG features can accurately distinguish

  17. Brain Inflammation in an Infant With Hemimegalencephaly, Escalating Seizures, and Epileptic Encephalopathy.

    Kim, Se Hee; Millichap, John J; Koh, Sookyong


    Hemimegalencephaly, a congenital brain malformation typically characterized by enlargement of one hemisphere, is frequently associated with intractable epilepsy. The authors report a case of a 12-month-old girl with hemimegalencephaly who underwent semiurgent hemispherectomy because of rapidly escalating seizures, arrested development, and associated encephalopathy. The brain tissue was examined and evaluated for neuroinflammation. Immunohistochemical analysis of the brain tissue revealed the presence of abundant activated CD68-positive microglia and reactive astrogliosis. Detection of active inflammatory changes in the brain of a patient with hemimegalencephaly complicated by intractable epilepsy suggests a potential role of ongoing brain inflammation in seizure exacerbation and epileptic encephalopathy.

  18. Cardiac arrest associated with epileptic seizures: A case report with simultaneous EEG and ECG

    Jafar Mehvari


    Full Text Available Ictal asystole is a rare, probably underestimated manifestation of epileptic seizures whose pathophysiology is still debated. This report describes two patients who had cardiac asystole at the end of their seizure. The first patient was a 13-year-old boy with complex partial seizures.. His MRI showed symmetrical signal abnormality in the bilateral parietooccipital lobe accompanied by mild gliosis and volume loss. During a 3-day long-term video-EEG monitoring, he had cardiac arrest at the end of one of his seizures that was secondarily generalized. The second one was a 42-year-old veteran with penetrating head trauma in the left frontal lobe due to shell injury. During long-term video-EEG monitoring, he had one generalized tonic–clonic seizure accompanied by bradycardia and cardiac asystole. Asystoles could have a role in the incidence of sudden unexpected death in epilepsy (SUDEP, meaning that the presence of ictal bradycardia is a risk factor for SUDEP. In cases of epileptic cardiac dysrhythmia, prolonged simultaneous EEG/ECG monitoring may be required. Cardiological investigation should be included in epilepsy management.

  19. Epileptic seizure classification in EEG signals using second-order difference plot of intrinsic mode functions.

    Pachori, Ram Bilas; Patidar, Shivnarayan


    Epilepsy is a neurological disorder which is characterized by transient and unexpected electrical disturbance of the brain. The electroencephalogram (EEG) is a commonly used signal for detection of epileptic seizures. This paper presents a new method for classification of ictal and seizure-free EEG signals. The proposed method is based on the empirical mode decomposition (EMD) and the second-order difference plot (SODP). The EMD method decomposes an EEG signal into a set of symmetric and band-limited signals termed as intrinsic mode functions (IMFs). The SODP of IMFs provides elliptical structure. The 95% confidence ellipse area measured from the SODP of IMFs has been used as a feature in order to discriminate seizure-free EEG signals from the epileptic seizure EEG signals. The feature space obtained from the ellipse area parameters of two IMFs has been used for classification of ictal and seizure-free EEG signals using the artificial neural network (ANN) classifier. It has been shown that the feature space formed using ellipse area parameters of first and second IMFs has given good classification performance. Experimental results on EEG database available by the University of Bonn, Germany, are included to illustrate the effectiveness of the proposed method.

  20. Comparison of fractal dimension estimation algorithms for epileptic seizure onset detection

    Polychronaki, G. E.; Ktonas, P. Y.; Gatzonis, S.; Siatouni, A.; Asvestas, P. A.; Tsekou, H.; Sakas, D.; Nikita, K. S.


    Fractal dimension (FD) is a natural measure of the irregularity of a curve. In this study the performances of three waveform FD estimation algorithms (i.e. Katz's, Higuchi's and the k-nearest neighbour (k-NN) algorithm) were compared in terms of their ability to detect the onset of epileptic seizures in scalp electroencephalogram (EEG). The selection of parameters involved in FD estimation, evaluation of the accuracy of the different algorithms and assessment of their robustness in the presence of noise were performed based on synthetic signals of known FD. When applied to scalp EEG data, Katz's and Higuchi's algorithms were found to be incapable of producing consistent changes of a single type (either a drop or an increase) during seizures. On the other hand, the k-NN algorithm produced a drop, starting close to the seizure onset, in most seizures of all patients. The k-NN algorithm outperformed both Katz's and Higuchi's algorithms in terms of robustness in the presence of noise and seizure onset detection ability. The seizure detection methodology, based on the k-NN algorithm, yielded in the training data set a sensitivity of 100% with 10.10 s mean detection delay and a false positive rate of 0.27 h-1, while the corresponding values in the testing data set were 100%, 8.82 s and 0.42 h-1, respectively. The above detection results compare favourably to those of other seizure onset detection methodologies applied to scalp EEG in the literature. The methodology described, based on the k-NN algorithm, appears to be promising for the detection of the onset of epileptic seizures based on scalp EEG.

  1. [Postoperative seizure in an epileptic patient with dentatorubral pallidoluysian atrophy].

    Yanagidate, Fumi; Dohi, Shuji; Hamaya, Yoshihiro; Ueda, Norio


    A 28-year-old male with dentatorubral pallidoluysian atrophy (DRPLA) was scheduled for evulsion of bone marrow nail after tibia fracture. He was diagnosed as having DRPLA at the age of 12. Although he was receiving anticonvulsants, regular seizures had occurred occasionally and his symptoms were exacerbating. General anesthesia was induced and maintained with intravenous propofol supplemented with fentanyl, nitrous oxide, and oxygen. The operation was performed uneventfully. After the surgery, his breathing was depressed and naloxone was administered to reverse the depression. Thereafter, generalized tonic seizure associated with involuntary movement of the left arm occurred. These symptoms ceased soon after rapid injection of diazepam. Inhaled and intravenous anesthetics have been alleged to have both proconvulsant and anticonvulsant activities in humans. In the present patient with DRPLA, propofol, fentanyl, nitrous oxide, naloxone, and neostigmine administered might be factors, which could have lowered the threshold for seizure activity. Further, patients with DRPLA might have decreased GABA in the basal ganglia, and anesthetics would affect GABA receptors. Thus we should be aware of occurrence of convulsion in DRPLA patients during and after anesthesia.

  2. Temporal seizure focus and status epilepticus are associated with high-sensitive troponin I elevation after epileptic seizures.

    Chatzikonstantinou, Anastasios; Ebert, Anne D; Hennerici, Michael G


    Postictal elevation of high-sensitive troponin I (TNI), a highly specific biomarker for myocardial ischemia, has been reported. We aimed at evaluating its association of high-sensitive troponin I (TNI) with seizure type and focus, as well as vascular risk factors. TNI was measured in 247 patients admitted to our clinic via the emergency room with an acute epileptic seizure. TNI control measurements were performed in 61.5% of cases. All patients underwent electroencephalography and cerebral imaging. Seizure focus - when possible - was determined using results from these examinations as well as clinical data. Of 247 patients, 133 (53.8%) were men, the mean age was 59 ± 18 years. 70 (28.3%) patients had focal and 177 (71.7%) generalized seizures. Status epilepticus was present in 38 cases (15.4%). Mean TNI was 0.05 ± 0.17. TNI was elevated in 27 patients (10.9%). Higher age, status epilepticus and temporal seizure focus were significantly associated with TNI elevation in multivariate analysis. In 21 (13.8%) of the patients with TNI control measurement, TNI was continuously elevated. Higher age and temporal seizure focus were significantly associated with continuously high TNI. Coronary heart disease and vascular risk factors were significantly associated with high TNI only in univariate analysis. No patient had a symptomatic myocardial ischemia. Postictal TNI elevation is relatively common in older patients with status epilepticus or temporal seizure focus. These data support the concept of relevant and possibly dangerous ictal effects on cardiac function especially in temporal lobe seizures. Although the risk of manifest postictal myocardial infarction seems to be very low, selected patients could profit from closer monitoring. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Time-frequency texture descriptors of EEG signals for efficient detection of epileptic seizure.

    Şengür, Abdulkadir; Guo, Yanhui; Akbulut, Yaman


    Detection of epileptic seizure in electroencephalogram (EEG) signals is a challenging task and requires highly skilled neurophysiologists. Therefore, computer-aided detection helps neurophysiologist in interpreting the EEG. In this paper, texture representation of the time-frequency (t-f) image-based epileptic seizure detection is proposed. More specifically, we propose texture descriptor-based features to discriminate normal and epileptic seizure in t-f domain. To this end, three popular texture descriptors are employed, namely gray-level co-occurrence matrix (GLCM), texture feature coding method (TFCM), and local binary pattern (LBP). The features that are obtained on the GLCM are contrast, correlation, energy, and homogeneity. Moreover, in the TFCM method, several statistical features are calculated. In addition, for the LBP, the histogram is used as a feature. In the classification stage, a support vector machine classifier is employed. We evaluate our proposal with extensive experiments. According to the evaluated terms, our method produces successful results. 100 % accuracy is obtained with LIBLINEAR. We also compare our method with other published methods and the results show the superiority of our proposed method.

  4. Clinical characteristics of epileptic seizures in a case of dihydropteridine reductase deficiency

    Mahoko Furujo


    Full Text Available We assessed the clinical characteristics and efficacy of neurotransmitters and levetiracetam in a patient with hyperphenylalaninemia due to dihydropteridine reductase (DHPR deficiency who developed epileptic seizures. A boy with DHPR deficiency, who had been successfully treated with tetrahydrobiopterin (BH4, levodopa, and 5-hydroxytryptophan (5-HTP since he was 2 months old, started having monthly episodes of blurred vision, loss of consciousness, and falls at the age of 12 years. He was taking BH4 510 mg/day, levodopa 670 mg/day, 5-HTP 670 mg/day, and entacapone 300 mg/day. We evaluated the seizure semiology, EEG findings, and efficacy of levodopa, 5-HTP, and levetiracetam (LEV. His seizures were comprised of an abrupt loss of awareness and eye deviation to the right. Interictal EEG showed slightly slow posterior-dominant rhythm in 7–8 Hz; intermittent, irregular slowing in the bilateral parieto-occipital region; and multiregional independent spikes in bilateral hemispheres. Ictal EEG showed a seizure pattern starting at the left temporal region. Brain MRI showed diffuse signal increase of deep white matter on T2-weighted and FLAIR images. Dosage increase of levodopa to 1340 mg/day, of 5-HTP to 1500 mg/day, or of both did not suppress seizures. Levetiracetam 2000 mg/day markedly reduced seizures without any adverse events. Patients with DHPR deficiency can develop epileptic seizures of partial onset which can be successfully and safely treated with LEV.

  5. Increased hair cortisol and antecedent somatic complaints in children with a first epileptic seizure.

    Stavropoulos, Ioannis; Pervanidou, Panagiota; Gnardellis, Charalampos; Loli, Nomiki; Theodorou, Virginia; Mantzou, Aimilia; Soukou, Faye; Sinani, Olga; Chrousos, George P


    Stress is the most frequent seizure-precipitating factor reported by patients with epilepsy, while stressful life events may increase seizure susceptibility in humans. In this study, we investigated the relations between both biological and behavioral measures of stress in children with a first epileptic seizure (hereafter called seizure). We hypothesized that hair cortisol, a biomarker of chronic stress reflecting approximately 3months of preceding exposure, might be increased in children with a first seizure. We also employed standardized questionnaires to examine presence of stress-related behavioral markers. This was a cross-sectional clinical study investigating stress-related parameters in children with a first seizure (First Epileptic Seizure Group (FESG), n=22) in comparison to healthy children without seizures (Control Group, n=29). Within 24h after a first seizure, hair samples were collected from children for the determination of cortisol. In parallel, perceived stress and anxiety and depressive symptoms were examined with appropriate self- and parent-completed questionnaires, and history of stressful life events during the past year was recorded. Emotional and behavioral problems were also assessed by parent-reported validated and widely-used questionnaires. Higher hair cortisol measurements were observed in the FESG than control children (7.5 versus 5.0pg/mg respectively, p=0.001). The former were more likely to complain of somatic problems than the latter (59.8 vs. 55.4 according to DSM-oriented Scale, p=0.021); however, there were no differences in perceived stress and anxiety or depressive symptoms between the two groups. Using ROC analysis of hair cortisol measurements for predicting disease status, the maximum sensitivity and specificity were observed for a cut-off point of 5.25pg/mg. Increased hair cortisol indicates chronic hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis prior to the first seizure. This might have contributed to

  6. Can hyper-synchrony in meditation lead to seizures? Similarities in meditative and epileptic brain states.

    Lindsay, Shane


    Meditation is used worldwide by millions of people for relaxation and stress relief. Given sufficient practice, meditators may also experience a variety of altered states of consciousness. These states can lead to a variety of unusual experiences, including physical, emotional and psychic disturbances. This paper highlights the correspondences between brain states associated with these experiences and the symptoms and neurophysiology of epileptic simple partial seizures. Seizures, like meditation practice, can result in both positive and negative experiences. The neurophysiology and chemistry underlying simple partial seizures are characterised by a high degree of excitability and high levels of neuronal synchrony in gamma-band brain activity. Following a survey of the literature that shows that meditation practice is also linked to high power gamma activity, an account of how meditation could cause such activity is provided. This paper discusses the diagnostic challenges for the claim that meditation practices lead to brain states similar to those found in epileptic seizures, and seeks to develop our understanding of the range of pathological and non-pathological states that result from a hyper-excited and hyper-synchronous brain.

  7. VEGF receptor-2 (Flk-1 overexpression in mice counteracts focal epileptic seizures.

    Litsa Nikitidou

    Full Text Available Vascular endothelial growth factor (VEGF was first described as an angiogenic agent, but has recently also been shown to exert various neurotrophic and neuroprotective effects in the nervous system. These effects of VEGF are mainly mediated by its receptor, VEGFR-2, which is also referred to as the fetal liver kinase receptor 1 (Flk-1. VEGF is up-regulated in neurons and glial cells after epileptic seizures and counteracts seizure-induced neurodegeneration. In vitro, VEGF administration suppresses ictal and interictal epileptiform activity caused by AP4 and 0 Mg(2+ via Flk-1 receptor. We therefore explored whether increased VEGF signaling through Flk-1 overexpression may regulate epileptogenesis and ictogenesis in vivo. To this extent, we used transgenic mice overexpressing Flk-1 postnatally in neurons. Intriguingly, Flk-1 overexpressing mice were characterized by an elevated threshold for seizure induction and a decreased duration of focal afterdischarges, indicating anti-ictal action. On the other hand, the kindling progression in these mice was similar to wild-type controls. No significant effects on blood vessels or glia cells, as assessed by Glut1 and GFAP immunohistochemistry, were detected. These results suggest that increased VEGF signaling via overexpression of Flk-1 receptors may directly affect seizure activity even without altering angiogenesis. Thus, Flk-1 could be considered as a novel target for developing future gene therapy strategies against ictal epileptic activity.

  8. Recurrent prolonged fugue states as the sole manifestation of epileptic seizures

    Geeta A Khwaja


    Full Text Available A fugue state is defined as an altered state of consciousness with varying degrees of motor activity and amnesia for the event. It may last for hours to days and may be psychogenic or organic in nature. Epileptic fugue states can be encountered in patients with absence or complex partial nonconvulsive status epilepticus or may occur as a postictal phenomenon in patients with generalized seizures. ′′absence status epilepticus′′ (AS is rare and seen in only 2.6% of the cases with ′′childhood absence epilepsy′′ (CAE. The diagnosis of AS can be elusive, but sudden onset and termination of the fugue state, classical electroencephalogram (EEG features, and response to a therapeutic trial of benzodiazepines helps in confirming the diagnosis and differentiating it from nonepileptic fugue states. We report a childhood onset case, with a 10 years history of recurrent episodes of prolonged fugue state lasting for up to 24 h, as the sole manifestation of epileptic seizures. The EEG features were suggestive of an AS, but there was no history of typical absences, myoclonus, or generalized tonic clonic seizures. This unusual and rare case cannot be categorized into one of the defined epilepsy syndromes like CAE but belongs to a recently identified syndrome of idiopathic generalized epilepsy known as ′′Absence status epilepsy′′ in which AS is the sole or the predominant seizure type.

  9. Patients with epilepsy and patients with psychogenic non-epileptic seizures

    Turner, Katherine; Piazzini, Ada; Chiesa, Valentina


    PURPOSE: The incidence of psychogenic non-epileptic seizures (PNES) is 4.9/100,000/year and it is estimated that about 20-30% of patients referred to tertiary care epilepsy centers for refractory seizures have both epilepsy and PNES. The purpose of our study is to evaluate psychiatric disorders...... and neuropsychological functions among patients with PNES, patients with epilepsy associated with PNES and patients with epilepsy. METHODS: We evaluated 66 consecutive in-patients with video-EEG recordings: 21 patients with epilepsy, 22 patients with PNES and 10 patients with epilepsy associated with PNES; 13 patients...... were excluded (8 because of mental retardation and 5 because they did not present seizures or PNES during the recording period). RESULTS: All patients with PNES had a psychiatric diagnosis (100%) vs. 52% of patients with epilepsy. Cluster B personality disorders were more common in patients with PNES...

  10. Non-invasive imaging of epileptic seizures in vivo using photoacoustic tomography

    Zhang Qizhi; Carney, Paul R; Yuan Zhen; Jiang Huabei [J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611 (United States); Liu Zhao [Department of Pediatrics, Division of Pediatric Neurology, University of Florida, Gainesville, FL 32610 (United States); Chen Huanxin; Roper, Steven N [Department of Neurosurgery, University of Florida, Gainesville, FL 32610-0265 (United States)], E-mail:


    Non-invasive laser-induced photoacoustic tomography (PAT) is an emerging imaging modality that has the potential to image the dynamic function of the brain due to its unique ability of imaging biological tissues with high optical contrast and ultrasound resolution. Here we report the first application of our finite-element-based PAT for imaging of epileptic seizures in an animal model. In vivo photoacoustic images were obtained in rats with focal seizures induced by microinjection of bicuculline, a GABA{sub A} antagonist, into the neocortex. The seizure focus was accurately localized by PAT as confirmed with gold-standard electroencephalogram (EEG). Compared to the existing neuroimaging modalities, PAT not only has the unprecedented advantage of high spatial and temporal resolution in a single imaging modality, but also is portable and low in cost, making it possible to bring brain imaging to the bedside.

  11. Auricular Acupuncture May Suppress Epileptic Seizures via Activating the Parasympathetic Nervous System: A Hypothesis Based on Innovative Methods.

    He, Wei; Rong, Pei-Jing; Li, Liang; Ben, Hui; Zhu, Bing; Litscher, Gerhard


    Auricular acupuncture is a diagnostic and treatment system based on normalizing the body's dysfunction. An increasing number of studies have demonstrated that auricular acupuncture has a significant effect on inducing parasympathetic tone. Epilepsy is a neurological disorder consisting of recurrent seizures resulting from excessive, uncontrolled electrical activity in the brain. Autonomic imbalance demonstrating an increased sympathetic activity and a reduced parasympathetic activation is involved in the development and progress of epileptic seizures. Activation of the parasympathetic nervous system such as vagus nerve stimulation has been used for the treatment of intractable epilepsy. Here, we propose that auricular acupuncture may suppress epileptic seizures via activating the parasympathetic nervous system.

  12. Auricular Acupuncture May Suppress Epileptic Seizures via Activating the Parasympathetic Nervous System: A Hypothesis Based on Innovative Methods

    Wei He


    Full Text Available Auricular acupuncture is a diagnostic and treatment system based on normalizing the body's dysfunction. An increasing number of studies have demonstrated that auricular acupuncture has a significant effect on inducing parasympathetic tone. Epilepsy is a neurological disorder consisting of recurrent seizures resulting from excessive, uncontrolled electrical activity in the brain. Autonomic imbalance demonstrating an increased sympathetic activity and a reduced parasympathetic activation is involved in the development and progress of epileptic seizures. Activation of the parasympathetic nervous system such as vagus nerve stimulation has been used for the treatment of intractable epilepsy. Here, we propose that auricular acupuncture may suppress epileptic seizures via activating the parasympathetic nervous system.

  13. Detection of epileptic seizure in EEG signals using linear least squares preprocessing.

    Roshan Zamir, Z


    An epileptic seizure is a transient event of abnormal excessive neuronal discharge in the brain. This unwanted event can be obstructed by detection of electrical changes in the brain that happen before the seizure takes place. The automatic detection of seizures is necessary since the visual screening of EEG recordings is a time consuming task and requires experts to improve the diagnosis. Much of the prior research in detection of seizures has been developed based on artificial neural network, genetic programming, and wavelet transforms. Although the highest achieved accuracy for classification is 100%, there are drawbacks, such as the existence of unbalanced datasets and the lack of investigations in performances consistency. To address these, four linear least squares-based preprocessing models are proposed to extract key features of an EEG signal in order to detect seizures. The first two models are newly developed. The original signal (EEG) is approximated by a sinusoidal curve. Its amplitude is formed by a polynomial function and compared with the predeveloped spline function. Different statistical measures, namely classification accuracy, true positive and negative rates, false positive and negative rates and precision, are utilised to assess the performance of the proposed models. These metrics are derived from confusion matrices obtained from classifiers. Different classifiers are used over the original dataset and the set of extracted features. The proposed models significantly reduce the dimension of the classification problem and the computational time while the classification accuracy is improved in most cases. The first and third models are promising feature extraction methods with the classification accuracy of 100%. Logistic, LazyIB1, LazyIB5, and J48 are the best classifiers. Their true positive and negative rates are 1 while false positive and negative rates are 0 and the corresponding precision values are 1. Numerical results suggest that these

  14. Dynamical analogy between epileptic seizures and seismogenic electromagnetic emissions by means of nonextensive statistical mechanics

    Eftaxias, Konstantinos; Minadakis, George; Potirakis, Stelios. M.; Balasis, Georgios


    The field of study of complex systems considers that the dynamics of complex systems are founded on universal principles that may be used to describe a great variety of scientific and technological approaches of different types of natural, artificial, and social systems. Several authors have suggested that earthquake dynamics and neurodynamics can be analyzed within similar mathematical frameworks. Recently, authors have shown that a dynamical analogy supported by scale-free statistics exists between seizures and earthquakes, analyzing populations of different seizures and earthquakes, respectively. The purpose of this paper is to suggest a shift in emphasis from the large to the small scale: our analyses focus on a single epileptic seizure generation and the activation of a single fault (earthquake) and not on the statistics of sequences of different seizures and earthquakes. We apply the concepts of the nonextensive statistical physics to support the suggestion that a dynamical analogy exists between the two different extreme events, seizures and earthquakes. We also investigate the existence of such an analogy by means of scale-free statistics (the Gutenberg-Richter distribution of event sizes and the distribution of the waiting time until the next event). The performed analysis confirms the existence of a dynamic analogy between earthquakes and seizures, which moreover follow the dynamics of magnetic storms and solar flares.

  15. Electroencephalographic evaluation of gold wire implants inserted in acupuncture points in dogs with epileptic seizures.

    Goiz-Marquez, G; Caballero, S; Solis, H; Rodriguez, C; Sumano, H


    The purpose of this study was to evaluate both, clinically and with electroencephalographic (EEG) recordings, the effect of gold wire implants in acupuncture points in dogs with uncontrolled idiopathic epileptic seizures. Fifteen dogs with such diagnosis were enrolled in the study. A first EEG recording was performed in all dogs under anaesthesia with xylazine (1mg/kg) and propofol (6 mg/kg) before the treatment protocol, and a second EEG was performed 15 weeks later. Relative frequency power, intrahemispheric coherence available through EEG, number of seizures and seizure severity were compared before and after treatment using a Wilcoxon signed-rank test. There were no significant statistical differences before and after treatment in relative power or in intrahemispheric coherence in the EEG recording. However, there was a significant mean difference in seizure frequency and seizure severity between control and treatment periods. After treatment, nine of the 15 dogs (60%) had at least a 50% reduction in seizures frequency during the 15 weeks established as follow-up of this treatment.

  16. Conversation analysis in the differential diagnosis of Italian patients with epileptic or psychogenic non-epileptic seizures: a blind prospective study.

    Cornaggia, Cesare Maria; Gugliotta, Simona Corinna; Magaudda, Adriana; Alfa, Rossella; Beghi, Massimiliano; Polita, Maria


    The differential diagnosis of epileptic seizures (ES) and psychogenic non-epileptic seizures (PNES) is often difficult. The diagnostic gold standard is video-EEG, but this procedure is limited because of its high cost and is not always available. Research groups from Germany and Britain have used conversation analysis (CA) of patients' descriptions of their seizures as a means of differentiating the type of seizure. The aim of this study was to verify the value of their considerations in relation to the Italian language. Ten subjects (five with ES and five with PNES) diagnosed by means of the video-EEG recording of one seizure were studied under blind conditions by a linguist. The patients with ES described their seizures in as much detail as possible and tried to reconstruct the experience as fully as they can, making an effort to describe their subjective symptoms, quantify the duration of the phases preceding and following the seizure, and use the image of an external entity overcoming them. On the contrary, the patients with PNES repeated their extraneousness to the events that occur, refused to reply, expressed amnesia, reconstructed the happening by referring to descriptions provided by witnesses, and often describe their seizures using the image of an internal entity of which they were victims. The linguist correctly identified nine cases out of ten using CA.

  17. Epileptic Seizure Detection in Eeg Signals Using Multifractal Analysis and Wavelet Transform

    Uthayakumar, R.; Easwaramoorthy, D.


    This paper explores the three different methods to explicitly recognize the healthy and epileptic EEG signals: Modified, Improved, and Advanced forms of Generalized Fractal Dimensions (GFD). The newly proposed scheme is based on GFD and the discrete wavelet transform (DWT) for analyzing the EEG signals. First EEG signals are decomposed into approximation and detail coefficients using DWT and then GFD values of the original EEGs, approximation and detail coefficients are computed. Significant differences are observed among the GFD values of the healthy and epileptic EEGs allowing us to classify seizures with high accuracy. It is shown that the classification rate is very less accurate without DWT as a preprocessing step. The proposed idea is illustrated through the graphical and statistical tools. The EEG data is further tested for linearity by using normal probability plot and we proved that epileptic EEG had significant nonlinearity whereas healthy EEG distributed normally and similar to Gaussian linear process. Therefore, we conclude that the GFD and the wavelet decomposition through DWT are the strong indicators of the state of illness of epileptic patients.

  18. Expression of connexin 36 in central nervous system and its role in epileptic seizure

    PENG Yu-fen; WU Jiong-xing; YANG Heng; DONG Xuan-qi; ZHENG Wen; SONG Zhi


    Objective This review discusses the experimental and clinical studies those show the expression of connexin 36 in the central nervous system and the possible role of connexin 36 in epileptic seizure.Data sources All articles used in this review were mainly searched from PubMed published in English from 1996 to 2012.Study selection Odginal articles and reviews were selected if they were related to the expression of connexin 36 in the central nervous system and its role in epilepsy.Results The distribution of connexin 36 is developmentally regulated,cell-specific and region-specific.Connexin 36 is involved in some neuronal functions and epileptic synchronization.Changes in the connexin 36 gene and protein were accompanied by seizures.Selective gap junction blockers have exerted anticonvulsant actions in a variety of experiments examined in both humans end experimental animals.Conclusions Connexin 36 plays an important role in both physiological and pathological conditions in the central nervous system.A better understanding of the role of connexin 36 in seizure activity may contribute to the development of new therapeutic approaches to treating epilepsy.

  19. Ecstatic epileptic seizures: a glimpse into the multiple roles of the insula

    Markus eGschwind


    Full Text Available Ecstatic epileptic seizures are a rare but compelling epileptic entity. During the first seconds of these seizures, ecstatic auras provoke feelings of well-being, intense serenity, bliss, and enhanced self-awareness. They are associated with the impression of time dilation, and can be described as a mystic experience by some patients. The functional neuroanatomy of ecstatic seizures is still debated. During recent years several patients presenting with ecstatic auras have been reported by others and us (in total n=49; a few of them in the setting of presurgical evaluation including electrical brain stimulation. According to the recently recognized functions of the insula, and the results of nuclear brain imaging and electrical stimulation, the ecstatic symptoms in these patients seem to localize to a functional network centered around the anterior insular cortex, where we thus propose to locate this rare ictal phenomenon. Here we summarize the role of the multiple sensory, autonomic, affective and cognitive functions of the insular cortex, which are integrated into the creation of self-awareness, and we suggest how this system may become dysfunctional on several levels during ecstatic aura.

  20. The influence of hubs in the structure of a neuronal network during an epileptic seizure

    Rodrigues, Abner Cardoso; Cerdeira, Hilda A.; Machado, Birajara Soares


    In this work, we propose changes in the structure of a neuronal network with the intention to provoke strong synchronization to simulate episodes of epileptic seizure. Starting with a network of Izhikevich neurons we slowly increase the number of connections in selected nodes in a controlled way, to produce (or not) hubs. We study how these structures alter the synchronization on the spike firings interval, on individual neurons as well as on mean values, as a function of the concentration of connections for random and non-random (hubs) distribution. We also analyze how the post-ictal signal varies for the different distributions. We conclude that a network with hubs is more appropriate to represent an epileptic state.

  1. Application of approximate entropy on dynamic characteristics of epileptic absence seizure

    Yi Zhou; Ruimei Huang; Ziyi Chen; Xin Chang; Jialong Chen; Lingli Xie


    Electroencephalogram signals are time-varying complex electrophysiological signals. Existing studies show that approximate entropy, which is a nonlinear dynamics index, is not an ideal method for electroencephalogram analysis. Clinical electroencephalogram measurements usually contain electrical interference signals, creating additional challenges in terms of maintaining robustness of the analytic methods. There is an urgent need for a novel method of nonlinear dynamical analysis of the electroencephalogram that can characterize seizure-related changes in cerebral dynamics. The aim of this paper was to study the fluctuations of approximate entropy in preictal, ictal, and postictal electroencephalogram signals from a patient with absence seizures, and to improve the algorithm used to calculate the approximate entropy. The approximate entropy algorithm, especially our modified version, could accurately describe the dynamical changes of the brain during absence seizures. We could also demonstrate that the complexity of the brain was greater in the normal state than in the ictal state. The fluctuations of the approximate entropy before epileptic seizures observed in this study can form a goodbasis for further study on the prediction of seizures with nonlinear dynamics.

  2. Epileptic Seizure Prediction by a System of Particle Filter Associated with a Neural Network

    Liu, Derong; Pang, Zhongyu; Wang, Zhuo


    None of the current epileptic seizure prediction methods can widely be accepted, due to their poor consistency in performance. In this work, we have developed a novel approach to analyze intracranial EEG data. The energy of the frequency band of 4-12 Hz is obtained by wavelet transform. A dynamic model is introduced to describe the process and a hidden variable is included. The hidden variable can be considered as indicator of seizure activities. The method of particle filter associated with a neural network is used to calculate the hidden variable. Six patients' intracranial EEG data are used to test our algorithm including 39 hours of ictal EEG with 22 seizures and 70 hours of normal EEG recordings. The minimum least square error algorithm is applied to determine optimal parameters in the model adaptively. The results show that our algorithm can successfully predict 15 out of 16 seizures and the average prediction time is 38.5 minutes before seizure onset. The sensitivity is about 93.75% and the specificity (false prediction rate) is approximately 0.09 FP/h. A random predictor is used to calculate the sensitivity under significance level of 5%. Compared to the random predictor, our method achieved much better performance.

  3. Proposing a two-level stochastic model for epileptic seizure genesis.

    Shayegh, F; Sadri, S; Amirfattahi, R; Ansari-Asl, K


    By assuming the brain as a multi-stable system, different scenarios have been introduced for transition from normal to epileptic state. But, the path through which this transition occurs is under debate. In this paper a stochastic model for seizure genesis is presented that is consistent with all scenarios: a two-level spontaneous seizure generation model is proposed in which, in its first level the behavior of physiological parameters is modeled with a stochastic process. The focus is on some physiological parameters that are essential in simulating different activities of ElectroEncephaloGram (EEG), i.e., excitatory and inhibitory synaptic gains of neuronal populations. There are many depth-EEG models in which excitatory and inhibitory synaptic gains are the adjustable parameters. Using one of these models at the second level, our proposed seizure generator is complete. The suggested stochastic model of first level is a hidden Markov process whose transition matrices are obtained through analyzing the real parameter sequences of a seizure onset area. These real parameter sequences are estimated from real depth-EEG signals via applying a parameter identification algorithm. In this paper both short-term and long-term validations of the proposed model are done. The long-term synthetic depth-EEG signals simulated by this model can be taken as a suitable tool for comparing different seizure prediction algorithms.

  4. IPS Interest in the EEG of Patients after a Single Epileptic Seizure

    Mounach, Jamal; Satte, Amal; Ouhabi, Hamid; El Hessni, Aboubaker


    Objective. This study aims to evaluate the incidence of pathological cerebral activity responses to intermittent rhythmic photic stimulation (IPS) after a single epileptic seizure. Patients and Methods. One hundred and thirty-seven EEGs were performed at the Neurophysiology Department of Mohamed V Teaching Military Hospital in Rabat. Clinical and EEG data was collected. Results. 9.5% of our patients had photoparoxysmal discharges (PPD). Incidence was higher in males than in females, but p value was not significant (p = 0.34), and it was higher in children compared to adults with significant p value (p = 0.08). The most epileptogenic frequencies were within the range 15–20 Hz. 63 patients had an EEG after 72 hours; among them 11 were photosensitive (p = 0.001). The frequency of the PPR was significantly higher in patients with generalized abnormalities than in focal abnormalities (p = 0.001). EEG confirmed a genetic generalized epilepsy in 8 cases among 13 photosensitive patients. Conclusion. PPR is age related. The frequencies within the range 15–20 Hz should inevitably be included in EEG protocols. The presence of PPR after a first seizure is probably more in favor of generalized seizure rather than the other type of seizure. PPR seems independent from the delay Seizure-EEG. Our study did not show an association between sex and photosensitivity. PMID:27635393

  5. IPS Interest in the EEG of Patients after a Single Epileptic Seizure

    Fatima Zahra Taoufiqi


    Full Text Available Objective. This study aims to evaluate the incidence of pathological cerebral activity responses to intermittent rhythmic photic stimulation (IPS after a single epileptic seizure. Patients and Methods. One hundred and thirty-seven EEGs were performed at the Neurophysiology Department of Mohamed V Teaching Military Hospital in Rabat. Clinical and EEG data was collected. Results. 9.5% of our patients had photoparoxysmal discharges (PPD. Incidence was higher in males than in females, but p value was not significant (p=0.34, and it was higher in children compared to adults with significant p value (p=0.08. The most epileptogenic frequencies were within the range 15–20 Hz. 63 patients had an EEG after 72 hours; among them 11 were photosensitive (p=0.001. The frequency of the PPR was significantly higher in patients with generalized abnormalities than in focal abnormalities (p=0.001. EEG confirmed a genetic generalized epilepsy in 8 cases among 13 photosensitive patients. Conclusion. PPR is age related. The frequencies within the range 15–20 Hz should inevitably be included in EEG protocols. The presence of PPR after a first seizure is probably more in favor of generalized seizure rather than the other type of seizure. PPR seems independent from the delay Seizure-EEG. Our study did not show an association between sex and photosensitivity.

  6. An Automatic Prediction of Epileptic Seizures Using Cloud Computing and Wireless Sensor Networks.

    Sareen, Sanjay; Sood, Sandeep K; Gupta, Sunil Kumar


    Epilepsy is one of the most common neurological disorders which is characterized by the spontaneous and unforeseeable occurrence of seizures. An automatic prediction of seizure can protect the patients from accidents and save their life. In this article, we proposed a mobile-based framework that automatically predict seizures using the information contained in electroencephalography (EEG) signals. The wireless sensor technology is used to capture the EEG signals of patients. The cloud-based services are used to collect and analyze the EEG data from the patient's mobile phone. The features from the EEG signal are extracted using the fast Walsh-Hadamard transform (FWHT). The Higher Order Spectral Analysis (HOSA) is applied to FWHT coefficients in order to select the features set relevant to normal, preictal and ictal states of seizure. We subsequently exploit the selected features as input to a k-means classifier to detect epileptic seizure states in a reasonable time. The performance of the proposed model is tested on Amazon EC2 cloud and compared in terms of execution time and accuracy. The findings show that with selected HOS based features, we were able to achieve a classification accuracy of 94.6 %.

  7. Enhanced susceptibility to spontaneous seizures of noda epileptic rats by loss of synaptic zn(2+.

    Atsushi Takeda

    Full Text Available Zinc homeostasis in the brain is associated with the etiology and manifestation of epileptic seizures. Adult Noda epileptic rats (NER, >12-week-old exhibit spontaneously generalized tonic-clonic convulsion about once a day. To pursue the involvement of synaptic Zn(2+ signal in susceptibility to spontaneous seizures, in the present study, the effect of zinc chelators on epileptogenesis was examined using adult NER. Clioquinol (CQ and TPEN are lipophilic zinc chelotors, transported into the brain and reduce the levels of synaptic Zn(2+. The incidence of tonic-clonic convulsion was markedly increased after i.p. injection of CQ (30-100 mg/kg and TPEN (1 mg/kg. The basal levels of extracellular Zn(2+ measured by ZnAF-2 were decreased before tonic-clonic convulsion was induced with zinc chelators. The hippocampal electroencephalograms during CQ (30 mg/kg-induced convulsions were similar to those during sound-induced convulsions in NER reported previously. Exocytosis of hippocampal mossy fibers, which was measured with FM4-64, was significantly increased in hippocampal slices from CQ-injected NER that did not show tonic-clonic convulsion yet. These results indicate that the abnormal excitability of mossy fibers is induced prior to epileptic seizures by injection of zinc chelators into NER. The incidence of tonic-clonic convulsion induced with CQ (30 mg/kg was significantly reduced by co-injection with aminooxyacetic acid (5-10 mg/kg, an anticonvulsant drug enhancing GABAergic activity, which did not affect locomotor activity. The present paper demonstrates that the abnormal excitability in the brain, especially in mossy fibers, which is potentially associated with the insufficient GABAergic neuron activity, may be a factor to reduce the threshold for epileptogenesis in NER.

  8. The electrophysiologic character of epileptic seizure%癫痫发作的神经电生理特征

    朱俊玲; 蒋大宗


    Epilepsy is a family of neurological disorders that are common and harmful to human's health. The etiologies of epilepsy and the clinical manifestations of seizures are complex and various. To elucidate the mechanisms underlying seizure generation, lots of researches in the anatomy, physiology, biochemistry, genetic and molecular biology of epilepsy have been done over many years. However, no single hypothesis provides a unifying frmnework within which all kinds of epilepsy can be included so far. In fact, the eleetrophysiologic essence of epileptic: seizure is abnormal excess discharges of neurons. On the standpoint of electrophysiology, the reasons of abnormal discharges of neurons are of common character: depolarizing currents with long durations and high amplitudes on cell levels, which is closely related to slow waves with high amplitudes on EEG levels. This can make us understand the mechanism of epileptic seizures better, and is helpful for well control and therapy of seizures.

  9. A Novel Constrained Topographic Independent Component Analysis for Separation of Epileptic Seizure Signals

    Min Jing


    Full Text Available Blind separation of the electroencephalogram signals (EEGs using topographic independent component analysis (TICA is an effective tool to group the geometrically nearby source signals. The TICA algorithm further improves the results if the desired signal sources have particular properties which can be exploited in the separation process as constraints. Here, the spatial-frequency information of the seizure signals is used to design a constrained TICA for the separation of epileptic seizure signal sources from the multichannel EEGs. The performance is compared with those from the TICA and other conventional ICA algorithms. The superiority of the new constrained TICA has been validated in terms of signal-to-interference ratio and correlation measurement.

  10. Psychogenic non-epileptic seizures in the post-anesthesia recovery unit

    Juan A. Ramos


    Full Text Available Abstract Introduction: Psychogenic non-epileptic seizures (PNES or “pseudoseizures” remain an obscure topic in the peri-operative setting. They are sudden and time-limited motor and cognitive disturbances, which mimic epileptic seizures, but are psychogenically mediated. Pseudoseizures occur more frequently than epilepsy in the peri-operative setting. Early diagnosis and management may prevent iatrogenic injury. Case: 48 year-old female with a history of depression and “seizures” presented for gynecologic surgery. She described her seizure history as “controlled” without anticonvulsant therapy. The patient underwent uneventful general anesthesia and recovered neurologically intact. During the first two postoperative hours, the patient experienced 3 episodes of seizure-like activity with generalized shaking of extremities and pelvic thrusting; her eyes were firmly closed. No tongue biting or incontinence was noted. The episodes lasted approximately 3 min each, one of which resolved spontaneously and the other two following intravenous lorazepam. During these episodes, the patient had stable hemodynamics and adequate ventilation such that endotracheal intubation was deemed unwarranted. Post-ictally, the patient was neurologically intact. Computed axial tomography of the head, metabolic assay, and electroencephalogram showed no abnormalities. A presumptive diagnosis of PNES was made. Discussion: Psychogenic non-epileptic seizures mimic shivering, and should be considered early in the differential diagnosis of postoperative shaking, as they may be more likely than epilepsy in this setting. Pseudoseizure patterns include asynchronous convulsive episodes lasting more than 90 s, forced eye closure with resistance to opening, and retained pupillary responses. Autonomic manifestations such as tachycardia, cyanosis and incontinence are usually absent. A psychiatric background is common. Knowledge and correct diagnosis of pseudoseizures is of

  11. Aberrant gamma band cortical sources and functional connectivity in adolescents with psychogenic non-epileptic seizures: A preliminary report.

    Umesh, Shreekantiah; Tikka, Sai Krishna; Goyal, Nishant; Sinha, Vinod Kumar; Nizamie, Shamshul Haque


    Psychogenic non-epileptic seizures (PNES) resemble epileptic seizures, but lack clinically evident abnormal electrical activity in the brain. We aimed to assess resting gamma spectral power, current source distribution and functional connectivity in adolescents with PNES. Interictal, 32 channels electroencephalographic recording of 15 adolescents with PNES was compared with 10 matched healthy controls. Spectral power, current source distribution and lagged linear coherence were assessed. Statistically significant gamma spectral power, cortical sources and connectivity pattern was found in some brain areas. Region specific aberrant gamma activity and its relationship to psychopathology are discussed. Copyright © 2016. Published by Elsevier Ireland Ltd.

  12. Epileptic Seizure Detection with Log-Euclidean Gaussian Kernel-Based Sparse Representation.

    Yuan, Shasha; Zhou, Weidong; Wu, Qi; Zhang, Yanli


    Epileptic seizure detection plays an important role in the diagnosis of epilepsy and reducing the massive workload of reviewing electroencephalography (EEG) recordings. In this work, a novel algorithm is developed to detect seizures employing log-Euclidean Gaussian kernel-based sparse representation (SR) in long-term EEG recordings. Unlike the traditional SR for vector data in Euclidean space, the log-Euclidean Gaussian kernel-based SR framework is proposed for seizure detection in the space of the symmetric positive definite (SPD) matrices, which form a Riemannian manifold. Since the Riemannian manifold is nonlinear, the log-Euclidean Gaussian kernel function is applied to embed it into a reproducing kernel Hilbert space (RKHS) for performing SR. The EEG signals of all channels are divided into epochs and the SPD matrices representing EEG epochs are generated by covariance descriptors. Then, the testing samples are sparsely coded over the dictionary composed by training samples utilizing log-Euclidean Gaussian kernel-based SR. The classification of testing samples is achieved by computing the minimal reconstructed residuals. The proposed method is evaluated on the Freiburg EEG dataset of 21 patients and shows its notable performance on both epoch-based and event-based assessments. Moreover, this method handles multiple channels of EEG recordings synchronously which is more speedy and efficient than traditional seizure detection methods.

  13. Effects of conventional anticonvulsant drugs on generalized tonic-clonic seizures in Noda epileptic rats.

    Inoue, Maki; Yamamoto, Ayaka; Kaneko, Yuka; Noda, Atsushi; Naito, Hiroyuki


    Noda epileptic rats (NERs) present with clinico-pathological manifestations reminiscent of human generalized tonic-clonic epilepsy. Thus, this strain of rat has been a model of primary, generalized, tonic-clonic epilepsy. However, the infrequency of seizures in these rats makes the assessment of antiepileptic drugs (AEDs) difficult. Therefore, traditional AEDs have only been tested in NERs against audiogenic seizures evoked by weekly acoustic priming from 3 to 22 weeks of age or by using the kindling procedure in adult animals. Adult NERs are susceptible to changes in their environment, such as bedding replacement or unpleasant sensory stimuli. In the present study, traditional AEDs-phenobarbital (PB) and sodium valproate (VPA)-were evaluated against seizures evoked by strong environmental stimuli in mature NERs that had not been previously primed. The number of animals presenting with seizures decreased in a dose-dependent manner following administration of either PB (dose range 1.0-5.0mg/kg) or VPA (50 and 100mg/kg). Consequently, the utility of NERs as a model of generalized tonic-clonic epilepsy was confirmed. This type of protocol can be used to further evaluate AEDs and test effects of chronic administration of AEDs. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Altered functional and structural connectivity networks in psychogenic non-epileptic seizures.

    Ju-Rong Ding

    Full Text Available Psychogenic non-epileptic seizures (PNES are paroxysmal behaviors that resemble epileptic seizures but lack abnormal electrical activity. Recent studies suggest aberrant functional connectivity involving specific brain regions in PNES. Little is known, however, about alterations of topological organization of whole-brain functional and structural connectivity networks in PNES. We constructed functional connectivity networks from resting-state functional MRI signal correlations and structural connectivity networks from diffusion tensor imaging tractography in 17 PNES patients and 20 healthy controls. Graph theoretical analysis was employed to compute network properties. Moreover, we investigated the relationship between functional and structural connectivity networks. We found that PNES patients exhibited altered small-worldness in both functional and structural networks and shifted towards a more regular (lattice-like organization, which could serve as a potential imaging biomarker for PNES. In addition, many regional characteristics were altered in structural connectivity network, involving attention, sensorimotor, subcortical and default-mode networks. These regions with altered nodal characteristics likely reflect disease-specific pathophysiology in PNES. Importantly, the coupling strength of functional-structural connectivity was decreased and exhibited high sensitivity and specificity to differentiate PNES patients from healthy controls, suggesting that the decoupling strength of functional-structural connectivity might be an important characteristic reflecting the mechanisms of PNES. This is the first study to explore the altered topological organization in PNES combining functional and structural connectivity networks, providing a new way to understand the pathophysiological mechanisms of PNES.

  15. Psychological interventions for psychogenic non-epileptic seizures: A meta-analysis.

    Carlson, Perri; Nicholson Perry, Kathryn


    The aim of this meta-analysis is to evaluate and synthesize the available evidence from the previous 20 years regarding the utility of psychological interventions in the management of psychogenic non-epileptic seizures (PNES). Studies were retrieved from MEDLINE via OvidSP and PsychINFO. Selection criteria included controlled and before-after non-controlled studies including case series, using seizure frequency as an outcome measurement. Studies were required to assess one or more types of psychological intervention for the treatment of PNES in adults. Data from 13 eligible studies was pooled to examine the effectiveness of psychological interventions in treating PNES on two primary outcomes: seizure reduction of 50% or more and seizure freedom. A meta-analysis was conducted with data extracted from 228 participants with PNES. Interventions reviewed in the analysis included CBT, psychodynamic therapy, paradoxical intention therapy, mindfulness and psychoeducation and eclectic interventions. Meta-analysis synthesized data from 13 studies with a total of 228 participants with PNES, of varied gender and age. Results showed 47% of people with PNES are seizure free upon completion of a psychological intervention. Additional meta-analysis synthesized data from 10 studies with a total of 137 participants with PNES. This analysis found 82% of people with PNES who complete psychological treatment experience a reduction in seizures of at least 50%. The studies identified for this analysis were diverse in nature and quality. The findings highlight the potential for psychological interventions as a favorable alternative to the current lack of treatment options offered to people with PNES. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  16. Clinical analysis of 32 patients with non- epileptic seizures passed for epileptic seizures%非癫痫发作误诊为癫痫发作32例临床分析

    李玉生; 黄圣明; 黄希顺


    Objective To investigate the causes and clinical characteristics of non - epileptic seizures misdiagnosed as epileptic seizures. Methods Clinical data of 32 patients with non - epileptic seizures misdiagnosed as epileptic seizures were analyzed retrospectively. Results Among 32 patients , 7 were syncope, 6 were psychic seizure, 4 were paroxysmal kinesigenic choreoathetosis, 4 were migraine, 4 were sleep disorder, 3 were acute anxiety attack, 2 were tourette syndrome, and hypopara-thyroidism, hypoglycemia attack was 1 case respectively. Conclusions Clinical doctors should attach much importance to epileptic discrimination; Diagnosis of epilepsy must be prudent, otherwise, it not only delayed treatment, but also brought about psychological and economic burden for the patients themselves and their relatives.%目的 分析非癫痫发作误诊为癫痫发作的原因及特点,以提高癫痫的诊断水平,减少误诊误治.方法 回顾性分析32例非癫痫发作性疾病被误诊为癫痫的临床资料.结果 32例中,7例为晕厥,6例为精神性发作,4例为阵发性运动诱发性运动障碍,4例为偏头痛,4例为睡眠障碍,3例为急性焦虑发作,2例为抽动-秽语综合症,甲状旁腺功能减退症、低血糖发作各l例.结论 临床医生对于癫痫的鉴别应该有足够的认识,诊断一定要慎重,否则不但耽误治疗,还将给患者及其亲属带来不必要的心理和经济负担.

  17. Chronic Trigeminal Nerve Stimulation Protects Against Seizures, Cognitive Impairments, Hippocampal Apoptosis, and Inflammatory Responses in Epileptic Rats.

    Wang, Qian-Qian; Zhu, Li-Jun; Wang, Xian-Hong; Zuo, Jian; He, Hui-Yan; Tian, Miao-Miao; Wang, Lei; Liang, Gui-Ling; Wang, Yu


    Trigeminal nerve stimulation (TNS) has recently been demonstrated effective in the treatment of epilepsy and mood disorders. Here, we aim to determine the effects of TNS on epileptogenesis, cognitive function, and the associated hippocampal apoptosis and inflammatory responses. Rats were injected with pilocarpine to produce status epilepticus (SE) and the following chronic epilepsy. After SE induction, TNS treatment was conducted for 4 consecutive weeks. A pilocarpine re-injection was then used to induce a seizure in the epileptic rats. The hippocampal neuronal apoptosis induced by seizure was assessed by TUNEL staining and inflammatory responses by immunohistochemistry and enzyme-linked immunosorbent assay (ELISA). The spontaneous recurrent seizure (SRS) number was counted through video monitoring, and the cognitive function assessed through Morris Water Maze (MWM) test. TNS treatment attenuated the SRS attacks and improved the cognitive impairment in epileptic rats. A pilocarpine re-injection resulted in less hippocampal neuronal apoptosis and reduced level of interleukin-1 beta (IL-1β), tumor necrosis factor-α (TNF-α), and microglial activation in epileptic rats with TNS treatment in comparison to the epileptic rats without TNS treatment. It is concluded that TNS treatment shortly after SE not only protected against the chronic spontaneous seizures but also improved cognitive impairments. These antiepileptic properties of TNS may be related to its attenuating effects on hippocampal apoptosis and pro-inflammatory responses.

  18. Focal seizures and epileptic spasms in a child with Down syndrome from a family with a PRRT2 mutation.

    Igarashi, Ayuko; Okumura, Akihisa; Shimojima, Keiko; Abe, Shinpei; Ikeno, Mitsuru; Shimizu, Toshiaki; Yamamoto, Toshiyuki


    We describe a girl with Down syndrome who experienced focal seizures and epileptic spasms during infancy. The patient was diagnosed as having trisomy 21 during the neonatal period. She had focal seizures at five months of age, which were controlled with phenobarbital. However, epileptic spasms appeared at seven months of age in association with hypsarrhythmia. Upon treatment with adrenocorticotropic hormone, her epileptic spasms disappeared. Her younger brother also had focal seizures at five months of age. His development and interictal electroencephalogram were normal. The patient's father had had infantile epilepsy and paroxysmal kinesigenic dyskinesia. We performed a mutation analysis of the PRRT2 gene and found a c.841T>C mutation in the present patient, her father, and in her younger brother. We hypothesized that the focal seizures in our patient were caused by the PRRT2 mutation, whereas the epileptic spasms were attributable to trisomy 21. Copyright © 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  19. Reduced tonic inhibition after stroke promotes motor performance and epileptic seizures.

    Jaenisch, Nadine; Liebmann, Lutz; Guenther, Madlen; Hübner, Christian A; Frahm, Christiane; Witte, Otto W


    Stroke survivors often recover from motor deficits, either spontaneously or with the support of rehabilitative training. Since tonic GABAergic inhibition controls network excitability, it may be involved in recovery. Middle cerebral artery occlusion in rodents reduces tonic GABAergic inhibition in the structurally intact motor cortex (M1). Transcript and protein abundance of the extrasynaptic GABAA-receptor complex α4β3δ are concurrently reduced (δ-GABAARs). In vivo and in vitro analyses show that stroke-induced glutamate release activates NMDA receptors, thereby reducing KCC2 transporters and down-regulates δ-GABAARs. Functionally, this is associated with improved motor performance on the RotaRod, a test in which mice are forced to move in a similar manner to rehabilitative training sessions. As an adverse side effect, decreased tonic inhibition facilitates post-stroke epileptic seizures. Our data imply that early and sometimes surprisingly fast recovery following stroke is supported by homeostatic, endogenous plasticity of extrasynaptic GABAA receptors.

  20. People with Psychogenic non-epileptic seizures: A South African perspective

    Chrisma Pretorius


    Full Text Available Background: Psychogenic non-epileptic seizures (PNES is a disabling disorder which has a negative effect on the quality of life of individuals with PNES. A clear understanding of the disorder is necessary, however, to date, research about PNES in South Africa is limited.Objectives: The aims of this study were to explore the demographic variables of individuals with PNES in South Africa, to review the available body of research on PNES, and to compare it with our results.Method: Twenty-two people with PNES, with confirmed video EEG, were recruited by means of convenience sampling from two hospitals. Descriptive statistics were used to describe the demographic variables of the participants.Results: Internationally comparable results revealed misdiagnoses and low treatment delivery amongst a primarily female population.Conclusion: This study provided greater insight into individuals with PNES in South Africa, highlighting the need for more information, support, effective treatment and accurate diagnosis of PNES.

  1. Are psychogenic non-epileptic seizures just another symptom of conversion disorder?

    Kanaan, Richard A A; Duncan, Roderick; Goldstein, Laura H; Jankovic, Joseph; Cavanna, Andrea E


    Psychogenic non-epileptic seizures (PNES) are classified with other functional neurological symptoms as 'Conversion Disorder', but there are reasons to wonder whether this symptomatology constitutes a distinct entity. We reviewed the literature comparing PNES with other functional neurological symptoms. We find eight studies that directly examined this question. Though all but one found significant differences-notably in presenting age, trauma history, and dissociation-they were divided on whether these differences represented an important distinction. We argue that the aetiological and mechanistic distinctions they support, particularly when bolstered by additional data, give reason to sustain a separation between these conditions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Atlanto axial rotatory dislocation in adults: a rare complication of an epileptic seizure--case report.

    Tarantino, Roberto; Donnarumma, Pasquale; Marotta, Nicola; Missori, Paolo; Viozzi, Ilaria; Landi, Alessandro; Delfini, Roberto


    Atlanto Axial Rotatory Dislocations (AARDs) are a heterogeneous group of post-traumatic pathologies typical of the pediatric age, and rare in adults. We describe the case of a 34-year-old woman, developing Atlanto Axial Rotatory Fixation (AARF) after a generalized tonic-clonic epileptic seizure, an extremely rare traumatic cause never described in literature. AARF was detected only 1 month after the accident and nonsurgical treatment was attempted at the beginning. The patient underwent surgery only 2 months after the accident. The best treatment should be conservative reduction within 1 month; when it is not possible, it is advisable to perform surgery as soon as possible. C1-C2 fixation with Harm's technique is the gold standard for fixed luxations. Delay of treatment makes intraoperative reduction more difficult and increase the establishment of the chronic permanent change of neck muscles and ligaments.

  3. Clinical profile of psychogenic non-epileptic seizures in adults: A study of 63 cases

    Yogesh Patidar


    Full Text Available Aims: To evaluate clinical profile and short-term outcome of psychogenic non-epileptic seizures (PNES in Indian adult population. Setting and Design: A prospective observational study, conducted at tertiary teaching institute at New Delhi. Materials and Methods: Sixty-three patients with confirmed PNES were enrolled. The diagnosis was based on witnessing the event during video-electroencephalography (Video-EEG monitoring. A detailed clinical evaluation was done including evaluation for coexistent anxiety or depressive disorders. Patients were divided into two groups on the basis of excessive or paucity of movements during PNES attacks. Patients were followed-up to 12 months for their PNES frequency. Statistical Analysis: Means and standard deviations were calculated for continuous variables. Chi-square and Students t-test were used to compare categorical and continuous variables respectively. Results: The mean age at onset of PNES was 25.44 years; with F:M ratio of 9.5:1. Coexistent epilepsy was present in 13 (20.63% cases. Twenty-two patients (44% with only PNES ( n = 50 had received antiepileptic drugs. Out of 63 patients of PNES 24 (38.1% had predominant motor phenomenon, whereas 39 (61.9% had limp attacks. The common features observed were pre-ictal headache, ictal eye closure, jaw clenching, resistant behavior, ictal weeping, ictal vocalization, and unresponsiveness during episodes. Comorbid anxiety and depressive disorders was seen in 62.3% and 90.16% patients, respectively. Short-term (6-12 months outcome of 45 patients was good (seizure freedom in 46.66% and >50% improvement in 24.44% cases. Conclusion: PNES is common, but frequently misdiagnosed and treated as epileptic seizures. A high index of suspicion is required for an early diagnosis. Proper disclosure of diagnosis and management of the psychiatric comorbidities can improve their outcome. Limitation: Limited sample size and change in seizures frequency as the only parameter for

  4. Ngram-derived pattern recognition for the detection and prediction of epileptic seizures.

    Amir Eftekhar

    Full Text Available This work presents a new method that combines symbol dynamics methodologies with an Ngram algorithm for the detection and prediction of epileptic seizures. The presented approach specifically applies Ngram-based pattern recognition, after data pre-processing, with similarity metrics, including the Hamming distance and Needlman-Wunsch algorithm, for identifying unique patterns within epochs of time. Pattern counts within each epoch are used as measures to determine seizure detection and prediction markers. Using 623 hours of intracranial electrocorticogram recordings from 21 patients containing a total of 87 seizures, the sensitivity and false prediction/detection rates of this method are quantified. Results are quantified using individual seizures within each case for training of thresholds and prediction time windows. The statistical significance of the predictive power is further investigated. We show that the method presented herein, has significant predictive power in up to 100% of temporal lobe cases, with sensitivities of up to 70-100% and low false predictions (dependant on training procedure. The cases of highest false predictions are found in the frontal origin with 0.31-0.61 false predictions per hour and with significance in 18 out of 21 cases. On average, a prediction sensitivity of 93.81% and false prediction rate of approximately 0.06 false predictions per hour are achieved in the best case scenario. This compares to previous work utilising the same data set that has shown sensitivities of up to 40-50% for a false prediction rate of less than 0.15/hour.

  5. An integrative view of mechanisms underlying generalized spike-and-wave epileptic seizures and its implication on optimal therapeutic treatments.

    Boyuan Yan

    Full Text Available Many types of epileptic seizures are characterized by generalized spike-and-wave discharges. In the past, notable effort has been devoted to understanding seizure dynamics and various hypotheses have been proposed to explain the underlying mechanisms. In this paper, by taking an integrative view of the underlying mechanisms, we demonstrate that epileptic seizures can be generated by many different combinations of synaptic strengths and intrinsic membrane properties. This integrative view has important medical implications: the specific state of a patient characterized by a set of biophysical characteristics ultimately determines the optimal therapeutic treatment. Through the same view, we further demonstrate the potentiation effect of rational polypharmacy in the treatment of epilepsy and provide a new angle to resolve the debate on polypharmacy. Our results underscore the need for personalized medicine and demonstrate that computer modeling and simulation may play an important role in assisting the clinicians in selecting the optimal treatment on an individual basis.

  6. A Case of Habitual Neck Compression Induced Electroencephalogram Abnormalities: Differentiating from Epileptic Seizures Using a Tc-99m HMPAO SPECT

    Choi, Hongyoon; Seo, Minseok; Lee, Hoyoung; Kim, Youngsoo; Yun, Changho; Kim, Sangeun; Park, Sungho [Seoul National Univ. Bundang Hospital, Seongnam (Korea, Republic of)


    Self-induced hypoxia has been reported particularly in adolescents, and it can result in neurological injury. Here, we present a case of electroencephalogram (EEG) abnormalities induced by habitual neck compression differentiated from epileptic seizures by Tc-99m HMPAO SPECT. A 19-year-old male was admitted for evaluation of recurrent generalized tonic-clonic seizures. No interictal EEG abnormality was detected; however, abnormal slow delta waves were found immediately after habitual right neck compression. To differentiate EEG abnormalities due to a hemodynamic deficit induced by habitual neck compression from an epileptic seizure, Tc-99m HMPAO SPECT was performed immediately after right carotid artery compression. Abnormal delta waves were triggered, and cerebral hypoperfusion in the right internal carotid artery territory was detected on Tc-99m HMPAO SPECT. The slow delta wave detected on the EEG resulted from the cerebral hypoperfusion because of the habitual neck compression.

  7. Efficient feature selection using a hybrid algorithm for the task of epileptic seizure detection

    Lai, Kee Huong; Zainuddin, Zarita; Ong, Pauline


    Feature selection is a very important aspect in the field of machine learning. It entails the search of an optimal subset from a very large data set with high dimensional feature space. Apart from eliminating redundant features and reducing computational cost, a good selection of feature also leads to higher prediction and classification accuracy. In this paper, an efficient feature selection technique is introduced in the task of epileptic seizure detection. The raw data are electroencephalography (EEG) signals. Using discrete wavelet transform, the biomedical signals were decomposed into several sets of wavelet coefficients. To reduce the dimension of these wavelet coefficients, a feature selection method that combines the strength of both filter and wrapper methods is proposed. Principal component analysis (PCA) is used as part of the filter method. As for wrapper method, the evolutionary harmony search (HS) algorithm is employed. This metaheuristic method aims at finding the best discriminating set of features from the original data. The obtained features were then used as input for an automated classifier, namely wavelet neural networks (WNNs). The WNNs model was trained to perform a binary classification task, that is, to determine whether a given EEG signal was normal or epileptic. For comparison purposes, different sets of features were also used as input. Simulation results showed that the WNNs that used the features chosen by the hybrid algorithm achieved the highest overall classification accuracy.

  8. Automatic epileptic seizure detection in EEGs using MF-DFA, SVM based on cloud computing.

    Zhang, Zhongnan; Wen, Tingxi; Huang, Wei; Wang, Meihong; Li, Chunfeng


    Epilepsy is a chronic disease with transient brain dysfunction that results from the sudden abnormal discharge of neurons in the brain. Since electroencephalogram (EEG) is a harmless and noninvasive detection method, it plays an important role in the detection of neurological diseases. However, the process of analyzing EEG to detect neurological diseases is often difficult because the brain electrical signals are random, non-stationary and nonlinear. In order to overcome such difficulty, this study aims to develop a new computer-aided scheme for automatic epileptic seizure detection in EEGs based on multi-fractal detrended fluctuation analysis (MF-DFA) and support vector machine (SVM). New scheme first extracts features from EEG by MF-DFA during the first stage. Then, the scheme applies a genetic algorithm (GA) to calculate parameters used in SVM and classify the training data according to the selected features using SVM. Finally, the trained SVM classifier is exploited to detect neurological diseases. The algorithm utilizes MLlib from library of SPARK and runs on cloud platform. Applying to a public dataset for experiment, the study results show that the new feature extraction method and scheme can detect signals with less features and the accuracy of the classification reached up to 99%. MF-DFA is a promising approach to extract features for analyzing EEG, because of its simple algorithm procedure and less parameters. The features obtained by MF-DFA can represent samples as well as traditional wavelet transform and Lyapunov exponents. GA can always find useful parameters for SVM with enough execution time. The results illustrate that the classification model can achieve comparable accuracy, which means that it is effective in epileptic seizure detection.

  9. A coupled ordinary differential equation lattice model for the simulation of epileptic seizures

    Larter, Raima; Speelman, Brent; Worth, Robert M.


    A coupled ordinary differential equation lattice model for the CA3 region of the hippocampus (a common location of the epileptic focus) is developed. This model consists of a hexagonal lattice of nodes, each describing a subnetwork consisting of a group of prototypical excitatory pyramidal cells and a group of prototypical inhibitory interneurons connected via on/off excitatory and inhibitory synapses. The nodes communicate using simple rules to simulate the diffusion of extracellular potassium. Both the integration time over which a node's trajectory is integrated before the diffusional event is allowed to occur and the level of inhibition in each node were found to be important parameters. Shorter integration times lead to total synchronization of the lattice (similar to synchronous neural activity occurring during a seizure) whereas longer times cause more random spatiotemporal behavior. Moderately diminished levels of inhibition lead to simple nodal oscillatory behavior. It is postulated that both the lack of inhibition and an alteration in conduction time may be necessary for the development of a behaviorally manifest seizure.

  10. Healthcare-seeking behavior of patients with epileptic seizure disorders attending a tertiary care hospital, Kolkata

    Abhik Sinha


    Full Text Available Introduction : Neurological diseases are very important causes of prolonged morbidity and disability, leading to profound financial loss. Epilepsy is one of the most important neurological disorders Healthcare seeking by epilepsy patients is quite diverse and unique. Aims and Objectives: The study was conducted among the epilepsy patients, to assess their healthcare-seeking behavior and its determinants. Materials and Methods: Three hundred and fifteen epilepsy patients, selected by systematic random sampling, in the neuromedicine outpatient department of a tertiary care hospital were interviewed with a predesigned, pretested, semi-structured proforma. Results and Conclusion: More than 90% sought healthcare just after the onset of a seizure. The majority opted for allopathic medicine and the causes for not seeking initial care from allopaths were ignorance, faith in another system, constraint of money, and so on. A significant association existed between rural residence and low social status of the patients with initial care seeking from someone other than allopaths. No association was found among sex, type of seizure, educational status of the patients, and care seeking. The mean treatment gap was 2.98 ± 10.49 months and the chief motivators were mostly the family members. Patients for anti epileptic drugs preferred neurologists in urban areas and general practitioners in rural areas. District care model of epilepsy was proposed in the recommendation.

  11. Hardware for seizure prediction: towards wearable devices to support epileptic people.

    Castellaro, Cipriano; Favaro, Gianpietro; Salemi, Giovanni; Sarto, Matteo; Rizzo, Nicola


    This paper presents the hardware developed for the EPILEPSIAE project (, focused on epileptic seizure prediction. A portable low power acquisition system for EEG signals, called LTM-EU (Long Term Monitoring), with 64 channels and 2048 Hz sampling rate each and a safe (high isolation) PC interface on a PCIe bus specifically designed for this task, is described. The acquisition system, designed for a rapid commercialization, though used for research purposes, got the CE certification. The signal from the patient, on each channel, is amplified, converted in digital form and stored into a local flash memory (SD-MMC, 4 GB). Data are then formatted into a serial stream at 4 Mb/s and sent through a half-duplex RS485 link to the host where a specifically designed PCIe (BQPCIe) interface receive them and release the information to the OS (Windows or Linux). The amplifier runs with a couple of AA battery for more than 15 hours (300 mW). If a wireless link is established (Bluetooth), a bandwidth limited stream of data (or a subset of channels) is sent for monitoring purposes. The mission is to support the researchers of the consortium with a suitable hardware to have a real time seizure prediction system for algorithms tests. In the experimental phase all algorithms run on a portable PC, wire or wireless connected to the acquisition system.

  12. ABC optimized RBF network for classification of EEG signal for epileptic seizure identification

    Sandeep Kumar Satapathy


    Full Text Available The brain signals usually generate certain electrical signals that can be recorded and analyzed for detection in several brain disorder diseases. These small signals are expressly called as Electroencephalogram (EEG signals. This research work analyzes the epileptic disorder in human brain through EEG signal analysis by integrating the best attributes of Artificial Bee Colony (ABC and radial basis function networks (RBFNNs. We have used Discrete Wavelet Transform (DWT technique for extraction of potential features from the signal. In our study, for classification of these signals, in this paper, the RBFNNs have been trained by a modified version of ABC algorithm. In the modified ABC, the onlooker bees are selected based on binary tournament unlike roulette wheel selection of ABC. Additionally, kernels such as Gaussian, Multi-quadric, and Inverse-multi-quadric are used for measuring the effectiveness of the method in numerous mixtures of healthy segments, seizure-free segments, and seizure segments. Our experimental outcomes confirm that RBFNN with inverse-multi-quadric kernel trained with modified ABC is significantly better than RBFNNs with other kernels trained by ABC and modified ABC.

  13. TLR4, ATF-3 and IL8 inflammation mediator expression correlates with seizure frequency in human epileptic brain tissue.

    Pernhorst, Katharina; Herms, Stefan; Hoffmann, Per; Cichon, Sven; Schulz, Herbert; Sander, Thomas; Schoch, Susanne; Becker, Albert J; Grote, Alexander


    Data from animal models has nicely shown that inflammatory processes in the central nervous system (CNS) can modulate seizure frequency. However, a potential relationship between the modulation of seizure frequency and gene expression of key inflammatory factors in human epileptic tissue is still unresolved. Brain tissue from pharmacoresistant patients with mesial temporal lobe epilepsy (mTLE) provides a unique prerequisite for clinico-neuropathological correlations. Here, we have concentrated on gene expression of the human key inflammatory mediators, TLR4, ATF-3 and IL8, in correlation to seizure frequency and additional clinical parameters in human epileptic brain tissue of pharmacoresistant mTLE patients. Furthermore, we characterized the cell types expressing the respective proteins in epileptic hippocampi. Total RNAs were isolated from n=26 hippocampi of pharmacoresistant mTLE patients using AllPrep DNA/RNA Mini Kit. cRNA was used for hybridization on Human HT-12 v3 Expression BeadChips with Illumina Direct Hybridization Assay Kit and resulting gene expression data was normalized based on the Illumina BeadStudio software suite by means of quantile normalization with background subtraction. Corresponding human hippocampal sections for immunohistochemistry were probed with antibodies against TLR4, ATF-3, IL8 and glial fibrillary acidic protein (GFAP), neuronal nuclear protein (NeuN) and the microglial marker HLA-DR. We observed abundant TLR4 gene expression to relate to seizure frequency per month. For ATF-3, we found an inverse correlation of expression to seizure frequency. Lower expression of IL8 was significantly associated with high seizure frequency. Further, we detected TLR4 expression in neurons and GFAP-positive astrocytes of pharmacoresistant mTLE patients. Only neurons of human epileptic hippocampi express ATF-3. IL8 was expressed in microglia and reactive astrocytes. Our results suggest a differential correlation of key inflammatory factor

  14. Automated Algorithm for Generalized Tonic–Clonic Epileptic Seizure Onset Detection Based on sEMG Zero-Crossing Rate

    Conradsen, Isa; Beniczky, Sándor; Hoppe, Karsten


    Patients are not able to call for help during a generalized tonic–clonic epileptic seizure. Our objective was to develop a robust generic algorithm for automatic detection of tonic–clonic seizures, based on surface electromyography (sEMG) signals suitable for a portable device. Twenty-two seizure......% with a mean detection latency of 13.7 s, while the rate of false detection was limited to 1 false alarm per 24 h. The overall performance of the presented generic algorithm is adequate for clinical implementation.......Patients are not able to call for help during a generalized tonic–clonic epileptic seizure. Our objective was to develop a robust generic algorithm for automatic detection of tonic–clonic seizures, based on surface electromyography (sEMG) signals suitable for a portable device. Twenty-two seizures...... were analyzed from 11 consecutive patients. Our method is based on a high-pass filtering with a cutoff at 150 Hz, and monitoring a count of zero crossings with a hysteresis of $\\pm 50\\,\\mu \\hbox{V}$ . Based on data from one sEMG electrode (on the deltoid muscle), we achieved a sensitivity of 100...

  15. Blood-brain barrier changes with kainic acid-induced limbic seizures

    Zucker, D.K.; Wooten, G.F.; Lothman, E.W.


    Rats were treated with kainic acid (KA) i.v. to produce increasingly severe limbic seizures that were monitored with a behavioral rating scale. At various times after the induction of seizures, the animals; blood-brain barriers (B-BB) were studied with alpha-(/sup 14/C)aminoisobutyric acid ((/sup 14/C)AIBA) autoradiography. Using optical density ratios, a coefficient was devised to assess the functional integrity of the B-BB in discrete anatomic regions and to quantitatively compare these measurements among different groups of experimental animals. In animals that exhibited only mild seizures, the B-BB was not different from controls. Animals with severe limbic seizures, however, showed alterations. For as long as 2 h after delivery of KA, the B-BB appeared normal; from 2 to 24 h, the permeability to (/sup 14/C)AIBA was markedly increased throughout the brain, especially in limbic regions; from 24 h to 7 days the B-BB returned to normal except for a small residual change in limbic structures. These findings were confirmed with Evans blue dye studies of the B-BB. A correlation between focal accentuation of B-BB alterations and neuropathologic changes was found. These experiments indicted that recurrent limbic seizures may lead to a breakdown in the B-BB independent of systemic metabolic derangements. Marked focal metabolic and electrical changes, however, occurred in several limbic structures several hours before the blood-brain barrier was altered.

  16. Effect of magnesium oxide on the activity of standard anti-epileptic drugs against experimental seizures in rats

    Dhande Priti


    Full Text Available Objectives : To study the effect of oral magnesium oxide supplementation alone and on the activity of standard anti-epileptic drugs in the animal models of maximal electroshock seizures (MES and chemically (pentylenetetrazole [PTZ]-induced seizures. Methods : Healthy male albino rats were given magnesium oxide (MgO supplementation orally in various doses (500, 750 and 1000 mg/kg /day for 4 weeks (day 1 to day 28. On day 0 and day 29, response to MES (180 mA for 0.2 s was tested 1 h after pre-administration of phenytoin or carbamazepine orally. Similarly, in the other groups, the response to PTZ 40 mg/kg i.p. was tested 1 h after pre-administration of oral sodium valproate. Results : Oral administration of MgO in a low dose (500 mg/kg for 4 weeks in healthy rats appears to exert protective effect against MES. High oral doses of MgO (750 and 1000 mg/kg appear to enhance the activity of phenytoin and carbamazepine in the MES model. MgO supplementation was seen to decrease the latency of PTZ-induced seizures. Conclusion : The dose of oral MgO appears to have an inverse relation with the protective effect in MES-induced seizure model. High doses of MgO supplementation given orally appear to enhance the activity of standard anti-epileptic drugs in the MES-induced seizure model.

  17. Parcel-based connectivity analysis of fMRI data for the study of epileptic seizure propagation.

    Tana, Maria Gabriella; Bianchi, Anna Maria; Sclocco, Roberta; Franchin, Tiziana; Cerutti, Sergio; Leal, Alberto


    The aim of this work is to improve fMRI Granger Causality Analysis (GCA) by proposing and comparing two strategies for defining the topology of the networks among which cerebral connectivity is measured and to apply fMRI GCA for studying epileptic seizure propagation. The first proposed method is based on information derived from anatomical atlas only; the other one is based on functional information and employs an algorithm of hierarchical clustering applied to fMRI data directly. Both methods were applied to signals recorded during seizures on a group of epileptic subjects and two connectivity matrices were obtained for each patient. The performances of the different parcellation strategies were evaluated in terms of their capability to recover information about the source and the sink of the network (i.e., the starting and the ending point of the seizure propagation). The first method allows to clearly identify the seizure onset in all patients, whereas the network sources are not so immediately recognizable when the second method was used. Nevertheless, results obtained using functional clustering do not contradict those obtained with the anatomical atlas and are able to individuate the main pattern of propagation. In conclusion, the way nodes are defined can influence the easiness of identification of the epileptogenic focus but does not produce contradictory results showing the effectiveness of proposed approach to formulate hypothesis about seizure propagation at least in the early phase of investigation.

  18. Experience in using injectable valproic acid (convulex in patients with serial epileptic seizures and status epilepticus at the prehospital stage

    A. V. Lebedeva


    Full Text Available Objective: to evaluate the efficacy of injectable valproate (convulex in patients with serial epileptic seizures and status epilepticus (SE at the prehospital stage.Patients and methods. Thirty-two adult patients, including 17 (53% men and 15 (47% women, were examined. Most patients were aged over 40 years (mean age 54.7±9.4 years. To define the required dose of the drug, the authors estimated the patient's weight that averaged 76.8±1.9 kg, i.e. there was a preponderance of patients who needed convulex, more than 500 mg, to achieve a therapeutic effect.Results. It was impossible to reliably and validly evaluate the type of a seizure as the medical emergency team (MET generally observed the patient with a just evolving seizure and the medical history data were not always valid therefore the type of convulsions and the type of a seizure were evaluated. In most cases, solitary convulsive attacks (tonic and/or clonic convulsions and/or serial seizures were observed in 12 (37.5% and 14 (43.7% patients, respectively; SE was recorded in 6 (8.8% patients. Generalized seizures (without a clear focal onset were prevalent in 24 (75% patients while 8 (25% patients were found to have partial seizures (seizure onset lateralization, a focal onset. According to the pattern of convulsions, seizures may be classified into three types: tonic-clonic, clonic, and tonic in 22 (68.8%, 7 (21.9%, and 3 (9.3% patients, respectively. Analysis of the efficacy of intravenously injectable valproate (convulex in the group of patients with SE and epileptic seizures indicated that complete cessation of seizures could be achieved in 68.8%, their rate decreased in other 9.4% of the patients. Seizures were preserved in 7 (21.8% cases, which required additional administration of drugs. Conclusion. Injectable valproic acid (convulex has a high efficacy and may be preclinically used as the drug of choice to arrest SE and serial seizures caused by both epilepsy and other

  19. Etiological prevalence of epilepsy and epileptic seizures in hospitalized elderly in a Brazilian tertiary center – Salvador - Brazil

    Telma Rocha de Assis


    Full Text Available Epilepsy in the elderly has high incidence and prevalence and is often underecognized. Objective To describe etiological prevalence of epilepsy and epileptic seizures in elderly inpatients. Methods Retrospective analysis was performed on elderly patients who had epilepsy or epileptic seizures during hospitalization, from January 2009 to December 2010. One hundred and twenty patients were enrolled. They were divided into two age subgroups (median 75 years with the purpose to compare etiologies. Results The most common etiology was ischemic stroke (36.7%, followed by neoplasias (13.3%, hemorrhagic stroke (11.7%, dementias (11.4% and metabolic disturbances (5.5%. The analysis of etiological association showed that ischemic stroke was predominant in the younger subgroup (45% vs 30%, and dementias in the older one (18.9% vs 3.8%, but with no statistical significance (p = 0.23. Conclusion This study suggests that epilepsy and epileptic seizures in the elderly inpatients have etiological association with stroke, neoplasias and dementias.

  20. Chronic activity wheel running reduces the severity of kainic acid-induced seizures in the rat: possible role of galanin.

    Reiss, J I; Dishman, R K; Boyd, H E; Robinson, J K; Holmes, P V


    Studies in both humans and rodents suggest that exercise can be neuroprotective, but the mechanisms by which this occurs are still poorly understood. Three weeks of voluntary, physical activity in rats upregulates prepro-galanin messenger RNA levels in the locus coeruleus. Galanin is a neuropeptide extensively coexisting with norepinephrine that decreases neuronal hyperexcitability both in vivo and in vitro. Thus, exercise may diminish neural hyperexcitability through a galaninergic mechanism. The current experiments tested whether voluntary activity wheel running would protect against kainic acid-evoked seizures and whether galaninergic signaling is a necessary factor in this protection. In experiment 1, rats were given access to running wheels or remained sedentary for three weeks. After this period, rats received an intraperitoneal (i.p.) injection of 0, 7, 10 or 14 mg/kg kainic acid. Exercise decreased the severity of or eliminated seizure behaviors and hippocampal c-fos expression induced by kainic acid. In experiment 2, exercising or sedentary rats were injected intracerebroventricularly (i.c.v.) with 0.2 or 0.4 microg of kainic acid following either an injection of M-40 (a galanin receptor antagonist) or saline. Exercise decreased kainic acid-induced seizures at the 0.2 microg dose, and M-40 (6 nmol) decreased this effect. In contrast, there were no detectable differences between exercising and sedentary rats in behavior at the 0.4 microg dose. The results suggest that the protective effects of exercise against seizures are at least partially mediated by regulation of neural excitability through a process involving galanin.

  1. Wavelet neural networks initialization using hybridized clustering and harmony search algorithm: Application in epileptic seizure detection

    Zainuddin, Zarita; Lai, Kee Huong; Ong, Pauline


    Artificial neural networks (ANNs) are powerful mathematical models that are used to solve complex real world problems. Wavelet neural networks (WNNs), which were developed based on the wavelet theory, are a variant of ANNs. During the training phase of WNNs, several parameters need to be initialized; including the type of wavelet activation functions, translation vectors, and dilation parameter. The conventional k-means and fuzzy c-means clustering algorithms have been used to select the translation vectors. However, the solution vectors might get trapped at local minima. In this regard, the evolutionary harmony search algorithm, which is capable of searching for near-optimum solution vectors, both locally and globally, is introduced to circumvent this problem. In this paper, the conventional k-means and fuzzy c-means clustering algorithms were hybridized with the metaheuristic harmony search algorithm. In addition to obtaining the estimation of the global minima accurately, these hybridized algorithms also offer more than one solution to a particular problem, since many possible solution vectors can be generated and stored in the harmony memory. To validate the robustness of the proposed WNNs, the real world problem of epileptic seizure detection was presented. The overall classification accuracy from the simulation showed that the hybridized metaheuristic algorithms outperformed the standard k-means and fuzzy c-means clustering algorithms.

  2. Identification of compounds with anti-convulsant properties in a zebrafish model of epileptic seizures

    Sarah Baxendale


    The availability of animal models of epileptic seizures provides opportunities to identify novel anticonvulsants for the treatment of people with epilepsy. We found that exposure of 2-day-old zebrafish embryos to the convulsant agent pentylenetetrazole (PTZ rapidly induces the expression of synaptic-activity-regulated genes in the CNS, and elicited vigorous episodes of calcium (Ca2+ flux in muscle cells as well as intense locomotor activity. We then screened a library of ∼2000 known bioactive small molecules and identified 46 compounds that suppressed PTZ-inducedtranscription of the synaptic-activity-regulated gene fos in 2-day-old (2 dpf zebrafish embryos. Further analysis of a subset of these compounds, which included compounds with known and newly identified anticonvulsant properties, revealed that they exhibited concentration-dependent inhibition of both locomotor activity and PTZ-induced fos transcription, confirming their anticonvulsant characteristics. We conclude that this in situ hybridisation assay for fos transcription in the zebrafish embryonic CNS is a robust, high-throughput in vivo indicator of the neural response to convulsant treatment and lends itself well to chemical screening applications. Moreover, our results demonstrate that suppression of PTZ-induced fos expression provides a sensitive means of identifying compounds with anticonvulsant activities.

  3. Fuzzy topological digital space and digital fuzzy spline of electroencephalography during epileptic seizures

    Shah, Mazlina Muzafar; Wahab, Abdul Fatah


    Epilepsy disease occurs because of there is a temporary electrical disturbance in a group of brain cells (nurons). The recording of electrical signals come from the human brain which can be collected from the scalp of the head is called Electroencephalography (EEG). EEG then considered in digital format and in fuzzy form makes it a fuzzy digital space data form. The purpose of research is to identify the area (curve and surface) in fuzzy digital space affected by inside epilepsy seizure in epileptic patient's brain. The main focus for this research is to generalize fuzzy topological digital space, definition and basic operation also the properties by using digital fuzzy set and the operations. By using fuzzy digital space, the theory of digital fuzzy spline can be introduced to replace grid data that has been use previously to get better result. As a result, the flat of EEG can be fuzzy topological digital space and this type of data can be use to interpolate the digital fuzzy spline.

  4. Large-Scale Modeling of Epileptic Seizures: Scaling Properties of Two Parallel Neuronal Network Simulation Algorithms

    Lorenzo L. Pesce


    Full Text Available Our limited understanding of the relationship between the behavior of individual neurons and large neuronal networks is an important limitation in current epilepsy research and may be one of the main causes of our inadequate ability to treat it. Addressing this problem directly via experiments is impossibly complex; thus, we have been developing and studying medium-large-scale simulations of detailed neuronal networks to guide us. Flexibility in the connection schemas and a complete description of the cortical tissue seem necessary for this purpose. In this paper we examine some of the basic issues encountered in these multiscale simulations. We have determined the detailed behavior of two such simulators on parallel computer systems. The observed memory and computation-time scaling behavior for a distributed memory implementation were very good over the range studied, both in terms of network sizes (2,000 to 400,000 neurons and processor pool sizes (1 to 256 processors. Our simulations required between a few megabytes and about 150 gigabytes of RAM and lasted between a few minutes and about a week, well within the capability of most multinode clusters. Therefore, simulations of epileptic seizures on networks with millions of cells should be feasible on current supercomputers.

  5. Reduced tonic inhibition after stroke promotes motor performance and epileptic seizures

    Jaenisch, Nadine; Liebmann, Lutz; Guenther, Madlen; Hübner, Christian A.; Frahm, Christiane; Witte, Otto W.


    Stroke survivors often recover from motor deficits, either spontaneously or with the support of rehabilitative training. Since tonic GABAergic inhibition controls network excitability, it may be involved in recovery. Middle cerebral artery occlusion in rodents reduces tonic GABAergic inhibition in the structurally intact motor cortex (M1). Transcript and protein abundance of the extrasynaptic GABAA-receptor complex α4β3δ are concurrently reduced (δ-GABAARs). In vivo and in vitro analyses show that stroke-induced glutamate release activates NMDA receptors, thereby reducing KCC2 transporters and down-regulates δ-GABAARs. Functionally, this is associated with improved motor performance on the RotaRod, a test in which mice are forced to move in a similar manner to rehabilitative training sessions. As an adverse side effect, decreased tonic inhibition facilitates post-stroke epileptic seizures. Our data imply that early and sometimes surprisingly fast recovery following stroke is supported by homeostatic, endogenous plasticity of extrasynaptic GABAA receptors. PMID:27188341

  6. Optimal Feature Space Selection in Detecting Epileptic Seizure based on Recurrent Quantification Analysis and Genetic Algorithm

    Saleh LAshkari


    Full Text Available Selecting optimal features based on nature of the phenomenon and high discriminant ability is very important in the data classification problems. Since it doesn't require any assumption about stationary condition and size of the signal and the noise in Recurrent Quantification Analysis (RQA, it may be useful for epileptic seizure Detection. In this study, RQA was used to discriminate ictal EEG from the normal EEG where optimal features selected by combination of algorithm genetic and Bayesian Classifier. Recurrence plots of hundred samples in each two categories were obtained with five distance norms in this study: Euclidean, Maximum, Minimum, Normalized and Fixed Norm. In order to choose optimal threshold for each norm, ten threshold of ε was generated and then the best feature space was selected by genetic algorithm in combination with a bayesian classifier. The results shown that proposed method is capable of discriminating the ictal EEG from the normal EEG where for Minimum norm and 0.1˂ε˂1, accuracy was 100%. In addition, the sensitivity of proposed framework to the ε and the distance norm parameters was low. The optimal feature presented in this study is Trans which it was selected in most feature spaces with high accuracy.

  7. Concurrent administration of the MMPI-2 and PAI in a sample of patients with epileptic or non-epileptic seizures: implications for an inpatient epilepsy monitoring unit.

    Gale, Shawn D; Hill, Stacy W


    The Minnesota Multiphasic Personality Inventory-second edition (MMPI-2) and the Personality Assessment Inventory (PAI) are commonly used in the epilepsy monitoring unit (EMU) to evaluate personality characteristics and mood-related symptoms in those individuals being evaluated for epileptic seizures (ES) or psychogenic non-epileptic seizures (PNES). A direct comparison of these measures through concurrent administration to the same group has not been carried out. Both measures were administered to 40 patients (17 ES and 23 PNES). Logistic regression suggested the optimal predictive model for EMU discharge diagnosis included subscales from each measure, which outperformed either measure separately. Combining the conversion (SOM-C) and health concerns (SOM-H) subscales from the PAI and the hysteria subscale (Hy) from the MMPI-2 resulted in 85% overall classification accuracy, 86.7% sensitivity, and 82.4% specificity. Variability in the literature regarding the predictive utility of these measures may stem from the possibility that they measure different aspects of PNES. Copyright © 2012 Elsevier Inc. All rights reserved.


    O. M. Kuchkovsky


    Full Text Available Physiological mechanisms of convulsions status during epilepsy or episindrom significantly different from the mechanisms, which were describe for other disorders associated with glutamatergic system, such as schizophrenia (a decrease of glutamate in neurons and increased dopaminergic load, drug addiction and alcoholism (the formation of endogenous opioids and dopamine, strengthening the role of GABA-ergic system. With glutamatergic transmission are сconnect not only convulsive state, but also the realization of higher integrative functions. Therefore, the development of epilepsy, particularly  which caused glutamate, implemented by activating Zn-ergic hippocampal neurons, associate with complex changes in human mental functions. Based on a scientific literature about  of the role of chelating zinc in the mechanisms of glutamatergic transmission, we can  suggest it participation in the mechanisms of formation of epilepsy  convulsions. In experience on animals, was show that in the animal organism of stressing correlative changes observe zinc content and secretory material in the hippocampus, Paneth cells  and B cells of pancreas. The nature of the changes depend on the stressor. When this change of zinc content in the hippocampus and hypothalamus (as the main regulator of stress reaction were multidirectional that this can be explained by the release of metal together with secretory material in the hypothalamus into the bloodstream. Research epileptic activity  of hippocampus by administering to the animal chelate 8 BSQ allowed to establish the dependence between convulsant action  and first  stress condition of the animal. Evocation of stress by 8-BSQ and physical activity, immobilization and alcohol abuse found that the convulsive effect of this reagent during intravitreal research increased in the case of prior exposure by specified kinds of stressors. In this pre-convulsive effect on exertion increased by 266% and the zinc content

  9. Selecting Statistical Characteristics of Brain Signals to Detect Epileptic Seizures using Discrete Wavelet Transform and Perceptron Neural Network

    Rezvan Abbasi


    Full Text Available Electroencephalogram signals (EEG have always been used in medical diagnosis. Evaluation of the statistical characteristics of EEG signals is actually the foundation of all brain signal processing methods. Since the correct prediction of disease status is of utmost importance, the goal is to use those models that have minimum error and maximum reliability. In anautomatic epileptic seizure detection system, we should be able to distinguish between EEG signals before, during and after seizure. Extracting useful characteristics from EEG data can greatly increase the classification accuracy. In this new approach, we first parse EEG signals to sub-bands in different categories with the help of discrete wavelet transform(DWT and then we derive statistical characteristics such as maximum, minimum, average and standard deviation for each sub-band. A multilayer perceptron (MLPneural network was used to assess the different scenarios of healthy and seizure among the collected signal sets. In order to assess the success and effectiveness of the proposed method, the confusion matrix was used and its accuracy was achieved98.33 percent. Due to the limitations and obstacles in analyzing EEG signals, the proposed method can greatly help professionals experimentally and visually in the classification and diagnosis of epileptic seizures.

  10. Oxidative Stress and Epileptic Seizures%氧化应激与癫痫发作

    刘养凤; 周柏玉; 迟丽屹; 潘娜; 王静


    由过量自由基释放导致的氧化应激参与了多种神经退化性疾病的病理过程.然而,氧化应激和癫痫之间的关系最近才得到认可.积累的证据证明氧化应激作为一个关键因素不仅是癫痫发作的后果,而且可能参与了癫痫发生.因此,旨在降低氧化应激的抗氧化治疗最近在癫痫治疗中引起相当的关注.然而,许多资料表明在所有的癫痫发作模型中氧化应激的表现特征不尽相同.这篇综述回顾了不同的动物癫痫模型(比如,红藻氨酸、匹鲁卡品、戊四氮),急性和慢性氧化应激的产生和影响,认为它对蛋白、脂质和抗氧化防御系统产生危害,这篇综述并且分析了癫痫发作中氧化应激产生的可能原因.提示抗氧化治疗可能可以作为缓解癫痫发作和保护损伤神经元的方法.%Oxidative stress resulting from excessive free-radical release is involved in the pathogenesis of a number of neurologic conditions and neurodegenerative disorders. However, the role of oxidative stress in epilepsies has only recently begun to be recognized. Accumulative evidence shows that Oxidative stress is emerging as a key factor that not only resulted from seizures, but may also contribute to epileptogenesis. Therefore, antioxidant therapies aimed at reducing oxidative stress have received considerable attention in epilepsy treatment. However, much evidence suggests that oxidative stress does not always have the same pattern in all seizures models. Thus, this review provides an overview aimed at achieving a better understanding of this issue. Evidence for the production and consequences of acute and chronic oxidative stress in various animal models of epilepsy (I.e., genetic rat models, kainic acid, pilocarpine, pentylenetetrazol) are reviewed, and damage to proteins, lipids, and antioxidant defenses is considered. In addition, this article analyzed the causes of oxidative stress in epileptic seizures. This review suggests

  11. Psychogenic non-epileptic seizures: so-called psychiatric comorbidity and underlying defense mechanisms

    Beghi M


    Full Text Available Massimiliano Beghi,1,2 Paola Beffa Negrini,1 Cecilia Perin,1,3 Federica Peroni,1,3 Adriana Magaudda,4 Cesare Cerri,1,3 Cesare Maria Cornaggia1,3 1Department of Surgery and Translational Medicine, University of Milano-Bicocca, 2Department of Mental Health, “Guido Salvini” Hospital, Garbagnate Milanese, Milan, Italy; 3Rehabilitation Medicine, Istituti Clinici Zucchi, Carate Brianza, Monza and Brianza, Italy; 4Epilepsy Center, Department of Neuroscience, University of Messina, Messina, Italy Abstract: In Diagnostic and Statistical Manual of Mental Disorders, fifth edition, psychogenic non-epileptic seizures (PNES do not have a unique classification as they can be found within different categories: conversion, dissociative, and somatization disorders. The ICD-10, instead, considers PNES within dissociative disorders, merging the dissociative disorders and conversion disorders, although the underlying defense mechanisms are different. The literature data show that PNES are associated with cluster B (mainly borderline personality disorders and/or to people with depressive or anxiety disorders. Defense mechanisms in patients with PNES with a prevalence of anxious/depressive symptoms are of “neurotic” type; their goal is to lead to a “split”, either vertical (dissociation or horizontal (repression. The majority of patients with this type of PNES have alexithymia traits, meaning that they had difficulties in feeling or perceiving emotions. In subjects where PNES are associated with a borderline personality, in which the symbolic function is lost, the defense mechanisms are of a more archaic nature (denial. PNES with different underlying defense mechanisms have different prognoses (despite similar severity of PNES and need usually a different treatment (pharmacological or psychological. Thus, it appears superfluous to talk about psychiatric comorbidity, since PNES are a different symptomatic expression of specific psychiatric disorders


    Joseph O. Fadare


    Full Text Available Background: Epilepsy is a chronic neurological disorder requiring long-term treatment. Seizure control requires adequate blood levels of anti-seizure drugs. Carbarmazepine is one of the most prescribed antiepileptic drugs in Nigeria. This study was carried out to investigate the correlation between serum levels of carbamazepine and seizure control and adverse drug reactions among epileptics in Ibadan, Nigeria. Methods: In a cross-sectional study, sixty-nine patients with confirmed diagnosis of epilepsy who had been on treatment with carbamazepine alone or in combination with phenytoin for at least one month were enrolled into the study and divided into two groups based on seizure control. Drug level in pre-dose (steady state venous blood was analyzed using high performance liquid chromatography. Result: The mean serum concentration of carbamazepine (CBZ and carbamazepine-epoxide (CBZ-EP was 13.5±9.3ìg/mL and 6.34±12.61ìg/mL respectively. Patients with good seizure control had mean serum CBZ concentration of 12.7 ± 9.2ìg/mL versus 15.02 ± 9.7ìg/mL among patients with poor seizure control (P=0.33. The serum concentration of CBZ-EP in patients with good seizure control was 8.05 ± 15.2ìg/mL while it was 3.11 ± 3.5ìg/mL in the second group (P=0.122. Drowsiness was the commonest adverse drug reaction (26.1% and it did not necessitate withdrawal of the drug. Conclusion The study showed that serum level of carbamazepine does not correlate with seizure control and adverse drug reactions.

  13. Epileptic Angina

    Sachin Sureshbabu


    Conclusion: Pain is a rare manifestation of epilepsy observed in less than 1% of patients. When present, it is usually accompanied by other focal features. This rare occurrence of epileptic seizures masquerading as angina is a novel observation.

  14. Effects of Vitamin E on seizure frequency, electroencephalogram findings, and oxidative stress status of refractory epileptic patients.

    Mehvari, Jafar; Motlagh, Fataneh Gholami; Najafi, Mohamad; Ghazvini, Mohammad Reza Aghaye; Naeini, Amirmansour Alavi; Zare, Mohamad


    Oxidative stress has been a frequent finding in epileptic patients receiving antiepileptic drugs (AEDs). In this study, the influence of Vitamin E on the antiseizure activity and redox state of patients treated with carbamazepine, sodium valproate, and levetiracetam has been investigated. This double-blind, placebo-controlled trial was carried out on 65 epileptic patients with chronic antiepileptic intake. The subjects received 400 IU/day of Vitamin E or placebo for 6 months. Seizure frequency, electroencephalogram (EEG), and redox state markers were measured monthly through the study. Total antioxidant capacity, catalase and glutathione were significantly higher in Vitamin E received group compared with controls (P < 0.05) whereas malodialdehyde levels did not differ between two groups (P < 0.07). Vitamin E administration also caused a significant decrease in the frequency of seizures (P < 0.001) and improved EEG findings (P = 0.001). Of 32 patients in case group, the positive EEG decreased in 16 patients (50%) whereas among 33 patients in control group only 4 patients (12.1%) showed decreased positive EEG. The results of this preliminary study indicate that coadministration of antioxidant Vitamin E with AEDs improves seizure control and reduces oxidative stress.

  15. Hidden focal EEG seizures during prolonged suppressions and high-amplitude bursts in early infantile epileptic encephalopathy.

    Al-Futaisi, Amna; Banwell, Brenda; Ochi, Ayako; Hew, Justine; Chu, Bill; Oishi, Makoto; Otsubo, Hiroshi


    We report on a 27-month-old female with atypical early infantile epileptic encephalopathy (EIEE), who developed tonic spasms, partial seizures and myoclonic jerks along with episodic bradycardia at 5 days. We recorded digital electroencephalography (EEG) using either an 11-channel neonatal montage or 19 channel scalp electrodes, at 200 Hz sampling rate, and a single reference for a minimum of 30 min. At 18 days EEG showed suppression-burst (SB) patterns during wakefulness and sleep. Tonic spasms concomitant with bursts recorded as brief, low-amplitude fast waves. EEG at 8 months showed increased amplitude of bursts to 1 mV and extension of suppression periods to 65 s. By increasing recording sensitivity, we detected focal epileptiform discharges of slow rhythmic sharp and slow waves building to 30 microV during suppression periods. Status epilepticus occurred at 16 months. EEG at 27 months returned to the previous SB pattern with rare partial seizures. This report is the first to demonstrate clinically silent focal EEG seizures during prolonged suppression periods in atypical EIEE by off-line digital EEG. Digital EEG sensitivity can reveal covert electrical activity during suppression periods in epileptic neonates and infants.

  16. Combined effects of epileptic seizure and phenobarbital induced overexpression of P-glycoprotein in brain of chemically kindled rats

    Jing, Xinyue; Liu, Xiang; Wen, Tao; Xie, Shanshan; Yao, Dan; Liu, Xiaodong; Wang, Guangji; Xie, Lin


    Background and purpose: The multidrug resistance of epilepsy may result from the overexpression of P-glycoprotein, but the mechanisms are unclear. We investigated whether the overexpression of P-glycoprotein in the brains of subjects with pharmacoresistant epilepsy resulted from both drug effects and seizure activity. Experimental approach: Kindled rats were developed by injecting a subconvulsive dose of pentylenetetrazole (33 mg·kg−1·day−1, i.p.) for 28 days. Groups were then treated with an oral dose of phenobarbital (45 mg·kg−1·day−1) for 40 days. In accord with behavioural observations, P-glycoprotein activity in brain was assessed using brain-to-plasma concentration ratios of rhodamine 123. P-glycoprotein levels in the brain regions were further evaluated using RT-PCR and Western blot analysis. The distribution of phenobarbital in the brain was assessed by measuring phenobarbital concentrations 1 h following its oral administration. Key results: The kindling significantly increased P-glycoprotein activity and expression. Good associations were found among P-glycoprotein activity, expression and phenobarbital concentration in the hippocampus. Short-term treatment with phenobarbital showed good anti-epileptic effect; the maximum effect occurred on day 14 when overexpression of P-glycoprotein was reversed. Continuous treatment with phenobarbital had a gradually reduced anti-epileptic effect and on day 40, phenobarbital exhibited no anti-epileptic effect; this was accompanied by both a re-enhancement of P-glycoprotein expression and decreased phenobarbital concentration in the hippocampus. P-glycoprotein function and expression were also increased in age-matched normal rats treated with phenobarbital. Conclusions and implications: The overexpression of P-glycoprotein in the brain of subjects with pharmacoresistant epilepsy is due to a combination of drug effects and epileptic seizures. PMID:20233212

  17. Epileptic seizure-induced hypertension and its prevention by calcium channel blockers: a real-time study in conscious telemetered rats.

    Beig, Mirza Irfan; Chandra, Ramesh; Talwar, Anita; Fahim, Mohammad; Katyal, Anju


    Epileptic seizures are accompanied by changes in autonomic function that in turn influence the cardiovascular system (hypertension and bradyarrhythmia). We have studied possible cardioprotective activity (during the ictal state in conscious animals) of valproic acid, nifedipine, and verapamil, alone and in combination, during pentylenetetrazole (PTZ)-induced seizures. Telemetry system was used for recording EEG, blood pressure, and heart rate in conscious, freely moving rats during seizures. We observed that PTZ-induced seizures were accompanied by hypertension and bradyarrhythmia. Pretreatment with valproic acid did not block seizure-induced hypertension and bradyarrhythmia. Nifedipine alone and in combination with valproic acid blocked seizure-induced hypertension and bradyarrhythmia significantly. We also observed that pretreatment with verapamil alone and in combination with valproic acid did not block seizure-induced hypertension and bradyarrhythmia significantly. Our results suggest that pretreatment with nifedipine alone or in combination with valproic acid provides protection against seizure-induced hypertension and bradyarrhythmia.

  18. Counterpoint to “What Is an Epileptic Seizure?” By D’Ambrosio and Miller

    Dudek, F Edward; Bertram, Edward H


    D’Ambrosio and Miller argue that brief (i.e., one to a few seconds), rhythmic electrographic events accompanied by behavioral arrest, which they have observed in rats after lateral fluid percussion (i.e., in an animal model of traumatic brain injury), should be considered seizures in this model of posttraumatic epilepsy (1). A counter argument is that these events are not characteristic of the seizures seen clinically in posttraumatic epilepsy or in other forms of acquired epilepsy. Furthermore, several types of brief, rhythmic activity can be recorded in the electroencephalogram (EEG) of animals and humans without epilepsy. One cannot exclude the possibility that such events represent normal electrical activity, which may (or even may not) occur more often after brain injury. Thus, caution is required. In this counterpoint to “What Is an Epileptic Seizure?” by D’Ambrosio and Miller, the assertion is made that experimental studies on animal models of acquired epilepsy that claim electrographic events to be seizures, when the possibility exists that they may not be seizures characteristic of human acquired epilepsy, could be counterproductive, since research resources could be focused on animal models that may not actually demonstrate acquired epilepsy. PMID:20697504

  19. Optogenetic activation of VGLUT2-expressing excitatory neurons blocks epileptic seizure-like activity in the mouse entorhinal cortex

    Yekhlef, Latefa; Breschi, Gian Luca; Taverna, Stefano


    We investigated whether an anti-epileptic effect is obtained by selectively activating excitatory neurons expressing ChR2 under the promoter for the synaptic vesicular glutamate transporter 2 (VGLUT2). VGLUT2-expressing cells were optically stimulated while local field potential and whole-cell patch-clamp recordings were performed in mouse entorhinal cortical slices perfused with the proconvulsive compound 4-aminopyridine (4-AP). In control conditions, blue light flashes directly depolarized the majority of putative glutamatergic cells, which in turn synaptically excited GABAergic interneurons. During bath perfusion with 4-AP, photostimuli triggered a fast EPSP-IPSP sequence which was often followed by tonic-clonic seizure-like activity closely resembling spontaneous ictal discharges. The GABAA-receptor antagonist gabazine blocked the progression of both light-induced and spontaneous seizures. Surprisingly, prolonged photostimuli delivered during ongoing seizures caused a robust interruption of synchronous discharges. Such break was correlated with a membrane potential depolarization block in principal cells, while putative GABAergic interneurons changed their firing activity from a burst-like to an irregular single-spike pattern. These data suggest that photostimulation of glutamatergic neurons triggers seizure-like activity only in the presence of an intact GABAergic transmission and that selectively activating the same glutamatergic cells robustly interrupts ongoing seizures by inducing a strong depolarization block, resulting in the disruption of paroxysmal burst-like firing. PMID:28230208


    K. Yu. Mukhin


    Full Text Available Epileptic spasms are epileptic seizures with sudden flexion/extension or of the mixed flexion and extension type, mainly involving the proximal and truncal muscles, that are normally longer than myoclonic seizures but shorter than tonic seizures, and last for about 1 second. For diagnostics of epileptic spasms, it is necessary that they are combined with ictal and interictal epileptiform patterns on electroencephalography (EEG. The first detailed clinical description of seizures of the infantile spasms type was provided by English pediatrician W.J. West in 1841. The term of infantile spasms is limited with age and means epileptic spasms that occur to children in early infancy, usually up to 1 y.o. Infantile spasms cannot be synonymous to the West syndrome. Infantile spasms are a type of epileptic seizures and West syndrome is a form of epilepsy that is usually manifested through hypsarrhythmia on the EEG and mental retardation, apart from infantile spasms. Epileptic spasms is the term broader than infantile spasms. Committee of the International League Against Epilepsy (ILAE recommends exactly the “epileptic spasms” term, as this type of seizures is not a prerogative of the West syndrome and can be observed in children older than 1 y.o. and even in adults. The authors provided a detailed review of modern references devoted to epileptic spasms including the history of the issue, determination of the term, and position of epileptic spasms in modern classification systems, approaches to diagnostics including differential diagnosis, treatment, and prognosis.

  1. The similarities between the hallucinations associated with the partial epileptic seizures of the occipital lobe and ball lightning observations

    Cooray, G. K.; Cooray, V.


    Ball Lightning was seen and described since antiquity and recorded in many places. Ball lightning is usually observed during thunderstorms but large number of ball lightning observations is also reported during fine weather without any connection to thunderstorms or lightning. However, so far no one has managed to generate them in the laboratory. It is photographed very rarely and in many cases the authenticity of them is questionable. It is possible that many different phenomena are grouped together and categorized simply as ball lightning. Indeed, the visual hallucinations associated with simple partial epileptic seizures, during which the patient remains conscious, may also be categorized by a patient unaware of his or her condition as ball lightning observation. Such visual hallucinations may occur as a result of an epileptic seizure in the occipital, temporo-occipital or temporal lobes of the cerebrum [1,2,3]. In some cases the hallucination is perceived as a coloured ball moving horizontally from the periphery to the centre of the vision. The ball may appear to be rotating or spinning. The colour of the ball can be red, yellow, blue or green. Sometimes, the ball may appear to have a solid structure surrounded by a thin glow or in other cases the ball appears to generate spark like phenomena. When the ball is moving towards the centre of the vision it may increase its intensity and when it reaches the centre it can 'explode' illuminating the whole field of vision. During the hallucinations the vision is obscured only in the area occupied by the apparent object. The hallucinations may last for 5 to 30 seconds and rarely up to a minute. Occipital seizures may spread into other regions of the brain giving auditory, olfactory and sensory sensations. These sensations could be buzzing sounds, the smell of burning rubber, pain with thermal perception especially in the arms and the face, and numbness and tingling sensation. In some cases a person may experience only

  2. Epilepsy and weather: A significant correlation between the onset of epileptic seizures and specific atmospherics — a pilot study

    Ruhenstroth-Bauer, G.; Baumer, H.; Kugler, J.; Spatz, R.; Sönning, W.; Filipiak, B.


    The possibility of connections between weather and the onset of epileptic seizures has long been suggested (see, for example, the Hammurabi Codex 1600 BC). Work in the 20th Century points to a probability that the onset of both local and generalised epilepsy is significantly influenced by an interaction between genetic and extrinsic factors. In an attempt to clarify the situation a detailed study of the history of 315 attacks from 1 Jan. to 31 July 1981 suffered by a small number of patients in Munich has been undertaken. Although linkages between “classical” meteorological parameters and the onset of seizures are very weak, links with more generalised indexes (e.g. passage of fronts and disturbances) are more promising. However, the correlation between onsets and “atmospherics” of 28 KHz (positive) and 10 KHz (negative) impulses, are significant and call for urgent study.

  3. The impact of self-efficacy, alexithymia and multiple traumas on posttraumatic stress disorder and psychiatric co-morbidity following epileptic seizures: a moderated mediation analysis.

    Chung, Man Cheung; Allen, Rachel D; Dennis, Ian


    This study investigated the incidence of posttraumatic stress disorder (PTSD) and psychiatric co-morbidity following epileptic seizure, whether alexithymia mediated the relationship between self-efficacy and psychiatric outcomes, and whether the mediational effect was moderated by the severity of PTSD from other traumas. Seventy-one (M=31, F=40) people with a diagnosis of epilepsy recruited from support groups in the United Kingdom completed the Posttraumatic Stress Diagnostic Scale, the Hospital Anxiety and Depression Scale, the Toronto Alexithymia Scale-20 and the Generalized Self-Efficacy Scale. They were compared with 71 people (M=29, F=42) without epilepsy. For people with epilepsy, 51% and 22% met the diagnostic criteria for post-epileptic seizure PTSD and for PTSD following one other traumatic life event respectively. For the control group, 24% met the diagnostic criteria for PTSD following other traumatic life events. The epilepsy group reported significantly more anxiety and depression than the control. Partial least squares (PLS) analysis showed that self-efficacy was significantly correlated with alexithymia, post-epileptic seizure PTSD and psychiatric co-morbidity. Alexithymia was also significantly correlated with post-epileptic seizure PTSD and psychiatric co-morbidity. Mediation analyses confirmed that alexithymia mediated the path between self-efficacy and post-epileptic seizure PTSD and psychiatric co-morbidity. Moderated mediation also confirmed that self-efficacy and PTSD from one other trauma moderated the effect of alexithymia on outcomes. To conclude, people can develop posttraumatic stress disorder symptoms and psychiatric co-morbidity following epileptic seizure. These psychiatric outcomes are closely linked with their belief in personal competence to deal with stressful situations and regulate their own functioning, to process rather than defend against distressing emotions, and with the degree of PTSD from other traumas.

  4. Dynamics of regional brain activity in epilepsy: a cross-disciplinary study on both intracranial and scalp-recorded epileptic seizures

    Minadakis, George; Ventouras, Errikos; Gatzonis, Stylianos D.; Siatouni, Anna; Tsekou, Hara; Kalatzis, Ioannis; Sakas, Damianos E.; Stonham, John


    Objective. Recent cross-disciplinary literature suggests a dynamical analogy between earthquakes and epileptic seizures. This study extends the focus of inquiry for the applicability of models for earthquake dynamics to examine both scalp-recorded and intracranial electroencephalogram recordings related to epileptic seizures. Approach. First, we provide an updated definition of the electric event in terms of magnitude and we focus on the applicability of (i) a model for earthquake dynamics, rooted in a nonextensive Tsallis framework, (ii) the traditional Gutenberg and Richter law and (iii) an alternative method for the magnitude-frequency relation for earthquakes. Second, we apply spatiotemporal analysis in terms of nonextensive statistical physics and we further examine the behavior of the parameters included in the nonextensive formula for both types of electroencephalogram recordings under study. Main results. We confirm the previously observed power-law distribution, showing that the nonextensive formula can adequately describe the sequences of electric events included in both types of electroencephalogram recordings. We also show the intermittent behavior of the epileptic seizure cycle which is analogous to the earthquake cycles and we provide evidence of self-affinity of the regional electroencephalogram epileptic seizure activity. Significance. This study may provide a framework for the analysis and interpretation of epileptic brain activity and other biological phenomena with similar underlying dynamical mechanisms.

  5. A low-power configurable neural recording system for epileptic seizure detection.

    Qian, Chengliang; Shi, Jess; Parramon, Jordi; Sánchez-Sinencio, Edgar


    This paper describes a low-power configurable neural recording system capable of capturing and digitizing both neural action-potential (AP) and fast-ripple (FR) signals. It demonstrates the functionality of epileptic seizure detection through FR recording. This system features a fixed-gain, variable-bandwidth (BW) front-end circuit and a sigma-delta ADC with scalable bandwidth and power consumption. The ADC employs a 2nd-order single-bit sigma-delta modulator (SDM) followed by a low-power decimation filter. Direct impulse-response implementation of a sinc(3) filter and 8-cycle data pipelining in an IIR filter are proposed for the decimation filter design to improve the power and area efficiency. In measurements, the front end exhibits 39.6-dB DC gain, 0.8 Hz to 5.2 kHz of BW, 5.86- μVrms input-referred noise, and 2.4- μW power consumption in AP mode, while showing 38.5-dB DC gain, 250 to 486 Hz of BW, 2.48- μVrms noise, and 4.5- μW power consumption in FR mode. The noise efficiency factor (NEF) is 2.93 and 7.6 for the AP and FR modes, respectively. At 77-dB dynamic range (DR), the ADC has a peak SNR and SNDR of 75.9 dB and 67 dB, respectively, while consuming 2.75-mW power in AP mode. It achieves 78-dB DR, 76.2-dB peak SNR, 73.2-dB peak SNDR, and 588- μW power consumption in FR mode. Both analog and digital power supply voltages are 2.8 V. The chip is fabricated in a standard 0.6- μm CMOS process. The die size is 11.25 mm(2).

  6. Positron emission tomography in patients with psychogenic non-epileptic seizures

    McGonigal A


    Full Text Available Aileen McGonigal,1–3 Marie Arthuis,3 Jean-Arthur Micoulaud-Franchi,4,5 Fabrice Bartolomei,1–3 Eric Guedj6–8 1Institut de Neurosciences des Systèmes, INSERM UMR 1106, Marseille, France; 2Aix Marseille University, Faculty of Medicine, Marseille, France; 3Clinical Neurophysiology Department, Timone Hospital, Marseille, France; 4Department of Functional Investigation of the Nervous System, Sleep Clinic, Bordeaux University Hospital, Bordeaux, France; 5USR CNRS 3413, University of Bordeaux, France; 6Biophysics and Nuclear Medicine Department, Timone Hospital, Marseille, France; 7Aix-Marseille University, CERIMED, Marseille, France; 8Aix-Marseille University, CNRS, UMR7289, INT, Marseille, FranceWe have read with interest the recent review entitled “Uncovering the etiology of conversion disorder: insights from functional neuroimaging” by Maryam Ejareh dar and Richard AA Kanaan,1 published in Neuropsychiatric Disease and Treatment. Our paper on resting state brain metabolism measured by positron emission tomography (PET was included and discussed.2 We were most surprised to see that the authors of the review seem to have misunderstood the findings of our study, which concerned patients with psychogenic non-epileptic seizures (PNES. The authors state that the 16 patients included in our study “were later found to have PNES with comorbid epilepsy”. This is incorrect, since our study included only patients with PNES in whom comorbid epilepsy was excluded. This crucial point is indeed detailed in the Methods section of our article and clearly stated in the abstract: “in all patients, the diagnosis was subsequently confirmed to be PNES with no coexisting epilepsy.” It is thus on the basis of incorrect understanding of our results that Drs Ejareh dar and Kanaan discuss the possible significance of hypometabolism in the anterior cingulate region described in our paper, and erroneously suggest that interpretation of PET findings is

  7. Epileptic seizure propagation from the second somatic sensory area to the fronto-medial region, by insular redistribution. A case report and a connectome description

    Balogh Attila


    Full Text Available Introduction. The seizure propagation phenomenon by inducing remote symptoms brings several difficulties in finding the seizure onset and delineating the epileptic network which should be taken into consideration in epilepsy surgery. By demonstrating a difficult (MRI negative epilepsy surgery case explored with invasive presurgical evaluation we highlight the importance to recognise the secondary sensory area and to explore the the parieto-opercular-insular-medial frontal network in certain cases. A further conclusion is the consideration of the redistributory role of the insula as a special structure in the cerebral connectome, having a role in epileptic network organisation.

  8. Phenobarbital administration every eight hours: improvement of seizure management in idiopathic epileptic dogs with decreased phenobarbital elimination half-life.

    Stabile, F; Barnett, C R; De Risio, L


    Estimated prevalence of canine idiopathic epilepsy is 0.6 per cent in the first-opinion canine population in the UK. Phenobarbital monotherapy has been reported to reduce/eradicate seizure activity in 60-93 per cent of idiopathic epileptic dogs (IEDs). The objective of this study was to evaluate safety and efficacy of the administration of phenobarbital orally every eight hours in IEDs with phenobarbital elimination half-life less than 20 hours. Medical records of 10 IEDs in which steady state trough serum phenobarbital levels were within the reference range and phenobarbital elimination half-life had become less than 20 hours following prolonged administration every 12 hours were reviewed. Side effects and seizure frequency when phenobarbital was administered every 12 hours or 8 hours were compared. In all dogs the side effects of the antiepileptic medication treatment improved. When phenobarbital was administered every eight hours, 9/10 dogs experienced improvement in seizure frequency and 8/10 dogs maintained seizure freedom for a period three times longer than the longest interictal interval period previously recorded. Reduction in the severity and number of clusters of seizures was recorded in one of the remaining two dogs. The administration of phenobarbital orally every eight hours in IEDs with decreased phenobarbital elimination half-life appears safe and can improve seizure management. The results of this study were presented in abstract form (poster) for the 28th symposium of the European Society of Veterinary Neurology - European College of Veterinary Neurology (ESVN), September 18-19, 2015, Amsterdam, Netherlands. British Veterinary Association.

  9. A clinical trial of single dose rectal and oral administration of diazepam for the prevention of serial seizures in adult epileptic patients.


    The clinical anticonvulsant efficacy of single dose rectal and oral administration of diazepam 20 mg was examined in two double-blind placebo-controlled trials in adult epileptic patients. All subjects suffered from drug resistant epilepsy and frequently experienced serial seizures. Diazepam was administered rectally as a new experimental suppository formulation immediately after a seizure and was highly effective in preventing recurrent fits within a 24 h observation period (p less than 0.00...

  10. Nonseizure SUDEP: Sudden unexpected death in epilepsy without preceding epileptic seizures.

    Lhatoo, Samden D; Nei, Maromi; Raghavan, Manoj; Sperling, Michael; Zonjy, Bilal; Lacuey, Nuria; Devinsky, Orrin


    To describe the phenomenology of monitored sudden unexpected death in epilepsy (SUDEP) occurring in the interictal period where death occurs without a seizure preceding it. We report a case series of monitored definite and probable SUDEP where no electroclinical evidence of underlying seizures was found preceding death. Three patients (two definite and one probable) had SUDEP. They had a typical high SUDEP risk profile with longstanding intractable epilepsy and frequent generalized tonic-clonic seizures (GTCS). All patients had varying patterns of respiratory and bradyarrhythmic cardiac dysfunction with profound electroencephalography (EEG) suppression. In two patients, patterns of cardiorespiratory failure were similar to those seen in some patients in the Mortality in Epilepsy Monitoring Units Study (MORTEMUS). SUDEP almost always occur postictally, after GTCS and less commonly after a partial seizure. Monitored SUDEP or near-SUDEP cases without a seizure have not yet been reported in literature. When nonmonitored SUDEP occurs in an ambulatory setting without an overt seizure, the absence of EEG information prevents the exclusion of a subtle seizure. These cases confirm the existence of nonseizure SUDEP; such deaths may not be prevented by seizure detection-based devices. SUDEP risk in patients with epilepsy may constitute a spectrum of susceptibility wherein some are relatively immune, death occurs in others with frequent GTCS with one episode of seizure ultimately proving fatal, while in others still, death may occur even in the absence of a seizure. We emphasize the heterogeneity of SUDEP phenomena. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  11. NeuroKinect: A Novel Low-Cost 3Dvideo-EEG System for Epileptic Seizure Motion Quantification.

    João Paulo Silva Cunha

    motion trajectories when compared to a 2D frame by frame tracking procedure. We conclude that this new approach provides a more comfortable (both for patients and clinical professionals, simpler, faster and lower-cost procedure than previous approaches, therefore providing a reliable tool to quantitatively analyze MOI patterns of epileptic seizures in the routine of EMUs around the world. We hope this study encourages other EMUs to adopt similar approaches so that more quantitative information is used to improve epilepsy diagnosis.

  12. [Effect of citicoline on the development of chronic epileptization of the brain (pentylenetetrazole kindling) and acute seizures reaction of kindled mice C57Bl/6].

    Kuznetzova, L V; Karpova, M N; Zinkovsky, K A; Klishina, N V


    In experiments on mice C57Bl/6 was studied effects of citicoline (500 mg/kg, i.p.) on development of chronically epileptization of the brain--pentylenetetrazole (PTZ) kindling (30 mg/kg PTZ, i.p. during 24 days) and on acute generalized seizures (i.v., 1% solution of PTZ with the speed of 0.01 ml/s). It was shown that daily injection of citicoline an hour before the introduction of PTZ had no effect on development of chronically epileptization of the brain --PTZ-kindling (the latency of seizures appearance and their severity). However, citicoIine posses anticonvulsive effects on acute seizures in kindled mice. In animals with increased seizure susceptibility of the brain caused by kindling and severity of seizures 2-3 points injection citicoline after 14 days of kindling had anticonvulsive effect, increasing the threshold clonic seizures. Injection of citicoline during 24 days of kindled animals and severity of seizures 3-5 points caused the increase of thresholds as clonic and tonic phase of seizures with lethal outcome. Thus, the anticonvulsant effect of citicoline more pronounced in the long-term use.

  13. Cardiac troponin I (CTnI level among children with epileptic seizures

    Ahmed Anwer Attia Khattab


    Conclusion: Cardiac troponin I is a perfect tool for early detection of cases with myocardial dysfunction in epileptic patients – cardiac troponin I is significantly increased in children with epilepsy especially the complicated epilepsy. Cardiac injury in epileptic children is more common in patients with early onset epilepsy, positive prenatal problem, idiopathic epilepsy, abnormal imaging and EEG – elevated TnI levels may be of value in assessing the severity and eventual outcome and mortality risk of the disease in children with epilepsy.

  14. Epileptic Seizure Detection and Prediction Based on Continuous Cerebral Blood Flow Monitoring – a Review

    Senay Tewolde


    Full Text Available Epilepsy is the third most common neurological illness, affecting 1% of the world’s population. Despite advances in medicine, about 25 to 30% of the patients do not respond to or cannot tolerate the severe side effects of medical treatment, and surgery is not an option for the majority of patients with epilepsy. The objective of this article is to review the current state of research on seizure detection based on cerebral blood flow (CBF data acquired by thermal diffusion flowmetry (TDF, and CBF-based seizure prediction. A discussion is provided on the applications, advantages, and disadvantages of TDF in detecting and localizing seizure foci, as well as its role in seizure prediction. Also presented are an overview of the present challenges and possible future research directions (along with methodological guidelines of the CBF-based seizure detection and prediction methods.

  15. NeuroKinect: A Novel Low-Cost 3Dvideo-EEG System for Epileptic Seizure Motion Quantification

    Cunha, João Paulo Silva; Choupina, Hugo Miguel Pereira; Rocha, Ana Patrícia; Fernandes, José Maria; Achilles, Felix; Loesch, Anna Mira; Vollmar, Christian; Hartl, Elisabeth; Noachtar, Soheyl


    body motion trajectories when compared to a 2D frame by frame tracking procedure. We conclude that this new approach provides a more comfortable (both for patients and clinical professionals), simpler, faster and lower-cost procedure than previous approaches, therefore providing a reliable tool to quantitatively analyze MOI patterns of epileptic seizures in the routine of EMUs around the world. We hope this study encourages other EMUs to adopt similar approaches so that more quantitative information is used to improve epilepsy diagnosis. PMID:26799795

  16. Chaotic electrical stimulation of the subthalamic nucleus - mossy fiber sprouting, epileptic seizures, and brain electrical activity in pentylenetetrazol-kindled rats

    Shenggen Chen; Chunhui Che; Huapin Huang; Changyun Liu; Xiaoyun Zhuang; Fang Jiang


    BACKGROUND: Previous studies have demonstrated that appropriate interventions can alter brain electrical activity of epileptic patients prior to and during a seizure, leading to maintenance of a highly chaotic state, thereby inhibiting abnormal epileptic discharges, and eventually controlling epileptic seizure. OBJECTIVE: This study was designed to observe the effects of chaotic electrical stimulation to the subthalamic nucleus on mossy fiber sprouting, epileptic seizures, and electrical discharges, and to summarize the most suitable intervention. DESIGN, TIME AND SETTING: This randomized grouping, neuroelectrophysiological study was performed at the Laboratory of Neurology, Union Hospital Affiliated to Fujian Medical University in September 2007.MATERIALS: Fifty-five healthy, male, Sprague Dawley rats were subjected to an epileptic model by an intraperitoneal injection of pentylenetetrazol. The YC-2 programmed electrical stimulator was provided by Chengdu Instrument Factory, China; the video electroencephalographic system (KT-88-2400) and 24-hour active electroencephalographic system were products of Contec Medical System Co., Ltd., China; pentylenetetrazol was purchased from Sigma, USA.METHODS: The present interventional method consisted of electrical stimulation to the subthalamic nucleus with an intensity of 500 μ A, pulse width 0.05 ms, frequency 30 Hz, and a duration of 20 minutes for 14 successive days. Fifty-five rats were divided into 6 groups: (1) pre-stimulation (n = 10), pentylenetetrazol was administered and 30 minutes later, chaotic electrical stimulation was performed; (2) synchronous stimulation (n = 10), rats received pentylenetetrazol and chaotic electrical stimulation concurrently; (3) post-administration stimulation (n = 10), after pentylenetetrazol administration, chaotic electrical stimulation was performed immediately after cessation of a seizure; (4) sham-stimulation (n = 10), following pentylenetetrazol administration, an electrode was

  17. A Case of Lung Cancer with Brain Metastases Diagnosed After Epileptic Seizure

    Hakan Simsek


    Full Text Available  LETTER TO THE EDITOR CONCERNING THE CASE REPORT “A case of lung cancer with brain metastases diagnosed after epileptic seizure” by M. Eroglu et al. J Clin Anal Med 2015; 6(3: 384-6

  18. Cannabidiol Post-Treatment Alleviates Rat Epileptic-Related Behaviors and Activates Hippocampal Cell Autophagy Pathway Along with Antioxidant Defense in Chronic Phase of Pilocarpine-Induced Seizure.

    Hosseinzadeh, Mahshid; Nikseresht, Sara; Khodagholi, Fariba; Naderi, Nima; Maghsoudi, Nader


    Abnormal and sometimes severe behavioral and molecular symptoms are usually observed in epileptic humans and animals. To address this issue, we examined the behavioral and molecular aspects of seizure evoked by pilocarpine. Autophagy can promote both cell survival and death, but there are controversial reports about the neuroprotective or neurodegenerative effects of autophagy in seizure. Cannabidiol has anticonvulsant properties in some animal models when used as a pretreatment. In this study, we investigated alteration of seizure scores, autophagy pathway proteins, and antioxidant status in hippocampal cells during the chronic phase of pilocarpine-induced epilepsy after treatment with cannabidiol. Cannabidiol (100 ng, intracerebroventricular injection) delayed the chronic phase of epilepsy. Single administration of cannabidiol during the chronic phase of seizure significantly diminished seizure scores such as mouth clonus, head nodding, monolateral and bilateral forelimb clonus and increased the activity of catalase enzyme and reduced glutathione content. Such a protective effect in the behavioral scores of epileptic rats was also observed after repeated administrations of cannabidiol at the onset of the silent phase. Moreover, the amount of Atg7, conjugation of Atg5/12, Atg12, and LC3II/LC3I ratio increased significantly in epileptic rats treated with repeated injections of cannabidiol. In short, our results suggest that post-treatment of Cannabidiol could enhance the induction of autophagy pathway and antioxidant defense in the chronic phase of epilepsy, which could be considered as the protective mechanisms of cannabidiol in a temporal lobe epilepsy model.

  19. High-frequency brain networks undergo modular breakdown during epileptic seizures.

    Fuertinger, Stefan; Simonyan, Kristina; Sperling, Michael R; Sharan, Ashwini D; Hamzei-Sichani, Farid


    Cortical high-frequency oscillations (HFOs; 100-500 Hz) play a critical role in the pathogenesis of epilepsy; however, whether they represent a true epileptogenic process remains largely unknown. HFOs have been recorded in the human cortex but their network dynamics during the transitional period from interictal to ictal phase remain largely unknown. We sought to determine the high-frequency network dynamics of these oscillations in patients with epilepsy who were undergoing intracranial electroencephalographic recording for seizure localization. We applied a graph theoretical analysis framework to high-resolution intracranial electroencephalographic recordings of 24 interictal and 24 seizure periods to identify the spatiotemporal evolution of community structure of high-frequency cortical networks at rest and during multiple seizure episodes in patients with intractable epilepsy. Cortical networks at all examined frequencies showed temporally stable community architecture in all 24 interictal periods. During seizure periods, high-frequency networks showed a significant breakdown of their community structure, which was characterized by the emergence of numerous small nodal communities, not limited to seizure foci and encompassing the entire recorded network. Such network disorganization was observed on average 225 s before the electrographic seizure onset and extended on average 190 s after termination of the seizure. Gamma networks were characterized by stable community dynamics during resting and seizure periods. Our findings suggest that the modular breakdown of high-frequency cortical networks represents a distinct functional pathology that underlies epileptogenesis and corresponds to a cortical state of highest propensity to generate seizures. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  20. TNF-overexpression in Borna disease virus-infected mouse brains triggers inflammatory reaction and epileptic seizures.

    Katharina Kramer

    Full Text Available Proinflammatory state of the brain increases the risk for seizure development. Neonatal Borna disease virus (BDV-infection of mice with neuronal overexpression of tumor necrosis factor-α (TNF was used to investigate the complex relationship between enhanced cytokine levels, neurotropic virus infection and reaction pattern of brain cells focusing on its role for seizure induction. Viral antigen and glial markers were visualized by immunohistochemistry. Different levels of TNF in the CNS were provided by the use of heterozygous and homozygous TNF overexpressing mice. Transgenic TNF, total TNF (native and transgenic, TNF-receptor (TNFR1, TNFR2, IL-1 and N-methyl-D-aspartate (NMDA-receptor subunit 2B (NR2B mRNA values were measured by real time RT-PCR. BDV-infection of TNF-transgenic mice resulted in non-purulent meningoencephalitis accompanied by epileptic seizures with a higher frequency in homozygous animals. This correlated with lower weight gain, stronger degree and progression of encephalitis and early, strong microglia activation in the TNF-transgenic mice, most obviously in homozygous animals. Activation of astroglia could be more intense and associated with an unusual hypertrophy in the transgenic mice. BDV-antigen distribution and infectivity in the CNS was comparable in TNF-transgenic and wild-type animals. Transgenic TNF mRNA-expression was restricted to forebrain regions as the transgene construct comprised the promoter of NMDA-receptor subunit2B and induced up-regulation of native TNF mRNA. Total TNF mRNA levels did not increase significantly after BDV-infection in the brain of transgenic mice but TNFR1, TNFR2 and IL-1 mRNA values, mainly in the TNF overexpressing brain areas. NR2B mRNA levels were not influenced by transgene expression or BDV-infection. Neuronal TNF-overexpression combined with BDV-infection leads to cytokine up-regulation, CNS inflammation and glial cell activation and confirmed the presensitizing effect of elevated

  1. Attachment style, relationship quality, and psychological distress in patients with psychogenic non-epileptic seizures versus epilepsy.

    Green, Becky; Norman, Paul; Reuber, Markus


    Psychopathology levels are elevated in patients with psychogenic non-epileptic seizures (PNES) and those with epilepsy. However, patients with PNES report higher rates of trauma and neglect, poorer health-related quality of life (HRQoL), and an increased prevalence of insecure attachment. We examined to what extent attachment style and relationship quality with their main informal carer impact on levels of HRQoL, depression, and anxiety in patients with PNES versus those with epilepsy. Consecutive patients with PNES (N=23) and epilepsy (N=72) completed questionnaires about attachment style, quality of their relationship with their main informal carer, seizure severity, HRQoL, depression, and anxiety. Patients with PNES reported higher levels of anxiety and depression and lower HRQoL than those with epilepsy. PNES: No significant correlations were found with HRQoL but depression correlated positively with attachment avoidance, attachment anxiety, and relationship conflict. Anxiety correlated positively with attachment avoidance, attachment anxiety, and relationship conflict, and negatively with relationship depth and support. Epilepsy: HRQoL correlated negatively with seizure severity, depression, anxiety, attachment avoidance, and attachment anxiety. Depression correlated positively with attachment avoidance, attachment anxiety, and relationship conflict. Anxiety correlated positively with seizure severity, attachment avoidance, and attachment anxiety. Correlations between measures of relationship quality and anxiety were stronger in patients with PNES versus those with epilepsy (zs=2.66 to 2.97, psrelationship quality explained larger amounts of variance in depression (45%) and anxiety (60%) in the patients with PNES than those with epilepsy (16% and 13%). Levels of anxiety and depression were higher in patients with PNES than those with epilepsy. Interpersonal problems were much more closely associated with anxiety and depression in patients with PNES than those

  2. Effects of cell phone radiation on lipid peroxidation, glutathione and nitric oxide levels in mouse brain during epileptic seizure.

    Esmekaya, Meric Arda; Tuysuz, Mehmet Zahid; Tomruk, Arın; Canseven, Ayse G; Yücel, Engin; Aktuna, Zuhal; Keskil, Semih; Seyhan, Nesrin


    The objective of the this study was to evaluate the effects of cellular phone radiation on oxidative stress parameters and oxide levels in mouse brain during pentylenetetrazole (PTZ) induced epileptic seizure. Eight weeks old mice were used in the study. Animals were distributed in the following groups: Group I: Control group treated with PTZ, Group II: 15min cellular phone radiation+PTZ treatment+30min cellular phone radiation, Group III: 30min cellular phone radiation+PTZ treatment+30min cellular phone radiation. The RF radiation was produced by a 900MHz cellular phone. Lipid peroxidation, which is the indicator of oxidative stress was quantified by measuring the formation of thiobarbituric acid reactive substances (TBARS). The glutathione (GSH) levels were determined by the Ellman method. Tissue total nitric oxide (NOx) levels were obtained using the Griess assay. Lipid peroxidation and NOx levels of brain tissue increased significantly in group II and III compared to group I. On the contrary, GSH levels were significantly lower in group II and III than group I. However, no statistically significant alterations in any of the endpoints were noted between group II and Group III. Overall, the experimental findings demonstrated that cellular phone radiation may increase the oxidative damage and NOx level during epileptic activity in mouse brain.

  3. Metallothionein reduces central nervous system inflammation, neurodegeneration, and cell death following kainic acid-induced epileptic seizures

    Penkowa, Milena; Florit, Sergi; Giralt, Mercedes


    , such as oxidative stress (formation of nitrotyrosine, malondialdehyde, and 8-oxoguanine), neurodegeneration (neuronal accumulation of abnormal proteins), and apoptotic cell death (judged by TUNEL and activated caspase-3). This reduced bystander damage in TgMT mice could be due to antiinflammatory and antioxidant...

  4. Baccoside A suppresses epileptic-like seizure/convulsion in Caenorhabditis elegans.

    Pandey, Rakesh; Gupta, Shipra; Tandon, Sudeep; Wolkenhauer, Olaf; Vera, Julio; Gupta, Shailendra K


    The 1 mm long Caenorhabditis elegans is one of the prime research tools to study different human neurodegenerative diseases. We have considered the case in which increase in the surrounding temperature of this multicellular model leads to abnormal bursts of neuronal cells that can be linked to seizure or convulsion. The induction of such seizure/convulsion mechanism was done by gradually increasing the temperature with 1x buffer (100 mM NaCl, 50 mM MgCl(2)) in adult C. elegans. In the present experiment it is demonstrated that Baccoside A can significantly reduce the seizure/convulsion in C. elegans at higher temperatures (26-28+/-1 degrees C). Furthermore, in T-type Ca(2+) channel cca-1 mutant worms, no convulsion was recorded. Our experimental results suggest that plant molecules from Bacopa monnieri may be useful in suppressing the seizure/convulsion in worms.

  5. Role of GluK1 kainate receptors in seizures, epileptic discharges, and epileptogenesis.

    Fritsch, Brita; Reis, Janine; Gasior, Maciej; Kaminski, Rafal M; Rogawski, Michael A


    Kainate receptors containing the GluK1 subunit have an impact on excitatory and inhibitory neurotransmission in brain regions, such as the amygdala and hippocampus, which are relevant to seizures and epilepsy. Here we used 2-amino-3-(3-hydroxy-5-tert-butylisoxazol-4-yl) propanoic acid (ATPA), a potent and selective agonist of kainate receptors that include the GluK1 subunit, in conjunction with mice deficient in GluK1 and GluK2 kainate receptor subunits to assess the role of GluK1 kainate receptors in provoking seizures and in kindling epileptogenesis. We found that systemic ATPA, acting specifically via GluK1 kainate receptors, causes locomotor arrest and forelimb extension (a unique behavioral characteristic of GluK1 activation) and induces myoclonic behavioral seizures and electrographic seizure discharges in the BLA and hippocampus. In contrast, the proconvulsant activity of systemic AMPA, kainate, and pentylenetetrazol is not mediated by GluK1 kainate receptors, and deletion of these receptors does not elevate the threshold for seizures in the 6 Hz model. ATPA also specifically activates epileptiform discharges in BLA slices in vitro via GluK1 kainate receptors. Olfactory bulb kindling developed similarly in wild-type, GluK1, and GluK2 knock-out mice, demonstrating that GluK1 kainate receptors are not required for epileptogenesis or seizure expression in this model. We conclude that selective activation of kainate receptors containing the GluK1 subunit can trigger seizures, but these receptors are not necessary for seizure generation in models commonly used to identify therapeutic agents for the treatment of epilepsy.

  6. Anti-epileptic effects of neuropeptide Y gene transfection into the rat brain

    Changzheng Dong; Wenqing Zhao; Wenling Li; Peiyuan Lv; Xiufang Dong


    Neuropeptide Y gene transfection into normal rat brain tissue can provide gene overexpression, which can attenuate the severity of kainic acid-induced seizures. In this study, a recombinant adeno-associated virus carrying the neuropeptide Y gene was transfected into brain tissue of rats with kainic acid-induced epilepsy through stereotactic methods. Following these transfections, we verified overexpression of the neuropeptide Y gene in the epileptic brain. Electroencephalograms showed that seizure severity was significantly inhibited and seizure latency was significantly prolonged up to 4 weeks after gene transfection. Moreover, quantitative fluorescent PCR and western blot assays revealed that the mRNA and protein expression of the N-methyl-D-aspartate receptor subunits NR1, NR2A, and NR2B was inhibited in the hippocampus of epileptic rats. These findings indicate that neuropeptide Y may inhibit seizures via down-regulation of the functional expression of N-methyl-D-aspartate receptors.

  7. A tautology in the classification of generalized non-convulsive epileptic seizures.

    Seino, M; Fujiwara, T; Miyakoshi, M; Yagi, K


    Five patients with the Lennox-Gastaut syndrome who have shown generalized nonconvulsive seizures were presented. The seizure manifestations which occurred spontaneously were documented by simultaneous recording and analyzed in terms of clinical and electroencephalographic correlates. According to the diagnostic criteria of the International Classification, it was possible, on the one hand, to regard them as "atypical complex absences" in which the impairment of consciousness is accompanied by other symptoms, which tend to dominate the clinical picture. They were: hypotonic, hypertonic, myoclonic and akinetic components, respectively. On the other hand, if we give a special weight to the accompanying symptoms, it is entirely possible that they are at the same time diagnosed atonic, axial tonic, bilateral myoclonic and akinetic seizures. The initial impairment of consciousness is common to all the seizure manifestations, and the ictal and interictal EEG expressions are not of diagnostic significance. A question arises as to whether two different nomenclatures were arbitrarily given to a unique ictal manifestation or not as far as the generalized non-convulsive seizures were concerned.

  8. The appropriacy of fluency tests in assessing epileptic seizure lateralization in children with partial epilepsy

    Vuksanović Jasmina


    Full Text Available Fluency tests are frequently used in clinical practice to asses executive functions. The literature data are not unequivocal although in a great number of papers is pointed out the importance of the left hemisphere, specially of the left frontal lobes in the mediation of phonological fluency and the right hemisphere in the mediation of nonverbal fluency. This paper considers the suitability of fluency tests for the detection of left versus right seizure laterality. The sample consisted of thirty-two epilepsy patients divided into two groups: LHF-participants with the seizure focus in the left hemisphere (n=16, and DHF-participants with the seizure focus in the right hemisphere (n=16, and K-the control group of t age-matched healthy children (n=50 aged 7-11 years. The qualitative and quantitative comparison of the phonological and nonverbal fluency performance was carried out in consideration of the seizure laterality as well as compared to the healthy controls. The results of phonological fluency performance revealed that the performance of the LHF group was significantly reduced as compared to both DHF and K group. The analysis of nonverbal fluency performance revealed that the performance of the DHF group was significantly reduced as compared to both LHF and K group The qualitative analysis obtained valuable data, which could additionally contribute to the neuropsychological evaluation of the left versus right seizure laterality.

  9. Epileptic fast intracerebral EEG activity: evidence for spatial decorrelation at seizure onset

    Wendling, Fabrice; Bartolomei, Fabrice; Bellanger, Jean-Jacques; Bourien, Jérôme; Chauvel, Patrick


    Low-voltage rapid discharges (or fast EEG ictal activity) constitute a characteristic electrophysiological pattern in focal seizures of human epilepsy. They are characterized by a decrease of signal voltage with a marked increase of signal frequency (typically beyond 25 Hz). They have long been observed in stereoelectroencephalographic (SEEG) signals recorded with intra-cerebral electrodes, generally occurring at seizure onset and simultaneously involving distinct brain regions. Spectral properties of rapid ictal discharges as well as spatial correlations measured between SEEG signals generated from distant sites before, during and after these discharges were studied. Cross-correlation estimates within typical EEG sub-bands and statistical tests performed in ten patients suffering from partial epilepsy (frontal, temporal or fronto-temporal) reveal that SEEG signals are significantly de-correlated during the discharge period compared to periods that precede and follow this discharge. These results can be interpreted as a functional decoupling of distant brain sites at seizure onset followed by an abnormally high re-coupling when the seizure develops. They lead to the concept of “disruption” that is complementary of that of “activation” (revealed by significantly high correlations between signals recorded during seizures), both giving insights into our understanding of pathophysiological processes involved in human partial epilepsies as well as in the interpretation of clinical semiology. PMID:12764064

  10. Low-Power Implantable Device for Onset Detection and Subsequent Treatment of Epileptic Seizures: A Review

    Muhammad Tariqus Salam


    Full Text Available Over the past few years, there has been growing interest in neuro-responsive intracerebral local treatments of seizures, such as focal drug delivery, focal cooling, or electrical stimulation. This mode of treatment requires an effective intracerebral electroencephalographic acquisition system, seizure detector, brain stimulator, and wireless system that consume ultra-low power. This review focuses on alternative brain stimulation treatments for medically intractable epilepsy patients. We mainly discuss clinical studies of long-term responsive stimulation and suggest safer optimized therapeutic options for epilepsy. Finally, we conclude our study with the proposed low-power, implantable fully integrated device that automatically detects low-voltage fast activity ictal onsets and triggers focal treatment to disrupt seizure progression. The detection performance was verified using intracerebral electroencephalographic recordings from two patients with epilepsy. Further experimental validation of this prototype is underway.

  11. Automated Video Detection of Epileptic Convulsion Slowing as a Precursor for Post-Seizure Neuronal Collapse.

    Kalitzin, Stiliyan N; Bauer, Prisca R; Lamberts, Robert J; Velis, Demetrios N; Thijs, Roland D; Lopes Da Silva, Fernando H


    Automated monitoring and alerting for adverse events in people with epilepsy can provide higher security and quality of life for those who suffer from this debilitating condition. Recently, we found a relation between clonic slowing at the end of a convulsive seizure (CS) and the occurrence and duration of a subsequent period of postictal generalized EEG suppression (PGES). Prolonged periods of PGES can be predicted by the amount of progressive increase of interclonic intervals (ICIs) during the seizure. The purpose of the present study is to develop an automated, remote video sensing-based algorithm for real-time detection of significant clonic slowing that can be used to alert for PGES. This may help preventing sudden unexpected death in epilepsy (SUDEP). The technique is based on our previously published optical flow video sequence processing paradigm that was applied for automated detection of major motor seizures. Here, we introduce an integral Radon-like transformation on the time-frequency wavelet spectrum to detect log-linear frequency changes during the seizure. We validate the automated detection and quantification of the ICI increase by comparison to the results from manually processed electroencephalography (EEG) traces as "gold standard". We studied 48 cases of convulsive seizures for which synchronized EEG-video recordings were available. In most cases, the spectral ridges obtained from Gabor-wavelet transformations of the optical flow group velocities were in close proximity to the ICI traces detected manually from EEG data during the seizure. The quantification of the slowing-down effect measured by the dominant angle in the Radon transformed spectrum was significantly correlated with the exponential ICI increase factors obtained from manual detection. If this effect is validated as a reliable precursor of PGES periods that lead to or increase the probability of SUDEP, the proposed method would provide an efficient alerting device.

  12. Zebrafish larvae exposed to ginkgotoxin exhibit seizure-like behavior that is relieved by pyridoxal-5′-phosphate, GABA and anti-epileptic drugs

    Gang-Hui Lee


    The etiology of epilepsy is a very complicated, multifactorial process that is not completely understood. Therefore, the availability of epilepsy animal models induced by different mechanisms is crucial in advancing our knowledge and developing new therapeutic regimens for this disorder. Considering the advantages of zebrafish, we have developed a seizure model in zebrafish larvae using ginkgotoxin, a neurotoxin naturally occurring in Ginkgo biloba and hypothesized to inhibit the formation of the neurotransmitter γ-aminobutyric acid (GABA. We found that a 2-hour exposure to ginkgotoxin induced a seizure-like behavior in zebrafish larvae. This seizure-like swimming pattern was alleviated by the addition of either pyridoxal-5′-phosphate (PLP or GABA and responded quickly to the anti-convulsing activity of gabapentin and phenytoin, two commonly prescribed anti-epileptic drugs (AEDs. Unexpectedly, the ginkgotoxin-induced PLP depletion in our experimental setting did not affect the homeostasis of folate-mediated one-carbon metabolism, another metabolic pathway playing a crucial role in neural function that also relies on the availability of PLP. This ginkgotoxin-induced seizure behavior was also relieved by primidone, which had been tested on a pentylenetetrazole-induced zebrafish seizure model but failed to rescue the seizure phenotype, highlighting the potential use and complementarity of this ginkgotoxin-induced seizure model for AED development. Structural and morphological characterization showed that a 2-hour ginkgotoxin exposure did not cause appreciable changes in larval morphology and tissues development. In conclusion, our data suggests that this ginkgotoxin-induced seizure in zebrafish larvae could serve as an in vivo model for epileptic seizure research and potential AED screening.

  13. DREADDs suppress seizure-like activity in a mouse model of pharmacoresistant epileptic brain tissue

    Avaliani, N.; Andersson, M.; Thomsen, Annika Højrup Runegaard


    Epilepsy is a neurological disorder with a prevalence of ≈1% of general population. Available antiepileptic drugs (AEDs) have multiple side effects and are ineffective in 30% of patients. Therefore, development of effective treatment strategies is highly needed, requiring drug-screening models...... in mouse OHSCs. As we also found that STIB in mouse OHSCs is resistant to common AED, valproic acid, collectively our findings suggest that DREADD-based strategy may be effective in suppressing epileptiform activity in a pharamcoresitant epileptic brain tissue....

  14. Efficient epileptic seizure detection by a combined IMF-VoE feature.

    Qi, Yu; Wang, Yueming; Zheng, Xiaoxiang; Zhang, Jianmin; Zhu, Junming; Guo, Jianping


    Automatic seizure detection from the electroen-cephalogram (EEG) plays an important role in an on-demand closed-loop therapeutic system. A new feature, called IMF-VoE, is proposed to predict the occurrence of seizures. The IMF-VoE feature combines three intrinsic mode functions (IMFs) from the empirical mode decomposition of a EEG signal and the variance of the range between the upper and lower envelopes (VoE) of the signal. These multiple cues encode the intrinsic characteristics of seizure states, thus are able to distinguish them from the background. The feature is tested on 80.4 hours of EEG data with 10 seizures of 4 patients. The sensitivity of 100% is obtained with a low false detection rate of 0.16 per hour. Average time delays are 19.4s, 13.2s, and 10.7s at the false detection rates of 0.16 per hour, 0.27 per hour, and 0.41 per hour respectively, when different thresholds are used. The result is competitive among recent studies. In addition, since the IMF-VoE is compact, the detection system is of high computational efficiency and able to run in real time.

  15. Brain Inflammation in an Infant With Hemimegalencephaly, Escalating Seizures, and Epileptic Encephalopathy

    Kim, Se Hee; Millichap, John J.; Koh, Sookyong


    Hemimegalencephaly, a congenital brain malformation typically characterized by enlargement of one hemisphere, is frequently associated with intractable epilepsy. The authors report a case of a 12-month-old girl with hemimegalencephaly who underwent semiurgent hemispherectomy because of rapidly escalating seizures, arrested development, and associated encephalopathy. The brain tissue was examined and evaluated for neuroinflammation. Immunohistochemical analysis of the brain tissue revealed the...

  16. Improved epileptic seizure detection combining dynamic feature normalization with EEG novelty detection.

    Bogaarts, J G; Hilkman, D M W; Gommer, E D; van Kranen-Mastenbroek, V H J M; Reulen, J P H


    Continuous electroencephalographic monitoring of critically ill patients is an established procedure in intensive care units. Seizure detection algorithms, such as support vector machines (SVM), play a prominent role in this procedure. To correct for inter-human differences in EEG characteristics, as well as for intra-human EEG variability over time, dynamic EEG feature normalization is essential. Recently, the median decaying memory (MDM) approach was determined to be the best method of normalization. MDM uses a sliding baseline buffer of EEG epochs to calculate feature normalization constants. However, while this method does include non-seizure EEG epochs, it also includes EEG activity that can have a detrimental effect on the normalization and subsequent seizure detection performance. In this study, EEG data that is to be incorporated into the baseline buffer are automatically selected based on a novelty detection algorithm (Novelty-MDM). Performance of an SVM-based seizure detection framework is evaluated in 17 long-term ICU registrations using the area under the sensitivity-specificity ROC curve. This evaluation compares three different EEG normalization methods, namely a fixed baseline buffer (FB), the median decaying memory (MDM) approach, and our novelty median decaying memory (Novelty-MDM) method. It is demonstrated that MDM did not improve overall performance compared to FB (p < 0.27), partly because seizure like episodes were included in the baseline. More importantly, Novelty-MDM significantly outperforms both FB (p = 0.015) and MDM (p = 0.0065).

  17. Can we prevent blood dyscrasia (leucopenia, thrombocytopenia) and epileptic seizures induced by clozapine.

    Herceg, Miroslav; Muzinić, Lana; Jukić, Vlado


    Clozapine is associated with various haematological adverse effects, including leukopenia, neutropenia, agarnulocytosis, leukocytosis, anaemia, eosinophilia, thrombocytopenia and thrombocythaemia. Recognition and treatment of clozapine-related seizures also will become increasingly important as clozapine use grows in the 1990s. The decision to stop clozapine as a result of haematological adverse effects or seizures is a frustrating one for the clinician, and frequently disastrous for the patient. Cessation of treatment results in relapse. In case that patient is unresponsive to other antipsychotic, restarting clozapine should be consider, despite the risk involved. As the risk of a second agranulocytosis is much higher in those patients, various methods of militating against repeat blood dyscrasias have been treated, including granulocyte colony-stimulating factor and lithium. The decision to restart clozapine should be taken on case-by-case basis and should take into account the likely risks and benefits of restarting. Prior response to clozapine and magnitude of patient deterioration on stopping treatment are important factors to take into this consideration. Clozapine-related seizures did not preclude successful treatment with clozapine. A strategy that has been proposed to reduce the occurrence of seizures is the addition of an anticonvulsant agent. However, clozapine does induce a variety of adverse effects, most of which are of limited duration and either preventable or manageable if a number of simple clinical procedures are followed. With careful haematologyc control, the risk of agranulocytosis can be minimized and in case of clozapine related seizures recommendations include dose reduction, electroencephalogram (EEG), plasma-level monitoring and prophylactic antiepileptic treatment. Re-exposure to clozapine may rarely be attempted where there are facilities for very close and frequent monitoring.

  18. Effect of the classic ketogenic diet on the treatment of refractory epileptic seizures

    Luciana Duarte Martins


    Full Text Available OBJECTIVE:The ketogenic diet is used as a therapeutic alternative for the treatment of epilepsy in patients with refractory epilepsy. It simulates biochemical changes typical of fasting. The present study verified the nutritional impact of the ketogenic diet on children with refractory epilepsy. METHODS: Nutritional status data (dietary, biochemical and anthropometric measurements, seizure frequency, and adverse events were collected from the medical records and during outpatient clinic visits of children over a period of 36 months. RESULTS: Of the 29 children who initiated the ketogenic diet, 75.8% presented fewer seizures after one month of treatment. After six months, 48.3% of the patients had at least a 90.0% decrease in seizure frequency, and 50.0% of these patients presented total seizure remission. At 12 months, eight patients continued to show positive results, and seven of these children remained on the ketogenic diet for 24 months. There was an improvement of the nutritional status at 24 months, especially in terms of weight, which culminated with the recovery of proper weightforheight. There were no significant changes in biochemical indices (total cholesterol and components, triglycerides, albumin, total protein, creatinine, glycemia, serum aspartate transaminase and serum alanine transaminase. Serum cholesterol levels increased significantly in the first month, fell in the following six months, and remained within the normal limits thereafter. CONCLUSION: In conclusion, patients on the classic ketogenic diet for at least 24 months gained weight. Moreover, approximately one third of the patients achieved significant reduction in seizure frequency, and some patients achieved total remission.

  19. [A case of a pediatric patient with tuberous sclerosis (Bourneville-Pringle disease) and frequent epileptic seizure for intensive dental treatment under general anesthesia].

    Mimura, Shinichiro; Kikura, Mutsuhito; Itagaki, Taiga; Inokuma, Mie; Iwamoto, Tatsuaki; Kawakubo, Atsushi; Hirano, Kazuhiro; Sato, Shigehito


    Tuberous sclerosis (Bourneville-Pringle disease) is a rare disease with a triad of mental retardation, epilepsy, and facial spot. Management of the patients with tuberous sclerosis under general anesthesia has been previously reported. However, there are few case reports about management under general anesthesia of a pediatric patient with tuberous sclerosis with frequent epileptic seizure. Here, we report a case of a pediatric patient with tuberous sclerosis and frequent epileptic seizure who underwent intensive dental treatment under general anesthesia with careful management of epilepsy. The patient was discharged on the day of surgery without any complications. In this case report, we discussed the appropriate assessment of the complications of tuberous sclerosis; such as, of central nervous, circulatory, respiratory, endocrine, and urinary systems including the management of general anesthesia.

  20. Ictal technetium-99m ethyl cysteinate dimer single-photon emission tomographic findings and propagation of epileptic seizure activity in patients with extratemporal epilepsies

    Noachtar, S.; Arnold, S.; Werhahn, K.J. [Department Neurologie, Ludwig-Maximilians Universitaet, Muenchen (Germany); Yousry, T.A. [Muenchen Univ. (Germany). Abt. fuer Neuroradiologie; Bartenstein, P. [Department of Nuclear Medicine, Technical University of Munich, Munich (Germany); Tatsch, K. [Department of Nuclear Medicine, Ludwig-Maximilians University of Munich, Munich (Germany)


    We investigated the influence of the propagation of extratemporal epileptic seizure activity on the regional increase in cerebral blood flow, which is usually associated with epileptic seizure activity. Forty-two consecutive patients with extratemporal epilepsies were prospectively evaluated. All patients underwent ictal SPET studies with simultaneous electroencephalography (EEG) and video recordings of habitual seizures and imaging studies including cranial magnetic resonance imaging and positron emission tomography with 2-[{sup 18}F]-fluoro-2 deoxy-d-glucose. Propagation of epilptic seizure activity (PESA) was defined as the absence of hyperperfusion on ictal ECD SPET in the lobe of seizure onset, but its presence in another ipsilateral or contralateral lobe. Observers analysing the SPET images were not informed of the other results. PESA was observed in 8 of the 42 patients (19%) and was ipsilateral to the seizure onset in five (63%) of these eight patients. The time between clinical seizure onset and injection of the ECD tracer ranged from 14 to 61 s (mean 34 s). Seven patients (88%) with PESA had parieto-occipital epilepsy and one patient had a frontal epilepsy. PESA was statistically more frequent in patients with parieto-occipital lobe epilepsies (58%) than in the remaining extratemporal epilepsy syndromes (3%) (P<0.0002). These findings indicate that ictal SPET studies require simultaneous EEG-video recordings in patients with extratemporal epilepsies. PESA should be considered when interpreting ictal SPET studies in these patients. Patients with PESA are more likely to have parieto-occipital lobe epilepsy than seizure onset in other extratemporal regions. (orig./MG) (orig.) With 1 fig., 2 tabs., 23 refs.

  1. Effect of the classic ketogenic diet on the treatment of refractory epileptic seizures

    Luciana Duarte Martins; Vera Cristina Terra; Carolina Ferreira Nicoletti; Paula Garcia Chiarello; Julio Sérgio Marchini; Américo Ceiki Sakamoto; Carla Barbosa Nonino-Borges


    Objective The ketogenic diet is used as a therapeutic alternative for the treatment of epilepsy in patients with refractory epilepsy. It simulates biochemical changes typical of fasting. The present study verified the nutritional impact of the ketogenic diet on children with refractory epilepsy. Methods Nutritional status data (dietary, biochemical and anthropometric measurements), seizure frequency, and adverse events were collected from the medical records and during outpatient clinic visit...

  2. Epileptic Seizure Detection Using Lacunarity and Bayesian Linear Discriminant Analysis in Intracranial EEG.

    Zhou, Weidong; Liu, Yinxia; Yuan, Qi; Li, Xueli


    Automatic seizure detection plays an important role in long-term epilepsy monitoring, and seizure detection algorithms have been intensively investigated over the years. This paper proposes an algorithm for seizure detection using lacunarity and Bayesian linear discriminant analysis (BLDA) in long-term intracranial EEG. Lacunarity is a measure of heterogeneity for a fractal. The proposed method first conducts wavelet decomposition on EEGs with five scales, and selects the wavelet coefficients at scale 3, 4, and 5 for subsequent processing. Effective features including lacunarity and fluctuation index are extracted from the selected three scales, and then sent into the BLDA for training and classification. Finally, postprocessing which includes smoothing, threshold judgment, multichannels integration, and collar technique is applied to obtain high sensitivity and low false detection rate. The proposed algorithm is evaluated on 289.14 h intracranial EEG data from 21-patient Freiburg dataset and yields a sensitivity of 96.25% and a false detection rate of 0.13/h with a mean delay time of 13.8 s.

  3. Lacosamide for the prevention of partial onset seizures in epileptic adults

    Anna Kelemen


    Full Text Available Anna Kelemen1, Péter Halász21National Institute of Neurosciences, Epilepsy Center, Budapest, Hungary; 2Faculty of Information Technology, Pázmány Péter Catholic University, Budapest, Hungary Abstract: Lacosamide is a newly registered antiepileptic drug with dual mechanisms of action. It selectively enhances slow inactivation of voltage-gated sodium channels, resulting in stabilization of hyperexcitable neuronal membranes and inhibition of repetitive neuronal firing. It also binds to a collapsing-response mediator protein-2, CRMP2. Lacosamide has a favorable pharmacokinetic profile; is rapidly and completely absorbed, has a relatively long elimination half-life of 13 hours which allows twice-daily administration, linear pharmacokinetics, and has low potential for drug interactions and renal elimination. Both oral and intravenous formulations of lacosamide are being developed. In placebo-controlled clinical trials, lacosamide was effective in seizure reduction as adjunctive therapy in patients with uncontrolled partial-onset seizures. Lacosamide was generally well tolerated. The most frequently reported adverse events in placebo-controlled trials were dizziness, headache, nausea, and diplopia. Intravenous lacosamide has a comparably good safety profile.Keywords: lacosamide, epilepsy, partial onset seizures

  4. Encapsulated galanin-producing cells attenuate focal epileptic seizures in the hippocampus.

    Nikitidou, Litsa; Torp, Malene; Fjord-Larsen, Lone; Kusk, Philip; Wahlberg, Lars U; Kokaia, Mérab


    Encapsulated cell biodelivery (ECB) is a relatively safe approach, since the devices can be removed in the event of adverse effects. The main objectives of the present study were to evaluate whether ECB could be a viable alternative of cell therapy for epilepsy. We therefore developed a human cell line producing galanin, a neuropeptide that has been shown to exert inhibitory effects on seizures, most likely acting via decreasing glutamate release from excitatory synapses. To explore whether ECB of genetically modified galanin-producing human cell line could provide seizure-suppressant effects, and test possible translational prospect for clinical application, we implanted ECB devices bilaterally into the hippocampus of rats subjected to rapid kindling, a model for recurrent temporal lobe seizures. Two clones from a genetically modified human cell line secreting different levels of galanin were tested. Electroencephalography (EEG) recordings and stimulations were performed by electrodes implanted into the hippocampus at the same surgical session as ECB devices. One week after the surgery, rapid kindling stimulations were initiated. Enzyme-linked immunosorbent assay (ELISA) measurements prior to device implantation showed a release of galanin on average of 8.3 ng/mL/24 h per device for the low-releasing clone and 12.6 ng/mL/24 h per device for the high-releasing clone. High-releasing galanin-producing ECB devices moderately decreased stimulation-induced focal afterdischarge duration, whereas low-releasing ECB devices had no significant effect. Our study shows that galanin-releasing ECB devices moderately suppress focal stimulation-induced recurrent seizures. Despite this moderate effect, the study provides conceptual proof that ECB could be a viable alternative approach to cell therapy in humans, with the advantage that the treatment could be terminated by removing these devices from the brain. Thereby, this strategy provides a higher level of safety for future

  5. Health related quality of life in patients admitted for video-electroencephalography monitoring diagnosed with epilepsy or psychogenic non-epileptic seizures

    Yerdelen, Deniz; Altintas, Ebru


    Objective: To determine the health related quality of life (HRQOL) in patients with epilepsy or psychogenic non-epileptic seizures (PNES). Methods: This cross-sectional study was carried out between December 2010 and December 2014 in the Department of Neurology and Psychiatry, Faculty of Medicine, Baskent University, Adana, Turkey. Patients who were admitted for video-electroencephalography monitoring and diagnosed of epileptic seizures or PNES were asked to complete a questionnaire from the World Health Organization Quality of Life, and psychiatric comorbidities were diagnosed using the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition. Results: Patients with epilepsy and PNES were found to have similar HRQOL in physical, psychological, social, and environmental domains. However, the percentage of comorbid psychiatric disorders were higher in patients with PNES than patients with epilepsy. Conclusion: Patients with epilepsy and PNES have similar HRQOL, and PNES are resistant to the standard medical therapies used for the treatment of epileptic seizures. The direct lifetime cost of undiagnosed PNES may be of equal with intractable epilepsy. A better understanding of the impact of PNES manifestations and epilepsy would help to provide appropriate clinical, psychological and social care. PMID:26818167

  6. On the relation between cerebral cysteinyl-leukotriene formation and epileptic seizures.

    Simmet, T; Tippler, B


    In gerbils pentylenetetrazole- or handling-induced seizures were accompanied by cerebral formation of small amounts of cysteinyl-leukotrienes (LT) but large amounts of prostaglandin (PG) F2 alpha. By contrast, in rats injected with pentylenetetrazole or bicuculline very large amounts of PGF2 alpha but no cysteinyl-LT could be detected in the brain tissues. The data indicate that at least in rats the extensive neuronal activity during tonic-clonic convulsions is not necessarily sufficient for the activation of the 5-lipoxygenase pathway. Apparently important species differences do exist.

  7. Wavelet Jensen Shannon divergence as a tool for studying the dynamics of frequency band components in EEG epileptic seizures

    Pereyra, M. E.; Lamberti, P. W.; Rosso, O. A.


    We develop a quantitative method of analysis of EEG records. The method is based on the wavelet analysis of the record and on the capability of the Jensen-Shannon divergence (JSD) to identify dynamical changes in a time series. The JSD is a measure of distance between probability distributions. Therefore for its evaluation it is necessary to define a (time dependent) probability distribution along the record. We define this probability distribution from the wavelet decomposition of the associated time series. The wavelet JSD provides information about dynamical changes in the scales and can be considered a complementary methodology reported earlier [O.A. Rosso, S. Blanco, A. Rabinowicz, Signal Processing 86 (2003) 1275; O.A. Rosso, S. Blanco, J. Yordanova, V. Kolev, A. Figliola, M. Schürmann, E. Başar, J. Neurosci. Methods 105 (2001) 65; O.A. Rosso, M.T. Martin, A. Figliola, K. Keller, A. Plastino, J. Neurosci. Methods 153 (2006) 163]. In the present study we have demonstrated it by analyzing EEG signal of tonic-clonic epileptic seizures applying the JSD method. The display of the JSD curves enables easy comparison of frequency band component dynamics. This would, in turn, promise easy and successful comparison of the EEG records from various scalp locations of the brain.

  8. Low-frequency repetitive transcranial magnetic simulation prevents chronic epileptic seizure*

    Yinxu Wang; Xiaoming Wang; Sha Ke; Juan Tan; Litian Hu; Yaodan Zhang; Wenjuan Cui


    Although low-frequency repetitive transcranial magnetic simulation can potentially treat epilepsy, its underlying mechanism remains unclear. This study investigated the influence of low-frequency re-petitive transcranial magnetic simulation on changes in several nonlinear dynamic electroenceph-alographic parameters in rats with chronic epilepsy and explored the mechanism underlying repeti-tive transcranial magnetic simulation-induced antiepileptic effects. An epilepsy model was estab-lished using lithium-pilocarpine intraperitoneal injection into adult Sprague-Dawley rats, which were then treated with repetitive transcranial magnetic simulation for 7 consecutive days. Nonlinear elec-electroencephalographic parameters were obtained from the rats at 7, 14, and 28 days post-stimulation. Results showed significantly lower mean correlation-dimension and Kolmogo-rov-entropy values for stimulated rats than for non-stimulated rats. At 28 days, the complexity and point-wise correlation dimensional values were lower in stimulated rats. Low-frequency repetitive transcranial magnetic simulation has suppressive effects on electrical activity in epileptic rats, thus explaining its effectiveness in treating epilepsy.

  9. Measuring the level and content of consciousness during epileptic seizures: the Ictal Consciousness Inventory.

    Cavanna, A E; Mula, M; Servo, S; Strigaro, G; Tota, G; Barbagli, D; Collimedaglia, L; Viana, M; Cantello, R; Monaco, F


    Ictal alterations of the level of general awareness and subjective content of consciousness play a pivotal role in the clinical phenomenology of epilepsy, and reflect the pathological involvement of different neurobiological substrates. However, no self-reported measures have been proposed for patients experiencing altered conscious states during seizures. This study describes the development and validation of a new scale for the quantitative assessment of the level and content of ictal consciousness, the Ictal Consciousness Inventory (ICI). The ICI is a 20-item questionnaire generated on the basis of interviews with patients, literature review, and consultation with experts. It was tested on a sample of 110 patients attending three different epilepsy clinics in Northern Italy, who also completed standardized clinical scales. Standard psychometric methods were used to demonstrate that this scale satisfies criteria for acceptability, reliability, and validity. The ICI is proposed as a user-friendly and clinically sound instrument for the measurement of ictal alterations of consciousness in patients with epilepsy.

  10. Midkine, heparin-binding growth factor, blocks kainic acid-induced seizure and neuronal cell death in mouse hippocampus

    Lim In J


    Full Text Available Abstract Background Midkine (MK, a member of the heparin-binding growth factor family, which includes MK and pleiotrophin, is known to possess neurotrophic and neuroprotective properties in the central nervous system. Previous studies have shown that MK is an effective neuroprotective agent in reducing retinal degeneration caused by excessive light and decreasing hippocampal neuronal death in ischemic gerbil brain. The present study was undertaken to investigate whether MK acts as an anticonvulsant in kainic acid (KA-induced seizure in mouse and blocks KA-mediated neuronal cell death in hippocampus. Results Increased expression of MK was found in hippocampus of mouse following seizures induced by intracerebroventricular injection of KA, and MK expression was found in glial fibrillary acidic protein (GFAP-positive astrocytes. Concurrent injection of MK and KA attenuated KA-induced seizure activity and cell death of hippocampal neurons including pyramidal cells and glutamic acid decarboxylase 67 (GAD67-positive GABAergic interneurons in the CA3 and hilar area. Conclusion The results of the present study indicate that MK functions as an anticonvulsant and neuroprotective agent in hippocampus during KA-induced seizures.

  11. Can cortical silent period and motor threshold be practical parameters in the comparison of patients with generalized epilepsy and patients with psychogenic non-epileptic seizures?.

    İpekdal, İlker H; Karadaş, Ömer; Ulaş, Ümit H; Vural, Okay


    This study aimed to compare the cortical excitability of patients with generalized tonic-clonic seizures (GTCSs) and that of patients with psychogenic non-epileptic seizures (PNESs). Patients were classified into groups according to their electroencephalogram (EEG) findings and seizure types: group 1 = GTCS with an abnormal EEG, group 2 = GTCS with a normal EEG and group 3 = PNES with a normal EEG. The control group included healthy volunteers with normal EEGs. Cortical silent period (CSP) and motor threshold (MT) were measured for all groups and the results were compared. CSPs were significantly prolonged in groups 1 and 2 when compared with group 3 and the control group. No differences were found between the MT measurements of all groups. The prolongation of CSP may demonstrate the differences between the pathophysiological mechanisms of GTCS and those of PNES. Copyright © 2012 S. Karger AG, Basel.

  12. Seizure freedom is not adversely affected by early discontinuation of concomitant anti-epileptic drugs in the EULEV cohort of levetiracetam users.

    Droz-Perroteau, Cécile; Marchal, Cécile; Dureau-Pournin, Caroline; Lassalle, Régis; Jové, Jérémy; Robinson, Philip; Lavernhe, Gilles; Vespignani, Hervé; Moore, Nicholas; Fourrier-Réglat, Annie


    Fear of discontinuing concomitant anti-epileptic drugs (AEDs) may lead to potentially unnecessary and perhaps unsafe polypharmacy. The effect of withdrawing concomitant AEDs on epilepsy control was therefore studied in long-term users of levetiracetam. The EULEV cohort followed patients initiating levetiracetam in France in 2005 or 2006 for one year. In those maintaining levetiracetam throughout the study period, the association of a reduction in the number of concomitant AEDs during the first six months with seizure-freedom during the last six months of follow-up was investigated using logistic regression. Of the 356 patients continuing levetiracetam for at least 1 year, 140 (39.3%) were seizure-free during the last six months of follow-up. Partial symptomatic or generalised idiopathic epilepsy were associated with greater seizure-freedom than partial cryptogenic disease. Factors associated with seizures were: longer disease duration, initial incapacity, increased number of seizures in the six months preceding levetiracetam initiation, and number of consultations for epilepsy in the six months preceding levetiracetam initiation. There was a trend for the association between the early reduction in the number of concomitant AEDs and seizure-free status later during follow-up, which however did not reach statistical significance in the final propensity score-adjusted multivariate model (OR = 1.8, 95%CI [0.8;4.0]). Taking into account the various risk factors for seizures, the early reduction of concomitant AEDs was not associated with worse seizure rates during follow-up in real-life users of levetiracetam. Copyright © 2012 John Wiley & Sons, Ltd.

  13. Optimized Seizure Detection Algorithm: A Fast Approach for Onset of Epileptic in EEG Signals Using GT Discriminant Analysis and K-NN Classifier

    Azizi E.


    Full Text Available Background: Epilepsy is a severe disorder of the central nervous system that predisposes the person to recurrent seizures. Fifty million people worldwide suffer from epilepsy; after Alzheimer’s and stroke, it is the third widespread nervous disorder. Objective: In this paper, an algorithm to detect the onset of epileptic seizures based on the analysis of brain electrical signals (EEG has been proposed. 844 hours of EEG were recorded form 23 pediatric patients consecutively with 163 occurrences of seizures. Signals had been collected from Children’s Hospital Boston with a sampling frequency of 256 Hz through 18 channels in order to assess epilepsy surgery. By selecting effective features from seizure and non-seizure signals of each individual and putting them into two categories, the proposed algorithm detects the onset of seizures quickly and with high sensitivity. Method: In this algorithm, L-sec epochs of signals are displayed in form of a thirdorder tensor in spatial, spectral and temporal spaces by applying wavelet transform. Then, after applying general tensor discriminant analysis (GTDA on tensors and calculating mapping matrix, feature vectors are extracted. GTDA increases the sensitivity of the algorithm by storing data without deleting them. Finally, K-Nearest neighbors (KNN is used to classify the selected features. Results: The results of simulating algorithm on algorithm standard dataset shows that the algorithm is capable of detecting 98 percent of seizures with an average delay of 4.7 seconds and the average error rate detection of three errors in 24 hours. Conclusion: Today, the lack of an automated system to detect or predict the seizure onset is strongly felt.

  14. Optimized Seizure Detection Algorithm: A Fast Approach for Onset of Epileptic in EEG Signals Using GT Discriminant Analysis and K-NN Classifier

    Rezaee, Kh.; Azizi, E.; Haddadnia, J.


    Background Epilepsy is a severe disorder of the central nervous system that predisposes the person to recurrent seizures. Fifty million people worldwide suffer from epilepsy; after Alzheimer’s and stroke, it is the third widespread nervous disorder. Objective In this paper, an algorithm to detect the onset of epileptic seizures based on the analysis of brain electrical signals (EEG) has been proposed. 844 hours of EEG were recorded form 23 pediatric patients consecutively with 163 occurrences of seizures. Signals had been collected from Children’s Hospital Boston with a sampling frequency of 256 Hz through 18 channels in order to assess epilepsy surgery. By selecting effective features from seizure and non-seizure signals of each individual and putting them into two categories, the proposed algorithm detects the onset of seizures quickly and with high sensitivity. Method In this algorithm, L-sec epochs of signals are displayed in form of a third-order tensor in spatial, spectral and temporal spaces by applying wavelet transform. Then, after applying general tensor discriminant analysis (GTDA) on tensors and calculating mapping matrix, feature vectors are extracted. GTDA increases the sensitivity of the algorithm by storing data without deleting them. Finally, K-Nearest neighbors (KNN) is used to classify the selected features. Results The results of simulating algorithm on algorithm standard dataset shows that the algorithm is capable of detecting 98 percent of seizures with an average delay of 4.7 seconds and the average error rate detection of three errors in 24 hours. Conclusion Today, the lack of an automated system to detect or predict the seizure onset is strongly felt. PMID:27672628

  15. Protective effects of bupivacaine against kainic acid-induced seizure and neuronal cell death in the rat hippocampus.

    Chiu, Kuan Ming; Wu, Chia Chan; Wang, Ming Jiuh; Lee, Ming Yi; Wang, Su Jane


    The excessive release of glutamate is a critical element in the neuropathology of epilepsy, and bupivacaine, a local anesthetic agent, has been shown to inhibit the release of glutamate in rat cerebrocortical nerve terminals. This study investigated whether bupivacaine produces antiseizure and antiexcitotoxic effects using a kainic acid (KA) rat model, an animal model used for temporal lobe epilepsy, and excitotoxic neurodegeneration experiments. The results showed that administering bupivacaine (0.4 mg/kg or 2 mg/kg) intraperitoneally to rats 30 min before intraperitoneal injection of KA (15 mg/kg) increased seizure latency and reduced the seizure score. In addition, bupivacaine attenuated KA-induced hippocampal neuronal cell death, and this protective effect was accompanied by the inhibition of microglial activation and production of proinflammatory cytokines such as interleukin (IL)-1β, IL-6, and tumor necrosis factor-α in the hippocampus. Moreover, bupivacaine shortened the latency of escaping onto the platform in the Morris water maze learning performance test. Collectively, these data suggest that bupivacaine has therapeutic potential for treating epilepsy.

  16. Efficacy of anti-inflammatory therapy in a model of acute seizures and in a population of pediatric drug resistant epileptics.

    Nicola Marchi

    Full Text Available Targeting pro-inflammatory events to reduce seizures is gaining momentum. Experimentally, antagonism of inflammatory processes and of blood-brain barrier (BBB damage has been demonstrated to be beneficial in reducing status epilepticus (SE. Clinically, a role of inflammation in the pathophysiology of drug resistant epilepsies is suspected. However, the use anti-inflammatory drug such as glucocorticosteroids (GCs is limited to selected pediatric epileptic syndromes and spasms. Lack of animal data may be one of the reasons for the limited use of GCs in epilepsy. We evaluated the effect of the CG dexamethasone in reducing the onset and the severity of pilocarpine SE in rats. We assessed BBB integrity by measuring serum S100β and Evans Blue brain extravasation. Electrophysiological monitoring and hematologic measurements (WBCs and IL-1β were performed. We reviewed the effect of add on dexamethasone treatment on a population of pediatric patients affected by drug resistant epilepsy. We excluded subjects affected by West, Landau-Kleffner or Lennox-Gastaut syndromes and Rasmussen encephalitis, known to respond to GCs or adrenocorticotropic hormone (ACTH. The effect of two additional GCs, methylprednisolone and hydrocortisone, was also reviewed in this population. When dexamethasone treatment preceded exposure to the convulsive agent pilocarpine, the number of rats developing status epilepticus (SE was reduced. When SE developed, the time-to-onset was significantly delayed compared to pilocarpine alone and mortality associated with pilocarpine-SE was abolished. Dexamethasone significantly protected the BBB from damage. The clinical study included pediatric drug resistant epileptic subjects receiving add on GC treatments. Decreased seizure frequency (≥ 50% or interruption of status epilepticus was observed in the majority of the subjects, regardless of the underlying pathology. Our experimental results point to a seizure-reducing effect of

  17. Study of factors responsible for recurrence of seizures in controlled epileptics for more than 1 years after withdrawal of antiepileptic drugs.

    Lamdhade S


    Full Text Available 531 epileptic patients, who had achieved remission mostly for 2 years or more were studied. The mean follow up period was 5 years. Recurrence was noted in 103 patients (19% after gradual withdrawal of AED, over a period of 3-4 months. 424 patients (81% did not have recurrence. The recurrence rate was influenced adversely by factors like adolescent age and later onset seizures, pre-treatment duration of symptoms more than 3 years, pre-treatment precipitating factors like emotional stress, lack of sleep and meals (however, number in each group is small, positive family history of epilepsy, focal neurodeficit, absence and myoclonic plus grandmal type of clinical seizures, paroxysmal generalized spike and wave discharges and generalized short polyspike and wave discharges in the pretreatment EEG, atrophic changes on CT brain scan (in small numbers, head trauma at birth or later and hereditary factors as etiology of epilepsy, and more than 30 number of seizures before achieving the remission. Factors like, sex, frequency of seizures, period of remission i.e. two years or more and number of drugs used to achieve remission, did not have any significant adverse effect. However, in the last parameter 95% remission was achieved by one or a combination of two drugs (72% and 23% respectively.

  18. Bumetanide, an NKCC1 antagonist, does not prevent formation of epileptogenic focus but blocks epileptic focus seizures in immature rat hippocampus.

    Nardou, Romain; Ben-Ari, Yehezkel; Khalilov, Ilgam


    Excitatory GABA action induced by high [Cl(-)](i) is thought to contribute to seizure generation in neonatal neurons although the mechanism of this effect remains unclear. We report that bumetanide, a NKCC1 antagonist, reduces driving force of GABA-mediated currents (DF(GABA)) in neonatal hippocampal neurons and blocks the giant depolarizing potentials (GDPs), a spontaneous pattern of network activity. In the preparation composed of two intact interconnected hippocampi, bumetanide did not prevent generation of kainate-induced seizures, their propagation to the contralateral hippocampus, and formation of an epileptogenic mirror focus. However, in the isolated mirror focus, bumetanide effectively blocked spontaneous epileptiform activity transforming it to the GDP-like activity pattern. Bumetanide partially reduced DF(GABA) and therefore the excitatory action of GABA in epileptic neurons. Therefore bumetanide is a potent anticonvulsive agent although it cannot prevent formation of the epileptogenic mirror focus. We suggest that an additional mechanism other than NKCC1-mediated contributes to the persistent increase of DF(GABA) in epileptic neurons.

  19. Perioperafive management of neurosurgical patients with recurrent epileptic seizures%神经外科患者癫痫反复发作处理分析

    袁冠前; 高丹丹; 林军; 韩松; 吕博川; 粱国标; 魏学忠


    Objective To investigate the clinical features of recurrent epileptic seizures and perioperative management principles and methods of neurosurgical patients with recurrent epileptic seizures.Methods The clinical data,reasons for aggravated seizures,seizure characteristics,and treatment methods and results of 9 patients with recurrent epileptic seizures were analyzed retrospectively.Results Of all the 9 patients,3 were combined with glioma,1 with arachnoid cyst,1 with cavernous hemangioma and 1 with encephalomalacia; epilepsy history was noted in 7 patients; frontal lobe epilepsy was noted in 7,and temporal lobe epilepsy in 2.The reasons for seizure aggravation included drug-decrement(n=3),recent-diagnosed brain tumor(n=2)and surgical operation during intracranial electrode implantation(n=1); and unknown reason was noted in the other 3.Epileptic seizure types included partial seizure and secondary generalized seizure; the frequency of seizure ranged from 3 minutes of interval to several hours of interval.Patients given multiple antiepileptic drugs,including oral and parenteral administration,received good seizure-control; and levetiracetam showed good curative effect during the treatment.Conclusion Recurrent seizures show drug refractory,and is hard to control.The AEDs having good curative effect in partial seizure should be combined used in these patients with higher dosage than conventional initial dose; intravenous and intramuscular administration can be used; the seizures should be controlled as soon as posible.Levetiracetam has good curative effect on patients with recurrent seizures for its fast oral-absorption,rapid onset of action and good antiepileptic effect.%目的 探讨神经外科患者出现癫痫反复发作的临床特点、处理原则与方法.方法 回顾性分析沈阳军区总医院神经外科自2011年1月至6月收治的9例癫痫反复发作患者的临床资料,分析其加重的原因、发作特点及治疗方法和结果.结果 9

  20. Parvalbumin interneurons and calretinin fibers arising from the thalamic nucleus reuniens degenerate in the subiculum after kainic acid-induced seizures.

    Drexel, M; Preidt, A P; Kirchmair, E; Sperk, G


    The subiculum is the major output area of the hippocampus. It is closely interconnected with the entorhinal cortex and other parahippocampal areas. In animal models of temporal lobe epilepsy (TLE) and in TLE patients it exerts increased network excitability and may crucially contribute to the propagation of limbic seizures. Using immunohistochemistry and in situ-hybridization we now investigated neuropathological changes affecting parvalbumin and calretinin containing neurons in the subiculum and other parahippocampal areas after kainic acid-induced status epilepticus. We observed prominent losses in parvalbumin containing interneurons in the subiculum and entorhinal cortex, and in the principal cell layers of the pre- and parasubiculum. Degeneration of parvalbumin-positive neurons was associated with significant precipitation of parvalbumin-immunoreactive debris 24 h after kainic acid injection. In the subiculum the superficial portion of the pyramidal cell layer was more severely affected than its deep part. In the entorhinal cortex, the deep layers were more severely affected than the superficial ones. The decrease in number of parvalbumin-positive neurons in the subiculum and entorhinal cortex correlated with the number of spontaneous seizures subsequently experienced by the rats. The loss of parvalbumin neurons thus may contribute to the development of spontaneous seizures. On the other hand, surviving parvalbumin neurons revealed markedly increased expression of parvalbumin mRNA notably in the pyramidal cell layer of the subiculum and in all layers of the entorhinal cortex. This indicates increased activity of these neurons aiming to compensate for the partial loss of this functionally important neuron population. Furthermore, calretinin-positive fibers terminating in the molecular layer of the subiculum, in sector CA1 of the hippocampus proper and in the entorhinal cortex degenerated together with their presumed perikarya in the thalamic nucleus reuniens. In

  1. Recurrence rate of seizure following discontinuation of anti-epileptic drugs in patients with normal long term electroencephalography

    V Abdul Gafoor


    Full Text Available Background: The usefulness of electroencephalography (EEG in predicting seizure recurrence after antiepileptic drugs (AED tapering is a controversial subject. There have been no studies which tested the additional yield of long-term over routine EEG recordings in predicting seizure recurrence after AED withdrawal. Objective: The primary objective of our study is to determine the recurrence rate of seizure following AED withdrawal in patients with focal epilepsy, unknown cause who had normal long-term electroencephalography (LTEEG and secondary objective is to analyze the variables that would predict seizure recurrence. Materials and Methods: This was a prospective observational study. A total of 91 patients were included. 62 patients who had normal routine and LTEEG entered the final phase of the study were followed-up regularly for 1 year or until seizure recurrence whichever was earlier. Results: A total number of 91 patients were enrolled for the first phase of the study. Of these, 13 (14.29% patients had an abnormal routine EEG. Of the remaining patients, another 16 (17.58% had abnormal LTEEG. The remaining 62 patients with normal routine and long-term EEG entered the final phase of the study. Of these, 17 patients (27.41% had seizure recurrence during the follow-up while 45 (72.58% remained seizure free until the end of the 1 year follow-up. The significant variables associated with a higher risk of seizure relapse were a positive past history of seizure recurrence on prior drug withdrawal (relative risk: 2.19, confidence interval: 1.01-4.74, P < 0.05 and the duration of epilepsy until seizure control was achieved (P < 0.009. Conclusions: The recurrence rate of seizure in patients with a normal LTEEG is 27.41%. A positive past history of seizure recurrence and a longer time to achieve seizure freedom with AED increased the risk of seizure recurrence.

  2. The effect of PTZ-induced epileptic seizures on hippocampal expression of PSA-NCAM in offspring born to kindled rats

    Rajabzadeh Aliakbar


    Full Text Available Abstract Background Maternal epileptic seizures during pregnancy can affect the hippocampal neurons in the offspring. The polysialylated neural cell adhesion molecule (PSA-NCAM, which is expressed in the developing central nervous system, may play important roles in neuronal migration, synaptogenesis, and axonal outgrowth. This study was designed to assess the effects of kindling either with or without maternal seizures on hippocampal PSA-NCAM expression in rat offspring. Methods Forty timed-pregnant Wistar rats were divided into four groups: A Kind+/Seiz+, pregnant kindled (induced two weeks prior to pregnancy rats that received repeated intraperitoneal (i.p. pentylenetetrazol, PTZ injections on gestational days (GD 14-19; B Kind-/Seiz+, pregnant non-kindled rats that received PTZ injections on GD14-GD19; C Kind+/Seiz-, pregnant kindled rats that did not receive any PTZ injections; and D Kind-/Seiz-, the sham controls. Following birth, the pups were sacrificed on PD1 and PD14, and PSA-NCAM expression and localization in neonates’ hippocampi were analyzed by Western blots and immunohistochemistry. Results Our data show a significant down regulation of hippocampal PSA-NCAM expression in the offspring of Kind+/Seiz+ (p = 0.001 and Kind-/Seiz+ (p = 0.001 groups compared to the sham control group. The PSA-NCAM immunoreactivity was markedly decreased in all parts of the hippocampus, especially in the CA3 region, in Kind+/Seiz+ (p = 0.007 and Kind-/Seiz+ (p = 0.007 group’s newborns on both PD1 and 14. Conclusion Our findings demonstrate that maternal seizures but not kindling influence the expression of PSA-NCAM in the offspring’s hippocampi, which may be considered as a factor for learning/memory and cognitive impairments reported in children born to epileptic mothers.

  3. Low distribution of synaptic vesicle protein 2A and synaptotagimin-1 in the cerebral cortex and hippocampus of spontaneously epileptic rats exhibiting both tonic convulsion and absence seizure.

    Hanaya, R; Hosoyama, H; Sugata, S; Tokudome, M; Hirano, H; Tokimura, H; Kurisu, K; Serikawa, T; Sasa, M; Arita, K


    The spontaneously epileptic rat (SER) is a double mutant (zi/zi, tm/tm) which begins to exhibit tonic convulsions and absence seizures after 6 weeks of age, and repetitive tonic seizures over time induce sclerosis-like changes in SER hippocampus with high brain-derived neurotrophic factor (BDNF) expression. Levetiracetam, which binds to synaptic vesicle protein 2A (SV2A), inhibited both tonic convulsions and absence seizures in SERs. We studied SER brains histologically and immunohistochemically after verification by electroencephalography (EEG), as SERs exhibit seizure-related alterations in the cerebral cortex and hippocampus. SERs did not show interictal abnormal spikes and slow waves typical of focal epilepsy or symptomatic generalized epilepsy. The difference in neuronal density of the cerebral cortex was insignificant between SER and Wistar rats, and apoptotic neurons did not appear in SERs. BDNF distributions portrayed higher values in the entorhinal and piriform cortices which would relate with hippocampal sclerosis-like changes. Similar synaptophysin expression in the cerebral cortex and hippocampus was found in both animals. Low and diffuse SV2A distribution portrayed in the cerebral cortex and hippocampus of SERs was significantly less than that of all cerebral lobes and inner molecular layer (IML) of the dentate gyrus (DG) of Wistar rats. The extent of low SV2A expression/distribution in SERs was particularly remarkable in the frontal (51% of control) and entorhinal cortices (47%). Lower synaptotagmin-1 expression (vs Wistar rats) was located in the frontal (31%), piriform (13%) and entorhinal (39%) cortices, and IML of the DG (38%) in SER. Focal low distribution of synaptotagmin-1 accompanying low SV2A expression may contribute to epileptogenesis and seizure propagation in SER.

  4. Human fetal brain-derived neural stem/progenitor cells grafted into the adult epileptic brain restrain seizures in rat models of temporal lobe epilepsy.

    Lee, Haejin; Yun, Seokhwan; Kim, Il-Sun; Lee, Il-Shin; Shin, Jeong Eun; Park, Soo Chul; Kim, Won-Joo; Park, Kook In


    Cell transplantation has been suggested as an alternative therapy for temporal lobe epilepsy (TLE) because this can suppress spontaneous recurrent seizures in animal models. To evaluate the therapeutic potential of human neural stem/progenitor cells (huNSPCs) for treating TLE, we transplanted huNSPCs, derived from an aborted fetal telencephalon at 13 weeks of gestation and expanded in culture as neurospheres over a long time period, into the epileptic hippocampus of fully kindled and pilocarpine-treated adult rats exhibiting TLE. In vitro, huNSPCs not only produced all three central nervous system neural cell types, but also differentiated into ganglionic eminences-derived γ-aminobutyric acid (GABA)-ergic interneurons and released GABA in response to the depolarization induced by a high K+ medium. NSPC grafting reduced behavioral seizure duration, afterdischarge duration on electroencephalograms, and seizure stage in the kindling model, as well as the frequency and the duration of spontaneous recurrent motor seizures in pilocarpine-induced animals. However, NSPC grafting neither improved spatial learning or memory function in pilocarpine-treated animals. Following transplantation, grafted cells showed extensive migration around the injection site, robust engraftment, and long-term survival, along with differentiation into β-tubulin III+ neurons (∼34%), APC-CC1+ oligodendrocytes (∼28%), and GFAP+ astrocytes (∼8%). Furthermore, among donor-derived cells, ∼24% produced GABA. Additionally, to explain the effect of seizure suppression after NSPC grafting, we examined the anticonvulsant glial cell-derived neurotrophic factor (GDNF) levels in host hippocampal astrocytes and mossy fiber sprouting into the supragranular layer of the dentate gyrus in the epileptic brain. Grafted cells restored the expression of GDNF in host astrocytes but did not reverse the mossy fiber sprouting, eliminating the latter as potential mechanism. These results suggest that human fetal

  5. [PI 3 K/Akt signaling pathway contributed to the protective effect of acupuncture intervention on epileptic seizure-induced injury of hippocampal pyramidal cells in epilepsy rats].

    Yang, Fan; Ang, Wen-Ping; Shen, De-Kai; Liu, Xiang-Guo; Yang, Yong-Qing; Ma, Yun


    To observe the protective effect of acupuncture stimulation on pyramidal cells in hippocampal CA 1 and CA 3 regions and to analyze the involvement of phosphatidy linositol-3-kinase (PI 3 K)/protein kinase B(PKB or Akt) signaling pathway in the acupuncture effect in epilepsy rats. A total of 120 SD rats were randomly divided into normal control group, model group, LY 294002 (a specific antagonist for PI 3 K/Akt signaling) group, acupuncture+ LY 294002 group and acupuncture group (n = 24 in each group, 12 for H. E. staining, and 12 for electron microscope observation). Epilepsy model was established by intraperitoneal injection of pentylenetetrazol (PTZ, 5 microL). Manual acupuncture stimulation was applied to "Baihui" (GV 20) and "Dazhui" (GV 14) once daily for 5 days. Dimethyl Sulfoxide (DMSO, 5 microL, a control solvent) was given to rats of the normal, model and acupuncture groups, and LY294002 (5 microL, dissolved in DMSO) given to rats of the LY 294002 and acupuncture+ LY 294002 groups by lateral ventricular injection. Four hours and 24 h after modeling, the hippocampus tissues were sampled for observing pathological changes of CA 1 and CA 3 regions after H. E. staining under light microscope and for checkin ultrastructural changes of the pyramidal cells under transmission electron microscope. In comparison with the normal control group, the numbers of pyramidal cells of hippocampal CA 3 region in the model group were decreased significantly 4 h and 24 h after epileptic seizure (P acupuncture group were increased considerably in the number at both 4 h and 24 h after seizure (P acupuncture+ LY 294002 and model groups in the numbers of pyramidal cells at 4 h and 24 h after seizure (P > 0.05). Findings of the light microscope and electron microscope showed that the injury severity of pyramidal cells of hippocampal CA 1 and CA 3 regions was moderate 4 h after epileptic seizure and even worse 24 h after seizure in the model group, LY 294002 group and acupuncture+ LY

  6. Fractal analysis of electroencephalographic signals intracerebrally recorded during 35 epileptic seizures: evaluation of a new method for synoptic visualisation of ictal events.

    Bullmore, E T; Brammer, M J; Bourlon, P; Alarcon, G; Polkey, C E; Elwes, R; Binnie, C D


    Traditional electroencephalography (EEG) produces a large volume display of brain electrical activity, which creates problems particularly in assessment of long periods of intracranial, stereoelectroencephalographic (SEEG) recording. A method for fractal analysis that describes 100 SEEG data points in terms of a single estimate of fractal dimension (1 signal (using a Sun SPARCstation LX). The diagnostic sensitivity of this method, applied to quantification and synoptic visualisation of SEEG signals recorded during 35 epileptic seizures in 7 patients, is evaluated. It is found that the method consistently defines ictal onset in terms of rapid relative increase in FD across several channels. Clinically severe seizures are characterised by more intense and generalised ictal changes in FD than clinically less severe events. For all 7 patients, and for 75% of individual seizures, "fractal diagnoses" of anatomically defined ictal onset zone coincided closely with ictal onset zone independently determined by inspection of traditional EEG displays of the same data. We conclude that the method is a computationally feasible way to achieve substantial reduction in the volume of SEEG data without undue loss of diagnostically important information in the primary signal.

  7. Epilepsy in patients with psychogenic non-epileptic seizures Epilepsia em pacientes com crises não epilépticas psicogênicas

    Renato Luiz Marchetti


    Full Text Available The aim of this study was to evaluate the frequency of epilepsy in patients who presented psychogenic non-epileptic seizures (PNES. The evaluation was carried out during intensive VEEG monitoring in a diagnostic center for epilepsy in a university hospital. The difficulties involved in reaching this diagnosis are discussed. Ninety-eight patients underwent intensive and prolonged video-electroencephalographic (VEEG monitoring; out of these, a total of 28 patients presented PNES during monitoring. Epilepsy was defined as present when the patient presented epileptic seizures during VEEG monitoring or when, although not presenting epileptic seizures during monitoring, the patient presented unequivocal interictal epileptiform discharges. The frequency of epilepsy in patients with PNES was 50% (14 patients. Our findings suggest that the frequency of epilepsy in patients with PNES is much higher than that of previous studies, and point out the need, at least in some cases, for prolonging the evaluation of patients with PNES who have clinical histories indicating epilepsy.O objetivo deste estudo foi avaliar a frequência de epilepsia em pacientes que apresentaram crises não epilépticas psicogênicas (CNEP. Isto foi realizado durante monitoração intensiva por video-EEG num centro diagnóstico de epilepsia em um hospital universitário. As dificuldades envolvidas para se chegar a este diagnóstico são discutidas. Noventa e oito pacientes foram submetidos a monitoração intensiva por video-EEG; 28 destes pacientes apresentaram CNEP durante a monitoração. Epilepsia foi considerada presente quando o paciente apresentou crises epilépticas durante a avaliação pelo video-EEG ou quando, apesar da não ocorrência de crises epilépticas durante a avaliação, descargas epilépticas interictais inequívocas estavam presentes. A frequência de epilepsia em pacientes com CNEP foi 50% (14 pacientes. Nossos achados sugerem que a frequência de epilepsia em

  8. Towards prognostic biomarkers from BOLD fluctuations to differentiate a first epileptic seizure from new-onset epilepsy.

    Gupta, Lalit; Janssens, Rick; Vlooswijk, Mariëlle C G; Rouhl, Rob P W; de Louw, Anton; Aldenkamp, Albert P; Ulman, Shrutin; Besseling, René M H; Hofman, Paul A M; van Kranen-Mastenbroek, Vivianne H; Hilkman, Danny M; Jansen, Jacobus F A; Backes, Walter H


    The diagnosis of epilepsy cannot be reliably made prior to a patient's second seizure in most cases. Therefore, adequate diagnostic tools are needed to differentiate subjects with a first seizure from those with a seizure preceding the onset of epilepsy. The objective was to explore spontaneous blood oxygen level-dependent (BOLD) fluctuations in subjects with a first-ever seizure and patients with new-onset epilepsy (NOE), and to find characteristic biomarkers for seizure recurrence after the first seizure. We examined 17 first-seizure subjects, 19 patients with new-onset epilepsy (NOE), and 18 healthy controls. All subjects underwent clinical investigation and received electroencephalography and resting-state functional magnetic resonance imaging (MRI). The BOLD time series were analyzed in terms of regional homogeneity (ReHo) and fractional amplitude of low-frequency fluctuations (fALFFs). We found significantly stronger amplitudes (higher fALFFs) in patients with NOE relative to first-seizure subjects and healthy controls. The frequency range of 73-198 mHz (slow-3 subband) appeared most useful for discriminating patients with NOE from first-seizure subjects. The ReHo measure did not show any significant differences. The fALFF appears to be a noninvasive measure that characterizes spontaneous BOLD fluctuations and shows stronger amplitudes in the slow-3 subband of patients with NOE relative first-seizure subjects and healthy controls. A larger study population with follow-up is required to determine whether fALFF holds promise as a potential biomarker for identifying subjects at increased risk to develop epilepsy. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  9. Crise epiléptica focal ipsilateral a tumor cerebral: relato de caso Focal epileptic seizures ipsilateral to the tumor: case report

    Sebastião Silva Gusmão


    Full Text Available Descreve-se um caso de crise focal somatosensorial ipsilateral a tumor cerebral e revê-se a literatura. Trata-se de ocorrência excepcional, tendo sido descritos apenas seis casos. Vários mecanismos fisiopatológicos foram propostos para explicar a crise focal somatosensorial ipsilateral. A proximidade das lesões da convexidade cerebral baixa (perisilviana sugere o comprometimento da área somatosensorial secundária e parece comprovar os achados experimentais de crises somatosensoriais originadas desta área.Focal somatosensory epileptic seizures ipsilateral to a brain tumor is reported and the literature reviewed. It is an exceptional occurrence, having been described only six cases, with several mechanisms being proposed. The proximity of the lesions with the low cerebral convexity (perisylvian suggests the compromising of the secondary somatosensorial area, seeming to prove the experimental observation of somatosensorial crises originating in this area.

  10. [Consensus clinical practice guidelines of the Sociedad Andaluza de Epilepsia for the diagnosis and treatment of patients with their first epileptic seizure in emergencies].

    Serrano-Castro, P J; Sánchez-Alvarez, J C; Cañadillas-Hidalgo, F M; Galán-Barranco, J M; Moreno-Alegre, V; Mercadé-Cerdá, J M

    Epileptic seizures are the cause of between 0.3 and 1.2% of all visits to hospital emergency departments. Twenty-five per cent of patients visit after having their first seizure. Such an impact seems to justify the development of a health care protocol. Our proposal is to draw up a set of implicit evidence-based consensus practice guidelines, to use Liberati's nomenclature, concerning aspects related to the diagnostic procedure and recommended therapeutic management of patients with a first seizure who are being attended in an emergency department. A selective search was conducted on PubMed-Medline for quality scientific information on the subject using scientific evidence filters. This search was completed in other scientific evidence search engines, such as Tripdatabase, Biblioteca Cochrane Plus or DARE. The selected references were analysed and discussed by the authors, and the available evidence and any recommendations that could be drawn from it were collected. A total of 47 primary documents and 10 practice guidelines or protocols related with the proposed topic were identified. The recommendations were inserted in the text explicitly. The diagnostic and therapeutic protocol for all paroxysmal phenomena in emergencies consists of three successive phases: diagnosis of the cause of the epilepsy, integration of the significance of the seizure within the clinical context, and designing the therapeutic scheme. Each phase will depend on the outcomes of the previous one as a decision algorithm. The fundamental tools in each phase are: patient record and examination (phase 1), and complementary tests (phase 2). They are then used to produce a therapeutic decision scheme.

  11. Increased odds and predictive rates of MMPI-2-RF scale elevations in patients with psychogenic non-epileptic seizures and observed sex differences.

    Del Bene, Victor A; Arce Rentería, Miguel; Maiman, Moshe; Slugh, Mitch; Gazzola, Deana M; Nadkarni, Siddhartha S; Barr, William B


    The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) is a self-report instrument, previously shown to differentiate patients with epileptic seizures (ES) and psychogenic non-epileptic seizures (PNES). At present, the odds of MMPI-2-RF scale elevations in PNES patients, as well as the diagnostic predictive value of such scale elevations, remain largely unexplored. This can be of clinical utility, particularly when a diagnosis is uncertain. After looking at mean group differences, we applied contingency table derived odds ratios to a sample of ES (n=92) and PNES (n=77) patients from a video EEG (vEEG) monitoring unit. We also looked at the positive and negative predictive values (PPV, NPV), as well as the false discovery rate (FDR) and false omission rate (FOR) for scales found to have increased odds of elevation in PNES patients. This was completed for the overall sample, as well as the sample stratified by sex. The odds of elevations related to somatic concerns, negative mood, and suicidal ideation in the PNES sample ranged from 2 to 5 times more likely. Female PNES patients had 3-6 times greater odds of such scale elevations, while male PNES patients had odds of 5-15 times more likely. PPV rates ranged from 53.66% to 84.62%, while NPV rates ranged from 47.52% to 90.91%. FDR across scales ranged from 15.38% to 50%, while the FOR ranged from 9.09% to 52.47%. Consistent with prior research, PNES patients have greater odds of MMPI-2-RF scale elevations, particularly related to somatic concerns and mood disturbance. Female PNES patients endorsed greater emotional distress, including endorsement of suicide related items. Elevations of these scales could aid in differentiating PNES from ES patients, although caution is warranted due to the possibility of both false positives and the incorrect omissions of PNES cases. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Can Seizure-Alert Dogs predict seizures?

    Brown, Stephen W; Goldstein, Laura H


    An index observation where a dog was trained to alert to, as well as respond to, human tonic-clonic seizures led to further research and refinement of training techniques. This was followed by anecdotal reports of pet dogs spontaneously anticipating human epileptic seizures. An industry has since developed training Seizure-Alert Dogs (SADs) to give humans warnings of their seizures. In some cases this has been accompanied by a reduction in seizure frequency. SADs may be trained along with the person with epilepsy, responding specifically to that person's seizures, or may be trained separately. Recent sceptical reports of non-epileptic seizures in some people with SADs have cast doubt on dogs' ability to anticipate true epileptic seizures. This may reflect selection criteria for training programmes as well as training methods used, but does not necessarily indicate that SADs might not be able to predict epileptic seizures. Whether the seizures are epileptic or non-epileptic, it is speculated that SADs probably alert to subtle pre-ictal human behaviour changes, but may also be sensitive to heart rate or olfactory cues. As yet, however, no rigorous data exist as to whether seizure prediction by SADS is better than chance, and what false positive and negative prediction rates might be.

  13. Mean daily plasma concentrations of beta-endorphin, leu-enkephalin, ACTH, cortisol, and DHEAS in epileptic patients with complex partial seizures evolving to generalized tonic-clonic seizures.

    Marek, Bogdan; Kajdaniuk, Dariusz; Kos-Kudła, Beata; Kapustecki, Janusz; Swietochowska, Elzbieta; Ostrowska, Zofia; Siemińska, Lucyna; Nowak, Mariusz; Głogowska-Szelag, Joanna; Borgiel-Marek, Halina; Ciesielska-Kopacz, Nelly; Foltyn, Wanda; Pierzchała, Krystyna; Krysiak, Robert; Bienek, Radosław


    A multitude of mechanisms have been implicated in the pathophysiology of epilepsy. To assess mean daily plasma concentrations of ACTH, cortisol, DHEAS, leu-enkephalin, and beta-endorphin in epileptic patients with complex partial seizures evolving to tonic-clonic in relation to frequency of seizure occurrence (groups with seizure occurrences - several per week and several per year) and duration of the disease (groups less than and more than 10 years). We decided to analyse mean daily values of beta-endorphin and leu-enkephalin because of significant differences in concentrations of these substances in blood during the day. The study was performed on 17 patients (14 males + 3 females; mean age 31.8 yrs) treated with carbamazepine (300-1800 mg/day). The control group consisted of six age-matched healthy volunteers. Blood was collected at 8 a.m., 2 p.m., 8 p.m., and 2 a.m. Intergroup analysis was performed with the use of ANOVA Kruskal-Wallis test. Mean daily concentrations of ACTH and cortisol in the blood of the patients with epilepsy were higher in comparison with those of the healthy volunteers, independently of the frequency of seizures and duration of the disease. Mean daily concentrations of beta-endorphin in the blood of the patients with epilepsy were higher in the groups of patients with more severe clinical course of disease (with more frequently occurring epilepsy seizures and longer duration of the disease) in comparison with healthy subjects. Mean daily concentrations of leu-enkephalin in the blood of the patients with epilepsy were higher in the group of patients with short duration of the disease in comparison with the group with long duration of the disease. 1. Pituitary-adrenal axis hyperactivity is observed in patients with clinically active epilepsy, independently of the frequency of seizures and duration of the disease. 2. Changes in endogenous opioid system activity are related to the clinical activity of epilepsy - beta-endorphin concentrations

  14. Neonatal seizures-part 1: Not everything that jerks, stiffens and shakes is a fit.

    Hart, Anthony R; Pilling, Elizabeth L; Alix, James J P


    The neonatal period is the most frequent time of life to have epileptic seizures. However, neonates can also exhibit unusual movements that are not epileptic seizures. Differentiating between epileptic and non-epileptic movements can be difficult. Many neonatal seizures exhibit few or no clinical features at all. This article is for the benefit of paediatric trainees and reviews the published evidence on which neonatal movements are likely to be epileptic seizures and which are not. We also discuss epileptic seizure classification.

  15. Validity of the clinical and content scales of the Multiphasic Personality Inventory Minnesota 2 for the diagnosis of psychogenic non-epileptic seizures.

    del Barrio, A; Jiménez-Huete, A; Toledano, R; García-Morales, I; Gil-Nagel, A


    The use of the Multiphasic Personality Inventory Minnesota 2 (MMPI-2) for the diagnosis of psychogenic non-epileptic seizures (PNES) is controversial. This study examines the validity of the clinical scales and, unlike previous works, the content scales. Cross-sectional study of 209 patients treated in the epilepsy unit. We performed a logistic regression analysis, taking video-electroencephalography as the reference test, and as predictor variables age, sex, IQ and clinical (model A) or content scales (model B) of the MMPI-2. The models were selected according to the Aikake index and compared using the DeLong test. We analyzed 37 patients with PNES alone, or combined with seizures, and 172 patients with seizures only. The model consisting of sex, Hs (hypochondriasis) and Pa (paranoia) showed a sensitivity of 77.1%, a specificity of 76.8%, a percentage of correct classification of 76.8%, and an area under the curve (AUC) of 0.836 for diagnosing CNEP. Model B, consisting of sex, HEA (health concerns) and FRS (fears), showed a sensitivity of 65.7%, a specificity of 78.0%, a percentage of correct classification of 75.9% and an AUC of 0.840. DeLong's test did not detect significant differences. The MMPI-2 has a moderate validity for the diagnosis of PNES in patients referred to an epilepsy unit. Using content scales does not significantly improve results from the clinical scales. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  16. Marital status of patients with epilepsy with special reference to the influence of epileptic seizures on the patient's married life.

    Wada, Kazumaru; Iwasa, Hiroto; Okada, Motohiro; Kawata, Yuko; Murakami, Takuya; Kamata, Akihisa; Zhu, Gang; Osanai, Takao; Kato, Takuhiko; Kaneko, Sunao


    We investigated the marital status of the patients with epilepsy to clarify the clinical factors impeding improvement of the quality of life in adults with epilepsy. We examined the marital status of adult patients with epilepsy who did not have mental retardation and had been treated at Hirosaki University Hospital, Hirosaki, Japan, for >5 years. The present study included 278 patients (142 men and 136 women) ranging from age 20 to 60 years. Sixty-six men and 52 women were single. Seventy-six males and 84 females had been married. The present study investigated the proportion of patients in whom seizures were controlled at the time of marriage. Percentages were only 30% for men and 22% for women. This result showed that in many patients, seizures were not controlled when they were married, which suggests that seizures themselves may not markedly inhibit marriage. Thirteen men and 16 women (total, 29 patients) had experienced divorce. Epilepsy was the cause of divorce in seven of the 29 patients who had been divorced. Of these seven patients, only one patient had informed the spouse of the disease before marriage. In the remaining six patients, seizures were witnessed after marriage or the disease was revealed by medication, which resulted in divorces. Concerning the association between marriage and the job, a close relation was found between the presence or absence of marriage and the presence or absence of a job among male patients.

  17. TNF-Overexpression in Borna Disease Virus-Infected Mouse Brains Triggers Inflammatory Reaction and Epileptic Seizures

    Kramer, Katharina; Schaudien, Dirk; Eisel, Ulrich L. M.; Herzog, Sibylle; Richt, Juergen A.; Baumgaertner, Wolfgang; Herden, Christiane


    Proinflammatory state of the brain increases the risk for seizure development. Neonatal Borna disease virus (BDV)-infection of mice with neuronal overexpression of tumor necrosis factor-alpha (TNF) was used to investigate the complex relationship between enhanced cytokine levels, neurotropic virus i

  18. Seizures

    ... have warning symptoms before the attack, such as: Fear or anxiety Nausea Vertigo (feeling as if you are spinning or moving) Visual symptoms (such as flashing bright lights, spots, or wavy lines before the eyes) Causes Seizures of all types are caused by disorganized and sudden electrical activity ...

  19. Fibromyalgia and seizures.

    Tatum, William O; Langston, Michael E; Acton, Emily K


    The purpose of this case-matched study was to determine how frequently fibromyalgia is associated with different paroxysmal neurological disorders and explore the utility of fibromyalgia as a predictor for the diagnosis of psychogenic non-epileptic seizures. The billing diagnosis codes of 1,730 new, non-selected patient encounters were reviewed over a three-year period for an epileptologist in a neurology clinic to identify all patients with historical diagnoses of fibromyalgia. The frequency with which epileptic seizures, psychogenic non-epileptic seizures, and physiological non-epileptic events were comorbid with fibromyalgia was assessed. Age and gender case-matched controls were used for a between-group comparison. Wilcoxon tests were used to analyse interval data, and Chi-square was used to analyse categorical data (pFibromyalgia was retrospectively identified in 95/1,730 (5.5%) patients in this cohort. Females represented 95% of the fibromyalgia sample (age: 53 years; 95% CI: 57, 51). Forty-three percent of those with fibromyalgia had a non-paroxysmal, neurological primary clinical diagnosis, most commonly chronic pain. Paroxysmal events were present in 57% of fibromyalgia patients and 54% of case-matched controls. Among patients with fibromyalgia and paroxysmal disorders, 11% had epileptic seizures, 74% had psychogenic non-epileptic seizures, and 15% had physiological non-epileptic events, compared to case-matched controls with 37% epileptic seizures, 51% psychogenic non-epileptic events, and 12% physiological non-epileptic events (p = 0.009). Fibromyalgia was shown to be a predictor for the diagnosis of psychogenic non-epileptic seizures in patients with undifferentiated paroxysmal spells. However, our results suggest that the specificity and sensitivity of fibromyalgia as a marker for psychogenic non-epileptic seizures in a mixed general neurological population of patients is less than previously described.

  20. Epileptic Encephalopathies in Adults and Childhood

    Zekiye Kural


    Full Text Available Epileptic encephalopathies are motor-mental retardations or cognitive disorders secondary to epileptic seizures or epileptiform activities. Encephalopaties due to brain damage, medications, or systemic diseases are generally not in the scope of this definition, but they may rarely accompany the condition. Appropriate differential diagnosis of epileptic seizures as well as subclinical electroencephalographic discharges are crucial for management of seizures and epileptiform discharges and relative regression of cognitive deterioration in long-term followup. Proper antiepileptic drug, hormonal treatment, or i.v. immunoglobulin choice play major role in prognosis. In this paper, we evaluated the current treatment approaches by reviewing clinical electrophysiological characteristics of epileptic encephalopathies.

  1. Nuclear Factor-Kappa B Activity Regulates Brain Expression of P-Glycoprotein in the Kainic Acid-Induced Seizure Rats

    Nian Yu


    Full Text Available This study was aimed to investigate the effect of NF-κB activity on the seizure susceptibility, brain damage, and P-gp expression in kainic acid- (KA- induced seizure rats. Male SD rats were divided into saline control group (NS group, KA induced epilepsy group (EP group, and epilepsy group intervened with NF-κB inhibitor-pyrrolidine dithiocarbamate salt (PDTC group or with dexamethasone (DEX group. No seizures were observed in the rats of NS group. Compared with NS group, increased P-gp expression and NF-κB activation in the rat brain of the EP group were observed after KA micro-injection. Both PDTC and DEX pre-treatment significantly increased the latency to grade III or V seizure onset compared to EP group but failed to show neuron-protective effect as the number of survival neurons didn't significantly differ from that in EP group. Furthermore, PDTC pre-treatment significantly decreased P-gp expression along with NF-κB activation in the hippocampus CA3 area and amygdala complex of rats compared with the EP group, implying that NF-κB activation involved in the seizure susceptibility and seizure induced brain P-gp over-expression. Additionally, DEX pre-treatment only decreased P-gp expression level without inhibition of NF-κB activation, suggesting NF-κB independent pathway may also participate in regulating seizure induced P-gp over-expression.

  2. Time distribution of epileptic seizures during video-EEG monitoring. Implications for health insurance systems in developing countries.

    Quiroga, R C; Pirra, L; Podestá, C; Leiguarda, R C; Rabinowicz, A L


    An attempt was made to identify guidelines to help establish epilepsy monitoring units in developing countries. We assessed the time distribution of seizures during video-EEG monitoring and we also estimated the minimum time required for such a procedure and the impact of these variables upon the health insurance system. Mean time for recording five stereotyped clinical events was 72 hours, with a significant number of events recorded between midnight and 0600 hours (P < 0.05). This pilot study may help to establish local policies that will warrant an adequate work-up for our patients.

  3. Relationship of indicators of neuropathology, psychopathology, and effort to neuropsychological results in patients with epilepsy or psychogenic non-epileptic seizures.

    Locke, Dona E C; Berry, David T R; Fakhoury, Toufic A; Schmitt, Frederick A


    Previous research suggests epilepsy and psychogenic non-epileptic seizure (PNES) patients do not show consistent group differences on neuropsychological measures. However, both groups of patients show decreased neuropsychological performance when compared to a normal population (Cragar, Berry, Fakhoury, Cibula, & Schmitt, 2002). Swanson, Springer, Benbadis, and Morris (2000) have suggested epilepsy patients show decreased neurocognitive functioning due to neuropathology whereas PNES patients show decreased neurocognitive functioning due to psychopathology. Effort has also been implicated as an important factor in neuropsychological test results in general (Green, 2003). The purpose of this study was to investigate the relationships of medical history variables (e.g., duration of disorder), neuropathology, psychopathology, and effort to neuropsychological findings in epilepsy and PNES patients. Neuropsychological functioning was divided into six domains: intelligence, memory, language, executive functions, visual-spatial, and motor. Results indicated that medical history variables were related to intellectual, memory, language, and motor functioning. Psychopathology was associated with all cognitive domains except executive functioning. Effort was related to intellectual, memory, language, visual-spatial, and motor functioning. Neuropathology and diagnosis were related only to memory.

  4. Synchrotron X-ray microtransections: a non invasive approach for epileptic seizures arising from eloquent cortical areas

    Pouyatos, B.; Nemoz, C.; Chabrol, T.; Potez, M.; Bräuer, E.; Renaud, L.; Pernet-Gallay, K.; Estève, F.; David, O.; Kahane, P.; Laissue, J. A.; Depaulis, A.; Serduc, R.


    Synchrotron-generated X-ray (SRX) microbeams deposit high radiation doses to submillimetric targets whilst minimizing irradiation of neighboring healthy tissue. We developed a new radiosurgical method which demonstrably transects cortical brain tissue without affecting adjacent regions. We made such image-guided SRX microtransections in the left somatosensory cortex in a rat model of generalized epilepsy using high radiation doses (820 Gy) in thin (200 μm) parallel slices of tissue. This procedure, targeting the brain volume from which seizures arose, altered the abnormal neuronal activities for at least 9 weeks, as evidenced by a decrease of seizure power and coherence between tissue slices in comparison to the contralateral cortex. The brain tissue located between transections stayed histologically normal, while the irradiated micro-slices remained devoid of myelin and neurons two months after irradiation. This pre-clinical proof of concept highlights the translational potential of non-invasive SRX transections for treating epilepsies that are not eligible for resective surgery.

  5. Intracerebroventricular administration of inosine is anticonvulsant against quinolinic acid-induced seizures in mice: an effect independent of benzodiazepine and adenosine receptors.

    Ganzella, Marcelo; Faraco, Rafael Berger; Almeida, Roberto Farina; Fernandes, Vinícius Fornari; Souza, Diogo Onofre


    Inosine (INO) has an anticonvulsant effect against seizures induced by antagonists of GABAergic system. Quinolinic acid (QA) is an agonist NMDA receptors implicated in the neurobiology of seizures. In the present study, we investigated the anticonvulsant effect of intracerebroventricular (i.c.v.) INO administration against QA-induced seizures in adult mice. We also investigated whether the benzodiazepines (BZ) or adenosine (ADO) receptors were involved in the INO effects. Animals were pretreated with an i.c.v. injection of either vehicle or INO before an i.c.v. administration of 4 μl QA (36.8 nmol). All animals pretreated with vehicle followed by QA presented seizures. INO protected against QA-induced seizures in a time and dose dependent manner (up to 60% at 400 nmol, 5 min before QA injection). Diazepam (DZ) and ADO (i.c.v.) also exhibited anticonvulsant effect against QA induced seizures. Additionally, i.p. administration of either flumazenil, a BZ receptor antagonist, or caffeine, an ADO receptor antagonist, did not change the anticonvulsant potency of INO i.c.v. injection, but completely abolished the DZ and ADO anticonvulsant effects, respectively. In conclusion, this study demonstrated that INO exert anticonvulsant effect against hyperactivity of the glutamatergic system independently of BZ or ADO receptors activation.

  6. Terminology of psychogenic nonepileptic seizures.

    Brigo, Francesco; Igwe, Stanley C; Ausserer, Harald; Nardone, Raffaele; Tezzon, Frediano; Bongiovanni, Luigi Giuseppe; Tinazzi, Michele; Trinka, Eugen


    Several different terms have been used to describe "psychogenic nonepileptic seizures" (PNES) in the literature. In this study, we evaluated the most common English terms used to describe PNES on Google and in PubMed using multiple search terms ( and The information prevalence of the five terms most frequently used to refer to PNES in PubMed were: psychogenic non(-)epileptic seizure(s), followed by pseudo(-)seizure(s), non(-)epileptic seizure(s), psychogenic seizure(s), and non(-)epileptic event(s). The five most frequently adopted terms to describe PNES in Google were: psychogenic non(-)epileptic seizure(s), followed by non(-)epileptic event(s), psychogenic attack(s), non(-)epileptic attack(s), and psychogenic non(-)epileptic attack(s). The broad spectrum of synonyms used to refer to PNES in the medical literature reflects a lack of internationally accepted, uniform terminology for PNES. In addition to "seizure(s)," lay people use the word "attack(s)" to describe PNES. Although considered obsolete, some terms, e.g., pseudoseizure(s), are still used in the recent medical literature. Adopting a uniform terminology to describe PNES could facilitate communication between epileptologists, physicians without specific expertise in epilepsy, and patients.

  7. Effect of saikosaponin-a on epileptic seizures in refractory epilepsy rats%柴胡皂苷a对难治性癫痫大鼠痫性发作的影响

    谢炜; 孟春想; 史国军; 范穗强; 洪雨; 陈伟军


    Objective To investigate the effect of saikosaponin-a (SSa) on epileptic seizures of refractory epilepsy rats induced by pilocarpine. Methods Except for the control group (A), 48 Sprague-Dawley refractory epilepsy model rats were randomly divided into 4 groups, namely the model group (B), sodium valproate group (C), low and high dose of SSa group (D and E).Croup A and B were given with the same amount of saline by lavage.and group C was administrated with sodium valproale 200 mg/kg.Group D and E were given intraperitoneal injection of 1.09 mg/kg and 2.18 mg/kg SSa, respectively. At 4 weeks and 8 weeks after treatment, the frequency, average lime and the degree of epileptic seizure in RE rats were evaluated. Results There was no epileptic seizure in group A,but more epileptic seizure was observed in group B(P>0.05). Epileptic seizures were decreased in group C, D and E when compared with group B (P<0.05). The reduction of epileptic seizure was most apparent in group E. Conclusion SSa has a prominent antiepiletic effect to decrease epileptic seizure in rats.%目的 探讨柴胡皂苷a(SSa)对匹罗卡品致难治性癫痫模型大鼠痫性发作的影响.方法 将制备成功的48只SD难治性癫痫大鼠模型随机分为模型组(B)、丙戊酸钠组(C)、柴胡皂苷a低剂量组(D)和高剂量组(E)4组,每组各12只,另有空白对照组(A)12只.A、B组给予等量生理盐水,C组H用量为200 mg/kg,D、E组用药浓度依次为1.09 mg/kg、2.18 mg/kg,A、B、C组灌胃给药,D、E组腹腔注射给药.分别观察给药4周、8周后痫性发作次数、平均发作时间及发作级别的变化.结果 痫性发作方面,A组无痫性发作,B组大鼠痫性发作明显(P>0.05),C、D、E组大鼠痫性发作均有不同程度的减轻(P<0.05),E组大鼠痫性发作减轻最明显.结论 柴胡皂苷a能减轻难治性癫痫大鼠的痫性发作,有明显的抗癫痫作用.

  8. Overexpression of γ-aminobutyric acid transporter subtype I leads to susceptibility to kainic acid-induced seizure in transgenic mice


    γ-aminobutyric acid (GABA) is the principal inhibitory neurotransmitter,and the GABAergic synaptic transmission is normally terminated by the rapid uptake through GABA transporters.With transgenic mice ubiquitously overexpressing GABA transporter subtype I (GAT1),the present study explored the pathophysiological role of GAT1 in epileptogenesis.Though displaying no spontaneous seizure activity,these mice exhibit altered electroencephalographic patterns and increased susceptibility to seizure induced by kainic acid.In addition,the GABAA receptor and glutamate transporters are up-regulated in transgenic mice,which perhaps reflects a compensatory or corrective change to the elevated level of GAT1.These preliminary findings support the hypothesis that excitatory and inhibitory neurotransmission,and seizure susceptibility can be altered by neurotransmitter transporters.

  9. Changes in brain glucose use and extracellular ions associated with kainic acid-induced seizures: (/sup 14/C)-2-deoxyglucose and intracranial

    Chastain, J.E Jr.


    The effect of kainic acid (KA) on brain glucose use with coadministration of diazepam, and the effect of KA on brain extracellular (K/sup +/), Ca/sup 2 +/), and (Na/sup +/) was investigated in rats by means of (/sup 14/C)-2-deoxyglucose (2-DG) and intracranial microdialysis, respectively. Also, the impact of intracranial microdialysis on brain regional metabolic function was studied. Co-treatment with KA and diazepam attenuated KA-induced 3 hr increases and prevented 48 hr decreases in glucose use within all structures measured, particularly the piriform cortex and amygdala. Hippocampal CA/sub 3/, CA/sub 4/, and CA/sub 1/-ventral were least affected by diazepam. The results suggest that diazepam suppresses KA seizure spread from its focus, proposed to be CA/sub 3/. KA-induced ions changes were studied by intracranial microdialysis. Dialysis fibers were implanted within the hippocampus or piriform cortex and perfused 24 hr later. Samples, collected before and after KA, were analyzed for (K/sup +/), (Ca/sup 2 +/), and (Na/sup +/). KA caused an early and prolonged increase in extracellular (K/sup +/) and a negligible decrease in (Ca/sup 2 +/) within the hippocampus. In the piriform cortex, both (K/sup +/) and (Na/sup +/) increase during a period of early seizure signs. The results indicate that ion homostatic control of ion levels is better maintained during parenteral KA-induced seizures than when the brain is activated locally or during ischemia/hypoxia. The effect of intracranial microdialysis was studied by means of 2-DG in control state and KA-induced seizure state. The results indicate that intracranial microdialysis alters brain metabolic function during KA-induced seizures, but not in the control state. At 3 hr post KA, seizure metabolic activity was enhanced within the piriform cortex, and attenuated within the hippocampus.

  10. Self-esteem and psychiatric features of Turkish adolescents with psychogenic non-epileptic seizures: a comparative study with epilepsy and healthy control groups.

    Say, Gokçe N; Tasdemir, Haydar A; Akbas, Seher; Yüce, Murat; Karabekiroglu, Koray


    Children and adolescents with psychogenic non-epileptic seizures (PNES) and epilepsy are known to have psychosocial problems. The aim of the present study was to compare the psychosocial difficulties, history of stressful life events/abuse, psychiatric diagnosis, and self-esteem of adolescents with PNES to the ones with epilepsy and healthy controls at a tertiary care center in Turkey. Thirty-four adolescents with PNES diagnosed by video-EEG were compared with 23 adolescents that have epilepsy and 35 healthy volunteers. Comorbid psychiatric diagnoses of participants were examined by semi-structured interviews using Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (KSADS-PL). Self-esteem of adolescents was evaluated by Rosenberg Self Esteem Scale (RSES). No differences in sociodemographic features were observed between the groups. The PNES group showed significantly higher rates of parental conflicts, difficulties in relationship with siblings/peers, school under-achievement, and history of stressful events/abuse. The rates of comorbid psychiatric disorders were 64.7% in PNES and 47.8% in epilepsy group. The most common disorders in both groups were attention deficit hyperactivity disorder (ADHD) and depressive disorder. The rate of posttraumatic stress disorder (PTSD) was significantly increased in the PNES group. Additionally, adolescents with PNES displayed significantly lower levels of self-esteem than the other groups. It could be concluded that both disorders involved a high risk for developing psychiatric disorders; additionally, adolescents with PNES have higher rates of stressors and lower levels of self-esteem. Findings from this investigation point to the importance of psychiatric interventions in pediatric PNES and also epilepsy.

  11. Comparisons of childhood trauma, alexithymia, and defensive styles in patients with psychogenic non-epileptic seizures vs. epilepsy: Implications for the etiology of conversion disorder.

    Kaplan, Marcia J; Dwivedi, Alok K; Privitera, Michael D; Isaacs, Kelly; Hughes, Cynthia; Bowman, Michelle


    It has been theorized that conversion disorder is the result of emotion that cannot be experienced consciously as feeling states or put into words (i.e., alexithymia), but there is little confirming empirical evidence. We sought to characterize subjects with conversion disorder compared to subjects with a distinct medical illness, using the model of psychogenic non-epileptic seizures (PNES) vs. epilepsy (ES), on measures of childhood traumatic experience, alexithymia and maturity of psychological defensive strategies. All subjects admitted to the Epilepsy Monitoring Unit of the University of Cincinnati Medical Center were offered self-report questionnaires (Childhood Trauma Questionnaire, Toronto Alexithymia Scale-20 and Response Evaluation Measure-71) at the outset of evaluation. Diagnosis of each subject was confirmed by video-EEG and we compared subjects with PNES to those with ES on these measures. 82 subjects had ES AND 96 had PNES. Those with PNES were significantly more likely to have experienced childhood trauma in all domains (p=.005 to p=.05), and were significantly more likely to have alexithymia (p=.0267). There was a significant difference in the capacity to identify feelings, and a trend towards significance in capacity to describe feelings. There were no differences in defensive styles between the two groups. PNES diagnosis was associated with female sex, higher alexithymia scores and higher rates of childhood trauma, but not with differences in defensive styles compared to ES. These findings add empirical evidence for theories regarding the cause of conversion disorder and may aid in the design of prospective treatment trials in patients with conversion disorder. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. A 1.83 μJ/Classification, 8-Channel, Patient-Specific Epileptic Seizure Classification SoC Using a Non-Linear Support Vector Machine.

    Bin Altaf, Muhammad Awais; Yoo, Jerald


    A non-linear support vector machine (NLSVM) seizure classification SoC with 8-channel EEG data acquisition and storage for epileptic patients is presented. The proposed SoC is the first work in literature that integrates a feature extraction (FE) engine, patient specific hardware-efficient NLSVM classification engine, 96 KB SRAM for EEG data storage and low-noise, high dynamic range readout circuits. To achieve on-chip integration of the NLSVM classification engine with minimum area and energy consumption, the FE engine utilizes time division multiplexing (TDM)-BPF architecture. The implemented log-linear Gaussian basis function (LL-GBF) NLSVM classifier exploits the linearization to achieve energy consumption of 0.39 μ J/operation and reduces the area by 28.2% compared to conventional GBF implementation. The readout circuits incorporate a chopper-stabilized DC servo loop to minimize the noise level elevation and achieve noise RTI of 0.81 μ Vrms for 0.5-100 Hz bandwidth with an NEF of 4.0. The 5 × 5 mm (2) SoC is implemented in a 0.18 μm 1P6M CMOS process consuming 1.83 μ J/classification for 8-channel operation. SoC verification has been done with the Children's Hospital Boston-MIT EEG database, as well as with a specific rapid eye-blink pattern detection test, which results in an average detection rate, average false alarm rate and latency of 95.1%, 0.94% (0.27 false alarms/hour) and 2 s, respectively.

  13. Domoic Acid Epileptic Disease

    John S. Ramsdell


    Full Text Available Domoic acid epileptic disease is characterized by spontaneous recurrent seizures weeks to months after domoic acid exposure. The potential for this disease was first recognized in a human case study of temporal lobe epilepsy after the 1987 amnesic shellfish-poisoning event in Quebec, and was characterized as a chronic epileptic syndrome in California sea lions through investigation of a series of domoic acid poisoning cases between 1998 and 2006. The sea lion study provided a breadth of insight into clinical presentations, unusual behaviors, brain pathology, and epidemiology. A rat model that replicates key observations of the chronic epileptic syndrome in sea lions has been applied to identify the progression of the epileptic disease state, its relationship to behavioral manifestations, and to define the neural systems involved in these behavioral disorders. Here, we present the concept of domoic acid epileptic disease as a delayed manifestation of domoic acid poisoning and review the state of knowledge for this disease state in affected humans and sea lions. We discuss causative mechanisms and neural underpinnings of disease maturation revealed by the rat model to present the concept for olfactory origin of an epileptic disease; triggered in dendodendritic synapases of the olfactory bulb and maturing in the olfactory cortex. We conclude with updated information on populations at risk, medical diagnosis, treatment, and prognosis.

  14. Ischemia-induced degeneration of CA1 pyramidal cells decreases seizure severity in a subgroup of epileptic gerbils and affects parvalbumin immunoreactivity of CA1 interneurons.

    Winkler, D T; Scotti, A L; Nitsch, C


    Mongolian gerbils are epilepsy-prone animals. In adult gerbils two major groups can be differentiated according to their seizure behavior: Highly seizure-sensitive gerbils exhibit facial and forelimb clonus or generalized tonic-clonic seizures from the first test on, while kindled-like gerbils are seizure free for the first three to six consecutive tests, later develop forelimb myoclonus, and eventually progress to generalized tonic-clonic seizures. In the hippocampus, seizure history of the individual animal is mirrored in the intensity in which GABAergic neurons are immunostained for the calcium-binding protein parvalbumin: they lose parvalbumin with increasing seizure incidence. In a first step to clarify the influence of hippocampal projection neurons on spontaneous seizure behavior and related parvalbumin expression, we induced degeneration of the CA1 pyramidal cells by transient forebrain ischemia. This results in a decreased seizure sensitivity in highly seizure-sensitive gerbils. The kindling-like process, however, is not permanently blocked by the ischemic nerve cell loss, suggesting that an intact CA1 field is not a prerequisite for the development of seizure behavior. The seizure-induced loss of parvalbumin from the ischemia-resistant interneurons recovers after ischemia. Thus, changes in parvalbumin content brought about by repeated seizures are not permanent but can rather be modulated by novel stimuli.

  15. Cortical silent period following transcranial magnetic stimulation in epileptic patients.

    Ertaş, N K; Gül, G; Altunhalka, A; Kirbas, D


    Cortical silent period (SP) following transcranial magnetic stimulation is mainly due to cortical inhibitory mechanisms. SP may have a value for detecting inhibitory mechanisms in epileptic patients with or without treatment. The aim of this study was to evaluate the effect of both the epilepsy and the antiepileptic medication on these inhibitory mechanisms. The subgroups studied consisted of (a) normal subjects, (b) unmedicated epileptic patients, (c) epileptic patients with uncontrolled seizures under medication, (d) epileptic patients with controlled seizures under medication. SP following transcranial magnetic stimulation was measured in all subjects. The SP values from shortest to the longest were in the following order: 1) normal subjects; 2) epileptic patients with controlled seizures under medication; 3) unmedicated epileptic patients; 4) epileptic patients with uncontrolled seizures under medication. Our findings probably indicate the enhanced interictal inhibitory mechanisms in epilepsy which is resistant to antiepileptic medication.

  16. 柯尔莫哥罗夫熵对大鼠痫性发作的预报价值%Value of Kolmogorov entropy on the prediction of seizure in epileptic rats

    王顺先; 马英; 王寅旭


    Objective To investigate the application of Kolmogorov entropy (KE) in epileptic rats induced by lithium-pilocarpine,and to explore its value in predicting epileptic seizures. Methods Twenty-four Sprague-Dawley(SD) rats were randomly divided into 3 groups; a normal group, a control group and epileptic group. Acute chemical models were made by lithium-pilocarpine. The rats were received continuous electroencephalographic(EEG) monitoring by scalp surface electrode. Changes of KE of EEG signal in the epileptic group were analysis in the whole seizure process and compared with those in the normal group and control group. Results In the whole seizure process of the rats induced by lithium -pilocarpine, KE began to decline during the pre-ictal period and dropped sharply during the ictal period . KE in the pre-ictal and ictal period declined apparently comparing with that in the non -ictal period. KE in the epileptic group had significant differences during the ictal and pre -ictal period compared with that in the normal group and the control group (P < 0. 05 ). Conclusions Changes of KE reveal the changes of the complex ictal EEG signals,and may be useful to predict epileptic seizure.%目的 研究柯尔莫哥罗夫熵(KE)在氯化锂-匹鲁卡品致痫大鼠脑电监测中的应用,探讨运用KE预报痫性发作的可行性.方法 将24只健康雄性SD大鼠随机分为3组,分别为正常组、对照组和致痫组,致痫组采用氯化锂-匹鲁卡品制作急性痫性发作模型,利用头皮电极连续记录大鼠脑电信号,运用KE对瘸性发作大鼠全过程的脑电信号进行分析,并与正常组及注射生理盐水的对照组对比分析.结果 在整个痫性发作过程中,KE在发作前期开始下降,而在痫性发作期显著下降,与发作间期比较,发作前期与发作期的KE明显降低.致痫组痫性发作期和发作前期的KE值与正常组对比差异具有统计学意义(P<0.05).结论 KE的变化提示痫性发作过程脑电

  17. Complex partial seizure, disruptive behaviours and the Nigerian ...

    Complex partial seizure, disruptive behaviours and the Nigerian Legal System. ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search · USING ... Background: Complex partial seizure is an epileptic seizure which results in ...

  18. Ketogenic Diet in Epileptic Encephalopathies

    Suvasini Sharma; Manjari Tripathi


    The ketogenic diet is a medically supervised high-fat, low-carbohydrate diet that has been found useful in patients with refractory epilepsy. It has been shown to be effective in treating multiple seizure types and epilepsy syndromes. In this paper, we review the use of the ketogenic diet in epileptic encephalopathies such as Ohtahara syndrome, West syndrome, Dravet syndrome, epilepsy with myoclonic atonic seizures, and Lennox-Gastaut syndrome.

  19. Ketogenic Diet in Epileptic Encephalopathies

    Suvasini Sharma


    Full Text Available The ketogenic diet is a medically supervised high-fat, low-carbohydrate diet that has been found useful in patients with refractory epilepsy. It has been shown to be effective in treating multiple seizure types and epilepsy syndromes. In this paper, we review the use of the ketogenic diet in epileptic encephalopathies such as Ohtahara syndrome, West syndrome, Dravet syndrome, epilepsy with myoclonic atonic seizures, and Lennox-Gastaut syndrome.


    M. B. Mironov


    Full Text Available The authors consider the historical description, nosological entity, clinical and electroencephalographic manifestations of gelastic seizures, a rare type of epileptic seizures manifesting as sudden attacks of spasmodic laughter. They describe their case of gelastic seizures in a child with tuberous sclerosis.

  1. Frontal lobe nonconvulsive status epilepticus: a case of epileptic stuttering, aphemia, and aphasia--not a sign of psychogenic nonepileptic seizures.

    Kaplan, Peter W; Stagg, Ryan


    Stuttering is a repetitive, iterative disfluency of speech, and is usually seen as a developmental problem in childhood. Acquired causes in adults include strokes and medications. When stuttering occurs with seizure-like events, it is usually attributed to psychogenic nonepileptic seizures. We describe an elderly man who experienced personality change and bouts of stuttering, followed by anarthria with preserved writing and then aphasia affecting written and uttered language, and ending with confusion. EEG recordings showed nonconvulsive status epilepticus (NCSE) with focality in the left frontal region followed by bifrontal NCSE. This case enlarges our understanding of the behavioral correlates of focal frontal seizures to include simple partial seizures with speech and then language output disturbances (aphemia, then aphasia), progressing to complex partial phenomenology in the setting of frontal NCSE.

  2. EEG features of patients with epileptic seizure secondary to tuberous sclerosis complex%伴有癫痫发作的结节性硬化症患者的脑电图特点

    李花; 胡湘蜀; 沈鼎烈; 费凌霞; 潘速跃


    目的 分析伴有癫痫发作的结节性硬化症(TSC)患者的脑电图特点.方法 总结101例有痫性发作的TSC患者的临床资料,对其发作间期及发作期脑电图进行分析.结果 癫痫的发病年龄从10d~ 28岁不等,3岁以内发病者68人(67%).101例患者均行24h视频脑电图监测,3例脑电图正常,98例脑电图异常,其中3例存在高幅失律,23例为慢波背景活动,72例背景活动正常或接近正常,但其中11例患者脑电图可见较多慢活动.在有痉挛发作的13例患者中,3例脑电图背景为高幅失律,7例为慢波背景活动.发作间期显示痫样波在双侧均明显者35例,一侧痫样波明显者63例,主要集中在前头部.48例患者监测到发作,监测到的发作最常见为部分性发作(27例),26例可以明确起源,主要集中在额颞叶.结论 大多数TSC患者脑电图异常,可见痫样波发放,54% TSC患者通过视频脑电图可以明确痫样波起源,主要在额颞叶,左右两侧无明显差异.%Objective To analyze the EEG features of patients with epileptic seizure secondary to tuberous sclerosis complex (TSC). Methods We retrospectively reviewed the clinical data of 101 patients with epileptic seizure secondary to TSC and analyzed the interictal and ictal EEG features. Results The onset age of patients ranged from 10 days to 28 years. Sixty - eight patients (67% ) experienced the first onset when they were less than 3 years old. Among 101 patients undergoing video - EEG monitoring for 24 hours, 3 patients had normal EEG and 98 patients showed abnormal results. Of 98 patients, 3 cases had hypsarrhythmia and 23 cases showed slow wave background activities. Seventy - two patients had normal or near normal background activities, but 11 cases showed slower wave activities. Of 13 patients with spasms seizure, 3 cases had hypsarrhythmia and 7 cases showed slow wave background activities. Thirty - five patients exhibited bilateral multifocal epileptiform activity

  3. Classification of seizures and epilepsy.

    Riviello, James J


    The management of seizures and epilepsy begins with forming a differential diagnosis, making the diagnosis, and then classifying seizure type and epileptic syndrome. Classification guides treatment, including ancillary testing, management, prognosis, and if needed, selection of the appropriate antiepileptic drug (AED). Many AEDs are available, and certain seizure types or epilepsy syndromes respond to specific AEDs. The identification of the genetics, molecular basis, and pathophysiologic mechanisms of epilepsy has resulted from classification of specific epileptic syndromes. The classification system used by the International League Against Epilepsy is periodically revised. The proposed revision changes the classification emphasis from the anatomic origin of seizures (focal vs generalized) to seizure semiology (ie, the signs or clinical manifestations). Modified systems have been developed for specific circumstances (eg, neonatal seizures, infantile seizures, status epilepticus, and epilepsy surgery). This article reviews seizure and epilepsy classification, emphasizing new data.

  4. Crises epilépticas no período neonatal: análise descritiva de uma população hospitalar Neonatal epileptic seizures: descriptive analysis in a hospital population

    Soniza Vieira Alves-Leon


    Full Text Available OBJETIVO: Investigar a incidência e a letalidade de crises epilépticas neonatais e as condições associadas à sua presença. MÉTODOS: Estudo retrospectivo observacional de base hospitalar com crianças nascidas de janeiro de 1995 a dezembro de 2004 acompanhadas por quatro semanas após o parto. Analisaram-se os dados referentes aos períodos pré-natal, intraparto e neonatal. RESULTADOS: Foram identificados 6.600 nascidos vivos de 6.483 partos, encontrando-se 61 casos incidentes de crises epilépticas neonatais (0,9%. A primeira crise ocorreu até 12 horas após o parto em 45,3% dos neonatos. Das mães analisadas, 32,8% apresentaram síndromes hipertensivas. Entre os 61 pacientes, 91,8% eram conceptos únicos e 4,9% eram primeiro e segundo gemelares. O peso foi menor que 2500g em 50,8% e a restri��ão do crescimento intrauterino ocorreu em 25,9% das gestações analisadas. Obervaram-se: hipoglicemia neonatal (56,5%, icterícia neonatal (52,1% e asfixia perinatal (70,7%. Desenvolveram sepse bacteriana 32 crianças e 17 apresentaram síndrome de aspiração meconial ao nascer. O desequilíbrio ácido-básico ocorreu em 68,1% ao longo de 28 dias pós-parto. A letalidade foi de 47,4%, sendo mais frequente no sexo masculino (65,6% e em filhos de mães afro-descendentes (67,2%. CONCLUSÕES: A incidência de crises epilépticas no período neonatal identificada neste estudo foi três a quatro vezes superior à incidência relatada em hospitais de países desenvolvidos, embora as características dos casos fossem semelhantes. A letalidade foi de 47,4% e a asfixia grave foi a condição patológica intraparto mais frequente.OBJECTIVE:To investigate their incidence and lethality of neonatal epileptic seizures and their associated conditions. METHODS: A retrospective observational hospital-based study was carried out in infants born between January 1995 and December 2004. The infants were followed up for four weeks after birth. Data on the

  5. Management of seizures in children.

    El-Radhi, A Sahib

    Seizures are common events in children and up to 10% of all children experience at least one seizure during their childhood. They can be triggered by many conditions such as fever, medications or injury. Febrile seizures are the most common types of seizures, affecting 3-4% of children. While epilepsy is typically recurrent and unprovoked, a single, isolated seizure is not epilepsy. Taking a detailed history of the seizure description helps establish the diagnosis. A video recording of the event can also support the diagnosis and rule out non-epileptic seizures that resemble seizures, such as pseudo-seizure. Seeing a child having a seizure, particularly if it is the first one, is usually frightening and distressing for the parents. First seizure should always be evaluated by health professionals because of a possible serious underlying cause. If the seizure occurs at home, the child should be placed in the recovery side position to prevent the swallowing of any vomit. The care of a child who does have epilepsy is best achieved by a community or hospital epilepsy specialist nurse. These nurses play a pivotal role in providing a close link between the epileptic children and their families. Such a nurse is also in an ideal position to establish a link between the doctor and affected families, offering valuable advice and support, and visiting the epileptic child at home.

  6. Epileptic Seizure Detection based on Wavelet Transform Statistics Map and EMD Method for Hilbert-Huang Spectral Analyzing in Gamma Frequency Band of EEG Signals

    Morteza Behnam


    Full Text Available Seizure detection using brain signal (EEG analysis is the important clinical methods in drug therapy and the decisions before brain surgery. In this paper, after signal conditioning using suitable filtering, the Gamma frequency band has been extracted and the other brain rhythms, ambient noises and the other bio-signal are canceled. Then, the wavelet transform of brain signal and the map of wavelet transform in multi levels are computed. By dividing the color map to different epochs, the histogram of each sub-image is obtained and the statistics of it based on statistical momentums and Negentropy values are calculated. Statistical feature vector using Principle Component Analysis (PCA is reduced to one dimension. By EMD algorithm and sifting procedure for analyzing the data by Intrinsic Mode Function (IMF and computing the residues of brain signal using spectrum of Hilbert transform and Hilbert – Huang spectrum forming, one spatial feature based on the Euclidian distance for signal classification is obtained. By K-Nearest Neighbor (KNN classifier and by considering the optimal neighbor parameter, EEG signals are classified in two classes, seizure and non-seizure signal, with the rate of accuracy 76.54% and with variance of error 0.3685 in the different tests.

  7. Transient global amnesia mimics: Transient epileptic amnesia

    Nicolas Nicastro


    Full Text Available We describe the case of a 79-year-old patient referred for suspected transient global amnesia, after an episode of anterograde amnesia which lasted 90 min. An EEG, performed after the episode, showed bilateral temporal electrographic seizures, orienting the diagnosis toward a transient epileptic amnesia. Transient epileptic amnesia is defined by temporal lobe epilepsy characterized by recurrent transient amnestic episodes of 30–90 min in duration, sometimes associated with olfactory hallucinations or oral automatisms. Response to antiepileptic drugs is excellent. We would like to raise awareness toward this epileptic amnesia when facing atypical or recurrent transient amnestic episodes.

  8. Heart rate analysis differentiates dialeptic complex partial temporal lobe seizures from auras and non-epileptic seizures A análise da freqüência cardíaca diferencia crises dialépticas parciais complexas de auras e crises não epilépticas

    Gisele R. de Oliveira


    Full Text Available The distinction of non-epileptic from epileptic events is difficult even for experienced neurologists. We retrospectively evaluated 59 dialeptic events from 27 patients admitted for video EEG monitoring to check whether heart rate (HR analysis could help in differentiating dialeptic complex partial temporal lobe seizures (TLS from dialeptic simple partial TLS, and non-epileptic dialeptic events. Baseline HR was increased in the simple partial TLS in comparison to complex partial TLS and non-epileptic groups (pA distinção entre eventos não epilépticos de epilépticos é difícil mesmo para neurologistas experientes. Analisamos 59 eventos dialéticos de 27 pacientes internados para monitorização por video-EEG para checar se a análise da frequência cardíaca (FC poderia auxiliar na diferenciação de crises dialépticas parciais complexas de crises dialépticas parciais simples e eventos dialépticos não epilépticos. A freqüência cardíaca basal estava aumentada nos pacientes com crises parciais simples em comparação com o período basal dos grupos parcial complexa e não epiléptico (p<0,05. Houve aumento da freqüência cardíaca em cada crise dialéptica parcial complexa (100% dos eventos, p<0,05, mas a FC retornou aos níveis basais na fase pós-ictal. A FC ictal não foi alterada nos grupos de crises não epiléticas e nos pacientes com crises parciais simples. Nossos achados sugerem que a taquicardia ictal com mediação central é característica de crises parciais complexas dialépticas (tanto taquicardia quanto bradicardia têm sido relatados durante crises temporais parciais complexas. Tal achado poderá ser utilizado como critério para diferenciar crises dialépticas parciais complexas de crises dialépticas parciais simples e eventos dialépticos não epilépticos.

  9. Serodiagnosis of neurocysticercosis in patients with epileptic seizure using ELISA and immunoblot assay Sorodiagnóstico da neurocisticercose em pacientes com crises epiléticas, por meio de ELISA e immunoblot

    Maria M.I. Ishida


    Full Text Available Sera from 88 patients from Santa Catarina and São Paulo states of Brazil, with epileptic seizures who underwent cerebral computed tomography (CT were analyzed for the detection of antibodies to T. solium cysticercus by ELISA and Immunoblot (IB with the following antigens: Taenia solium cysticercus total saline (Tso, Taenia crassiceps cysticercus vesicular fluid (Tcra-vf and T. crassiceps cysticercus glycoproteins (Tcra-gp. ELISA carried out with Tso, Tcra-vf and Tcra-gp antigens showed 95%, 90% and 80% sensitivities, respectively, and 68%, 85% and 93% specificities, respectively. In the epileptic patients group, ELISA positivity was 30%, 51% and 35% with Tso, Tcra-vf and Tcra-gp antigens respectively. Considering the IB as the confirmatory test, the positivity was 16% (14/88 in the epileptic patients total group and 22% (12/54 in the epileptic patients with positive CT and signals of cysticercosis. We found a significant statistical correlation among ELISA or IB results and the phase of the disease when any antigens were used (p Amostras de soro de 88 pacientes dos Estados de Santa Catarina e São Paulo, Brasil, com crises epilépticas e que se submeteram a exame de Tomografia Computadorizada (TC, foram examinadas para detecção de anticorpos anti-cisticercos de Taenia solium por meio de ELISA e Immunoblot (IB utilizando-se os seguintes antígenos: extrato salino total de cisticercos de T. solium (Tso; líquido vesicular de Taenia crassiceps (Tcra-vf e glicoproteínas purificadas de cisticercos de T. crassiceps (Tcra-gp. Os resultados de ELISA com os antígenos Tso, Tcra-vf e Tcra-gp mostraram 95%, 90% e 80% de sensibilidade, respectivamente, e 68%, 85% e 93% de especificidade, respectivamente. No grupo de pacientes epilépticos, a positividade do ELISA foi 30%, 51% e 35% com os antígenos Tso, Tcra-vf e Tcra-gp, respectivamente. Considerando o IB como teste confirmatório, a positividade foi de 16% (14/88 no grupo total de pacientes epil

  10. Treatment of seizures in multiple sclerosis

    Koch, Marcus W.; Polman, Susanne K. L.; Uyttenboogaart, Maarten; De Keyser, Jacques


    Background Epileptic seizures occur in only a minority of patients with multiple sclerosis (MS), but can have serious consequences. The available literature suggests an association of seizures in MS with cortical and subcortical demyelinating lesions, which suggest that seizures in MS are probably m

  11. eEF2K/eEF2 Pathway Controls the Excitation/Inhibition Balance and Susceptibility to Epileptic Seizures.

    Heise, Christopher; Taha, Elham; Murru, Luca; Ponzoni, Luisa; Cattaneo, Angela; Guarnieri, Fabrizia C; Montani, Caterina; Mossa, Adele; Vezzoli, Elena; Ippolito, Giulio; Zapata, Jonathan; Barrera, Iliana; Ryazanov, Alexey G; Cook, James; Poe, Michael; Stephen, Michael Rajesh; Kopanitsa, Maksym; Benfante, Roberta; Rusconi, Francesco; Braida, Daniela; Francolini, Maura; Proud, Christopher G; Valtorta, Flavia; Passafaro, Maria; Sala, Mariaelvina; Bachi, Angela; Verpelli, Chiara; Rosenblum, Kobi; Sala, Carlo


    Alterations in the balance of inhibitory and excitatory synaptic transmission have been implicated in the pathogenesis of neurological disorders such as epilepsy. Eukaryotic elongation factor 2 kinase (eEF2K) is a highly regulated, ubiquitous kinase involved in the control of protein translation. Here, we show that eEF2K activity negatively regulates GABAergic synaptic transmission. Indeed, loss of eEF2K increases GABAergic synaptic transmission by upregulating the presynaptic protein Synapsin 2b and α5-containing GABAA receptors and thus interferes with the excitation/inhibition balance. This cellular phenotype is accompanied by an increased resistance to epilepsy and an impairment of only a specific hippocampal-dependent fear conditioning. From a clinical perspective, our results identify eEF2K as a potential novel target for antiepileptic drugs, since pharmacological and genetic inhibition of eEF2K can revert the epileptic phenotype in a mouse model of human epilepsy. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail:

  12. Epileptic seizures in a descendant of Dom Pedro I Crises epilépticas em uma descendente de Dom Pedro I

    Marleide da Mota Gomes


    Full Text Available Intrauterine seizure is a rare event. Genetic predisposition and trauma are possible risk factors. OBJECTIVE: To review and comment on the historical description of intrauterine events of a bastard daughter of Dom Pedro I (Maria Isabel Alcântara Brasileira - 1830-1896. METHOD: Review of historical facts about the health of Dom Pedro I's daughter according to primary and secondary historical data. RESULTS: According to historical accounts, Dom Pedro I's daughter suffered trauma during the intrauterine period that provoked intrauterine seizures. At the age of eight years, she developed self-limited and benign generalized epilepsy. Like her father, she had mood problems and also learning difficulties. CONCLUSION: Dona Maria Isabel's own report does not shown sufficient evidence to support the diagnosis of post-traumatic intrauterine seizures. Nevertheless, her family history suggests a genetic basis for her epilepsy.A convulsão intra-uterina é evento raro, sendo possíveis fatores de risco a genética e o traumatismo. OBJETIVO: Rever e comentar a descrição histórica de eventos intra-uterinas de uma filha bastarda de D. Pedro I (Maria Isabel Alcântara Brasileira - 1830-1896. MÉTODO: Revisão dos fatos históricos sobre a saúde da filha do D. Pedro I, de acordo com dados históricos primários e secundários. RESULTADOS: A filha de Dom Pedro I, de acordo com relatos históricos teria sofrido um traumatismo durante o período intra-uterino, o que provocou convulsões intra-uterinas. Na idade de oito anos a menina desenvolveu uma epilepsia generalizada limitada e benigna. Como seu pai, teve problemas do humor e, também, dificuldades de aprendizagem. CONCLUSÃO: O relato de Dona Maria Isabel não gera prova suficiente para sustentar o diagnóstico de convulsões intra-uterinas de origem traumática. Não obstante, seus antecedentes familiares sugerem uma base genética para sua epilepsia.

  13. Cell signaling underlying epileptic behavior

    Yuri eBozzi


    Full Text Available Epilepsy is a complex disease, characterized by the repeated occurrence of bursts of electrical activity (seizures in specific brain areas. The behavioral outcome of seizure events strongly depends on the brain regions that are affected by overactivity. Here we review the intracellular signaling pathways involved in the generation of seizures in epileptogenic areas. Pathways activated by modulatory neurotransmitters (dopamine, norepinephrine and serotonin, involving the activation of extracellular-regulated kinases (ERKs and the induction of immediate early genes (IEGs will be first discussed in relation to the occurrence of acute seizure events. Activation of immediate early genes has been proposed to lead to long-term molecular and behavioral responses induced by acute seizures. We also review deleterious consequences of seizure activity, focusing on the contribution of apoptosis-associated signaling pathways to the progression of the disease. A deep understanding of signaling pathways involved in both acute and long-term responses to seizures continues to be crucial to unravel the origins of epileptic behaviors and ultimately identify novel therapeutic targets for the cure of epilepsy.

  14. Prosthetic management of an epileptic patient.

    Akeredolu, P A; Temisanren, O T; Danesi, M A


    This case report illustrates the problems of tooth loss in an epileptic patient. The patient presented with a broken denture following a seizure. She gave a history of breaking and swallowing her dentures during seizures. Before presentation she had worn five upper removable partial dentures. An upper removable partial denture with increased thickness of the acrylic palatal was fabricated and fitted satisfactorily. The patient was taught how to insert and remove the prosthesis as quickly as possible. Epileptic patients can use dentures but run the risk of frequently breaking and swallowing them during seizures. The risk can be reduced if patients and relatives are taught how to remove the dentures prior to or during seizures.

  15. Ohtahara syndrome: Early infantile epileptic encephalopathy

    Knežević-Pogančev Marija


    Full Text Available DEFINITION Ohtahara syndrome (early infantile epileptic encephalopathy with suppression bursts, is the earliest developing form of epileptic encephalopathy. ETHIOLOGY It considered to be a result of static structural developing brain damage. CLINICAL PICTURE Variable seizures develop mostly within the first 10 days of life, but may occur during the first hour after delivery. The most frequently observed seizure type are epileptic spasms, which may be either generalized and symmetrical or lateralized. The tonic spasms may occur in clusters or singly, while awake and during sleep alike. The duration of spasms is up to 10 seconds, and the interval between spasms within cluster ranges from 9 to 15 seconds. In one third of cases, other seizure types include partial motor seizures or hemiconvulsions The disorder takes a progressively deteriorating course with increasing frequency of seizures and severe retardation of psychomotor development. DIAGNOSTIC WORKUP In the initial stage of Ohtahara syndrome, interictal EEG shows a pattern of suppression-burst with high-voltage paroxysmal discharges separated by prolonged periods of nearly flat tracing that last for up to 18 seconds. PROGNOSIS AND THREATMENT Half of the reported children having Ohtahara syndrome die in infancy. Anticonvulsant helps little in controlling the seizures and halting the deterioration of psychomotor development. Severe psychomotor retardation is the rule. With time, the disorder may evolve into West syndrome or partial epilepsy. Psychomotor development may be slightly better if the infants do not develop West and later Lennox-Gastaut syndrome.

  16. Absence seizure control by a brain computer interface

    Maksimenko, V.A.; Heukelum, S. van; Makarov, V.V.; Kelderhuis, J.; Lüttjohann, A.; Koronovskii, A.A.; Hramov, A.E.; Luijtelaar, E.L.J.M. van


    The ultimate goal of epileptology is the complete abolishment of epileptic seizures. This might be achieved by a system that predicts seizure onset combined with a system that interferes with the process that leads to the onset of a seizure. Seizure prediction remains, as of yet, unresolved in

  17. [Multifocal epileptic crises following mumps].

    Parain, D; Boulloche, J


    A 15 years-old girl with no previous history of epilepsy or neurological disease presented three types of epileptic symptoms the same day: 1) clusters of rhythmic myoclonus of the left hemiface; 2) episodes of painful paresthesias of the left arm followed by secondary generalised seizures; 3) episodes of elementary visual hallucinations of the right hemifield. She had several seizures each hour and some were recorded. There were no EEG abnormalities during the facial myoclonus but rapid rhythms were seen during the sensory and visual partial seizures on the right parietal and left occipital lobes. There was no fever and no drowsiness. The CSF tap showed pleocytosis. Serological studies indicated recent mumps. The drugs were initially inefficient. The seizures disappeared after a month. The drugs were stopped after three months and the seizures had not relapsed after a one year's follow-up. Though there were no other sign of encephalitis, we believe that episode of multifocal seizures was due to mumps encephalitis.

  18. Estudo de fatores clínicos preditivos para crises epilépticas após acidente vascular cerebral isquêmico Preditive clinical factors for epileptic seizures after ischemic stroke

    Marcia Maiumi Fukujima


    Full Text Available Apresentamos aspectos clínicos de 35 pacientes com acidente vascular cerebral isquêmico que evoluíram com crises epilépticas (Grupo 1, comparando-os a 35 pacientes com AVCI sem crises epilépticas (Grupo 2. A comparação das idades entre os grupos não mostrou diferença significante. O sexo masculino e a raça branca predominaram em ambos os grupos. Diabetes melito, hipertensão arterial, ataque isquêmico transitório, acidente vascular cerebral pregresso, enxaqueca, doença de Chagas, embolia cerebral cardiogênica e uso de anticoncepcional oral não diferiram significantemente entre os grupos. Tabagismo e etilismo foram significantemente mais freqüentes no Grupo 1 (pPreditive clinical factors for epileptic seizures after ischemic stroke. Clinical features of 35 patients with ischemic stroke who developed epilepsy (Group 1 were compared with those of 35 patients with ischemic stroke without epilepsy (Group 2. The age of the patients did not differ between the groups. There were more men than women and more white than other races in both groups. Diabetes melitus, hypertension, transient ischemic attack, previous stroke, migraine, Chagas disease, cerebral embolism of cardiac origin and use of oral contraceptive did not differ between the groups. Smokers and alcohol users were more frequent in Group 1 (p<0,05. Most patients of Group 1 presented with hemiparesis; none presented cerebellar or brainstem involvement. Perhaps strokes in smokers have some different aspects, that let them more epileptogenic than in non smokers.

  19. Long-lasting c-fos and NGF mRNA expressions and loss of perikaryal parvalbumin immunoreactivity in the development of epileptogenesis after ethacrynic acid-induced seizure.

    Suzukawa, J; Omori, K; Okugawa, G; Fujiseki, Y; Heizmann, C W; Inagaki, C


    A single cerebroventricular injection of ethacrynic acid (EA), a Cl(-)-ATPase inhibitor, induces generalized tonic-clonic convulsions in mice. To clarify whether such convulsive stimulus triggers a long-lasting rearrangement of the neural circuitry culminating in seizure susceptibility, we examined molecular, cellular and behavioral changes following the EA-induced seizure. The expression of immediate early gene c-fos mRNA as an index for cellular activation increased biphasically, with an early transient increase at 60 min and a late prolonged increase on the 10th to 14th day post-EA administration, most remarkably in the hippocampus and pyriform cortex. On the 14th day post-EA seizure, subconvulsive dose of kainic acid (5-17.5 mg/kg) caused severe (stage 5) seizure in 77% of the mice, with 70% mortality. In addition, the expression of nerve growth factor (NGF) also showed biphasic increases with close spatiotemporal correlation with c-fos expression. Moreover, the number of cell somata and the density of axon fibers of parvalbumin (PARV)-positive cells, a subpopulation of GABAergic interneurons, decreased in area dentata, CA1 and CA3 on the 7th and 14th day post-EA seizure. In area dentata and CA1, the density of glutamic acid decarboxylase (GAD)-positive cells also decreased on the 14th day. Thus, the transient EA-induced seizures appear to develop seizure susceptibility by causing damage of a subpopulation of inhibitory interneurons along with increases in the expression of c-fos and NGF in limbic structures.

  20. [Reflex seizures, cinema and television].

    Olivares-Romero, Jesús


    In movies and television series are few references to seizures or reflex epilepsy even though in real life are an important subgroup of total epileptic syndromes. It has performed a search on the topic, identified 25 films in which they appear reflex seizures. Most seizures observed are tonic-clonic and visual stimuli are the most numerous, corresponding all with flashing lights. The emotions are the main stimuli in higher level processes. In most cases it is not possible to know if a character suffers a reflex epilepsy or suffer reflex seizures in the context of another epileptic syndrome. The main conclusion is that, in the movies, the reflex seizures are merely a visual reinforcing and anecdotal element without significant influence on the plot.

  1. 黄竹定痫胶囊对癫痫模型大鼠癫痫发作的影响%Influence of Huangzhu Dingxian Capsules on Epileptic Seizure of Epilepsy Model Rats

    王倩; 范文涛


    Objective: To study the influence of Huangzhu Dingxian capsules on epileptic seizure of amyl tetrazolium ( PTZ ) -induced epilepsy rats, and to discuss its antiepileptic mechanism. Methods: The high-dose group was given Huangzhu Dingxian capsules 6 mL,3 times/day, and the small-dose group given Huangzhu Dingxian capsules 2 mL,3 times/day, continuously for 28 d. Valproic acid sodium group was given valproic acid sodium 400 mg/kg,3 times/day, continuously for 28 d. Normal control group and model control group were given physiological saline,3 times/d, 1 mL/time, continuously for 28 d. The body weight, seizure level and duration of change were observed. Results : The weight gain and seizure level were reduced, and the attack last time was shortened. It showed that Huangzhu Dingxian capsules had good resistance to epilepsy action. The high-dose group and the small-dose group had significant differences in antiepileptic effect and dose-dependent manner. Conclusion: Huangzhu Dingxian-oapsules could significantly inhibit PTZ-induced epilepsy.%目的:研究黄竹定痫胶囊对戊四唑(PTZ)点燃型癫痫大鼠癫痫发作的影响,探讨黄竹定痫胶囊抗癫痫作用机理.方法:大剂量组灌服黄竹定痫胶囊6mL,3次/d;小剂量组灌服黄竹定痫胶囊2mL,3次/d;持续28 d.丙戊酸钠组灌服丙戊酸钠400 mg/kg,3次/d,连续28 d.正常对照组、模型对照组连续28 d灌服生理盐水,3次/d,1mL/次,持续28 d.观察癫痫大鼠体重、惊厥发作级别及持续时间的变化.结果:PTZ点燃癫痫大鼠体重增加,惊厥发作级别降低,发作持续时间缩短.表明黄竹定痫胶囊具有良好的抗癫痫作用:而中药大剂量组与小剂量组比较有显著性差异,表明黄竹定痫胶囊抗癫痫的作用与剂量成正相关.结论:黄竹定痫胶囊能显著抑制大鼠戊四唑点燃发作.

  2. Transient epileptic amnesia: clinical report of a cohort of patients.

    Lapenta, Leonardo; Brunetti, Valerio; Losurdo, Anna; Testani, Elisa; Giannantoni, Nadia Mariagrazia; Quaranta, Davide; Di Lazzaro, Vincenzo; Della Marca, Giacomo


    Transient epileptic amnesia is a seizure disorder, usually with onset in the middle-elderly and good response to low dosages of antiepileptic drugs. We describe the clinical, electroencephalography (EEG), and neuroimaging features of 11 patients with a temporal lobe epilepsy characterized by amnesic seizures as the sole or the main symptom. We outline the relevance of a detailed clinical history to recognize amnesic seizures and to avoid the more frequent misdiagnoses. Moreover, the response to monotherapy was usually good, although the epileptic disorder was symptomatic of acquired lesions in the majority of patients.

  3. [Simple febrile seizure, complex seizure, generalized epilepsy with febrile seizure plus, FIRES and new syndromes].

    Moreno de Flagge, Noris


    Febrile seizures are the most common seizures in childhood. They have been observed in 2-5% of children before the age of 5, but in some populations this figure may increase to 15%. It is a common cause of pediatric hospital admissions and cause of anxiety for parents. Febrile seizures could be the first manifestation of epilepsy. About 13% of epileptic patients have a history of febrile seizure, and 30% have had recurrent febrile seizures. Their phenotypic characteristics allow, in the majority of cases, a classification of the seizure, an elaboration of a prognosis and to assume a specific therapeutic attitude. It is possible to describe a spectrum according to their severity, from the benign simple seizure to the more complex, febrile seizure plus, Dravet'syndrome, and FIRES. During the past decade, molecular genetic studies have contributed to the identification of genetic factors involved in febrile seizure and related disorders, making the necessity of a careful follow up of these patients in order to detect risk factors earlier. We have reviewed the medical literature to update current knowledge of febrile seizures, their prognosis and their relation to new epileptic syndromes.

  4. Epileptic seizures and electroencephalographic findings in patients with mitochondrial myopathy encephalopathy, lactic acidosis and stroke-like episodes%线粒体脑肌病伴高乳酸血症和卒中样发作的癫痫发作及脑电图特点分析

    张晓; 王朝霞; 刘凤君; 邓馨; 于磊; 王薇薇; 袁云


    Objective To investigate the features of epileptic seizures and eletroencepalogram (EEG) in patients with mitochondrial myopathy encephalopathy,lactic acidosis and stroke-like episodes (MELAS).Methods Forty-four patients with MELAS were diagnosed at the First Hospital of Peking University from November 2007 to August 2013.EEG and head MRI were performed on all patients.The types of epileptic seizure and EEG changes were compared between patients in and outside stroke-like episodes.Results Epileptic seizures occurred in 39 of 44 patients (88.6%) with MELAS,while multitype epileptic seizures were presented in 26 cases (66.7%).In stroke-like episodes,22 patients presented with partial seizures,30 with generalized seizures and 17 with status epilepticus.In nonstroke-like episodes,7 patients presented with partial seizures,14 with generalized seizures and 2 with status epilepticus.The frequency of partial seizures,generalized tonic-clonic seizures,status epilepticus were 47.7% (21/44),68.2% (30/44),38.6% (17/44) in stroke-like episodes and 13.6% (6/44),27.3% (12/44),4.5% (2/44) in nonstroke-like episodes,which have statistical significance (x2 =12.022,14.758,15.103;P =0.001,0.000,0.000,respectively).Abnormal EEGs appeared in all patients.The rates of slow alpha frequency,diffuse δ or θ wave,epileptic discharges were 6.8% (3/44),43.2% (19/44),25.0%(11/44) in stroke-like episodes and 31.8% (14/44),59.1% (26/44),22.7% (10/44) in nonstroke-like episodes,respectively.Slow alpha frequency were significantly different between patients in and outside stroke-like episodes (x2 =8.822,P =0.003).Conclusions Epileptic seizures with different types are more common during stroke-like episodes in patients with MELAS.While the rates of epileptic discharges are also common outside the stroke-like episodes.%目的 探讨线粒体脑肌病伴高乳酸血症和卒中样发作(MELAS)患者的癫痫发作及脑电图特点.方法 收集2007年11月至2013年8

  5. Epileptic and nonepileptic features in patients with early onset epileptic encephalopathy and STXBP1 mutations.

    Milh, Mathieu; Villeneuve, Nathalie; Chouchane, Mondher; Kaminska, Anna; Laroche, Cécile; Barthez, Marie Anne; Gitiaux, Cyril; Bartoli, Céline; Borges-Correia, Ana; Cacciagli, Pierre; Mignon-Ravix, Cécile; Cuberos, Hélène; Chabrol, Brigitte; Villard, Laurent


    STXBP1 (MUNC18-1) mutations have been associated with various types of epilepsies, mostly beginning early in life. To refine the phenotype associated with STXBP1 aberrations in early onset epileptic syndromes, we studied this gene in a cohort of patients with early onset epileptic encephalopathy. STXBP1 was screened in a multicenter cohort of 52 patients with early onset epilepsy (first seizure observed before the age of 3 months), no cortical malformation on brain magnetic resonance imaging (MRI), and negative metabolic screening. Three groups of patients could be distinguished in this cohort: (1) Ohtahara syndromes (n = 38); (2) early myoclonic encephalopathies (n = 7); and (3) early onset epileptic encephalopathies that did not match any familiar syndrome (n = 7). None of the patients displayed any cortical malformation on brain MRI and all were screened through multiple video-electroencephalography (EEG) recordings for a time period spanning from birth to their sixth postnatal month. Subsequently, patients had standard EEG or video-EEG recordings. We found five novel STXBP1 mutations in patients for whom video-EEG recordings could be sampled from the beginning of the disease. All patients with a mutation displayed Ohtahara syndrome, since most early seizures could be classified as epileptic spasms and since the silent EEG periods were on average shorter than bursts. However, each patient in addition displayed a particular clinical and EEG feature: In two patients, early seizures were clonic, with very early EEG studies exhibiting relatively low amplitude bursts of activity before progressing into a typical suppression-burst pattern, whereas the three other patients displayed epileptic spasms associated with typical suppression-burst patterns starting from the early recordings. Epilepsy dramatically improved after 6 months and finally disappeared before the end of the first year of life for four patients; the remaining one patient had few seizures until 18

  6. Increased excitability and metabolism in pilocarpine induced epileptic rats: effect of Bacopa monnieri.

    Mathew, Jobin; Paul, Jes; Nandhu, M S; Paulose, C S


    We have evaluated the acetylcholine esterase and malate dehydrogenase activity in the muscle, epinephrine, norepinephrine, insulin and T3 content in the serum of epileptic rats. Acetylcholine esterase and malate dehydrogenase activity increased in the muscle and decreased in the heart of the epileptic rats compared to control. Insulin and T3 content were increased significantly in the serum of the epileptic rats. Our results suggest that repetitive seizures resulted in increased metabolism and excitability in epileptic rats. Bacopa monnieri and Bacoside-A treatment prevents the occurrence of seizures there by reducing the impairment on peripheral nervous system.

  7. Absence Seizure (Petit Mal Seizure)

    ... seizures are more common in girls. History of febrile seizures. Infants and children who have seizures brought on by fever are at greater risk of absence seizures. Family members who have seizures. Nearly half of ...

  8. Mozart K.448 listening decreased seizure recurrence and epileptiform discharges in children with first unprovoked seizures: a randomized controlled study

    Lin, Lung-Chang; Lee, Mei-Wen; Wei, Ruey-Chang; Mok, Hin-Kiu; Yang, Rei-Cheng


    Background Increasing numbers of reports show the beneficial effects of listening to Mozart music in decreasing epileptiform discharges as well as seizure frequency in epileptic children. There has been no effective method to reduce seizure recurrence after the first unprovoked seizure until now. In this study, we investigated the effect of listening to Mozart K.448 in reducing the seizure recurrence rate in children with first unprovoked seizures. Methods Forty-eight children who experienced...

  9. Seizure characteristics of epilepsy in childhood after acute encephalopathy with biphasic seizures and late reduced diffusion.

    Ito, Yuji; Natsume, Jun; Kidokoro, Hiroyuki; Ishihara, Naoko; Azuma, Yoshiteru; Tsuji, Takeshi; Okumura, Akihisa; Kubota, Tetsuo; Ando, Naoki; Saitoh, Shinji; Miura, Kiyokuni; Negoro, Tamiko; Watanabe, Kazuyoshi; Kojima, Seiji


    The aim of this study was to clarify characteristics of post-encephalopathic epilepsy (PEE) in children after acute encephalopathy with biphasic seizures and late reduced diffusion (AESD), paying particular attention to precise diagnosis of seizure types. Among 262 children with acute encephalopathy/encephalitis registered in a database of the Tokai Pediatric Neurology Society between 2005 and 2012, 44 were diagnosed with AESD according to the clinical course and magnetic resonance imaging (MRI) findings and were included in this study. Medical records were reviewed to investigate clinical data, MRI findings, neurologic outcomes, and presence or absence of PEE. Seizure types of PEE were determined by both clinical observation by pediatric neurologists and ictal video-electroencephalography (EEG) recordings. Of the 44 patients after AESD, 10 (23%) had PEE. The period between the onset of encephalopathy and PEE ranged from 2 to 39 months (median 8.5 months). Cognitive impairment was more severe in patients with PEE than in those without. Biphasic seizures and status epilepticus during the acute phase of encephalopathy did not influence the risk of PEE. The most common seizure type of PEE on clinical observation was focal seizures (n = 5), followed by epileptic spasms (n = 4), myoclonic seizures (n = 3), and tonic seizures (n = 2). In six patients with PEE, seizures were induced by sudden unexpected sounds. Seizure types confirmed by ictal video-EEG recordings were epileptic spasms and focal seizures with frontal onset, and all focal seizures were startle seizures induced by sudden acoustic stimulation. Intractable daily seizures remain in six patients with PEE. We demonstrate seizure characteristics of PEE in children after AESD. Epileptic spasms and startle focal seizures are common seizure types. The specific seizure types may be determined by the pattern of diffuse subcortical white matter injury in AESD and age-dependent reorganization of the brain

  10. [Epileptic seizures complicated by Takotsubo syndrome].

    Garea Garcia-Malvar, M J; Gonzalez-Silva, Y; Epureanu-Epureanu, V


    Introduccion. El sindrome de takotsubo es un trastorno caracterizado por disfuncion ventricular reversible, dolor precordial de tipo anginoso y cambios electrocardiograficos sin evidencia de obstruccion coronaria en coronariografia. Se desencadena por estres, y es frecuente tras crisis epilepticas. Presentamos el caso de una paciente que inicia esta miocardiopatia tras una crisis epileptica al finalizar su sesion de hemodialisis. Caso clinico. Mujer de 55 años en hemodialisis por insuficiencia renal cronica, con epilepsia secundaria a lesion residual frontoparietal derecha por un hematoma que preciso evacuacion quirurgica. Tras una sesion de hemodialisis experimenta una crisis epileptica focal con generalizacion secundaria y, horas despues de esta, dolor centrotoracico. En seriacion enzimatica se objetiva elevacion de troponina I y, electrocardiograficamente, ondas T negativas en derivaciones precordiales (V2-V6). Se realiza coronariografia, cuyo resultado es normal, y se demuestran alteraciones de la contractilidad, confirmadas como de caracter transitorio en un estudio ecocardiografico seriado. Todos los datos anteriores hacen sospechar el diagnostico de sindrome de takotsubo. Conclusion. Las complicaciones cardiacas son una de las causas de morbimortalidad en la epilepsia, y entre ellas se encuentra el sindrome de takotsubo. La incidencia real de dicho sindrome se desconoce, pero dada su implicacion en la mortalidad de causa cardiaca en la epilepsia es importante sospecharlo ante la presencia de disfuncion cardiaca tras una crisis epileptica.

  11. Biotelemetry system for Epilepsy Seizure Control

    Smith, LaCurtise; Bohnert, George W.


    The Biotelemetry System for Epilepsy Seizure Control Project developed and tested an automated telemetry system for use in an epileptic seizure prevention device that precisely controls localized brain temperature. This project was a result of a Department of Energy (DOE) Global Initiatives for Proliferation Prevention (GIPP) grant to the Kansas City Plant (KCP), Argonne National Laboratory (ANL), and Pacific Northwest National Laboratory (PNNL) to partner with Flint Hills Scientific, LLC, Lawrence, KS and Biophysical Laboratory Ltd (BIOFIL), Sarov, Russia to develop a method to help control epileptic seizures.

  12. Metabolic Causes of Epileptic Encephalopathy

    Joe Yuezhou Yu


    Full Text Available Epileptic encephalopathy can be induced by inborn metabolic defects that may be rare individually but in aggregate represent a substantial clinical portion of child neurology. These may present with various epilepsy phenotypes including refractory neonatal seizures, early myoclonic encephalopathy, early infantile epileptic encephalopathy, infantile spasms, and generalized epilepsies which in particular include myoclonic seizures. There are varying degrees of treatability, but the outcome if untreated can often be catastrophic. The importance of early recognition cannot be overemphasized. This paper provides an overview of inborn metabolic errors associated with persistent brain disturbances due to highly active clinical or electrographic ictal activity. Selected diseases are organized by the defective molecule or mechanism and categorized as small molecule disorders (involving amino and organic acids, fatty acids, neurotransmitters, urea cycle, vitamers and cofactors, and mitochondria and large molecule disorders (including lysosomal storage disorders, peroxisomal disorders, glycosylation disorders, and leukodystrophies. Details including key clinical features, salient electrophysiological and neuroradiological findings, biochemical findings, and treatment options are summarized for prominent disorders in each category.

  13. Vagus nerve stimulation for generalized epilepsy with febrile seizures plus (GEFS+ accompanying seizures with impaired consciousness

    Ryosuke Hanaya


    Full Text Available Generalized epilepsy with febrile seizures plus (GEFS+ is characterized by childhood-onset epilepsy syndrome. It involves febrile seizures and a variety of afebrile epileptic seizure types within the same pedigree with autosomal-dominant inheritance. Approximately 10% of individuals with GEFS+ harbor SCN1A, a gene mutation in one of the voltage-gated sodium channel subunits. Considerably less common are focal epilepsies including focal seizures with impaired consciousness. We report vagus nerve stimulation (VNS in a 6-year-old girl with GEFS+ who exhibited drug-resistant generalized tonic-clonic seizures and focal seizures with impaired consciousness.

  14. Glycolysis in energy metabolism during seizures

    Heng Yang; Jiongxing Wu; Ren Guo; Yufen Peng; Wen Zheng; Ding Liu; Zhi Song


    Studies have shown that glycolysis increases during seizures, and that the glycolytic metabolite lactic acid can be used as an energy source. However, how lactic acid provides energy for seizures and how it can participate in the termination of seizures remains unclear. We reviewed possible mechanisms of glycolysis involved in seizure onset. Results showed that lactic acid was involved in seizure onset and provided energy at early stages. As seizures progress, lactic acid reduces the pH of tissue and induces metabolic acidosis, which terminates the seizure. The specific mechanism of lactic acid-induced acidosis involves several aspects, which include lactic acid-induced inhibition of the glycolytic enzyme 6-diphosphate kinase-1, inhibition of the N-methyl-D-aspartate receptor, activation of the acid-sensitive 1A ion channel, strengthening of the receptive mechanism of the inhibitory neurotransmitter γ-aminobutyric acid, and changes in the intra- and extracellular environment.

  15. A signal processing based analysis and prediction of seizure onset in patients with epilepsy

    Namazi, Hamidreza; Kulish, Vladimir V.; Hussaini, Jamal; Hussaini, Jalal; Delaviz, Ali; Delaviz, Fatemeh; Habibi, Shaghayegh; Ramezanpoor, Sara


    One of the main areas of behavioural neuroscience is forecasting the human behaviour. Epilepsy is a central nervous system disorder in which nerve cell activity in the brain becomes disrupted, causing seizures or periods of unusual behaviour, sensations and sometimes loss of consciousness. An estimated 5% of the world population has epileptic seizure but there is not any method to cure it. More than 30% of people with epilepsy cannot control seizure. Epileptic seizure prediction, refers to fo...

  16. Drug utilization pattern of anti-epileptic drugs: a pharmacoepidemiologic study in Oman.

    Hanssens, Y; Deleu, D; Al Balushi, K; Al Hashar, A; Al-Zakwani, I


    To get an insight into the type and aetiology of epileptic seizures; to describe the drug utilization pattern of anti-epileptic drugs (AEDs) for the treatment of various forms of epileptic seizures in this tertiary referral centre in Oman; and to compare our drug utilization pattern with that from other countries. In addition, the tolerability of AEDs and the use of therapeutic drug monitoring (TDM) were evaluated. In a 6-month study, all epileptic patients aged 14 and above who were prescribed an AED were considered for analysis. Demographic data, type and aetiology of epileptic seizures, AED data, tests performed and adverse drug reaction (ADR) data were collected. A total of 1039 prescriptions originated from 488 epileptic patients. The age ranged from 14 to 77 years (median, 24 years). Generalized tonic-clonic seizures (51%) of idiopathic/cryptogenic origin (83%) were the most common type and aetiology of epileptic seizures, respectively. An average of 1.34 AEDs per patient was prescribed with 78% of patients being on monotherapy. Sodium valproate (49%) was the most frequently prescribed AED, followed by carbamazepine (44%), phenytoin (12%) and lamotrigine (11%). Ten patients suffered an ADR and phenobarbital followed by carbamazepine were most commonly the subject of TDM. Unlike the results in most other studies, generalized seizures represented the majority of epileptic seizures. The selection of the AEDs corresponded well with their known efficacy profiles for specific epileptic seizure types. Monotherapy was the type of therapy most frequently used, and sodium valproate and carbamazepine were the most commonly used AEDs.

  17. The influence of the full moon on seizure frequency: myth or reality?

    Benbadis, Selim R; Chang, Stanley; Hunter, Joel; Wang, Wei


    To investigate a possible relationship between seizure frequency and the lunar cycle, we reviewed the occurrence of seizures recorded in our epilepsy monitoring unit over a 3-year period. Analysis of the total number of seizures (epileptic plus nonepileptic) showed no significant association. A separate analysis revealed that for nonepileptic seizures, there was an increase at the full moon, and for epileptic seizures, an increase in the last quarter. We conclude that there is no "full moon" effect on seizures as a whole, although there is a possible effect on nonepileptic seizures.

  18. Migrating Partial Seizures of Infancy

    J Gordon Millichap


    Full Text Available A national surveillance study in conjunction with the British Paediatric Neurology Unit was undertaken to further define the clinical, pathological and molecular genetic features of migrating partial seizures of infancy (MPSI, a rare early infantile epileptic encephalopathy with poor prognosis.

  19. Neonatal vitamin-responsive epileptic encephalopathies.

    Gospe, Sidney M


    The treatment of neonatal seizures generally relies on the use of one or more anticonvulsant medications along with evaluation and management of any underlying etiology. In some circumstances, neonatal seizures are refractory to therapy and result in poor outcomes, including death. Certain rare vitamin- responsive inborn errors of metabolism may present as neonatal encephalopathy with anticonvulsant-resistant seizures. Therefore, it is vital for the clinicians of caring for seizing encephalopathic newborns to consider these particular disorders early in the hospital course. Pyridoxine-dependent seizures are due to deficiency of alpha-aminoadipic semialdehyde dehydrogenase (antiquitin) which is encoded by ALDH7A1. Seizures in infants who are pyridoxine-dependent must be treated using pharmacologic doses of pyridoxine (vitamin B(6)), and life-long therapy is required. Despite medical therapy, developmental handicaps, particularly in expressive language, are common. Folinic acidresponsive seizures are treated with supplements of folinic acid (5-formyltetrahydrofolate). Recently, patients with this condition were also demonstrated to be antiquitin deficient. Pyridoxal phosphate-dependent seizures result from a deficiency of pyridox(am)ine 5'-phosphate oxidase which is encoded by PNPO. Patients with this cause of seizures respond to pyridoxal phosphate but not to pyridoxine. This review discusses our current understanding of these three neonatal vitamin-responsive epileptic encephalopathies and a diagnostic and treatment protocol is proposed.

  20. Pyridoxal phosphate-dependent neonatal epileptic encephalopathy.

    Bagci, S; Zschocke, J; Hoffmann, G F; Bast, T; Klepper, J; Müller, A; Heep, A; Bartmann, P; Franz, A R


    Pyridox(am)ine-5'-phosphate oxidase converts pyridoxine phosphate and pyridoxamine phosphate to pyridoxal phosphate, a cofactor in many metabolic reactions, including neurotransmitter synthesis. A family with a mutation in the pyridox(am)ine-5'-phosphate oxidase gene presenting with neonatal seizures unresponsive to pyridoxine and anticonvulsant treatment but responsive to pyridoxal phosphate is described. Pyridoxal phosphate should be considered in neonatal epileptic encephalopathy unresponsive to pyridoxine.

  1. Pyridoxal phosphate-dependent neonatal epileptic encephalopathy


    Pyridox(am)ine-5′-phosphate oxidase converts pyridoxine phosphate and pyridoxamine phosphate to pyridoxal phosphate, a cofactor in many metabolic reactions, including neurotransmitter synthesis. A family with a mutation in the pyridox(am)ine-5′-phosphate oxidase gene presenting with neonatal seizures unresponsive to pyridoxine and anticonvulsant treatment but responsive to pyridoxal phosphate is described. Pyridoxal phosphate should be considered in neonatal epileptic encephalopathy unrespons...

  2. On the Centrality of the Focus in Human Epileptic Brain Networks

    Geier, Christian; Elger, Christian E; Lehnertz, Klaus


    There is increasing evidence for specific cortical and subcortical large-scale human epileptic networks to be involved in the generation, spread, and termination of not only primary generalized but also focal onset seizures. The complex dynamics of such networks has been studied with methods of analysis from graph theory. In addition to investigating network-specific characteristics, recent studies aim to determine the functional role of single nodes---such as the epileptic focus---in epileptic brain networks and their relationship to ictogenesis. Utilizing the concept of betweenness centrality to assess the importance of network nodes, previous studies reported the epileptic focus to be of highest importance prior to seizures, which would support the notion of a network hub that facilitates seizure activity. We performed a time-resolved analysis of various aspects of node importance in epileptic brain networks derived from long-term, multi-channel, intracranial electroencephalographic recordings from an epil...

  3. Epileptic EEG: a comprehensive study of nonlinear behavior.

    Daneshyari, Moayed; Kamkar, L Lily; Daneshyari, Matin


    In this study, the nonlinear properties of the electroencephalograph (EEG) signals are investigated by comparing two sets of EEG, one set for epileptic and another set for healthy brain activities. Adopting measures of nonlinear theory such as Lyapunov exponent, correlation dimension, Hurst exponent, fractal dimension, and Kolmogorov entropy, the chaotic behavior of these two sets is quantitatively computed. The statistics for the two groups of all measures demonstrate the differences between the normal healthy group and epileptic one. The statistical results along with phase-space diagram verify that brain under epileptic seizures possess limited trajectory in the state space than in healthy normal state, consequently behaves less chaotically compared to normal condition.

  4. Plasticity-modulated seizure dynamics for seizure termination in realistic neuronal models

    Koppert, M.M.J.; Kalitzin, S.; Lopes da Silva, F.H.; Viergever, M.A.


    In previous studies we showed that autonomous absence seizure generation and termination can be explained by realistic neuronal models eliciting bi-stable dynamics. In these models epileptic seizures are triggered either by external stimuli (reflex epilepsies) or by internal fluctuations. This scena

  5. Plasticity-modulated seizure dynamics for seizure termination in realistic neuronal models

    Koppert, M.M.J.; Kalitzin, S.; Lopes da Silva, F.H.; Viergever, M.A.


    In previous studies we showed that autonomous absence seizure generation and termination can be explained by realistic neuronal models eliciting bi-stable dynamics. In these models epileptic seizures are triggered either by external stimuli (reflex epilepsies) or by internal fluctuations. This

  6. An electron spin resonance study for real-time detection of ascorbyl free radicals after addition of dimethyl sulfoxide in murine hippocampus or plasma during kainic acid-induced seizures.

    Matsumoto, Shigekiyo; Shingu, Chihiro; Koga, Hironori; Hagiwara, Satoshi; Iwasaka, Hideo; Noguchi, Takayuki; Yokoi, Isao


    Electron spin resonance (ESR)-silent ascorbate solutions generate a detectable, likely concentration-dependent signal of ascorbyl free radicals (AFR) immediately upon addition of a molar excess of dimethyl sulfoxide (DMSO). We aimed to perform quantitative ESR analysis of AFR in real time after addition of DMSO (AFR/DMSO) to evaluate ascorbate concentrations in fresh hippocampus or plasma following systemic administration of kainate in mice. Use of a special tissue-type quartz cell allowed immediate detection of AFR/DMSO ESR spectra in fresh tissues from mice. AFR/DMSO content was increased significantly in fresh hippocampus or plasma obtained during kainate-induced seizures of mice, reaching maximum levels at 90 min after intraperitoneal administration of 50 mg/kg kainic acid. This suggests that oxidative injury of the hippocampus resulted from the accumulation of large amounts of ascorbic acid in the brain after kainic acid administration. AFR/DMSO content measured on an ESR spectrometer can be used for real-time evaluation of ascorbate content in fresh tissue. Due to the simplicity, good performance, low cost and real-time monitoring of ascorbate, this method may be applied to clinical research and treatment in the future.

  7. Prevalence of Migraine Headache in Epileptic Patients.

    Sayena Jabbehdari


    Full Text Available Epilepsy is one of the most common neurological disorders which a physician might come across in his career life. On the other hand, migraine is common disorders in society chronic headache such as migraine in epileptic patients give ride to difficulties in seizure treatment due to altering the sleeping pattern and calmness disarrangement. Therefore, early diagnosis and suitable treatment in epileptic patients is definitely inevitable, and it will help in a more desirable patients' treatment. So we aimed to evaluate the prevalence of migraine in epileptic patients and relation between these two disorders. Number of 150 epileptic patients attended to neurology clinic of Shohadaye Tajrish Hospital and Iranian Epilepsy Association between June 2010 to May 2011 were fulfilled the questionnaire, and the data has been assessed by SPSS software. In this study, we used MS-Q (migraine screening -questionnaire designed for early diagnosis of migraine in the general population. From all patients filling the questionnaire, the prevalence of migraine (with or without aura was as follows: 23 persons had criteria compatible with migraine with aura; 26 patients had migraine without aura. Migraine was more common in these patients: persons with academic degrees, women, patients who were used 2 antiepileptic drugs, and patients with high BMI. In this study, we showed that migraine in epileptic patients is more prevalent than the general population. Thus, early diagnosis and efficient treatment of migraine headache in these patients is mandatory. More studies are needed for evaluation of this issue.


    N. E. Kvaskova


    Full Text Available The paper describes the clinical, electroencephalographic (EEG, and neuroimaging features of focal epileptic myoclonus (FEM and the results of therapy in patients with this type of seizure. The latter was identified in 2.5 % of the cases of epilepsy with onset beyond the age of 18 years (n = 1261. The age of onset of FЕМ was from 5 months to 23 years (mean 8.1 ± 1.6 years. The addition of secondary generalized seizures was stated in 90.3% of cases; that of focal motor seizures, epileptic aura, and negative FЕМ was seen in 64.5, 25.8, and 12.8 %, respectively. FЕМ was most commonly located in the flexor muscles of the upper extremities (22.6 % and facial and upper limb muscles (25.6 %. The regional epileptoformactivity maximally located in the frontocentroparietal leads is a typical EEG pattern of FЕМ in all the patients. Magnetic resonance imaging most frequently revealed diffuse cortical and subcortical atrophy (29 % and total cortical hemiatrophy (32 %. There was no case of complete remission of FЕМ. Monotherapy with antiepileptic drugs (AEDs resulted in reduction of FЕМ in only 6.4 % of cases. During duo therapy, there was more than a 50 % reduction in FЕМ in 67.7 %. Our investigation has indicated that active FЕМ is a seizure type resistant to AEDs. This fact necessitates the detection of FЕМ at its early stages in order to predict the course of the disease and search for new therapies for epileptic syndromes associated with this type of seizures.

  9. Therapeutic approach to epileptic encephalopathies.

    Vigevano, Federico; Arzimanoglou, Alexis; Plouin, Perrine; Specchio, Nicola


    Epileptic encephalopathies (EEs) are electroclinical entities with a peculiar course of disease; seizures and electroencephalographic (EEG) epileptiform abnormalities, ictal and interictal, contribute to progressive disturbance of cerebral functions. Frequently EEs are drug resistant, and consequences may be catastrophic. The main goal of treatment is to stop the peculiar course of epilepsy, operating on three parameters: seizure control, reduction of EEG abnormalities, and developmental outcome. For a correct therapeutic approach it is mandatory to have an as accurate as possible syndromic and etiologic diagnosis. Given the poor efficacy of conventional antiepileptic drugs (AEDs), the use of specific drugs for EEs, such as adrenocorticotropic hormone (ACTH) and corticosteroids or stiripentol is suggested. In some cases the choice of treatment is strictly related to the etiology: vigabatrin in tuberous sclerosis, ketogenic diet in glucose transporter type 1 (GLUT-1) deficiency, and pyridoxine in pyridoxine deficiency. Some AEDs combinations, such as sodium valproate with lamotrigine, have also provided interesting results, for example, in Lennox-Gastaut syndrome, although controlled studies are lacking. Finally, early surgery can be an option in children with focal structural abnormalities responsible for EEs preferably before irreversible damage on developmental outcome. Multispecialist support is recommended in EE. Management should be global from the onset, integrating not only seizure control but also all issues related to comorbidities, particularly neuropsychological and psychiatric.

  10. Benign focal epilepsy of childhood with centrotemporal spikes (BECTS: clinical characteristics of seizures according to age at first seizure

    Miziara Carmen Silvia M.G.


    Full Text Available BECTS is characterized by the presence of simple partial motor seizures in the face and/or oropharynx, with or without sensory symptoms and often with secondary generalization. These seizures tend to occur more often during sleep or drowsiness. According to some authors, generalized seizures prevail over other types particularly among children aged five or less. The purpose of this study is to determine the characteristics of the first epileptic episode among children with BECTS, grouped by age as of their first epileptic seizure, as well as to analyze how such seizures change over the course of clinical evolution. A total of 61 children were examined, 16 of whom below the age of 5 and 45 above. With regard to the first and recurrent epileptic episodes, our final assessment showed that partial seizures occurred more frequently than generalized tonic-clonic seizures in both groups. Although no conclusive relation could be established between the type of partial seizure (i.e. simple versus complex and the children's age as of their first epileptic episode, it was possible to correlate the type of epileptic seizure with their clinical evolution, in which case simple partial seizures proved to be more frequent than complex partial seizures. It should be noted that the number of children under the age of five was relatively small, which evinces the need for further studies. It should also be borne in mind that the reported frequency of generalized seizures in these children's first epileptic episode may be due to their parents' lack of attention and familiarity with this pathology and their attendant difficulty in characterizing its clinical symptoms.

  11. Anti Epileptic Activity of Morinda citrifolia Linn Fruit Extract

    P. Muralidharan; Srikanth, J


    Fruit extract of Morinda citrifolia (Noni), a medicinal plant used in many neuro protective ayurvedic preparations was evaluated for its protective effect against seizures induced by Maximal Electro Shock (MES) method in rats. A daily dose of 200 and 400 mg/kg of the extract was administered to the animals for 15 days, after which seizures were induced by maximum electro shock method and the duration of various phases of epileptic attacks were recorded and compared with the control animals. A...

  12. NPY 通过小胶质细胞介导的神经免疫途径对大鼠癫痫发作行为学影响%The inhibiting effe ct of NPY on the epileptic seizures of rats by acting on microglia

    李琦军; 贾东召; 陈涛平; 吴永波; 常军英; 邢兆国; 张淑丽; 王道爱; 王彦志; 穆卫卢; 李炎


    seizure of rats by acting on microglia.Methods The primary cortex microglia of rats was cultured and purified, morphology of microglia were observed through immunocyto-chemistry staining, Primary cerebral cortical microglia of rats was divided into control group, LPS group, NPY+LPS group, NPY group and BIBP3226+NPY+LPS group.Microglia cells in control group were incubated with serum-free medium for 6 h;microglia cells in LPS group were incubated with serum-free medium including LPS( final concentration 100 ng/mL) for 6 h;microglia cells in NPY+LPS group were incubated with serum-free medium including NPY( final concentration 1μmol/L) for 0.5 h firstly, then continued the incubation for 6 h after adding LPS (final concentration 100 ng/mL);microglia cells in NPY group were incubated in serum-free medium including NPY ( final concentration 1 μmol/L ) for 6 h; microglia cells in BIBP3226+NPY+LPS group were incubated in serum-free medium including BIBP3226 ( final concentration 1 μmol/L ) which was NPY Y1 receptor blocking reagent for 0.5 h, then we incubated them for 0.5 h after adding NPY (final concentra-tion 1μmol/L) ,at last the cells were incubated for 6 h after adding LPS with the final concentration 100 ng/mL.20 adult SD rats were divided into control group,LPS group,NPY+LPS group and BIBP3226+NPY+LPS group,every group included five rats.The levels of epileptic seizure of rats in each group were observed after microglia conditioned mediums were injected re-spectively into ventricle of the adult rats.Behaviors of the rats in every group were observed, and epilepsy degree was evalua-ted based on Diehl’ s method.Results In 20 minutes, all the 5 rats in LSP group and BIBP3226+NPY+LPS group appeared severe epileptic seizure.There were 4 rats in NPY+LPS group appeared mild epileptic seizures in the same time.There was no rat appeared epileptic seizure in control group.The degrees of epileptic seizure of LPS group were significantly higher than that of the control group

  13. Occurrence and clinical features of epileptic and non-epileptic paroxysmal events in five children with Pallister-Killian syndrome.

    Filloux, Francis M; Carey, John C; Krantz, Ian D; Ekstrand, Jeffrey J; Candee, Meghan S


    Pallister-Killian syndrome (PKS) is a rare, sporadic genetic disorder caused by tetrasomy 12p mosaicism associated with a supernumerary isochromosome. Craniofacial dysmorphism, learning impairment and seizures are considered characteristic. However, little is known of the seizure and epilepsy patterns seen in PKS. To better define the occurrence and nature of epileptic and non-epileptic paroxysmal events in PKS, we describe our experience with 5 patients and compare their features with data from a larger cohort of PKS patients ascertained via a web-based parental questionnaire. Three of the 5 patients have had definite epileptic seizures, and one other has had paroxysmal events as yet not clarified. Four of the 5 have also had either non-epileptic paroxysmal events or episodes of uncertain nature. In those with epilepsy, all have had some period of relatively refractory seizures, all have required more than one antiepileptic drug, but none experienced status epilepticus. Only one of the patients with epilepsy (the oldest) has gone into remission. In two of the four with non-epileptic events, video-electroencephalographic monitoring has been valuable in clarifying the nature of the events. EEG characteristics include a slow dominant frequency as well as generalized and focal epileptiform features. Brain MRI findings can be normal but are variable. These specific findings correspond well to information reported by parents in a larger cohort of 51 individuals with PKS. Better understanding of the nature of epileptic and non-epileptic events in PKS will result from a more detailed analysis of objective data obtained from this larger cohort, and from deeper understanding of the molecular impact of 12p tetrasomy in selected cell lines.

  14. Occurrence and clinical features of epileptic and non-epileptic paroxysmal events in five children with Pallister–Killian syndrome

    Filloux, Francis M.; Carey, John C.; Krantz, Ian D.; Ekstrand, Jeffrey J.; Candee, Meghan S.


    Pallister–Killian syndrome (PKS) is a rare, sporadic genetic disorder caused by tetrasomy 12p mosaicism associated with a supernumerary isochromosome. Craniofacial dysmorphism, learning impairment and seizures are considered characteristic. However, little is known of the seizure and epilepsy patterns seen in PKS. To better define the occurrence and nature of epileptic and non-epileptic paroxysmal events in PKS, we describe our experience with 5 patients and compare their features with data from a larger cohort of PKS patients ascertained via a web-based parental questionnaire. Three of the 5 patients have had definite epileptic seizures, and one other has had paroxysmal events as yet not clarified. Four of the 5 have also had either non-epileptic paroxysmal events or episodes of uncertain nature. In those with epilepsy, all have had some period of relatively refractory seizures, all have required more than one antiepileptic drug, but none experienced status epilepticus. Only one of the patients with epilepsy (the oldest) has gone into remission. In two of the four with non-epileptic events, video-electroencephalographic monitoring has been valuable in clarifying the nature of the events. EEG characteristics include a slow dominant frequency as well as generalized and focal epileptiform features. Brain MRI findings can be normal but are variable. These specific findings correspond well to information reported by parents in a larger cohort of 51 individuals with PKS. Better understanding of the nature of epileptic and non-epileptic events in PKS will result from a more detailed analysis of objective data obtained from this larger cohort, and from deeper understanding of the molecular impact of 12p tetrasomy in selected cell lines. PMID:22349688

  15. Diagnostic value of amplitude-integrated electroencephalogram for epileptic seizures in pediatric intensive care unit%振幅整合脑电图在儿童重症监护室癫痫发作中的诊断价值

    王新华; 沈金梅; 姚佩丽; 周渊峰; 高萱; 马健; 陆国平; 周水珍; 王艺


    Objective To assess the value of amplitude-integrated electroencephalogram(aEEG) in diagnose of epileptic seizure and status epilepticus in pediatric intensive care unit (PICU).Methods Thirty-five children admitted to Children's Hospital of Fudan University from January to December 2014 with severe neurologia situation in PICU were investigated,and bedside video-EEG(VEEG) findings were recorded for more than 4 hours.VEEG signals were transformed into aEEG signals by Galileo NT PMS software:one-channel aEEG (C3-C4),mutichannel aEEG (F3-F4;C3-C4;P3-P4;T3-T4) plus original EEG.Electrical seizure activity on VEEG was signed out with respect to its occurrence,duration and localization of seizure onset;while aEEG seizure was recorded only during its occurrence.The relationship between aEEG and VEEG was analyzed by Spearman analysis.Results A total of 61 traces in 35 cases were suitable for analysis.(1) gender:24 male and 11 female;years of age:12 cases of 2 months-1 year old,13 cases > 1-6 years old,10 cases > 6-12 years old;etiological factors:15 cases associated with severe viral encephalitis,6 cases associated with epilepsy,6 cases associated with intracranial hemorrhage,5 cases associated with hypoxic-ischemic encephalopathy (HIE),3 cases with other factors.(2) The results were divided into 2 groups:status epilepticus (SE) group and epileptic seizures group.There were 37 traces in SE group,19 traces of them were convulsive SE,and severe viral encephalitis and epilepsy were the most common causes.The other 18 traces were non-convulsive SE,the most common causes were severe viral encephalitis,HIE and intracranial hemorrhage.There were 24 traces in non-SE group,and 118 frequencies of epileptic seizures were monitored.(3)The diagnostic value of aEEG for SE and epileptic seizures:37 traces with status epilepticus on VEEG were all diagnosed as SE on aEEG.For non-SE electrical seizures,the sensitivity of aEEG for detection of electrical seizures was as follows:79.66

  16. Deep Recurrent Neural Networks for seizure detection and early seizure detection systems

    Talathi, S. S. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)


    Epilepsy is common neurological diseases, affecting about 0.6-0.8 % of world population. Epileptic patients suffer from chronic unprovoked seizures, which can result in broad spectrum of debilitating medical and social consequences. Since seizures, in general, occur infrequently and are unpredictable, automated seizure detection systems are recommended to screen for seizures during long-term electroencephalogram (EEG) recordings. In addition, systems for early seizure detection can lead to the development of new types of intervention systems that are designed to control or shorten the duration of seizure events. In this article, we investigate the utility of recurrent neural networks (RNNs) in designing seizure detection and early seizure detection systems. We propose a deep learning framework via the use of Gated Recurrent Unit (GRU) RNNs for seizure detection. We use publicly available data in order to evaluate our method and demonstrate very promising evaluation results with overall accuracy close to 100 %. We also systematically investigate the application of our method for early seizure warning systems. Our method can detect about 98% of seizure events within the first 5 seconds of the overall epileptic seizure duration.

  17. Utility of different seizure induction protocols in psychogenic nonepileptic seizures.

    Goyal, Gourav; Kalita, Jayantee; Misra, Usha K


    Psychogenic non epileptic seizure (PNES) can be induced by several induction tests but their relative usefulness has not been evaluated. In this study, we report the sensitivity and specificity of various induction tests in the diagnosis of PNES and assess their discomfort level. The induction tests were: (a) compression of temple region (CTR), (b) verbal suggestion (VS), (c) tuning fork application (TFA), (d) moist swab application (MSA), (e) torch light stimulation (TLS) and (f) saline injection (SI). Up to 3 trials were done for each test except for normal saline injection which was given once. For comparison of these tests, patients with epileptic seizures were included as controls. The time to precipitate PNES was recorded and patients' discomfort levels were noted on a 0-10 scale. Video EEG was recorded in the PNES patients. 140 patients with PNES and 50 controls with epileptic seizures were included. The diagnostic yield of CTR was 65.7%, TFA 61.4%, MSA 60.7%, SI 55.6%, VS 54.3% and TLS 40.7%. These tests did not induce seizures in the controls. All these tests had 100% specificity and 100% positive predictive value in the diagnosis of PNES. The maximum discomfort was reported with SI and minimum with MSA. The similarity of efficacy and discomfort with CTR and TFA appear to be the most optimal induction techniques when compared with VS, AMS, TLS, and SI.

  18. Cellular and network mechanisms of electrographic seizures

    Bazhenov, Maxim; Timofeev, Igor; Fröhlich, Flavio; Sejnowski, Terrence J.


    Epileptic seizures constitute a complex multiscale phenomenon that is characterized by synchronized hyperexcitation of neurons in neuronal networks. Recent progress in understanding pathological seizure dynamics provides crucial insights into underlying mechanisms and possible new avenues for the development of novel treatment modalities. Here we review some recent work that combines in vivo experiments and computational modeling to unravel the pathophysiology of seizures of cortical origin. We particularly focus on how activity-dependent changes in extracellular potassium concentration affects the intrinsic dynamics of neurons involved in cortical seizures characterized by spike/wave complexes and fast runs. PMID:19190736


    K. Yu. Мukhin


    Full Text Available The article is devoted to rare and unique type of epileptic seizures – inhibitory motor seizures, characterized by the inability to execute a voluntary movement with preserved consciousness. The exact prevalence of this type of seizures is not known, but many cases are unrecognized or non-correctly diagnosed as Todd's paralysis. Therefore practical doctors should know the clinical and electroencephalographic characteristics of this type of seizures andtake them into account in the differential diagnoses . The authors presented a detailed review of the literature, including the historical data, etiology, pathogenesis and proposed mechanisms of formation of inhibitory motor seizures, clinical and EEG characteristics, therapeutic approaches. Antiepileptic drugs of choice used in the treatment of inhibitory motor seizures are valproic acid (preferably depakine chronosphere – original prolonged form of valproate. The authors also presented their observations of patients with inhibitory motor seizures.

  20. Risk factors of recurrent seizure, co-morbidities, and mortality in new onset seizure in elderly.

    Phabphal, Kanitpong; Geater, Alan; Limapichat, Kitti; Sathirapanya, Pornchai; Setthawatcharawanich, Suwanna


    To determine the risk factors of seizure recurrence and the most common comorbidities in elderly patients with epilepsy. We did a retrospective study of 278 patients older than 65 years with first seizure. We evaluated electrolytes, blood glucose, urea and creatinine levels, and performed electrocardiography (ECG), and routine electroencephalogram (EEG) on all patients. We evaluated seizure recurrence and comorbidities at 2 years. Univariate analysis found that significant (Pseizure recurrence were etiology of seizure, EEG, and status epilepticus at first presentation. In multivariate regression analysis, etiology of seizure and EEG were significant statistical factors in seizure recurrence at 2 years follow up. Age, sex, duration of time between first seizure and diagnosis of seizure, seizure type, misdiagnosis of non-epileptic seizure, and use of antiepileptic drugs were not significant factors for predicting seizure recurrence. Depression and anxiety were the most common comorbidities in our study, followed by sleep-related disorders and stroke. There were no statistically significantly differences in comorbidities between patients who remained seizure free and patients who had recurrent seizure. Most of the new onset seizures in our elderly patients were focal onset. Acute symptomatic etiology, remote symptomatic etiology, progressive symptomatic etiology and abnormal EEG features were powerful predictors of seizure recurrence, and mood disorder, sleep disorder and stroke were the common comorbidities. Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  1. Low-frequency hippocampal stimulation increases the extracellular γ-aminobutyrate level in the brain, inhibits the epileptic seizures and after discharges of the amygdala in pharmacoresistant temporal lobe epileptic rats%低频海马电刺激增加耐药性颞叶癫痫大鼠脑细胞外液γ-氨基丁酸含量和抑制癫痫发作及杏仁核后放电

    伍国锋; 刘晓英; 洪震; 唐太峰


    目的 建立多药耐药性颞叶癫痫模型,以杏仁核后放电频率、癫痫发作频率、海马细胞外液γ-氨基丁酸(GABA)浓度为指标,观察海马电刺激治疗耐药性颞叶癫痫的疗效及可能机制.方法 选用Wistar大鼠120只,制作慢性杏仁核点燃癫痫模型,模型制作成功后,应用经典抗癫痫药苯妥英钠和苯巴比妥进行筛选,根据癫痫大鼠对药物的反应区别出耐药性癫痫大鼠及药物敏感大鼠,将耐药性癫痫大鼠分为耐药对照组(n=8)及海马刺激组(n=8),对耐药性癫痫大鼠进行低频海马电刺激,用微透析方法收集脑组织细胞外液,采用高效液相色谱法检测海马电刺激后GABA含量的变化.结果 海马刺激组经过2周的低频电刺激后,癫痫发作受到明显抑制,杏仁核后放电频率及波幅降低,8:00-9:00 am和8:00-9:00 pm 2个时段的GABA浓度(μg/ml)分别为32.69±7.80、35.76±6.27,2个时段的GABA浓度(μg/ml)都明显高于耐药对照组(26.58±6.87,t=-21.45,P=0.000;31.50 ±4.87,t=-15.74,P=0.000),差异具有统计学意义.结论 低频电刺激海马可以明显抑制点燃模型的癫痫发作,抑制耐药性颞叶癫痫模型的后放电,降低杏仁核后放电频率及波幅、缩短后放电持续时间,该作用可能是通过增加脑细胞外液GABA浓度而实现的.%Objective To establish a multi-drug resistant model of temporal lobe epilepsy and observe the effect of hippocampal stimulation on pharmacoresistant epileptic rats and its possible mechanism with the use of indexes including after discharges (AD) of the amygdalae,the stimulus-induced seizures and the extracellular levels of γ-aminobutyrate (GABA).Methods Totally,120 Wistar rats were used for the amygdaloid kindled model of epilepsy by chronic stimulation of amygaloid basal lateral nucleus.Based on the successful kindled model of epilepsy,we selected the pharmacoresistant and pharmacosensitive epileptic rats according to their response to

  2. Stability of synchronization clusters and seizurability in temporal lobe epilepsy.

    Agostina Palmigiano

    Full Text Available PURPOSE: Identification of critical areas in presurgical evaluations of patients with temporal lobe epilepsy is the most important step prior to resection. According to the "epileptic focus model", localization of seizure onset zones is the main task to be accomplished. Nevertheless, a significant minority of epileptic patients continue to experience seizures after surgery (even when the focus is correctly located, an observation that is difficult to explain under this approach. However, if attention is shifted from a specific cortical location toward the network properties themselves, then the epileptic network model does allow us to explain unsuccessful surgical outcomes. METHODS: The intraoperative electrocorticography records of 20 patients with temporal lobe epilepsy were analyzed in search of interictal synchronization clusters. Synchronization was analyzed, and the stability of highly synchronized areas was quantified. Surrogate data were constructed and used to statistically validate the results. Our results show the existence of highly localized and stable synchronization areas in both the lateral and the mesial areas of the temporal lobe ipsilateral to the clinical seizures. Synchronization areas seem to play a central role in the capacity of the epileptic network to generate clinical seizures. Resection of stable synchronization areas is associated with elimination of seizures; nonresection of synchronization clusters is associated with the persistence of seizures after surgery. DISCUSSION: We suggest that synchronization clusters and their stability play a central role in the epileptic network, favoring seizure onset and propagation. We further speculate that the stability distribution of these synchronization areas would differentiate normal from pathologic cases.

  3. Analyzing reliability of seizure diagnosis based on semiology.

    Jin, Bo; Wu, Han; Xu, Jiahui; Yan, Jianwei; Ding, Yao; Wang, Z Irene; Guo, Yi; Wang, Zhongjin; Shen, Chunhong; Chen, Zhong; Ding, Meiping; Wang, Shuang


    This study aimed to determine the accuracy of seizure diagnosis by semiological analysis and to assess the factors that affect diagnostic reliability. A total of 150 video clips of seizures from 50 patients (each with three seizures of the same type) were observed by eight epileptologists, 12 neurologists, and 20 physicians (internists). The videos included 37 series of epileptic seizures, eight series of physiologic nonepileptic events (PNEEs), and five series of psychogenic nonepileptic seizures (PNESs). After observing each video, the doctors chose the diagnosis of epileptic seizures or nonepileptic events for the patient; if the latter was chosen, they further chose the diagnosis of PNESs or PNEEs. The overall diagnostic accuracy rate for epileptic seizures and nonepileptic events increased from 0.614 to 0.660 after observations of all three seizures (p semiological diagnosis of seizures is greatly affected by the seizure type as well as the doctor's experience. Although the overall reliability is limited, it can be improved by observing more seizures. Copyright © 2014 Elsevier Inc. All rights reserved.


    E. D. Belousova


    Full Text Available The author represents the review and discussion of current scientific literature devoted to epileptic encephalopathy with continuous spikes-waves activity during sleep — the special form of partly reversible age-dependent epileptic encephalopathy, characterized by triad of symptoms: continuous prolonged epileptiform (spike-wave activity on EEG in sleep, epileptic seizures and cognitive disorders. The author describes the aspects of classification, pathogenesis and etiology, prevalence, clinical picture and diagnostics of this disorder, including the peculiar anomalies on EEG. The especial attention is given to approaches to the treatment of epileptic encephalopathy with continuous spikeswaves activity during sleep. Efficacy of valproates, corticosteroid hormones and antiepileptic drugs of other groups is considered. The author represents own experience of treatment this disorder with corticosteroids, scheme of therapy and assessment of efficacy.

  5. Knowledge about epilepsy among teachers and epileptic patients

    Maria F. Valls Tosetti


    Full Text Available 223 epileptics patients and their families and 136 teachers from public and private schools were submitted to similar questionnaires related to inheritance, transmission, cure, complilcation rates, care during seizures, need for information on the disease, habits, comparison with other diseases and to the educational and social performances of epileptics. Cure and complication nates accounted for the main differences between those populations. Epileptics could recognize a bigger number of complications but still expected to be cured from the disease. The majority of teachers and patients have never been informed about epilepsy and this finding was related to the big number of equivocal answers obtained from them. Put together, the data showed that social and educational performance of epileptic patients could be disturbed by medical and social parameters. Some, of them could be improved by an educational program towards these aspects of epilepsy.

  6. The role of antiepileptic drugs in free radicals generation and antioxidant levels in epileptic patients.

    Eldin, Essam Eldin Mohamed Nour; Elshebiny, Hosam Abdel-Fattah; Mohamed, Tarek Mostafa; Abdel-Aziz, Mohamed Abdel-Azim; El-Readi, Mahmoud Zaki


    Many risk factors are encountered during the pathogenesis of epilepsy. In this study, the effect of seizure frequency on free radical generation and antioxidants levels in epileptic patients was evaluated. This study was carried out on 15 healthy controls (GI) and 60 epileptic patients treated with mono- or poly-therapy of carbamazepine, valproic acid, or phenytoin. The treated epileptic patients were divided into 2 main groups according to the seizure frequency: controlled seizure patients GII (n = 30) and uncontrolled seizure patients GIII (n = 30). GII included the GIIA subgroup (n = 15) which had been seizure free for more than 12 months and the GIIB subgroup (n = 15) which had been seizure free for a period from 6 to12 months. GIII included GIIIA (n = 15) and GIIIB (n = 15) for patients which had a seizure frequency of less than and more than four times/month, respectively. In comparison to the control group (GI), the levels of nitric oxide (NO) and malondialdehyde/creatinine ratio were significantly increased in GIIB, GIIIA, and GIIIB, while vitamins A and E levels were significantly decreased in GIIIB. Serum NO levels had significant negative correlations with serum vitamin E in the GIIA and GIIB groups, and with vitamin A in the GIIIA and GIIIB groups. However, serum NO had positive correlation with urinary MDA/Cr ratio. The imbalance between free radical generation and antioxidant system in epileptic patients may be a factor in seizure frequency.

  7. The role of local field potential coupling in epileptic synchronization

    Jiongxing Wu; Heng Yang; Yufeng Peng; Liangjuan Fang; Wen Zheng; Zhi Song


    This review hopes to clearly explain the following viewpoints: (1) Neuronal synchronization underlies brain functioning, and it seems possible that blocking excessive synchronization in an epileptic neural network could reduce or even control seizures. (2) Local field potential coupling is a very common phenomenon during synchr in networks. Removal of neurons or neuronal networks that are coupled can significantly alter the extracellular field potential. Interventions of coupling mediated by local field potentials could result in desynchronization of epileptic seizures. (3) The synchronized electrical activity generated by neurons is sensitive to changes in the size of the extracellular space, which affects the efficiency of field potential transmission and the threshold of cell excitability. (4) Manipulations of the field potential fluctuations could help block synchronization at seizure onset.

  8. [Liposteroid therapy for refractory epileptic spasms].

    Shimono, Kuriko Kagitani; Imai, Katsumi; Idoguchi, Rie; Kamio, Noriko; Okinaga, Takeshi; Ozono, Keiichi


    Liposteroid was administered intravenously to 6 patients with refractory epileptic spasms. In one case, the spasms initially disappeared but then reappeared after three months. Another case had a transient and slight decrease of epileptic spasms. In the only patient in whom spasms disappeared, EEG abnormalities were greatly improved with diffuse spikes and waves changing into focal spikes. Two cases displayed hyperexcitability, insomnia and acting out behavior, and the therapy was discontinued in one of them. One case had appetite loss and another showed an increase in tonic seizures. No patient had serious adverse effects such as infection, edema, subdural hematoma and brain shrinkage. Although liposteroid therapy has been recommended as an easy, useful and safe alternative for ACTH, we found considerable adverse effects and only a small effect on refractory spasms, and conclude that the regimen should be modified.

  9. Seizure-induced disinhibition of the HPA axis increases seizure susceptibility.

    O'Toole, Kate K; Hooper, Andrew; Wakefield, Seth; Maguire, Jamie


    Stress is the most commonly reported precipitating factor for seizures. The proconvulsant actions of stress hormones are thought to mediate the effects of stress on seizure susceptibility. Interestingly, epileptic patients have increased basal levels of stress hormones, including corticotropin-releasing hormone (CRH) and corticosterone, which are further increased following seizures. Given the proconvulsant actions of stress hormones, we proposed that seizure-induced activation of the hypothalamic-pituitary-adrenal (HPA) axis may contribute to future seizure susceptibility. Consistent with this hypothesis, our data demonstrate that pharmacological induction of seizures in mice with kainic acid or pilocarpine increases circulating levels of the stress hormone, corticosterone, and exogenous corticosterone administration is sufficient to increase seizure susceptibility. However, the mechanism(s) whereby seizures activate the HPA axis remain unknown. Here we demonstrate that seizure-induced activation of the HPA axis involves compromised GABAergic control of CRH neurons, which govern HPA axis function. Following seizure activity, there is a collapse of the chloride gradient due to changes in NKCC1 and KCC2 expression, resulting in reduced amplitude of sIPSPs and even depolarizing effects of GABA on CRH neurons. Seizure-induced activation of the HPA axis results in future seizure susceptibility which can be blocked by treatment with an NKCC1 inhibitor, bumetanide, or blocking the CRH signaling with Antalarmin. These data suggest that compromised GABAergic control of CRH neurons following an initial seizure event may cause hyperexcitability of the HPA axis and increase future seizure susceptibility.

  10. Endocannabinoid system protects against cryptogenic seizures.

    van Rijn, Clementina M; Perescis, Martin F J; Vinogradova, Lyudmila; van Luijtelaar, Gilles


    Effects of the cannabinoid antagonist rimonabant on the EEG were investigated in healthy, non-epileptic rats. The drug was administered orally at 30 mg/kg/day for 3 weeks. The EEG was recorded continuously. In 3 out of 13 rats, limbic convulsive seizures, which were not related to the time of drug administration, were observed after 5-8 days. We hypothesize that an accumulation of micro-injuries in the brain is responsible for these "spontaneous" seizures.

  11. Rufinamide for the treatment of epileptic spasms.

    Olson, H E; Loddenkemper, T; Vendrame, M; Poduri, A; Takeoka, M; Bergin, A M; Libenson, M H; Duffy, F H; Rotenberg, A; Coulter, D; Bourgeois, B F; Kothare, S V


    The purpose of this study was to determine the safety and efficacy of rufinamide for treatment of epileptic spasms. We retrospectively reviewed patients treated with rufinamide for epileptic spasms from January 2009 to March 2010. Age, presence of hypsarrhythmia, change in seizure frequency following rufinamide initiation, and side effects were assessed. Patients who had a ≥ 50% reduction in spasm frequency were considered responders. Of all 107 children treated with rufinamide during the study period, 38 (36%) had epileptic spasms. Median patient age was 7 years (range: 17 months to 23). One patient had hypsarrhythmia at the time of treatment with rufinamide, and 9 other patients had a history of hypsarrhythmia. Median starting dose of rufinamide was 9 mg/kg/day (range: 2-18) and median final treatment dose was 39 mg/kg/day (range: 8-92). All patients were receiving concurrent antiepileptic drug therapy, with the median number of antiepileptic drugs being 3 (range: 2-6). Median duration of follow-up since starting rufinamide was 171 days (range: 10-408). Responder rate was 53%. Median reduction in spasm frequency was 50% (interquartile range=-56 to 85%, P99% reduction in spasms. Rufinamide was discontinued in 7 of 38 patients (18%) because of lack of efficacy, worsening seizures, or other side effects. Minor side effects were reported in 14 of 38 patients (37%). Rufinamide appears to be a well-tolerated and efficacious adjunctive therapeutic option for children with epileptic spasms. A prospective study is warranted to validate our observations. Copyright © 2010 Elsevier Inc. All rights reserved.

  12. Seizure Onset Detection based on one sEMG channel

    Conradsen, Isa; Beniczky, Sandor; Hoppe, Karsten


    We present a new method to detect seizure onsets of tonic-clonic epileptic seizures based on surface electromyography (sEMG) data. The proposed method is generic and based on a single channel making it ideal for a small detection or monitoring device. The sEMG signal is high-pass filtered...

  13. Music and its association with epileptic disorders.

    Maguire, Melissa


    The association between music and epileptic seizures is complex and intriguing. Musical processing within the human brain recruits a network which involves many cortical areas that could activate as part of a temporal lobe seizure or become hyperexcitable on musical exposure as in the case of musicogenic epilepsy. The dichotomous effect of music on seizures may be explained by modification of dopaminergic circuitry or counteractive cognitive and sensory input in ictogenesis. Research has explored the utility of music as a therapy in epilepsy and while limited studies show some evidence of an effect on seizure activity; further work is required to ascertain its clinical potential. Sodium channel-blocking antiepileptic drugs, e.g., carbamazepine and oxcarbazepine, appear to effect pitch perception particularly in native-born Japanese, a rare but important adverse effect, particularly if a professional musician. Temporal lobe surgery for right lateralizing epilepsy has the capacity to effect all facets of musical processing, although risk and correlation to resection area need further research. There is a need for the development of investigative tools of musical processing that could be utilized along the surgical pathway. Similarly, work is also required in devising a musical paradigm as part of electroencephalography to improve surveillance of musicogenic seizures. These clinical applications could aid the management of epilepsy and preservation of musical ability. © 2015 Elsevier B.V. All rights reserved.

  14. Mental Development of Children with Non-epileptic Paroxysmal States in Medical History

    Turovskaya N.G.,


    Full Text Available The author studied mental functions disorders in children with a history of paroxysmal states of various etiologies and compared mental development disorder patterns in patients with epileptic and non-epileptic paroxysms. Study sample were 107 children, aged 6 to 10 years. The study used experimental psychological and neuropsychological techniques. According to the empirical study results, non-epileptic paroxysms unlike epileptic much less combined with a number of mental functions disorders and intelligence in general. However, non-epileptic paroxysmal states as well as epileptic seizure associated with increasing activity exhaustion and abnormal function of the motor analyzer (dynamic and kinesthetic dyspraxia. Visual memory disorders and modal-nonspecific memory disorders have more pronounced importance in the mental ontogenesis structure in children with convulsive paroxysms compared to children with cerebral pathology without paroxysms history

  15. Management Of Post Stroke Seizures

    Kavian Ghandehari


    Full Text Available The incidence of seizures in relation to stroke is 8.9%, with a frequency of 10.6 and 8.6% in haemorrhagic and ischaemic stroke, respectively. In subarachnoid haemorrhage the incidence is 8.5%. Due to the fact that infarcts are significantly more frequent than haemorrhages, seizures are mainly related to occlusive vascular disease of the brain. The general view is to consider stroke-related seizures as harmless complications in the course of a prolonged vascular disease involving the heart and brain. Seizures can be classified as those of early and those of late onset in a paradigm comparable to post-traumatic epilepsy, with an arbitrary dividing point of two weeks after the event. Most early-onset seizures occur during the first day after the stroke. Late-onset seizures occur three times more often than early-onset ones. A first late-onset epileptic event is most likely to take place between six months and two years after the stroke. However, up to 28% of patients develop their first seizure several years later. Simple partial seizures, with or without secondary generalisation, account for about 50% of total seizures, while complex partial spells, with or without secondary generalisation, and primary generalised tonic–clonic insults account for approximately 25% each. Status epilepticus occurs in 12% of stroke patients, but the recurrence rate after an initial status epilepticus is not higher than after a single seizure. Inhibitory seizures, mimicking transient ischaemic attacks, are observed in 7.1% of cases. The only clinical predictor of late-onset seizures is the initial presentation of partial anterior circulation syndrome due to a territorial infarct. Patients with total anterior circulation syndrome have less chance of developing epileptic spells, not only due to their shorter life expectancy but also due to the fact that the large infarcts are sharply demarcated in these patients. The optimal timing and type of antiepileptic drug

  16. Channel selection for automatic seizure detection

    Duun-Henriksen, Jonas; Kjaer, Troels Wesenberg; Madsen, Rasmus Elsborg


    Objective: To investigate the performance of epileptic seizure detection using only a few of the recorded EEG channels and the ability of software to select these channels compared with a neurophysiologist. Methods: Fifty-nine seizures and 1419 h of interictal EEG are used for training and testing...... of an automatic channel selection method. The characteristics of the seizures are extracted by the use of a wavelet analysis and classified by a support vector machine. The best channel selection method is based upon maximum variance during the seizure. Results: Using only three channels, a seizure detection...... sensitivity of 96% and a false detection rate of 0.14/h were obtained. This corresponds to the performance obtained when channels are selected through visual inspection by a clinical neurophysiologist, and constitutes a 4% improvement in sensitivity compared to seizure detection using channels recorded...

  17. Seizure detection algorithms based on EMG signals

    Conradsen, Isa

    Background: the currently used non-invasive seizure detection methods are not reliable. Muscle fibers are directly connected to the nerves, whereby electric signals are generated during activity. Therefore, an alarm system on electromyography (EMG) signals is a theoretical possibility. Objective......: to show whether medical signal processing of EMG data is feasible for detection of epileptic seizures. Methods: EMG signals during generalised seizures were recorded from 3 patients (with 20 seizures in total). Two possible medical signal processing algorithms were tested. The first algorithm was based...... on the amplitude of the signal. The other algorithm was based on information of the signal in the frequency domain, and it focused on synchronisation of the electrical activity in a single muscle during the seizure. Results: The amplitude-based algorithm reliably detected seizures in 2 of the patients, while...

  18. 77 FR 12360 - Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders


    ...; Epilepsy and Seizure Disorders AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT. ACTION..., the exemptions would enable these individuals with seizure disorders to operate CMVs in interstate... indicates that if an individual has had a sudden episode of a non-epileptic seizure or loss of consciousness...

  19. Febrile Seizures and Behavioural and Cognitive Outcomes in Preschool Children: An Old Issue Revisited

    Deonna, Thierry


    The possible deleterious role of febrile seizures on development is an old issue. It took a long time to realize that impaired development or occurrence of chronic epilepsy affected a very small minority of children with febrile seizures. These children either had pre-existing brain damage, specific genetic epileptic conditions, or seizure-induced…

  20. Aggravation of atonic seizures by rufinamide: A case report.

    Bektaş, Gonca; Çalışkan, Mine; Aydın, Ali; Pembegül Yıldız, Edibe; Tatlı, Burak; Aydınlı, Nur; Özmen, Meral


    Rufinamide is a novel antiepileptic drug used as adjunctive therapy in patients with Lennox-Gastaut syndrome and provides seizure control especially in tonic and atonic seizures. Rufinamide is expected to be effective in intractable epilepsy when atonic and tonic seizures exist. However, rufinamide induced seizure aggravation has been reported in a few patients, which was not associated with a specific type of seizure. A 12-year-old boy with intractable epilepsy had tonic and atonic seizures despite treatment with valproic acid (3000mg/day), levetiracetam (3000mg/day) and clobazam (40mg/day). Rufinamide was administered as adjuvant therapy. After 2weeks on rufinamide, he experienced atonic seizure worsening, and the frequency of epileptic discharges increased. The deterioration in seizure frequency and epileptiform discharges resolved when rufinamide was discontinued. Rufinamide may aggravate atonic seizures in patients with intractable epilepsy. Copyright © 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  1. Crisis epilépticas generalizadas asociadas a intoxicación pasiva por cocaína en un lactante Generalized epileptic seizures in an infant due to passive exposure to cocaine

    S. Aguilera


    Full Text Available Fundamento. Las crisis convulsivas sin fiebre en lactantes implican un diagnóstico diferencial amplio. Caso clínico. Lactante mujer de 7 meses que presenta, estando afebril, dos crisis generalizadas tónico-clónicas breves en 23 horas. Su desarrollo psicomotor y estaturo-ponderal seguía un curso normal. Se obtuvo analítica de sangre, ecografía cerebral y electroencefalograma, normales. Debido a una situación sociofamiliar desfavorable, se realizaron tóxicos en orina, positivos para cocaína en dos muestras sucesivas; se negativizaron en 48 horas. Estuvo en contacto con humo ambiental horas previas al inicio de las crisis. Sin crisis en los siguientes 6 meses, con desarrollo normal, sigue bajo vigilancia por asistencia social. Discusión. La inhalación pasiva de humo de cocaína se asocia a crisis convulsivas en lactantes. Este riesgo es casi desconocido en nuestro país, a pesar del aumento del consumo de crack. Ante una primera crisis epiléptica afebril en cualquier edad, se debe incluir de forma rutinaria la detección de tóxicos en orina.Background. The differential diagnosis of afebrile seizures in the first year of life is extensive. Case report. A 7-month old infant presented two afebrile generalized tonic-clonic seizures in 23 hours; her psychomotor and growth development followed a normal course. Laboratory analysis, cerebral echography and electroencephalogram were normal. Urine toxicology was positive for cocaine on two occasions. A negative urine sample was obtained 48 hours later. The parents denied drug abuse but explained a recent exposure to smoke some hours before the episode. The patient had no seizures in the following six months, with normal psychomotor development. Discussion. Passive inhalation of cocaine is associated with seizures in infants. There is no perception of the risk of passive exposure to cocaine in our country, despite the increasing consumption of crack in young adults. Urine toxicology should be

  2. [Ecstatic seizures].

    Likhachev, S A; Astapenko, A V; Osos, E L; Zmachynskaya, O L; Gvishch, T G


    Ecstatic seizures is a rare manifestation of epilepsy. They were described for the first time by F.M. Dostoevsky. Currently, the description of ecstatic seizures is possible to find in the scientific literature. The description of the own observation of a patient with emotional-affective seizures is presented. A role of the anterior insular cortex in the ecstatic seizures origin is discussed. The similarities between the feelings reported during ecstatic seizures and the feelings experienced under the effect of stimulant addictive drugs are described. The possible reasons of the low frequency of emotional-affective seizures are considered.

  3. Epileptogenesis and epileptic maturation in phosphorylation site-specific SNAP-25 mutant mice.

    Watanabe, Shigeru; Yamamori, Saori; Otsuka, Shintaro; Saito, Masanori; Suzuki, Eiji; Kataoka, Masakazu; Miyaoka, Hitoshi; Takahashi, Masami


    Snap25(S187A/S187A) mouse is a knock-in mouse with a single amino acid substitution at a protein kinase C-dependent phosphorylation site of the synaptosomal-associated protein of 25 kDa (SNAP-25), which is a target-soluble NSF attachment protein receptor (t-SNARE) protein essential for neurotransmitter release. Snap25(S187A/S187A) mice exhibit several distinct phenotypes, including reductions in dopamine and serotonin release in the brain, anxiety-like behavior, and cognitive dysfunctions. Homozygous mice show spontaneous epileptic convulsions, and about 15% of the mice die around three weeks after birth. The remaining mice survive for almost two years and exhibit spontaneous recurrent seizures throughout their lifetime. Here, we conducted long-term continuous video electroencephalogram recording of the mice and analyzed the process of epileptogenesis and epileptic maturation in detail. Spikes and slow-wave discharges (SWDs) were observed in the cerebral cortex and thalamus before epileptic convulsions began. SWDs showed several properties similar to those observed in absence seizures including (1) lack of in the hippocampus, (2) movement arrest during SWDs, and (3) inhibition by ethosuximide. Multiple generalized seizures occurred in all homozygous mice around three weeks after birth. However, seizure generation stopped within several days, and a seizure-free latent period began. Following a spike-free quiet period, the number of spikes increased gradually, and epileptic seizures reappeared. Subsequently, spontaneous seizures occurred cyclically throughout the life of the mice, and several progressive changes in seizure frequency, seizure duration, seizure cycle interval, seizure waveform, and the number and waveform of epileptic discharges during slow-wave sleep occurred with different time courses over 10 weeks. Anxiety-related behaviors appeared suddenly within three days after epileptic seizures began and were delayed markedly by oral administration of

  4. Edema pulmonar neurogénico secundario a crisis epiléptica: Presentación de un caso y revisión de la literatura Neurogenic pulmonary edema secondary to epileptic seizures: Report of a case and a short review



    Full Text Available El edema pulmonar agudo neurogénico (EPN es un tipo de edema pulmonar que ocurre como consecuencia de una variada gama de lesiones del sistema nervioso central. Generalmente es subdiagnosticado. Se ha reportado en múltiples patologías y lesiones directas del sistema nervioso central. Presentamos el caso clínico de una mujer de mediana edad, con edema pulmonar agudo secundario a una crisis convulsiva epiléptica. Se realiza una revisión de la literatura con especial énfasis en las implicancias clínicas y tratamiento.The acute neurogenic pulmonary edema (NPE is a kind of pulmonary edema that occurs as a result of a variety of injuries of the central nervous system. Usually it is underdiagnosed. It has been reported in many diseases and direct injuries of the central nervous system. We present the clinical case of a middle age women with a neurogenic pulmonary edema secondary to a epileptic seizure. We made a review of the literature with special emphasis on clinical implications and treatment.

  5. Infantile epileptic syndromes and metabolic etiologies.

    Vigevano, Federico; Bartuli, Andrea


    Inherited metabolic disorders can cause onset of epilepsy in the first year of life. Epilepsy rarely dominates the clinical presentation, which is more frequently associated with other neurologic symptoms, such as mental retardation, hypotonia and/or dystonia, or vigilance disturbances. The pathogenesis of seizures is multifaceted; inherited metabolic disorder can affect the balance between excitatory and inhibitory chemical mediators, eliminate an energetic substrate at the cerebral level, cause in utero brain malformation, or provoke acute brain lesions. Some clinical disorders that strongly suggest particular metabolic etiologies can be identified. For example, specific clinical signs and findings on electroencephalogram (EEG) are characteristic of pyridoxine-dependent seizures, and inherited metabolic disorders associated with early myoclonic encephalopathy are well defined. In most cases, however, epilepsy secondary to inherited metabolic disorders presents with polymorphic clinical and EEG features that are difficult to classify into precise epileptic syndromes. Common characteristics of these seizures include onset in the first months of life; usually partial, multifocal; simple partial motor semiology; successive appearance of tonic seizures, spasms, and massive myoclonus; and resistance to antiepilepsy drugs. Inherited metabolic disorders must be considered in patients presenting with epilepsy and progressive neurologic worsening.

  6. Ictal epileptic headache revealing non convulsive status epilepticus in a case of eyelid myoclonia with absences.

    Fanella, Martina; Morano, Alessandra; Fattouch, Jinane; Albini, Mariarita; Casciato, Sara; Manfredi, Mario; Giallonardo, Anna Teresa; Di Bonaventura, Carlo


    Epileptic seizures and headache attacks are two common neurologic phenomena characterized by paroxysmal alteration of brain functions followed by complete restauration of the baseline condition. Headache and epilepsy are related in numerous ways, and they often co-occur. Although the link between these two diseases is not completely clear, several clinical, physiopathological and therapeutic features overlap. Headache is reported in association with epileptic seizures as a pre-ictal, ictal or post-ictal phenomenon. We present the case of a 40 year-old woman affected by eyelid myoclonia with absences (EMA) with a history of prolonged headache attacks. A video-EEG recording performed during one of these episodes showed subcontinuous epileptic activity consisting of generalized spike-and-wave discharges (GSWDs), clinically associated with tensive headache. Our work represents one of the few well EEG-documented cases of ictal epileptic headache in idiopathic generalized epilepsy (IGE).

  7. Dose-Dependent Effect of Curcumin on Learning and Memory Deficit in Kainate-Epileptic Rats

    Zahra Kiasalari


    Full Text Available Background & objectives : Epileptic seizures accompany disturbances in learning, memory, and cognitive skills. With regard to antiepileptic potential of curcumin and its beneficial effect on memory, the effect of its administration on learning and memory in kainate-epileptic rats was investigated.   Methods: Forty male rats were divided into sham, positive control ( valproate-treated epileptic, epileptic, and two curcumin-treated epileptic groups. Rat model of epilepsy was induced by unilateral intrahippocampal administration of 4 μg of kainate per rat. Rats received intraperitoneal injection of curcumin (50 and 100 mg/kg daily for 1 week before surgery. For evaluation of learning and memory, initial (IL and step-through latencies (STL were determined using passive avoidance test and alternation behavior percentage was obtained according to Y maze test.   Results: Regarding IL, there was no significant difference between the groups. In contrast, STL significantly decreased in curcumin-50-treated epileptic group (p<0.05 (a change from 263.1 to 184.5 s. However, this parameter significantly increased in curcumin-100-treated epileptic group as compared to epileptic group (p<0.01 (a change from 263.1 to 220.3 s. In addition, STL was also significantly higher in valproic acid-treated epileptic group versus epileptic group (p<0.05 (a change from 145.7 to 210.3 s. Alternation percentage was also significantly higher in curcumin-50- and curcumin-100-treated epileptic groups relative to epileptic group (p<0.05 (a change from 60.5 to 77.6 and 80.3%.   Conclusion: Curcumin could dose-dependently enhance the consolidation and recall in epileptic animals and could improve spatial memory in such animals.

  8. Valproic acid-induced hyperammonaemic coma and unrecognised portosystemic shunt.

    Nzwalo, Hipólito; Carrapatoso, Leonor; Ferreira, Fátima; Basilio, Carlos


    Hyperammonaemic encephalopathy is a rare and potentially fatal complication of valproic acid treatment. The clinical presentation of hyperammonaemic encephalopathy is wide and includes seizures and coma. We present a case of hyperammonaemic coma precipitated by sodium valproate use for symptomatic epilepsy in a patient with unrecognised portosystemic shunt, secondary to earlier alcoholism. The absence of any stigmata of chronic liver disease and laboratory markers of liver dysfunction delayed the recognition of this alcohol-related complication. The portal vein bypass led to a refractory, valproic acid-induced hyperammonaemic coma. The patient fully recovered after dialysis treatment.

  9. Distribution entropy analysis of epileptic EEG signals.

    Li, Peng; Yan, Chang; Karmakar, Chandan; Liu, Changchun


    It is an open-ended challenge to accurately detect the epileptic seizures through electroencephalogram (EEG) signals. Recently published studies have made elaborate attempts to distinguish between the normal and epileptic EEG signals by advanced nonlinear entropy methods, such as the approximate entropy, sample entropy, fuzzy entropy, and permutation entropy, etc. Most recently, a novel distribution entropy (DistEn) has been reported to have superior performance compared with the conventional entropy methods for especially short length data. We thus aimed, in the present study, to show the potential of DistEn in the analysis of epileptic EEG signals. The publicly-accessible Bonn database which consisted of normal, interictal, and ictal EEG signals was used in this study. Three different measurement protocols were set for better understanding the performance of DistEn, which are: i) calculate the DistEn of a specific EEG signal using the full recording; ii) calculate the DistEn by averaging the results for all its possible non-overlapped 5 second segments; and iii) calculate it by averaging the DistEn values for all the possible non-overlapped segments of 1 second length, respectively. Results for all three protocols indicated a statistically significantly increased DistEn for the ictal class compared with both the normal and interictal classes. Besides, the results obtained under the third protocol, which only used very short segments (1 s) of EEG recordings showed a significantly (p entropy algorithm. The capability of discriminating between the normal and interictal EEG signals is of great clinical relevance since it may provide helpful tools for the detection of a seizure onset. Therefore, our study suggests that the DistEn analysis of EEG signals is very promising for clinical and even portable EEG monitoring.

  10. Correlation between level of serum prolactin and epileptic discharges of electroencephalogram from 24 to 36 hours after epileptic onset

    Xiaowei Hu; Wanli Dong; Min Xu


    BACKGROUND: Researchers discovered that serum prolactin could rise following an epileptic seizure. The prolactin level might reach three times more than basic level within 30 minutes and decrease to the normal value 2 hours after the seizure occurred. The mechanism might result in an increase of serum prolactin concentrations with the activation of the hypothalamic-pituitary axis.OBJ ECTIVE:To probe into the correlation between changes of serum prolactin and incidence of epileptic discharges of electroencephalogram (EEG) at 24-36 hours after epileptic onset of patients with secondary epilepsy.DESIGN: Clinical observational study.SETTING: Department of Neurology, First Hospital affiliated to Soochow University.PARTICIPANTS: A total of 21 patients with secondary epilepsy were selected from the Department of Neurological Emergency or Hospital Room of the First Hospital affiliated to Soochow University from November 2005 to April 2006. There were 14 males and 7 females aged from 25 to 72 years. All patients met International League Anti-epileptic (ILAE) criteria in 1981 for secondary generalized tonic clonic seizure through CT or MRI and previous EEG. All patients were consent. Primary diseases included cerebral trauma (3 cases),tumor (2 cases), stroke (7 cases) and intracranial infeion (9 cases).METHODS: Venous blood of all patients was collected at 24-36 hours after epileptic onset. Serum prolactin kit (Beckman Coulter, Inc in USA) was used to measure value of serum prolactin according to kit instruction.Then, value of serum prolactin was compared with the normal value (male: 2.64-13.13 mg/L; female: 3.34-26.72 mg/L); meanwhile, EEG equipment (American Nicolet Incorporation) was used in this study.MAIN OUTCOME MEASURES: ① Abnormal rate of serum prolactin of patients with secondary epilepsy; ②Comparison between normal and abnormal level of serum prolactin and incidence of EEG epileptic discharge of patients with secondary epilepsy.RESULTS :All 21 patients with

  11. Management of a high risk epileptic patient under conscious sedation: A multidisciplinary approach

    Burnice Nalina Kumari Chellathurai; Ramakrishnan Thiagarajan; SelvaKumar Jayakumaran; Pradeep Devadoss; Elavazhagan,


    Epilepsy, characterized by the risk of recurrent seizures, is a chronic disease that afflicts about 5% of the world's population. The main dental problems associated with epileptic patients include gingival hyperplasia, minor oral injuries, tooth trauma, and prosthodontic problems, which require the dental treatment. Stress and fear are the most common triggering factors for the epilepsy in dental chair. Therefore, a more appropriate method of treating such epileptic patients may be warranted...

  12. Clinically silent seizures in a neonate with tuberous sclerosis.

    Ikeno, Mitsuru; Okumura, Akihisa; Abe, Shinpei; Igarashi, Ayuko; Hisata, Ken; Shoji, Hiromichi; Shimizu, Toshiaki


    Although seizures during infancy in patients with tuberous sclerosis complex are common, seizures in neonates are infrequent. Here, we report the clinical course and electroencephalography (EEG) findings of a neonate with tuberous sclerosis complex associated with clinically silent seizures. The patient was a girl in whom cardiac tumors were detected on fetal ultrasonography. Brain magnetic resonance imaging during the neonatal period showed subependymal and cortical tubers. Routine EEG indicated unexpected ictal changes with no noticeable clinical symptoms. Ictal EEG was associated with a subtle increase in heart rate and a brief increase in chin electromyogram. These changes were difficult to identify clinically. The patient later developed focal seizures and epileptic spasms and had severe psychomotor delay. The present case suggests the occurrence of clinically silent seizures before the appearance of epileptic spasms in infants with tuberous sclerosis, and that EEG is an option for neonates with a prenatal diagnosis. © 2015 Japan Pediatric Society.

  13. Complete remission of epileptic psychosis after temporal lobectomy: case report

    Marchetti Renato Luiz


    Full Text Available We report a case of a female patient with refractory complex partial seizures since 15 years of age, recurrent postictal psychotic episodes since 35 which evolved to a chronic refractory interictal psychosis and MRI with right mesial temporal sclerosis (MTS. After a comprehensive investigation (video-EEG intensive monitoring, interictal and ictal SPECT, and a neuropsychological evaluation including WADA test she was submitted to a right temporal lobectomy. Since then, she has been seizure-free with remission of psychosis, although with some persistence of personality traits (hiperreligiosity, viscosity which had been present before surgery. This case supports the idea that temporal lobectomy can be a safe and effective therapeutic measure for patients with MTS, refractory epilepsy and recurrent postictal epileptic psychosis or interictal epileptic psychosis with postictal exacerbation.

  14. Recognition of Epileptic EEG Using Probabilistic Neural Network

    Bao, Forrest Sheng; Lie, Donald Yu-Chun


    Epilepsy is one of the most common neurological disorders that greatly impair patients' daily lives. A classifier for automated epileptic EEG detection and patient monitoring can be very important for epilepsy diagnosis and patients' quality of life, especially for rural areas and developing countries where medical resources are limited. This paper describes our development of an accurate and fast EEG classifier that can differentiate the EEG data of healthy people from that of epileptic patients, and also detect patients' status (i.e., interictal vs. ictal). We deployed Probabilistic Neural Network (PNN) and fed it with 38 features extracted from the EEG data. The resulting PNN EEG classifier achieves an impressive accuracy greater than 96 as indicated by cross-validation. This prototype classifier is therefore suitable for automated epilepsy detection/diagnosis and seizure monitoring. It may even facilitate seizure prediction.

  15. Influence of normal versus slow antiepileptic drugs withdrawal on seizure recurrence in patients with epilepsy



    Objective To explore the influence of normal and slow antiepileptic drugs(AEDs) withdrawal on recurrence of epilepsy. Methods Epileptic patients with seizure-free more than 2 years were recruited to the study. They were first divided into normal

  16. Analysis of Epileptic Discharges from Implanted Subdural Electrodes in Patients with Sturge-Weber Syndrome.

    Yasushi Iimura

    Full Text Available Almost two-thirds of patients with Sturge-Weber syndrome (SWS have epilepsy, and half of them require surgery for it. However, it is well known that scalp electroencephalography (EEG does not demonstrate unequivocal epileptic discharges in patients with SWS. Therefore, we analyzed interictal and ictal discharges from intracranial subdural EEG recordings in patients treated surgically for SWS to elucidate epileptogenicity in this disorder.Five intractable epileptic patients with SWS who were implanted with subdural electrodes for presurgical evaluation were enrolled in this study. We examined the following seizure parameters: seizure onset zone (SOZ, propagation speed of seizure discharges, and seizure duration by visual inspection. Additionally, power spectrogram analysis on some frequency bands at SOZ was performed from 60 s before the visually detected seizure onset using the EEG Complex Demodulation Method (CDM.We obtained 21 seizures from five patients for evaluation, and all seizures initiated from the cortex under the leptomeningeal angioma. Most of the patients presented with motionless staring and respiratory distress as seizure symptoms. The average seizure propagation speed and duration were 3.1 ± 3.6 cm/min and 19.4 ± 33.6 min, respectively. Significant power spectrogram changes at the SOZ were detected at 10-30 Hz from 15 s before seizure onset, and at 30-80 Hz from 5 s before seizure onset.In patients with SWS, seizures initiate from the cortex under the leptomeningeal angioma, and seizure propagation is slow and persists for a longer period. CDM indicated beta to low gamma-ranged seizure discharges starting from shortly before the visually detected seizure onset. Our ECoG findings indicate that ischemia is a principal mechanism underlying ictogenesis and epileptogenesis in SWS.

  17. Computed tomographic study in young epileptics in Kashmir, India

    Mohd Ashraf


    Full Text Available Background: Infectious diseases like neurocysticercosis and neurotuberculosis are endemic in Indian subcontinent and are important causes of epilepsy. Epileptic children are prone to have poor school performance, higher levels of anxiety and depression apart from low self esteem. These treatable condition could be easily picked up on neuroimaging like cranial computed tomography (CT scan and treated accordingly at an earliest. Objectives: To assess the role of cranial computed tomography scan in children having epilepsy. Material and Methods: Seventy two children between the age of 1 month and 14 years were prospectively enrolled, who had atleast two unprovoked seizures greater than 24 hours apart, and all those children where seizures result from acute central nervous system insult were meticulously excluded. Diagnosis of epilepsy was based on detailed history, thorough clinical examination, routine laboratory tests with additional specific tests like electroencephalogram (EEG and CT scan brain. Results: Males constituted 62.5% and females 37.5% of our sample (p=0.247. The EEG was abnormal in 68.1% of all subjects, among which EEG was abnormal in 69.8% of generalized seizures, 64.7% in partial seizures and 1% in undetermined seizures. The spectrum of various seizure types in our study was generalized seizures in 73.6%, partial seizures in 23.6% & undetermined seizures in 2.8%. The incidence of these lesions in hospitalized young epileptics was 31.9%, in order of their frequency, it was cerebral atrophy and dilated ventricle (18.8% each; calcifications (15.5%; encephalomalacia and pachygyria (9.4% each; HIE changes, tuberous sclerosis (6.3% each; leucodystrophy, thin corpus callosum, large cisterna magna, granuloma and periventricular leukomalacia (3.1% each. The intracranial structural lesions were present in 22.6% of generalized seizures, 64.7% of partial seizures, none of undetermined seizures (p=0.004. Conclusion: Abnormal cranial CT scan


    M. B. Mironov


    Full Text Available According to definition, febrile seizures — benign, age-dependent, genetically predisposed condition in which the brain is susceptible to epileptic seizures, occurring in response to the fever. The article presents the outcome and trans­formation of febrile seizures in children by data of Svt. Luka's Institute of child neurology & epilepsy. The authors found, thatfebrile seizures can occur at onset of 21 epileptic syndromes with different etiologic factors and outcome. The clini­cal characteristics, EEG and neuroimaging data, as well as the effectiveness of antiepileptic drugs and prognosis of dif­ferentforms of epilepsy with febrile seizures in history are described in detail.  

  19. Immune-mediated steroid-responsive epileptic spasms and epileptic encephalopathy associated with VGKC-complex antibodies.

    Suleiman, Jehan; Brenner, Tanja; Gill, Deepak; Troedson, Christopher; Sinclair, Adriane J; Brilot, Fabienne; Vincent, Angela; Lang, Bethan; Dale, Russell C


    Autoantibodies that bind to voltage-gated potassium-channel complex proteins (VGKC-complex antibodies) occur frequently in adults with limbic encephalitis presenting with cognitive impairment and seizures. Recently, VGKC-complex antibodies have been described in a few children with limbic encephalitis, and children with unexplained encephalitis presenting with status epilepticus. We report a case of infantile-onset epileptic spasms and developmental delay compatible with epileptic encephalopathy. Our patient was a female infant, aged 4 months at presentation. She had evidence of immune activation in the central nervous system with elevated cerebrospinal fluid neopterin and mirrored oligoclonal bands, which prompted testing for autoantibodies. VGKC-complex antibodies were elevated (201 pmol/L, normalVGKC-complex antibodies might represent a marker of immune therapy responsiveness in a subgroup of patients with infantile epileptic encephalopathy.

  20. Altered sexual and reproductive functions in epileptic men taking carbamazepine.

    Reis, Rosana Maria; de Angelo, Alexandre Gonçalves; Sakamoto, Américo Ceiki; Ferriani, Rui Alberto; Lara, Lúcia Alves Silva


    Epileptic men may experience hormonal changes that may alter semen quality and sexual function. Alterations in male sexual and reproductive parameters may also be due to treatment with antiepileptic drugs to control seizures. To evaluate serum hormone concentrations, semen quality, the frequency of sexual intercourse (FSI), and erectile function in men with epileptic seizures controlled by carbamazepine (CBZ). The five-question form of the International Index of Erectile Function (IIEF-5), and semi-structured questionnaire. One hundred and eighteen men, aged 18-45 years, were included in this controlled, cross-sectional study: 63 men taking CBZ (epileptic group) were compared to 55 healthy men (control group). Blood sample was collected to determine hormones concentrations. Erectile function and the frequency of sexual relations were assessed by using questionnaires. Sperm morphology was analyzed by examining the quality of the head, intermediate part and tail of the spermatozoa. Using the IIEF-5, we observed a significant association between erectile dysfunction (ED) and groups (P sexual intercourse then controls (P ≤ 0.001). Epileptic men taking CBZ present with changes in hormonal levels, altered semen quality, ED, and a reduction in coital frequency. © 2012 International Society for Sexual Medicine.

  1. Nature and extent of perceived stigma among epileptics in Pakistan

    Rehana Khalil; Saadia Gul; Zahid Naeem


    Background: Epilepsy is one of the oldest disorders known to mankind. Often the social stigma (whether a and ldquo;felt and rdquo; stigma or an and ldquo;enacted and rdquo; stigma) attached to epilepsy is a greater handicap to the person with epilepsy compared to the disability associated with seizures or the side-effects from medications. The aim of this study was to explore the perceived sigma and discrimination among epileptics of Karachi, Pakistan. Methods: A descriptive cross sectio...

  2. Epileptic syndrome in systemic lupus erythematosus and neuronal autoantibody associations.

    Kampylafka, E I; Alexopoulos, H; Fouka, P; Moutsopoulos, H M; Dalakas, M C; Tzioufas, A G


    We investigated systemic lupus erythematosus (SLE) patients with epilepsy, a major and organic neurological symptom. Our aim was to test patients for the autoimmune epilepsy-associated antibodies anti-GAD, anti-NMDAR, anti-AMPAR1/2, anti-GABABR and anti-VGKC. We tested sera from ten SLE patients with current or previous episodes of epileptic seizures. In addition, sera were tested for staining on primary hippocampal neurons. The patients' clinical and neuroimaging profile, disease activity and accumulated damage scores and therapeutic regimens administered were recorded, and correlations were evaluated. Patients were negative for all anti-neuronal autoantibodies tested, and showed no staining on primary hippocampal cells, which suggests the absence of autoantibodies against neuronal cell surface antigens. Epileptic seizures were all tonic-clonic, and all patients had high disease activity (mean SLE Damage Acticity Index score 19.3 ± 7.3). Six patients had minor or no brain magnetic resonance imaging findings, and three had major findings. 9/10 patients received immunosuppression for 5 ± 4 months, while anti-convulsive treatment was administered to all patients (4.2 ± 3 years). Our results suggest that the majority of SLE-related epileptic seizures cannot be attributed to the action of a single antibody against neuronal antigens. Studies with larger neuropsychiatric SLE populations and stricter inclusion criteria are necessary to verify these findings. © The Author(s) 2016.

  3. Epilepsy in children with a history of febrile seizures.

    Lee, Sang Hyun; Byeon, Jung Hye; Kim, Gun Ha; Eun, Baik-Lin; Eun, So-Hee


    Febrile seizure, the most common type of pediatric convulsive disorder, is a benign seizure syndrome distinct from epilepsy. However, as epilepsy is also common during childhood, we aimed to identify the prognostic factors that can predict epilepsy in children with febrile seizures. The study comprised 249 children at the Korea University Ansan Hospital who presented with febrile seizures. The relationship between the subsequent occurrence of epilepsy and clinical factors including seizure and fever-related variables were analyzed by multivariate analysis. Twenty-five patients (10.0%) had additional afebrile seizures later and were diagnosed with epilepsy. The subsequent occurrence of epilepsy in patients with a history of febrile seizures was associated with a seizure frequency of more than 10 times during the first 2 years after seizure onset (Pseizures during a febrile seizure attack (P=0.005), and epileptiform discharges on electroencephalography (EEG) (P=0.008). Other factors such as the age at onset of first seizure, seizure duration, and family history of epilepsy were not associated with subsequent occurrence of epilepsy in this study. Febrile seizures are common and mostly benign. However, careful observation is needed, particularly for prediction of subsequent epileptic episodes in patients with frequent febrile seizures with known risk factors, such as developmental delay, history of preterm birth, several attacks during a febrile episode, and epileptiform discharges on EEG.

  4. The protective effect of myo-inositol on hippocamal cell loss and structural alterations in neurons and synapses triggered by kainic acid-induced status epilepticus.

    Kotaria, Nato; Kiladze, Maia; Zhvania, Mzia G; Japaridze, Nadezhda J; Bikashvili, Tamar; Solomonia, Revaz O; Bolkvadze, Tamar


    It is known that myo-inositol pretreatment attenuates the seizure severity and several biochemical changes provoked by experimentally induced status epilepticus. However, it remains unidentified whether such properties of myo-inositol influence the structure of epileptic brain. In the present light and electron microscopic research we elucidate if pretreatment with myo-inositol has positive effect on hippocampal cell loss, and cell and synapses damage provoked by kainic acid-induced status epilepticus. Adult male Wistar rats were treated with (i) saline, (ii) saline + kainic acid, (iii) myo-inositol + kainic acid. Assessment of cell loss at 2, 14, and 30 days after treatment demonstrate cytoprotective effect of myo-inositol in CA1 and CA3 areas. It was strongly expressed in pyramidal layer of CA1, radial and oriental layers of CA3 and in less degree-in other layers of both fields. Ultrastructural alterations were described in CA1, 14 days after treatment. The structure of neurons, synapses, and porosomes are well preserved in the rats pretreated with myo-inositol in comparing with rats treated with only kainic acid.

  5. Subsequent afebrile seizure in children who have a first seizure with fever after 6 years of age.

    Kim, Sung-Hwan; Lee, Hyun-Young; Kim, Yeun-Hee


    The objective was to evaluate the risk and the risk factors associated with subsequent afebrile seizures in 31 children who experienced their first seizure with fever after 6 years of age. The children were classified into two groups. Group I comprised children with their first seizure with fever after 6 years of age (n = 15). Group II comprised children who had febrile seizures before 5 years of age and who had recurrent seizures with fever after 6 years of age (n = 16). Of these 31 children, 7 (22.5%) had subsequent afebrile seizure. The cumulative probability of subsequent afebrile seizure was 13.3% at 6 months and 36 months in group I; in group II, the cumulative probability was 12.5% at 6 months, 18.8% at 18 months, 25% at 24 months, and 31.3% at 36 months. There was no significant difference in the risk for subsequent afebrile seizures between the two groups. There were no risk factors associated with an increased risk of subsequent afebrile seizures. If the first seizure with fever occurred after 6 years of age, this was a significant risk for subsequent afebrile seizure; the risk of seizure recurrence in this group appears to be similar to children who have persistent febrile seizures after 6 years of age, but far below that of children with first epileptic seizure. Copyright 2010 Elsevier Inc. All rights reserved.

  6. [Non-epileptic motor paroxysmal phenomena in wakefulness in childhood].

    Ruggieri, Víctor L; Arberas, Claudia L


    Paroxysmal events in childhood are a challenge for pediatric neurologists, given its highly heterogeneous clinical manifestations, often difficult to distinguish between phenomena of epileptic seizure or not. The non-epileptic paroxysmal episodes are neurological phenomena, with motor, sensory symptoms, and/or sensory impairments, with or without involvement of consciousness, epileptic phenomena unrelated, so no electroencephalographic correlative expression between or during episodes. From the clinical point of view can be classified into four groups: motor phenomena, syncope, migraine (and associated conditions) and acute psychiatric symptoms. In this paper we analyze paroxysmal motor phenomena in awake children, dividing them according to their clinical manifestations: extrapyramidal episodes (paroxysmal kinesiogenic, non kinesiogenic and not related to exercise dyskinesias, Dopa responsive dystonia) and similar symptoms of dystonia (Sandifer syndrome); manifestations of startle (hyperekplexia); episodic eye and head movements (benign paroxysmal tonic upward gaze nistagmus deviation); episodic ataxia (familial episodic ataxias, paroxysmal benign vertigo); stereotyped and phenomena of self-gratification; and myoclonic events (benign myoclonus of early infancy). The detection of these syndromes will, in many cases, allow an adequate genetic counseling, initiate a specific treatment and avoid unnecessary additional studies. Molecular studies have demonstrated a real relationship between epileptic and non-epileptic basis of many of these entities and surely the identification of the molecular basis and understanding of the pathophysiological mechanisms in many of them allow us, in the near future will benefit our patients.

  7. Ketogenic diet therapy is effective in encephalitis with refractory seizures.

    Matsuzono, Kosuke; Kurata, Tomoko; Deguchi, Shoko; Yamashita, Toru; Deguchi, Kentaro; Abe, Koji


    Although ketogenic diet therapy is effective in refractory seizures in childhood, its effect on adult encephalitis with similar refractory seizures and prolonged encephalopathy has not been well reported. We report here a case of a 22-year-old man with acute encephalitis with refractory repetitive partial seizures (AERRPS). Partial seizures of the face developed to repeated generalized convulsions, which were refractory against anti-epileptic drugs and a high dose of propofol. After struggling for 9 months, he dramatically recovered after ketogenic diet therapy. Ketogenic diet therapy may be an important tool to help cure AERRPS.

  8. 心因性非癫痫性发作儿童个性特征与父母养育方式的相关性分析%Analysis of correlation between personality characteristics and parental rearing pattern in children with psychogenic non-epileptic seizures

    查彩慧; 欧婉杏; 陈嘉慧; 汪玲华; 李志斌; 麦坚凝


    [Objective]To analyze the correlation between personality characteristics and parental rearing pattern in children with psychogenic non-epileptic seizures (PNES).[Methods]Forty-three consecutive patients with PNES and Forty-three matched patients were recruited from patients in our hospital between 2006 and 2009.The following questionnaires were used as outcome variables: Eysenck Personality Questionnaire (EPQ) for personality characteristics, Egma Minnen av Bardndosnauppforstran(EMBU) for rearing pattern.Correlation analysis were carried out between them.[Results]On comparison with the control group, the present children with PNES showed higher TP and TN scores of EPQ (P<0.01).The subscale scores of EMBU were lower in emotional warmth and understanding (father) and higher in punishment and sternness (father), excessive interference (father), excessive interference and overprotection (mother), rejection and deny (father and mother) than that of control children (P<0.01).The level of psychoticism, extrovisio-introvision, neuroticism and lie was positively correlated with some factors of EMBU and it was negatively correlated with the other factors in children with PNES.[Conclusion]The dyfunctional rearing pattern from their parents should prevent child with PNES from forming favourable personality characteristics.%[目的]探讨心因性非癫痫性发作(psychogenic non-epileptic seizures,PNES)儿童个性特征与父母教养方式的相关性. [方法]采用艾森克个性问卷(Eysenck Peersonality Questionnaire,EPQ)、父母养育方式问卷(EgmaMinncn av Bardndosnauppforstran,EMBU)对43例PNES儿童和43名正常对照组儿童进行评估,并作相关分析. [结果]PNES儿童EPQ中TP、TN分量表得分明显高于对照组儿童,差异有高度统计学意义(P<0.01);EMBU中父亲的情感温暖与理解因子得分低于对照组儿童,父亲的惩罚严厉因子、过分干涉因子、母亲的过分干涉与过度保护因子、父母亲的拒绝否

  9. Correlation Dimension Maps of EEG from Epileptic Absences

    Silva, C; Andrade, A; Foreid, J P; Ducla-Soares, E


    Purpose: The understanding of brain activity, and in particular events such as epileptic seizures, lies on the characterisation of the dynamics of the neural networks. The theory of non-linear dynamics provides signal analysis techniques which may give new information on the behaviour of such networks. Methods: We calculated correlation dimension maps for 19-channel EEG data from 3 patients with a total of 7 absence seizures. The signals were analysed before, during and after the seizures. Phase randomised surrogate data was used to test chaos. Results: In the seizures of two patients we could distinguish two dynamical regions on the cerebral cortex, one that seemed to exhibit chaos whereas the other seemed to exhibit noise. The pattern shown is essentially the same for seizures triggered by hyperventilation, but differ for seizures triggered by light flashes. The chaotic dynamics that one seems to observe is determined by a small number of variables and has low complexity. On the other hand, in the seizures ...

  10. Seizures in the critically ill.

    Ch'ang, J; Claassen, J


    Critically ill patients with seizures are either admitted to the intensive care unit because of uncontrolled seizures requiring aggressive treatment or are admitted for other reasons and develop seizures secondarily. These patients may have multiorgan failure and severe metabolic and electrolyte disarrangements, and may require complex medication regimens and interventions. Seizures can be seen as a result of an acute systemic illness, a primary neurologic pathology, or a medication side-effect and can present in a wide array of symptoms from convulsive activity, subtle twitching, to lethargy. In this population, untreated isolated seizures can quickly escalate to generalized convulsive status epilepticus or, more frequently, nonconvulsive status epileptics, which is associated with a high morbidity and mortality. Status epilepticus (SE) arises from a failure of inhibitory mechanisms and an enhancement of excitatory pathways causing permanent neuronal injury and other systemic sequelae. Carrying a high 30-day mortality rate, SE can be very difficult to treat in this complex setting, and a portion of these patients will become refractory, requiring narcotics and anesthetic medications. The most significant factor in successfully treating status epilepticus is initiating antiepileptic drugs as soon as possible, thus attentiveness and recognition of this disease are critical.

  11. Ketogenic diet efficacy in the treatment of intractable epileptic spasms.

    Kayyali, Husam R; Gustafson, Megan; Myers, Tara; Thompson, Lindsey; Williams, Michelle; Abdelmoity, Ahmad


    To determine the efficacy of the ketogenic diet in controlling epileptic spasms after failing traditional antiepileptic medication therapy. This is a prospective, case-based study of all infants with epileptic spasms who were referred for treatment with the ketogenic diet at our hospital between 2009 and 2012. All subjects continued to have epileptic spasms with evidence of hypsarrhythmia or severe epileptic encephalopathy on electroencephalography despite appropriate medication treatments. The diet efficacy was assessed through clinic visits, phone communications, and electroencephalography. Quality of life improvement was charted based on the caregiver's perspective. Twenty infants (15 males) were included in the study. The mean age at seizure onset was 4.5 months. Age at ketogenic diet initiation was 0.3 to 2.9 years (mean 1.20, standard deviation 0.78). Fifteen patients had epileptic spasms of unknown etiology; three had perinatal hypoxic ischemic encephalopathy, one had lissencephaly, and one had STXBP1 mutation. Fifteen infants failed to respond to adrenocorticotropin hormone and/or vigabatrin before going on the ketogenic diet. Three months after starting the diet, >50% seizure reduction was achieved in 70% of patients (95% CI 48-86). These results were maintained at 6- and 12-month intervals. All eight of the patients followed for 24 months had >50% seizure reduction (95% CI 63-100). At least 90% seizure reduction was reported in 20% of patients at 3 months (95% CI 7-42), 22% (95% CI 8-46) at 6 months, and 35% (95% CI 17-59) at 12 months. The majority of patients (63%) achieved improvement of their spasms within 1 month after starting the diet. Sixty percent of patients had electroencephalographic improvement. All caregivers reported improvement of the quality of life at the 3-month visit (95% confidence interval 81-100). This ratio was 94% at 6 months (95% CI 72-99) and 82% at 12 months (95% CI 58-95). The ketogenic diet is a safe and potentially

  12. Seizure semiology reflects spread from frontal to temporal lobe: evolution of hyperkinetic to automotor seizures as documented by invasive EEG video recordings.

    Tezer, Fadime Irsel; Agan, Kadriye; Borggraefe, Ingo; Noachtar, Soheyl


    This patient report demonstrates the importance of seizure evolution in the localising value of seizure semiology. Spread of epileptic activity from frontal to temporal lobe, as demonstrated by invasive recordings, was reflected by change from hyperkinetic movements to arrest of activity with mild oral and manual automatisms. [Published with video sequences].

  13. Malignant migrating partial seizures of infancy controlled by stiripentol and clonazepam.

    Merdariu, Dana; Delanoë, Catherine; Mahfoufi, Nora; Bellavoine, Vanina; Auvin, Stéphane


    The syndrome of malignant migrating partial seizures of infancy (MMPSI) is characterized by early onset of multiple seizure types and overall poor prognosis. Seizures are markedly drug resistant and few reports have suggested the efficacy of some antiepileptic drugs. We report one case of MMPSI in which prolonged seizure control is obtained with an association of clonazepam, levetiracetam and stiripentol, confirming thus the possibility of complete sustained seizure control in this epileptic syndrome. Of more than 60 cases reported to date, ours is the forth in which sustained complete control of seizures was obtained.

  14. The association between seizures and deposition of collagen in the brain in porcine Taenia solium neurocysticercosis.

    Christensen, Nina M; Trevisan, Chiara; Leifsson, Páll S; Johansen, Maria V


    Neurocysticercosis caused by infection with Taenia solium is a significant cause of epilepsy and seizures in humans. The aim of this study was to assess the association between seizures and the deposition of collagen in brain tissue in pigs with T. solium neurocysticercosis. In total 78 brain tissue sections from seven pigs were examined histopathologically i.e. two pigs with epileptic seizures and T. solium cysts, four pigs without seizures but with cysts, and one non-infected control pig. Pigs with epileptic seizures had a larger amount of collagen in their brain tissue, showing as large fibrotic scars and moderate amount of collagen deposited around cysts, compared to pigs without seizures and the negative control pig. Our results indicate that collagen is likely to play a considerable part in the pathogenesis of seizures in T. solium neurocysticercosis.

  15. Effect of serotonin depletion on seizures learning-memory in pilocarpine-induced epileptic rats%脑内5-羟色胺减少对致痫大鼠癫痫发作及学习记忆的影响

    吕晓钗; 黄华品; 林婉挥; 陈圣根


    目的:于中脑正中中缝核局部微量注射5,7-二羟色胺(5,7-DHT),探讨5-羟色胺(5-HT)与癫痫的关系及匹罗卡品(PILO)致痫大鼠学习记忆改变的可能机制.方法:成年SD大鼠随机分为PILO组、PILO+5,7-DHT组、空白对照组三组,然后根据是否出现癫痫持续状态(SE)再将PILO组分成:PILO+ SE组和PILO-SE组两亚组;利用视频脑电图观察大鼠癫痫发作及皮层脑电变化;运用Morris水迷宫测评大鼠空间学习记忆水平;最后运用免疫组化法观察大鼠中缝核5-HT能神经元.结果:大鼠予以5,7-DHT( PILO+ 5,7- DHT组)处理后造模成功率、死亡率及慢性期自发性发作频率均增高;与空白组比较PILO+ SE组中缝核5-HT能神经元数目有所下降(P<0.05),而PILO+5,7-DHT组下降更明显(P<0.01);与空白组比较PILO+ SE组平均逃避潜伏期延长、穿越平台次数减少、原平台象限停留时间缩短(P<0.05),而与PILO+ SE组比较PILO+ 5,7-DHT组变化不明显.结论:脑内5-H水平的降低容易诱发癫痫发作,尚不能认为癫痫大鼠合并认知功能障碍与脑内5-HT水平下降有关.%Objective: To investigate the relationship between serotonin(5-HT)and epilepsy and the mechanism of learning-memory in pi-locaipine(PILO)-induced epileptic rats after5,7-dihydroxytryplamine (5,7-DHT) microinjection in median raphe nucleus. Methods: Adult S D rats were randomly divided into 3 groups: PIL0 group, PTL0 + 5,7-DHT group, vehicle control group; PIL0 group was divided into two groups by status epilepticus(SE): PIL0+ SE group and HL0-SE group. The rats' seizures and cortex electroencephalography(EEG) were observed by vedio EEC. The rats' spatial learning-memory was evaluated by Morris water maze. Finally, serotonergic neuron in raphe nuclei was observed by immunohistochemisty. Results: After treatment of 5,7-DHT (PIL0 + 5,7-DHT group), the success rate, the mortality and the frequency of chronic spontaneous seizures in pilocarpine

  16. Dopey's seizure.

    Dan, B; Christiaens, F


    Angelman syndrome is a neurogenetic condition namely characterized by developmental delay, virtual absence of expressive verbal language, peculiar organization of movement, seizures and happy demeanor. This syndrome has been recognized since 1965, but it seems that Walt Disney presented an original depiction of it in his first full-length animated film, including myoclonic jerks and an apparently generalized tonic-clonic seizure.

  17. Excitatory amino acid transporter 2 downregulation correlates with thalamic neuronal death following kainic acid-induced status epilepticus in rat.

    Sakurai, Masashi; Kurokawa, Haruna; Shimada, Akinori; Nakamura, Kazuhiro; Miyata, Hajime; Morita, Takehito


    Recurrent seizures without interictal resumption (status epilepticus) have been reported to induce neuronal death in the midline thalamic region that has functional roles in memory and decision-making; however, the pathogenesis underlying status epilepticus-induced thalamic neuronal death is yet to be determined. We performed histological and immunohistochemical studies as well as cerebral blood flow measurement using 4.7 tesla magnetic resonance imaging spectrometer on midline thalamic region in Sprague-Dawley rats (n = 75, male, 7 weeks after birth, body weight 250-300 g) treated with intraperitoneal injection of kainic acid (10 mg/kg) to induce status epilepticus (n = 55) or normal saline solution (n = 20). Histological study using paraffin-embedded specimens revealed neuronal death showing ischemic-like changes and Fluoro-Jade C positivity with calcium deposition in the midline thalamic region of epileptic rats. The distribution of neuronal death was associated with focal loss of immunoreactivity for excitatory amino acid transporter 2 (EAAT2), stronger immunoreaction for glutamate and increase in number of Iba-1-positive microglial cells showing swollen cytoplasm and long processes. Double immunofluorescence study demonstrated co-expression of interleukin-1 beta (IL-1β) and inducible nitric oxide synthase (iNOS) within microglial cells, and loss of EAAT2 immunoreactivity in reactive astrocytes. These microglial alterations and astrocytic EAAT2 downregulation were also observed in tissue without obvious neuronal death in kainic acid-treated rats. These results suggest the possible role of glutamate excitotoxicity in neuronal death in the midline thalamic region following kainic acid-induced status epilepticus due to astrocytic EAAT2 downregulation following microglial activation showing upregulation of IL-1β and iNOS.

  18. Clinical and electrographic findings in epileptic vertigo and dizziness

    Lee, Seung-Han; Robinson, Karen A.; Kaplan, Peter W.; Newman-Toker, David E.


    Objective: Seizures can cause vestibular symptoms, even without obvious epileptic features. We sought to characterize epileptic vertigo or dizziness (EVD) to improve differentiation from nonepileptic causes, particularly when vestibular symptoms are the sole manifestation. Methods: We conducted a systematic review with electronic (Medline) and manual search for English-language studies (1955–2014). Two independent reviewers selected studies. Study/patient characteristics were abstracted. We defined 3 study population types: (1) seizures, some experiencing vertigo/dizziness (disease cohort); (2) vertigo/dizziness, some due to seizures (symptom cohort); (3) vertigo/dizziness due to seizures in all patients (EVD-only cohort). Results: We identified 84 studies describing 11,354 patients (disease cohort = 8,129; symptom cohort = 2,965; EVD-only cohort = 260). Among 1,055 EVD patients in whom a distinction could be made, non-isolated EVD was present in 8.5%, isolated EVD in 0.8%. Thorough diagnostic workups (ictal EEG, vestibular testing, and brain MRI to exclude other causes) were rare (vertigo presentations than with other brain regions remains unknown. Consistent with clinical wisdom, isolated EVD spells often last just seconds, although many patients experience longer spells. PMID:25795644

  19. Sociomedical aspects of epileptic patients: their employment and marital status.

    Wada, K; Kawata, Y; Murakami, T; Kamata, A; Zhu, G; Mizuno, K; Okada, M; Kaneko, S


    We examined the employment and marital status of adult patients with epilepsy who did not have mental retardation and who had been treated at Hirosaki University Hospital, Hirosaki, Japan, for more than 5 years. The present study included 278 patients (142 males and 136 females) ranging from 20 to 60 years of age. We investigated the occupational status of the subjects and found that 168 had permanent jobs, but 41 patients were unemployed at the time of this survey. The proportion of the patients whose seizures were controlled at the time of this survey was 68% (114/168) in the group having permanent jobs, and 22% (9/41) in the unemployed group. Forty cases answered that they had resigned from their jobs due to occurrence of epileptic seizures. Of these patients, 13 were dismissed and 27 resigned voluntarily due to the potential for seizures. As to relationship between jobs and neuropsychiatric complications, the incidence of a past history of psychotic states in the unemployed group was significantly higher than that in the employed group. As to marital status, 13 males and 16 females (n = 29) had experienced divorce. Seven cases (two males and five females) had answered that epilepsy had been the reason for their divorce. We conclude that epilepsy or epileptic seizures have various negative effects on the patient's social life.

  20. Febrile seizures - semiology in humans and animal models: evidence of focality and heterogeneity.

    Neville, Brian G R; Gindner, Diane


    The relationship between febrile seizures and hippocampal sclerosis has been the subject of longstanding discussion. Animal models for prolonged seizures have shown a clear causal relationship with focal limbic features at low dose and hippocampal damage at high dose. Careful history taking of febrile seizure semiology has shown focal early features often with clear temporal lobe elements. This would suggest that many febrile seizures are secondarily generalised hippocampal seizures. There is evidence of varying levels of epileptogenicity in specific infective causes of febrile seizures. Seizure semiology also suggests that a proportion of such seizures may be non-epileptic reflex asystolic attacks. Seizure semiology in febrile seizures deserves closer scrutiny. Copyright 2009 Elsevier B.V. All rights reserved.

  1. Evaluation of first nonfebrile seizures.

    Wilden, Jessica A; Cohen-Gadol, Aaron A


    Nonfebrile seizures may indicate underlying disease or epilepsy. The patient history can often distinguish epileptic seizures from nonepileptic disorders by identifying the events directly preceding the convulsion, associated conditions, and details of the seizure, including triggers, length, and type of movements. Laboratory testing, lumbar puncture, and neuroimaging may be indicated depending on the presentation, suspected etiology, and patient's age. Electroencephalography should be performed 24 to 48 hours after a first seizure because of its substantial yield and ability to predict recurrence. Neuroimaging is recommended for adults, infants, and children who have cognitive or motor developmental delay or a focal seizure. Neuroimaging may be scheduled on an outpatient basis for patients with stable vital signs who are awake and have returned to neurologic baseline. Emergent neuroimaging should be performed in patients with persistent decreased mental status or a new focal neurologic abnormality. Although magnetic resonance imaging is generally preferred to head computed tomography because of its greater sensitivity for intracranial pathology, computed tomography should be performed if intracranial bleeding is suspected because of recent head trauma, coagulopathy, or severe headache. Treatment with an antiepileptic drug after a first seizure does not prevent epilepsy in the long term, but it decreases the short-term likelihood of a second seizure. Adults with an unremarkable neurologic examination, no comorbidities, and no known structural brain disease who have returned to neurologic baseline do not need to be started on antiepileptic therapy. Treatment decisions should weigh the benefit of decreased short-term risk of recurrence against the potential adverse effects of antiepileptic drugs.

  2. Automatic Detection of Seizures with Applications

    Olsen, Dale E.; Harris, John C.; Cutchis, Protagoras N.; Cristion, John A.; Lesser, Ronald P.; Webber, W. Robert S.


    There are an estimated two million people with epilepsy in the United States. Many of these people do not respond to anti-epileptic drug therapy. Two devices can be developed to assist in the treatment of epilepsy. The first is a microcomputer-based system designed to process massive amounts of electroencephalogram (EEG) data collected during long-term monitoring of patients for the purpose of diagnosing seizures, assessing the effectiveness of medical therapy, or selecting patients for epilepsy surgery. Such a device would select and display important EEG events. Currently many such events are missed. A second device could be implanted and would detect seizures and initiate therapy. Both of these devices require a reliable seizure detection algorithm. A new algorithm is described. It is believed to represent an improvement over existing seizure detection algorithms because better signal features were selected and better standardization methods were used.

  3. Effects of antiepileptic drugs on the serum folate and vitamin B12 in various epileptic patients.

    Huang, Hong-Li; Zhou, Hao; Wang, Nuan; Yu, Chun-Yu


    Epilepsy is a common neurodegenerative disease with an increasing morbidity. Clinical treatment of epilepsy includes symptomatic treatment, etiological treatment, surgery and prevention. The aim of the present study was to determine the effects of antiepileptic drugs (AEDs) on serum folate and vitamin B12 in various epileptic patients, and to examine the correlation between these effects and secondary cerebrovascular events. A total of 68 epileptic patients, diagnosed between May 2012 and May 2014, were included in the present study. The study included 8 cases of autonomic seizures, 10 cases of absence seizures, 13 cases of complex partial seizures, 28 cases of generalized tonic-clonic seizures, and 9 cases of simple partial seizures. The patients received appropriate AED treatment according to the characteristics of epileptic seizure and the treatment guidance. The differences in the serum levels of folate and vitamin B12 in these patients, and the differences in the secondary cerebrovascular events in these patients after 1 year follow-up were analyzed. The difference in the AEDs used by various epileptic patients was statistically significant (PB12 in these patients following treatment were significantly lower than those prior to treatment (PB12 in these groups following treatment were not statistically significant (P>0.05). The difference in the incidence of cerebrovascular events in these groups at follow up was not statistically significant (P>0.05). The multifactorial logistic regression analysis revealed that the serum levels of folate and vitamin B12 were the independent risk factors for epilepsy with secondary cerebrovascular events [folate: odds ratio (OR)=0.536, P=0.039; vitamin: OR=0.382, P=0.041]. In conclusion, various AEDs may decrease the serum levels of folate and vitamin B12 and affect the secondary cerebrovascular events in various epileptic patients. Thus, regular supplementation of folate and vitamin B12 may be an option.


    Avadhesh Pratap Singh


    Full Text Available BACKGROUND Seizure is a paroxysmal alteration in neurologic function resulting from abnormal excessive neuronal electrical activity. Epilepsy is a chronic condition characterized by recurrent seizures unprovoked by an acute systemic or neurologic insult.1 An epileptic seizure is a clinical manifestation of abnormal, excessive neuronal activity arising in the grey matter of the cerebral cortex. MATERIALS AND METHODS Prospective studies of 100 patients with clinical impression of seizures were examined by 1.5 Tesla magnetic resonance imaging. RESULT A total of 100 patients satisfying the inclusion criteria were included in the study. The age range of patients was from neonate to elderly with male predominance, male 64 (64% and female 36 (36%. GTCS was the most common clinical diagnosis constituting (80% cases. The common abnormalities were cerebral infarction with gliosis (16%, infections – NCC (7% and tuberculoma (10%, cerebral atrophy (1%, developmental cortical malformations (2%, venous thrombosis (4%, low-grade glioma (9%, meningioma (3%. CONCLUSION MRI is the investigation of choice in patients with seizure disorder. The sensitivity of MRI in detecting abnormalities in patients with seizure disorder is in part associated to the underlying pathologies and by the MRI techniques and experience of the interpreting physician. Accurate diagnosis of the cause of seizure is crucial for finding an effective treatment. With its high spatial resolution, excellent inherent soft tissue contrast, multiplanar imaging capability and lack of ionizing radiation, MR imaging has emerged as a versatile tool in the evaluation of patients with seizure disorder.

  5. Seizure prediction: any better than chance?

    Andrzejak, Ralph G; Chicharro, Daniel; Elger, Christian E; Mormann, Florian


    To test whether epileptic seizure prediction algorithms have true predictive power, their performance must be compared with the one expected under well-defined null hypotheses. For this purpose, analytical performance estimates and seizure predictor surrogates were introduced. We here extend the Monte Carlo framework of seizure predictor surrogates by introducing alarm times surrogates. We construct artificial seizure time sequences and artificial seizure predictors to be consistent or inconsistent with various null hypotheses to determine the frequency of null hypothesis rejections obtained from analytical performance estimates and alarm times surrogates under controlled conditions. Compared to analytical performance estimates, alarm times surrogates are more flexible with regard to the testable null hypotheses. Both approaches have similar, high statistical power to indicate true predictive power. For Poisson predictors that fulfill the null hypothesis of analytical performance estimates, the frequency of false positive null hypothesis rejections can exceed the significance level for long mean inter-alarm intervals, revealing an intrinsic bias of these analytical estimates. Alarm times surrogates offer important advantages over analytical performance estimates. The key question in the field of seizure prediction is whether seizures can in principle be predicted or whether algorithms which have been presumed to perform better than chance actually are unable to predict seizures and simply have not yet been tested against the appropriate null hypotheses. Alarm times surrogates can help to answer this question.

  6. Is an epilepsy presurgical evaluation necessary for mid-grade and high-grade brain tumors presenting with seizures?

    Hamer, Hajo M; Hong, Seung Bong


    Patients with epilepsy caused by mid-grade and high-grade tumors do not usually undergo formal presurgical epilepsy evaluations before tumor resection. However, a minority of these patients may benefit significantly from just such a structured presurgical evaluation especially when seizure freedom or seizure reduction is a surgical aim in addition to total tumor resection. Typical cases comprise patients with multifocal tumors, tumors with bilateral extension, tumors over eloquent cortex, and the need for differentiation of spells of an uncertain nature, for example, epileptic versus psychogenic nonepileptic seizures. If they are epileptic, the definition of the epileptic lesion versus the epileptogenic zone and eloquent cortex can be another reason for monitoring. In addition to noninvasive recordings, invasive studies that use subdural or depths electrodes can be of special importance in these patients, leading to an exact delineation of the epileptogenic zone, usually extending beyond the epileptic lesion, and allow safe differentiation of epileptic from eloquent cortex.

  7. The lunar cycle and seizures in children

    Devleta Hadžić


    Full Text Available Aim To analyze the annual trend of hospitalization and potential influence of the lunar cycle of children treated for seizures.Methods The data of the patients treated for seizures (convulsions, epileptic seizures, disturbance of consciousness and epileptic seizures in children with neurodevelopmental disability in the Pediatrics Clinic of the University Clinical Center of Tuzla were retrospectively analyzed during 2008 in relation to seasonaldistribution, admission time (month, week, admission moment, day in a week, time of the day and the lunar cycle. Results Out f the totalof 234 treated children, 55 (23,5% were infants, 101 (43,1% were under six years of age and 78 (33,3% were of school age. The most common type of seizures were convulsions, 123 (42,6%. The seizures were numerous in the midst of the week, as opposed to weekends. Thein the midst of the week, as opposed to weekends. The highest number of children was treated in January, February, July and August, that it, in the fourth, seventh, twenty-seventh and thirty-first week of the year. Seizures occured during the day in 149 patients (63,7% and during the night in 84 (35,9% patients (p < 0,0034. The number of treated patients was significantly larger in the third and fourthlunar phases (p < 0,018. Conclusion The results suggested seasonal and weekly trends of hospitalization of patients with seizures and their relation with circadian and lunar cycles. There is a need for further prospective studies in order to get better understanding of the influence of the lunar cycle on health.

  8. Uric acid is released in the brain during seizure activity and increases severity of seizures in a mouse model for acute limbic seizures

    Thyrion, L.; Raedt, R.; Portelli, J.; van Loo, P.; Wadman, W.J.; Glorieux, G.; Lambrecht, B.N.; Janssens, S.; Vonck, K.; Boon, P.


    Recent evidence points at an important role of endogenous cell-damage induced pro-inflammatory molecules in the generation of epileptic seizures. Uric acid, under the form of monosodium urate crystals, has shown to have pro-inflammatory properties in the body, but less is known about its role in sei

  9. Uric acid is released in the brain during seizure activity and increases severity of seizures in a mouse model for acute limbic seizures

    L. Thyrion; R. Raedt; J. Portelli; P. van Loo; W.J. Wadman; G. Glorieux; B.N. Lambrecht; S. Janssens; K. Vonck; P. Boon


    Recent evidence points at an important role of endogenous cell-damage induced pro-inflammatory molecules in the generation of epileptic seizures. Uric acid, under the form of monosodium urate crystals, has shown to have pro-inflammatory properties in the body, but less is known about its role in sei

  10. Computed Tomography Findings in Patients with Seizure Disorder

    Sumnima Acharya; Awadesh Tiwari; Amit Shrestha; Rupesh Sharma; Raju prasad Shak


    Introduction: Seizure occurs in up to 10% of the population, whereas epilepsy is a chronic disease characterized by recurrent seizures that may affect up to 2% of the population. Modern neuroimaging is useful in diagnosis of  abnormalities underlying the epilepsies, but the information provided by imaging techniques can also contribute to proper classification of certain epileptic disorders and can delineate the genetics of some underlying syndromes. Neuroimaging is even more important for th...

  11. Seizures Related to Vitamin B6 Deficiency in Adults


    Vitamin B6 is closely associated with functions of the nervous, immune, and endocrine systems. Its deficiency may result in neurological disorders including convulsions and epileptic encephalopathy. Until today, this has only been reported in infants, children, and critically ill adult patients. We report a case of a 36year-old man with chronic alcoholism who presented with seizures after gastrointestinal disturbance. His seizures persisted even after treatment with antiepileptic drugs, but e...

  12. Instruction manual for the ILAE 2017 operational classification of seizure types.

    Fisher, Robert S; Cross, J Helen; D'Souza, Carol; French, Jacqueline A; Haut, Sheryl R; Higurashi, Norimichi; Hirsch, Edouard; Jansen, Floor E; Lagae, Lieven; Moshé, Solomon L; Peltola, Jukka; Roulet Perez, Eliane; Scheffer, Ingrid E; Schulze-Bonhage, Andreas; Somerville, Ernest; Sperling, Michael; Yacubian, Elza Márcia; Zuberi, Sameer M


    This companion paper to the introduction of the International League Against Epilepsy (ILAE) 2017 classification of seizure types provides guidance on how to employ the classification. Illustration of the classification is enacted by tables, a glossary of relevant terms, mapping of old to new terms, suggested abbreviations, and examples. Basic and extended versions of the classification are available, depending on the desired degree of detail. Key signs and symptoms of seizures (semiology) are used as a basis for categories of seizures that are focal or generalized from onset or with unknown onset. Any focal seizure can further be optionally characterized by whether awareness is retained or impaired. Impaired awareness during any segment of the seizure renders it a focal impaired awareness seizure. Focal seizures are further optionally characterized by motor onset signs and symptoms: atonic, automatisms, clonic, epileptic spasms, or hyperkinetic, myoclonic, or tonic activity. Nonmotor-onset seizures can manifest as autonomic, behavior arrest, cognitive, emotional, or sensory dysfunction. The earliest prominent manifestation defines the seizure type, which might then progress to other signs and symptoms. Focal seizures can become bilateral tonic-clonic. Generalized seizures engage bilateral networks from onset. Generalized motor seizure characteristics comprise atonic, clonic, epileptic spasms, myoclonic, myoclonic-atonic, myoclonic-tonic-clonic, tonic, or tonic-clonic. Nonmotor (absence) seizures are typical or atypical, or seizures that present prominent myoclonic activity or eyelid myoclonia. Seizures of unknown onset may have features that can still be classified as motor, nonmotor, tonic-clonic, epileptic spasms, or behavior arrest. This "users' manual" for the ILAE 2017 seizure classification will assist the adoption of the new system. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  13. Apneas observed in trisomy 18 neonates should be differentiated from epileptic apneas.

    Fukasawa, Tatsuya; Kubota, Tetsuo; Tanaka, Masaharu; Asada, Hideyuki; Matsusawa, Kaname; Hattori, Tetsuo; Kato, Yuichi; Negoro, Tamiko


    Many children with trisomy 18 have apneas from the neonatal period. It has been reported that some children with trisomy 18 have epilepsy, including epileptic apneas. However, no previous report has described epileptic apneas in trisomy 18 neonates. We retrospectively reviewed the clinical records of neonates with trisomy 18 who were born at Anjo Kosei Hospital between July 2004 and October 2013 and investigated whether they had epileptic apneas during the neonatal period and whether antiepileptic drugs (AEDs) were effective for treating them. We identified 16 patients with trisomy 18. Nine patients who died within 3 days of birth were excluded. Five of the remaining seven patients had apneas. All five patients underwent electroencephalograms (EEGs) to assess whether they suffered epileptic apneas. Three of the five patients had EEG-confirmed seizures. In two patients, the apneas corresponded to ictal discharges. In one patient, ictal discharges were recorded when she was under mechanical ventilation, but no ictal discharges that corresponded to apneas were recorded after she was extubated. AEDs were effective for treating the apneas and stabilizing the SpO2 in all three patients. Among neonates with trisomy 18 who lived longer than 3 days, three of seven patients had EEG-confirmed seizures. AEDs were useful for treating their epileptic apneas and stabilizing their SpO2. Physicians should keep epileptic apneas in mind when treating apneas in neonates with trisomy 18.

  14. The presence of consciousness in absence seizures.

    Bayne, Tim


    This paper examines three respects in which the study of epileptic absence seizures promises to inform our understanding of consciousness. Firstly, it has the potential to bear on debates concerning the behavioural and cognitive functions associated with consciousness. Secondly, it has the potential to illuminate the relationship between background states (or 'levels') of consciousness and the contents of consciousness. Thirdly, it has the potential to bear on our understanding of the unity of consciousness.

  15. The Presence of Consciousness in Absence Seizures

    Tim Bayne


    This paper examines three respects in which the study of epileptic absence seizures promises to inform our understanding of consciousness. Firstly, it has the potential to bear on debates concerning the behavioural and cognitive functions associated with consciousness. Secondly, it has the potential to illuminate the relationship between background states (or ‘levels’) of consciousness and the contents of consciousness. Thirdly, it has the potential to bear on our understanding of the unity o...

  16. Seizure Following Topical Gammabenzene Hexachloride Therapy

    Biswas Animesh


    Full Text Available Development of short-lived, self-limiting major epileptic seizures following an improper application of gammabenzene hexachloride (GBHC lotion in a 15 month old boy suffering from scabies with secondary bacterial infection is reported here due to its rarity in clinical practice and, more particularly, to stress the need of correct instructions on the use of GBHC application for the prevention of iatrogenic neurotoxicity.

  17. Electroencephalographic characterization of seizure activity in the synapsin I/II double knockout mouse

    Etholm, Lars; Lindén, Henrik; Eken, Torsten


    countable, the number of myoclonic jerks was significantly correlated to the number of such EEG complexes. Furthermore, some EEG recordings revealed epileptic regular discharges without clear behavioral seizure correlates. Our findings suggest that seizure behavior in SynDKO mice is not solely determined...

  18. The delta between postoperative seizure freedom and persistence: Automatically detected focal slow waves after epilepsy surgery

    Margit Schönherr


    Significance: The quantity of delta activity could be used as a diagnostic marker for recurrent seizures. The close relation to epileptic spike localizations and the resection volume of patients with successful second surgery imply involvement in seizure recurrence. This initial evidence suggests a potential application in the planning of second epilepsy surgery.

  19. Out-of-body experiences associated with seizures

    Bruce eGreyson


    Full Text Available Alterations of consciousness are critical factors in the diagnosis of epileptic seizures. With these alterations in consciousness, some persons report sensations of separating from the physical body, experiences that may in rare cases resemble spontaneous out-of-body experiences. This study was designed to identify and characterize these out-of-body-like subjective experiences associated with seizure activity. 55% of the patients in this study recalled some subjective experience in association with their seizures. Among our sample of 100 patients, 7 reported out-of-body experiences associated with their seizures. We found no differentiating traits that were associated with patients’ reports of out-of-body experiences, in terms of either demographics; medical history, including age of onset and duration of seizure disorder, and seizure frequency; seizure characteristics, including localization, lateralization, etiology, and type of seizure, and epilepsy syndrome; or ability to recall any subjective experiences associated with their seizures. Reporting out-of-body experiences in association with seizures did not affect epilepsy-related quality of life. It should be noted that even in those patients who report out-of-body experiences, such sensations are extremely rare events that do not occur routinely with their seizures. Most patients who reported out-of-body experiences described one or two experiences that occurred an indeterminate number of years ago, which precludes the possibility of associating the experience with the particular characteristics of that one seizure or with medications taken or other conditions at the time.

  20. Neuropeptide Y gene transfection inhibits post-epileptic hippocampal synaptic reconstruction

    Fan Zhang; Wenqing Zhao; Wenling Li; Changzheng Dong; Xinying Zhang; Jiang Wu; Na Li; Chuandong Liang


    Exogenous neuropeptide Y has antiepileptic effects; however, the underlying mechanism and optimal administration method for neuropeptide Y are still unresolved. Previous studies have used intracerebroventricular injection of neuropeptide Y into animal models of epilepsy. In this study, a recombinant adeno-associated virus expression vector carrying the neuropeptide Y gene was injected into the lateral ventricle of rats, while the ipsilateral hippocampus was injected with kainic acid to establish the epileptic model. After transfection of neuropeptide Y gene, mossy fiber sprouting in the hippocampal CA3 region of epileptic rats was significantly suppressed, hippocampal synaptophysin (p38) mRNA and protein expression were inhibited, and epileptic seizures were reduced. These experimental findings indicate that a recombinant adeno-associated virus expression vector carrying the neuropeptide Y gene reduces mossy fiber sprouting and inhibits abnormal synaptophysin expression, thereby suppressing post-epileptic synaptic reconstruction.

  1. Long-term neurological outcome of term-born children treated with two or more anti-epileptic drugs during the neonatal period

    van der Heide, Mariska J.; Roze, Elise; van der Veere, Christa N.; ter Horst, Hendrik J.; Brouwer, Oebele F.; Bos, Arend F.


    Background: Neonatal seizures may persist despite treatment with multiple anti-epileptic drugs (AEDs). Objective: To determine in term-born infants with seizures that required two or more AEDs, whether treatment efficacy and/or the underlying disorder were related to neurological outcome. Design/met

  2. Long-term neurological outcome of term-born children treated with two or more anti-epileptic drugs during the neonatal period

    van der Heide, Mariska J.; Roze, Elise; van der Veere, Christa N.; ter Horst, Hendrik J.; Brouwer, Oebele F.; Bos, Arend F.


    Background: Neonatal seizures may persist despite treatment with multiple anti-epileptic drugs (AEDs). Objective: To determine in term-born infants with seizures that required two or more AEDs, whether treatment efficacy and/or the underlying disorder were related to neurological outcome. Design/met

  3. Fractal Dimension in Epileptic EEG Signal Analysis

    Uthayakumar, R.

    Fractal Analysis is the well developed theory in the data analysis of non-linear time series. Especially Fractal Dimension is a powerful mathematical tool for modeling many physical and biological time signals with high complexity and irregularity. Fractal dimension is a suitable tool for analyzing the nonlinear behaviour and state of the many chaotic systems. Particularly in analysis of chaotic time series such as electroencephalograms (EEG), this feature has been used to identify and distinguish specific states of physiological function.Epilepsy is the main fatal neurological disorder in our brain, which is analyzed by the biomedical signal called Electroencephalogram (EEG). The detection of Epileptic seizures in the EEG Signals is an important tool in the diagnosis of epilepsy. So we made an attempt to analyze the EEG in depth for knowing the mystery of human consciousness. EEG has more fluctuations recorded from the human brain due to the spontaneous electrical activity. Hence EEG Signals are represented as Fractal Time Series.The algorithms of fractal dimension methods have weak ability to the estimation of complexity in the irregular graphs. Divider method is widely used to obtain the fractal dimension of curves embedded into a 2-dimensional space. The major problem is choosing initial and final step length of dividers. We propose a new algorithm based on the size measure relationship (SMR) method, quantifying the dimensional behaviour of irregular rectifiable graphs with minimum time complexity. The evidence for the suitability (equality with the nature of dimension) of the algorithm is illustrated graphically.We would like to demonstrate the criterion for the selection of dividers (minimum and maximum value) in the calculation of fractal dimension of the irregular curves with minimum time complexity. For that we design a new method of computing fractal dimension (FD) of biomedical waveforms. Compared to Higuchi's algorithm, advantages of this method include

  4. Ictal epileptic headache in adult life: Electroclinical patterns and spectrum of related syndromes.

    Fanella, Martina; Morano, Alessandra; Fattouch, Jinane; Albini, Mariarita; Manfredi, Mario; Giallonardo, Anna Teresa; Di Bonaventura, Carlo


    Both headache and epilepsy are frequent paroxysmal disorders that often co-occur or are related in numerous ways. Although ictal epileptic headache has become the focus of several studies, this remains a very rare and not well-known phenomenon. Electroclinical features, pathophysiology, and syndromic context are heterogeneous. We investigated the electroclinical and neuroimaging findings in a population of adult patients with ictal epileptic headache. We retrospectively examined 8800 EEG recordings of almost 4800 patients admitted to our video-EEG laboratory from 2010 to 2013 with a history of well-documented epilepsy. We selected patients who reported headache closely related to a seizure documented by video-EEG or 24-hour ambulatory EEG. We analyzed ictal electroclinical features of headache, and we defined the related epileptic syndromes. We identified five patients with ictal epileptic headache. Two patients described tension headache during an epileptic seizure. In three patients, the headache was accompanied by other "minor" neurological symptoms mimicking a migrainous aura. In all cases, the headache stopped with the end of the epileptic activity. Three patients had a history of partial symptomatic epilepsy with cerebral lesions (low grade glioma, astrocytoma, porencephalic cyst) in the left posterior regions, whereas two patients were affected by idiopathic generalized epilepsy. This study confirms the rarity of ictal epileptic headache. To date, well-documented video-EEG cases remain as exceptional reports, especially in cases of idiopathic generalized epilepsies. Moreover, we confirm the main involvement of posterior regions in patients with ictal epileptic headache affected by partial symptomatic epilepsies. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. The ketogenic diet can be used successfully in combination with corticosteroids for epileptic encephalopathies.

    Ville, Dorothée; Chiron, Catherine; Laschet, Jacques; Dulac, Olivier


    Hormonal therapy or ketogenic diet often permits overcoming the challenging periods of many epileptic encephalopathies (West and Lennox-Gastaut syndromes and encephalopathy with continuous spike-waves in slow sleep), but relapse affects over 20% of patients. We report here a monocenter pilot series of 42 consecutive patients in whom we combined oral steroids with the ketogenic diet for corticosteroid-resistant or -dependent epileptic encephalopathy. We retrospectively evaluated the effect on seizure frequency, interictal spike activity, neuropsychological course, and steroid treatment course. Twenty-three patients had West syndrome (WS), 13 had encephalopathy with continuous spike-waves in slow sleep (CSWS), and six others had miscellaneous epileptic encephalopathies. All patients succeeded to reach 0.8 to 1.6g/l ketone bodies in the urine following the usual KD regimen. For at least 6 months, 14/42 responded to the addition of the ketogenic diet: 4/23 with WS, 8/13 with CSWS, and 2/6 with miscellaneous epileptic encephalopathies. The addition of the KD allowed withdrawing steroids in all responders. Among them, 10/15 had been patients with steroid-dependent epileptic encephalopathy and 4/27 patients with steroid-resistant epileptic encephalopathy. Therefore, the ketogenic diet can be used successfully in combination with corticosteroids for epileptic encephalopathies. Patients presenting with steroid-dependent CSWS seem to be the best candidates.

  6. Rufinamide in refractory childhood epileptic encephalopathies other than Lennox-Gastaut syndrome.

    Coppola, G; Grosso, S; Franzoni, E; Veggiotti, P; Zamponi, N; Parisi, P; Spalice, A; Habetswallner, F; Fels, A; Verrotti, A; D'Aniello, A; Mangano, S; Balestri, A; Curatolo, P; Pascotto, A


    To report on the first multicenter Italian experience with rufinamide as adjunctive drug in children, adolescents and young adults with refractory childhood-onset epileptic encephalopathies other than Lennox-Gastaut syndrome. Thirty-eight patients (19 males, 19 females), aged between 4 and 34 (mean 13.7 ± 8.3, median 12.5), all affected by different types of childhood-onset refractory epileptic encephalopathies other than Lennox-Gastaut syndrome, were treated with rufinamide as adjunctive drug for a mean period of 11.4 months (range 3-26 months). Fifteen of 38 patients (39.5%) had a ≥ 50% seizure reduction in countable seizures. Complete seizure freedom was achieved in one of these patients (2.6%). Three patients (7.9%) had a 25-49% seizure reduction, whilst seizure frequency remained unchanged in 15 (39.5%) and increased in five patients (13.1%). Eleven patients (28.9%) reported adverse side effects. Vomiting was reported in five patients (13.1%); drowsiness, decreased appetite and irritability with migraine manifested in other four patients. They were transient and mild in all cases. Rufinamide may be an effective and well-tolerated adjunctive drug for the treatment of refractory childhood-onset epileptic encephalopathies other than Lennox-Gastaut syndrome. Rufinamide was most effective in patients with drop-attacks and (bi)frontal spike-wave discharges. © 2010 The Author(s). European Journal of Neurology © 2010 EFNS.

  7. Long-term developmental outcome after early hemispherotomy for hemimegalencephaly in infants with epileptic encephalopathy.

    Honda, Ryoko; Kaido, Takanobu; Sugai, Kenji; Takahashi, Akio; Kaneko, Yuu; Nakagwa, Eiji; Sasaki, Masayuki; Otsuki, Taisuke


    This study aimed to identify the effect of early hemispherotomy on development in a consecutive series of 12 infants with hemimegalencephaly (HME) demonstrating epileptic encephalopathy. Mean age at onset was 20.4 days (range, 1-140), mean age at surgery was 4.3 months (range, 2-9), and mean follow-up time was 78.8 months (range, 36-121). Eleven patients had a history of early infantile epileptic encephalopathy. Vertical parasagittal hemispherotomy was performed without mortality or severe morbidities. At follow-up, seizure freedom was obtained in 8 patients (66.7%), who showed significantly higher postoperative developmental quotient (DQ) (mean, 31.3; range, 7-61) than those with seizures (mean, 5.5; range, 3-8) (p=0.02). Within the seizure-free group, postoperative DQ correlated with preoperative seizure duration (r=-0.811, p=0.01). Our results showed that shorter seizure duration during early infancy could provide better postoperative DQ in infants with HME and epileptic encephalopathy. © 2013.

  8. Seizure semiology of lesional frontal lobe epilepsies in children.

    Battaglia, D; Lettori, D; Contaldo, I; Veredice, C; Sacco, A; Vasco, J; Martinelli, D; Chieffo, D; Tartaglione, T; Colosimo, C; Di Rocco, C; Guzzetta, F


    The aim of the study was to analyse the semiology of seizures in children with frontal lobe epilepsy (FLE) and to compare them with other paediatric cohorts described in the literature as well as with adult counterparts. We analysed 174 registered seizures of 18 cases under 12 years with lesional epilepsy whose frontal origin was defined by the concordance of neuroimaging and ictal electrographic findings, and confirmed by surgery in the six cases operated on. Seizures were generally short, with a high daily frequency and usually related to sleep. The most characteristic semiological pattern consisted of complex motor seizures, particularly hypermotor. Often seizures corresponded to a mixture of different semiological patterns (tonic, gelastic, automotor, hypermotor, versive) presenting in the same seizure, often as a unique type in the same patient. With regard to several aspects the semiology of FLE in our cohort looks like that reported in adult series, in particular as to the frequency of complex motor seizures. However, our cohort was also characterised by a more protean array of seizure semiology, stressing the occurrence of seizures typically present in adults (versive and complex motor) and of some seizure patterns more characteristic in children such as epileptic spasms; moreover, the rare occurrence of secondarily generalised tonic clonic seizures (SGTCS) was confirmed.

  9. Downregulated GABA and BDNF-TrkB pathway in chronic cyclothiazide seizure model.

    Kong, Shuzhen; Cheng, Zhihua; Liu, Jianhui; Wang, Yun


    Cyclothiazide (CTZ) has been reported to simultaneously enhance glutamate receptor excitation and inhibit GABAA receptor inhibition, and in turn it evokes epileptiform activities in hippocampal neurons. It has also been shown to acutely induce epileptic seizure behavior in freely moving rats. However, whether CTZ induced seizure rats could develop to have recurrent seizure still remains unknown. In the current study, we demonstrated that 46% of the CTZ induced seizure rats developed to have recurrent seizure behavior as well as epileptic EEG with a starting latency between 2 weeks and several months. In those chronic seizure rats 6 months after the seizure induction by the CTZ, our immunohistochemistry results showed that both GAD and GAT-1 were significantly decreased across CA1, CA3, and dentate gyrus area of the hippocampus studied. In addition, both BDNF and its receptor TrkB were also decreased in hippocampus of the chronic CTZ seizure rats. Our results indicate that CTZ induced seizure is capable of developing to have recurrent seizure, and the decreased GABA synthesis and transport as well as the impaired BDNF-TrkB signaling pathway may contribute to the development of the recurrent seizure. Thus, CTZ seizure rats may provide a novel animal model for epilepsy study and anticonvulsant drug testing in the future.

  10. Downregulated GABA and BDNF-TrkB Pathway in Chronic Cyclothiazide Seizure Model

    Shuzhen Kong


    Full Text Available Cyclothiazide (CTZ has been reported to simultaneously enhance glutamate receptor excitation and inhibit GABAA receptor inhibition, and in turn it evokes epileptiform activities in hippocampal neurons. It has also been shown to acutely induce epileptic seizure behavior in freely moving rats. However, whether CTZ induced seizure rats could develop to have recurrent seizure still remains unknown. In the current study, we demonstrated that 46% of the CTZ induced seizure rats developed to have recurrent seizure behavior as well as epileptic EEG with a starting latency between 2 weeks and several months. In those chronic seizure rats 6 months after the seizure induction by the CTZ, our immunohistochemistry results showed that both GAD and GAT-1 were significantly decreased across CA1, CA3, and dentate gyrus area of the hippocampus studied. In addition, both BDNF and its receptor TrkB were also decreased in hippocampus of the chronic CTZ seizure rats. Our results indicate that CTZ induced seizure is capable of developing to have recurrent seizure, and the decreased GABA synthesis and transport as well as the impaired BDNF-TrkB signaling pathway may contribute to the development of the recurrent seizure. Thus, CTZ seizure rats may provide a novel animal model for epilepsy study and anticonvulsant drug testing in the future.

  11. Cysticercosis in epileptic patients of Mulungu do Morro Northeastern Brazil



    Full Text Available With the aim to study the magnitude of infection by the metacestode of Taenia solium in a population of epileptic patients in the arid region of Bahia, Northeastern Brazil, we examined 200 consecutive cases who attended an ambulatory clinic in the disctrict of Mulungu do Morro. Sixty-six of the patients had a diagnosis of epilepsy. From them 10 (15.2% presented antibodies against a specific fraction of antigens in Western blot, and 4 (6.0% had circulating parasite products, as tested by capture ELISA. Only 1 case was positive for antibodies and antigens. We found that the frequency of seropositivity was related to the time without epileptic seizure. We conclude that cysticercosis is endemic in the region of Mulungu do Morro and that it is related to a benign form of epilepsy.

  12. Seizures beget seizures in temporal lobe epilepsies: the boomerang effects of newly formed aberrant kainatergic synapses.

    Ben-Ari, Yehezkel; Crepel, Valérie; Represa, Alfonso


    Do temporal lobe epilepsy (TLE) seizures in adults promote further seizures? Clinical and experimental data suggest that new synapses are formed after an initial episode of status epilepticus, however their contribution to the transformation of a naive network to an epileptogenic one has been debated. Recent experimental data show that newly formed aberrant excitatory synapses on the granule cells of the fascia dentate operate by means of kainate receptor-operated signals that are not present on naive granule cells. Therefore, genuine epileptic networks rely on signaling cascades that differentiate them from naive networks. Recurrent limbic seizures generated by the activation of kainate receptors and synapses in naive animals lead to the formation of novel synapses that facilitate the emergence of further seizures. This negative, vicious cycle illustrates the central role of reactive plasticity in neurological disorders.

  13. Absence epileptic activity in Wistar Albino Glaxo Rijswijk rat mothers.

    Kovács, Zsolt; Lakatos, Renáta Krisztina; Barna, János; Dobolyi, Árpád


    Absence epileptic activity was analyzed during pregnancy, the postpartum period and after weaning to establish alterations of seizures throughout the reproductive cycle. Wistar Albino Glaxo Rijswijk (WAG/Rij) rats were used in the study as a model of absence epilepsy and because their seizures do not interfere with rearing offspring. The number of spike-wave discharges (SWDs) was gradually elevated from the 19th pregnancy day to delivery. Meanwhile, the characteristics of individual SWDs did not change suggesting that SWD generation remained the same. In the postpartum and postweaning periods, the number of SWDs was not increased in the absence of pups. However, returning the pups to mothers resulted in a markedly elevated number of SWDs for 1h. If pups were taken away after 30min, the number of SWDs dropped immediately suggesting that the presence of pups increased the SWD number. The time mothers spent with the litter and in kyphosis suckling posture were in correlation with their SWD number further suggesting the importance of interaction with pups in SWD induction. Suckling elevates prolactin levels but surprisingly, its intracerebroventricular injection markedly reduced SWD number in suckled WAG/Rij mothers suggesting that the SWD-inducing effect of suckling is not mediated by prolactin. Rather, the elevated prolactin level may provide some protection against pro-epileptic effects of suckling. In conclusion, we first identified periods within the reproductive cycle with increased absence epileptic activity, implying that more attention should be devoted to epileptic activity changes in mothers. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Low dose zinc supplementation beneficially affects seizure development in experimental seizure models in rats.

    Kumar, Hemant; Katyal, Jatinder; Gupta, Yogendra K


    The role of zinc in seizure models and with antiepileptic drugs sodium valproate (SV) and phenytoin (PHT) was studied using experimental models of seizures in rats. Male Wistar rats, 150-250 g were administered zinc 2, 20, and 200 mg/kg, orally for 14 days. Sixty minutes after the last dose of zinc, rats were challenged with pentylenetetrazole (PTZ, 60 mg/kg, ip) or maximal electroshock (MES, 70 mA, 0.2 s duration). In another group, SV (150/300 mg/kg, ip) or PHT (40 mg/kg, ip) was administered after 30 min of zinc administration followed by seizure challenge. Zinc pretreatment at all doses had no effect on MES seizures. In PTZ seizures, with the lowest dose used, i.e., 2 mg/kg, a protective effect was observed. Neither the protection offered by the 100 % anticonvulsant dose of SV (300 mg/kg) in PTZ seizures was affected by pre-treatment with zinc nor a combination of subanticonvulsant dose of SV (150 mg/kg) and zinc offer any statistically significant advantage over either drug alone. The combination of phenytoin with zinc had no effect on any of the parameters tested. Apart from this, chronic zinc administration hampered development of chemically (PTZ)-kindled seizures in rats. Zinc supplementation is unlikely to have any undesirable effect when used in epileptics rather it may offer advantage in epileptic and seizure prone patients.

  15. Validity of the assessment of personality disorders for the diagnosis of psychogenic non-epileptic seizures%儿童个性特征测定在心因性非癫痫性发作鉴别诊断中的应用

    杨延萍; 凌如娟; 马杰


    目的 探讨儿童个性特征评估在心因性非癫痫性发作(PNES)、癫痫(EP)和健康对照(NC)之间鉴别诊断中的应用.方法 选取本中心心理专科和神经内科收诊的106例PNES患儿、138例EP患儿和139例儿童保健科健康体检的NC儿童作为研究对象.采用艾森克个性问卷(EPQ)和Piers-Harris儿童自我意识量表(PHCSS)对各组儿童进行评估,并进行比较分析.结果 PNES组患儿的个性缺陷程度明显高于EP组和NC组儿童,尤其焦虑(6.34±2.58)、合群(6.06±2.64)、幸福与满足(4.60±2.34)三个自我意识分量表评分明显低于EP组和NC组儿童,TP(59.23±8.22)和TN(56.16±8.27)两个艾森克个性问卷分量表评分明显高于EP组和NC组儿童,差异有统计学意义(P<0.05).焦虑分量表在鉴别诊断PNES组和NC组儿童时表现出了良好的判别能力,灵敏度和特异度分别为74.1%和72.6%,ROC曲线下面积达0.825.TP分量表在鉴别诊断PNES组和EP组儿童时表现出了较好的判别能力,灵敏度和特异度分别为52.8%和97.1%,ROC曲线下面积达0.789.结论 PNES患儿自我意识水平明显低于EP组和NC组患儿,个性多偏神经质和精神质,建议根据其心理特点和性格特征进行鉴别诊断和干预.%Objective To examine the ability of the assessment of personality to differentiate patients with psychogenic non-epileptic seizures (PNES) from normal controls (NC) and epileptic seizures (ES).Methods Patients were recruited from mental health department of our center.In all,106 children with PNES and 138 children with EP completed questionnaires including Eysenck Personality Questionnaire (EPQ) and Piers-Harris Children's Self-concept Scale (PHCSS).Both questionnaires were also completed by 139 healthy volunteers from children health care clinic.The results of three groups were compared to determine the diagnostic accuracy of the assessment of personality.Results Subjects with PNES reported significantly greater degree

  16. Automated Detection of Epileptic Seizures in the EEG


    1Department of Medical Physics & Bioengineering, Christchurch Hospital, Christchurch, New Zealand 2Department of Electrical Engineering, University...Number Author(s) Project Number Task Number Work Unit Number Performing Organization Name(s) and Address(es) Department of Medical Physics & Bioengineering

  17. [Visual epileptic seizures. Signs and symptoms, and clinical implications].

    González-Cuevas, Montserrat; Toledo, Manuel; Santamarina, Estevo; Sueiras-Gil, María; Cambrodí-Masip, Roser; Sarria, Silvana; Quintana, Manuel; Salas-Puig, Javier


    Introduccion. Los fenomenos visuales pueden ser sintomas de crisis epilepticas, aunque con un significado clinico y una relacion con el foco epileptogeno incierto. Objetivo. Describir las implicaciones clinicas de las crisis epilepticas visuales segun su semiologia en adultos. Pacientes y metodos. Durante un año se recoge consecutivamente a pacientes que describian semiologia visual como manifestacion principal de sus crisis y se clasifican los sintomas visuales segun las caracteristicas de la descripcion. Resultados. Se incluye a 78 pacientes con una edad media de 43,5 años. El 97% de los casos eran epilepsias focales. Entre el 63% de las epilepsias sintomaticas, el 57% eran vasculares. Las crisis visuales eran, en un 81,9%, el aura previa a la crisis, y en un 17,9%, crisis visuales aisladas. La coexistencia de crisis visuales y otro tipo de crisis se asocio a farmacorresistencia (p = 0,021). Los sintomas visuales fueron: alucinaciones simples (55,1%), ilusiones (23,1%), alucinaciones complejas (15,4%) y perdida de vision (6,4%). La localizacion lobar de las lesiones era occipital (24,4%), temporoparietooccipital (21,8%), temporal (9%), parietal (3,8%) y frontal (1,3%). Las lesiones occipitales se asociaron con alucinaciones visuales simples (p < 0,001), y las ilusiones visuales y alucinaciones visuales complejas, con lesiones de la encrucijada temporoparietooccipital (p < 0,05). Del 55,1% de los pacientes con lesion unilateral en la resonancia magnetica, el 33% referia los sintomas en el hemicampo visual contralateral. Conclusiones. Las crisis visuales se presentan, principalmente, como auras epilepticas. Las alucinaciones simples se relacionan con el origen occipital, mientras que las alucinaciones complejas se asocian con regiones cerebrales mas anteriores. La aparicion de fenomenos visuales lateralizados nos orienta a un origen en el hemisferio contralateral.

  18. Aliocha Dostoevski’s death during an epileptic seizure

    Edson José Amâncio

    Full Text Available ABSTRACT Mortality due to epilepsy is of great concern worldwide. Individuals with epilepsy have a two- or three-fold risk of death when compared to the general population. Based on biographical data and Anna Grigoriévna Dostoevskaia’s memories, the authors concluded that a prolonged episode of status epilepticus was the culprit in the death of young Aliocha, youngest son of Fyodor Mikhailovich and Anna Dostoevski. At the time of Aliocha’s death, very limited knowledge about epilepsy or therapeutic resources was available. Despite all the progress, epilepsies remain potentially fatal conditions. The suffering generated by Aliocha’s death and other similar cases remains as a challenge for epileptologists who assemble efforts to fight against such conditions.

  19. Detecting Epileptic Seizure from Scalp EEG Using Lyapunov Spectrum

    Truong Quang Dang Khoa


    Full Text Available One of the inherent weaknesses of the EEG signal processing is noises and artifacts. To overcome it, some methods for prediction of epilepsy recently reported in the literature are based on the evaluation of chaotic behavior of intracranial electroencephalographic (EEG recordings. These methods reduced noises, but they were hazardous to patients. In this study, we propose using Lyapunov spectrum to filter noise and detect epilepsy on scalp EEG signals only. We determined that the Lyapunov spectrum can be considered as the most expected method to evaluate chaotic behavior of scalp EEG recordings and to be robust within noises. Obtained results are compared to the independent component analysis (ICA and largest Lyapunov exponent. The results of detecting epilepsy are compared to diagnosis from medical doctors in case of typical general epilepsy.

  20. Recurrent abdominal pain: when an epileptic seizure should be suspected?

    Franzon Renata C.


    Full Text Available Recurrent episodes of abdominal pain are common in childhood. Among the diagnostic possibilities are migraine and abdominal epilepsy (AE. AE is an infrequent syndrome with paroxystic episodes of abdominal pain, awareness disturbance, EEG abnormalities and positive results with the introduction of antiepileptic drugs. We present one 6 year-old girl who had short episodes of abdominal pain since the age of 4. The pain was followed by cry, fear and occasionally secondary generalization. MRI showed tumor in the left temporal region. As a differential diagnosis, we report a 10 year-old boy who had long episodes of abdominal pain accompanied by blurring of vision, vertigo, gait ataxia, dysarthria, acroparesthesias and vomiting. He received the diagnosis of basilar migraine. In our opinion, AE is part of a large group (partial epilepsies and does not require a special classification. Pediatric neurologists must be aware of these two entities that may cause abdominal pain.

  1. Detecting epileptic seizure from scalp EEG using Lyapunov spectrum.

    Khoa, Truong Quang Dang; Huong, Nguyen Thi Minh; Toi, Vo Van


    One of the inherent weaknesses of the EEG signal processing is noises and artifacts. To overcome it, some methods for prediction of epilepsy recently reported in the literature are based on the evaluation of chaotic behavior of intracranial electroencephalographic (EEG) recordings. These methods reduced noises, but they were hazardous to patients. In this study, we propose using Lyapunov spectrum to filter noise and detect epilepsy on scalp EEG signals only. We determined that the Lyapunov spectrum can be considered as the most expected method to evaluate chaotic behavior of scalp EEG recordings and to be robust within noises. Obtained results are compared to the independent component analysis (ICA) and largest Lyapunov exponent. The results of detecting epilepsy are compared to diagnosis from medical doctors in case of typical general epilepsy.

  2. Management of dental patients with seizure disorders.

    Bryan, Robert B; Sullivan, Steven M


    Dental practitioners from time to time must treat patients with epilepsy or similar seizure disorders. This article describes the various classification for epilepsy, explains how such disorders are evaluated and diagnosed, discusses management methods, and addresses related issues for special populations, such as pregnant women and elderly. In addition, the article offers information about what special steps dentists should take in treating such epileptic patients and others vulnerable to seizures and in preparing offices and staff for the possibility that a patient will have a seizure in the office. In general, a patient with severe, poorly controlled epilepsy should be treated in a hospital. Otherwise, a well-controlled patient should easily be treated in the office.

  3. Controlling Seizures

    Henderson, Nancy


    This article describes how an implantable device could greatly improve the quality of life for people with epilepsy. Gabe Anderson was diagnosed with bilateral heterotopia, a congenital condition that can lead to the onset of complex partial seizures stemming from both hemispheres of the brain. In early 2004, Gabe became one of the first 35…

  4. Febrile Seizures

    ... medical facility for diagnosis and treatment. Call an ambulance if the seizure is less than 5 minutes but the child does not seem to be recovering quickly. Gradually place the child on a protected surface such as the floor or ground to prevent accidental injury. Do not restrain or ...

  5. Gene Panel Testing in Epileptic Encephalopathies and Familial Epilepsies

    Møller, Rikke S.; Larsen, Line H.G.; Johannesen, Katrine M.


    of a wide spectrum of epilepsies with age of onset spanning from the neonatal period to adulthood. A gene panel targeting 46 epilepsy genes was used on a cohort of 216 patients consecutively referred for panel testing. The patients had a range of different epilepsies from benign neonatal seizures...... to epileptic encephalopathies (EEs). Potentially causative variants were evaluated by literature and database searches, submitted to bioinformatic prediction algorithms, and validated by Sanger sequencing. If possible, parents were included for segregation analysis. We identified a presumed disease...

  6. Visibility of the inferior horns in computed tomography of normal subjects and epileptics

    Okuma, Yasuyuki; Narabayashi, Hirotaro; Inoue, Reiichi; Kuru, Yutaka; Nishimiya, Jin.


    In an attempt to examine how the inferior horn (IH) of lateral ventricle was visualized on computed tomography (CT), cranial CT was performed in 502 normal subjects and 163 epileptic patients, who ranged from infants to the aged. Age-dependent changes in the IH were examined by the frequency of visible IH. In the normal group, the frequency of visible IH was relatively high during infancy; and was the lowest (30 - 35 %) in the subjects aged in their twenties to thirties. It was, thereafter, increased with aging. On the contrary, the frequency of visible IH in the epileptic group was high (60 - 70 %), being independent of aging. For the age group ranging 20 - 39 years, it was significantly higher in the epileptic group than the normal group. This discrepancy can be explained by atrophy of the mesial temporal structures because the epileptic patients had no evidence of other abnormalities than those in IH on CT. The frequency of IH was high in patients with frequent grand mal seizures, long-standing course, or a history of complex type febrile convulsions, as well as in patients with temporal lobe epilepsy. These results not only provide substantial evidence that atrophy of the mesial temporal structures has an important role in the occurrence of temporal lobe seizure, but also support the theory that it may result from repeated seizures. (Namekawa, K.).

  7. Two epileptic syndromes, one brain: childhood absence epilepsy and benign childhood epilepsy with centrotemporal spikes.

    Cerminara, Caterina; Coniglio, Antonella; El-Malhany, Nadia; Casarelli, Livia; Curatolo, Paolo


    Childhood absence epilepsy (CAE) and benign childhood epilepsy with centrotemporal spikes (BCECTS), or benign rolandic epilepsy (BRE), are the most common forms of childhood epilepsy. CAE and BCECTS are well-known and clearly defined syndromes; although they are strongly dissimilar in terms of their pathophysiology, these functional epileptic disturbances share many features such as similar age at onset, overall good prognosis, and inheritance factors. Few reports are available on the concomitance of CAE and BCECTS in the same patients or the later occurrence of generalized epilepsy in patients with a history of partial epilepsy. In most cases described in the literature, absence seizures always started after the onset of benign focal epilepsy but the contrary has never occurred yet. We describe two patients affected by idiopathic generalized epileptic syndrome with typical absences, who experienced BCECTS after remission of seizures and normalization of EEG recordings. While the coexistence of different seizure types within an epileptic syndrome is not uncommon, the occurrence of childhood absence and BCECTS in the same child appears to be extremely rare, and this extraordinary event supports the hypothesis that CAE and BCECTS are two distinct epileptic conditions. However, recent interesting observations in animal models suggest that BCECTS and CAE could be pathophysiologically related and that genetic links could play a large role.

  8. EEG-confirmed epileptic activity in a cat with VGKC-complex/LGI1 antibody-associated limbic encephalitis.

    Pakozdy, Akos; Glantschnigg, Ursula; Leschnik, Michael; Hechinger, Harald; Moloney, Teresa; Lang, Bethan; Halasz, Peter; Vincent, Angela


    A 5-year-old, female client-owned cat presented with acute onset of focal epileptic seizures with orofacial twitching and behavioural changes. Magnetic resonance imaging showed bilateral temporal lobe hyperintensities and the EEG was consistent with ictal epileptic seizure activity. After antiepileptic and additional corticosteroid treatment, the cat recovered and by 10 months of follow-up was seizure-free without any problem. Retrospectively, antibodies to LGI1, a component of the voltage-gated potassium channel-complex, were identified. Feline focal seizures with orofacial involvement have been increasingly recognised in client-owned cats, and autoimmune limbic encephalitis was recently suggested as a possible aetiology. This is the first report of EEG, MRI and long-term follow-up of this condition in cats which is similar to human limbic encephalitis.

  9. Automatic multi-modal intelligent seizure acquisition (MISA) system for detection of motor seizures from electromyographic data and motion data.

    Conradsen, Isa; Beniczky, Sándor; Wolf, Peter; Kjaer, Troels W; Sams, Thomas; Sorensen, Helge B D


    The objective is to develop a non-invasive automatic method for detection of epileptic seizures with motor manifestations. Ten healthy subjects who simulated seizures and one patient participated in the study. Surface electromyography (sEMG) and motion sensor features were extracted as energy measures of reconstructed sub-bands from the discrete wavelet transformation (DWT) and the wavelet packet transformation (WPT). Based on the extracted features all data segments were classified using a support vector machine (SVM) algorithm as simulated seizure or normal activity. A case study of the seizure from the patient showed that the simulated seizures were visually similar to the epileptic one. The multi-modal intelligent seizure acquisition (MISA) system showed high sensitivity, short detection latency and low false detection rate. The results showed superiority of the multi-modal detection system compared to the uni-modal one. The presented system has a promising potential for seizure detection based on multi-modal data. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  10. ATPergic signalling during seizures and epilepsy.

    Engel, Tobias; Alves, Mariana; Sheedy, Caroline; Henshall, David C


    Much progress has been made over the last few decades in the identification of new anti-epileptic drugs (AEDs). However, 30% of epilepsy patients suffer poor seizure control. This underscores the need to identify alternative druggable neurotransmitter systems and drugs with novel mechanisms of action. An emerging concept is that seizure generation involves a complex interplay between neurons and glial cells at the tripartite synapse and neuroinflammation has been proposed as one of the main drivers of epileptogenesis. The ATP-gated purinergic receptor family is expressed throughout the brain and is functional on neurons and glial cells. ATP is released in high amounts into the extracellular space after increased neuronal activity and during chronic inflammation and cell death to act as a neuro- and gliotransmitter. Emerging work shows pharmacological targeting of ATP-gated purinergic P2 receptors can potently modulate seizure generation, inflammatory processes and seizure-induced brain damage. To date, work showing the functional contribution of P2 receptors has been mainly performed in animal models of acute seizures, in particular, by targeting the ionotropic P2X7 receptor subtype. Other ionotropic P2X and metabotropic P2Y receptor family members have also been implicated in pathological processes following seizures such as the P2X4 receptor and the P2Y12 receptor. However, during epilepsy, the characterization of P2 receptors was mostly restricted to the study of expressional changes of the different receptor subtypes. This review summarizes the work to date on ATP-mediated signalling during seizures and the functional impact of targeting the ATP-gated purinergic receptors on seizures and seizure-induced pathology. This article is part of the Special Issue entitled 'Purines in Neurodegeneration and Neuroregeneration'.

  11. Pallister-Killian syndrome: an unusual cause of epileptic spasms.

    Sánchez-Carpintero, Rocio; McLellan, Ailsa; Parmeggiani, Lucio; Cockwell, Annette E; Ellis, Richard J; Cross, J Helen; Eckhardt, Susan; Guerrini, Renzo


    Pallister-Killian syndrome (PKS) is a rare, sporadic, genetic disorder characterized by dysmorphic features, learning disability, and epilepsy. It is caused by a mosaic supernumerary isochromosome 12p (i[12p]). The i(12p) is rarely found in peripheral blood but it is present in skin fibroblasts. Recognition is essential for cytogenetic diagnosis. We describe a male aged 2 years 6 months and a female aged 11 years with PKS and epileptic spasms (ES). This type of seizure is not unusual in patients with brain malformations and with severe developmental delay, but it is sometimes difficult to recognize without video-electroencephalogram studies and could be mistaken for other types of seizure or behavioural manifestations. In these two patients with PKS, spasms had late onset, persisted beyond infancy, and were drug resistant. Clinicians should be aware of this possibility in PKS, which appears to be a rare cause of ES.

  12. Transient Epileptic Amnesia with Preserved Consciousness: a Report of Two Cases.

    Cho, Soohyun; Lee, Wong-Woo; Kang, Kyusik; Park, Jong-Moo; Kim, Byung-Kun; Kwon, Ohyun; Lee, Jung-Ju


    Transient epileptic amnesia (TEA) is defined as recurrent ictal and interictal transient memory disturbances typically occurring upon waking. Patients with TEA usually cannot remember the episodes. Electroencephalographic (EEG) abnormalities are usually localized on the dominant or bilateral temporal lobes. Here we report two cases of TEA with atypical features. The patients could remember the episodes afterwards, and abnormal discharges on EEG were detected in the temporal lobes of the non-dominant hemisphere. We suggest that confinement of epileptic discharge to the non-dominant temporal lobe can lead to partial preservation of consciousness during seizure attacks that produce transient amnesia.

  13. Ketogenic diet - A novel treatment for early epileptic encephalopathy due to PIGA deficiency.

    Joshi, Charuta; Kolbe, Diana L; Mansilla, M Adela; Mason, Sara; Smith, Richard J H; Campbell, Colleen A


    We describe the presentation and workup of two brothers with early-onset epileptic encephalopathy who became seizure-free on a ketogenic diet. Extensive testing culminated in whole exome sequencing, which led to the diagnosis of phosphatidyl inositol glycan biosynthesis class A protein (PIGA) deficiency. This familial case highlights the importance of genetic testing for early-onset epileptic encephalopathies and underscores the potential value of a ketogenic diet in the treatment of this condition. Copyright © 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  14. Effects of Anterior Thalamic Nucleus Deep Brain Stimulation in Chronic Epileptic Rats

    Amorim, Beatriz; Cavarsan, Clarissa; Miranda, Maisa Ferreira; Aarão, Mayra C.; Madureira, Ana Paula; Rodrigues, Antônio M.; Nobrega, José N.; Mello, Luiz E.; Hamani, Clement


    Deep brain stimulation (DBS) has been investigated for the treatment of epilepsy. In rodents, an increase in the latency for the development of seizures and status epilepticus (SE) has been reported in different animal models but the consequences of delivering stimulation to chronic epileptic animals have not been extensively addressed. We study the effects of anterior thalamic nucleus (AN) stimulation at different current intensities in rats rendered epileptic following pilocarpine (Pilo) administration. Four months after Pilo-induced SE, chronic epileptic rats were bilaterally implanted with AN electrodes or had sham-surgery. Stimulation was delivered for 6 h/day, 5 days/week at 130 Hz, 90 µsec. and either 100 µA or 500 µA. The frequency of spontaneous recurrent seizures in animals receiving stimulation was compared to that recorded in the preoperative period and in rats given sham treatment. To investigate the effects of DBS on hippocampal excitability, brain slices from animals receiving AN DBS or sham surgery were studied with electrophysiology. We found that rats treated with AN DBS at 100 µA had a 52% non-significant reduction in the frequency of seizures as compared to sham-treated controls and 61% less seizures than at baseline. Animals given DBS at 500 µA had 5.1 times more seizures than controls and a 2.8 fold increase in seizure rate as compared to preoperative values. In non-stimulated controls, the average frequency of seizures before and after surgery remained unaltered. In vitro recordings have shown that slices from animals previously given DBS at 100 µA had a longer latency for the development of epileptiform activity, shorter and smaller DC shifts, and a smaller spike amplitude compared to non-stimulated controls. In contrast, a higher spike amplitude was recorded in slices from animals given AN DBS at 500 µA. PMID:24892420

  15. A signal processing based analysis and prediction of seizure onset in patients with epilepsy.

    Namazi, Hamidreza; Kulish, Vladimir V; Hussaini, Jamal; Hussaini, Jalal; Delaviz, Ali; Delaviz, Fatemeh; Habibi, Shaghayegh; Ramezanpoor, Sara


    One of the main areas of behavioural neuroscience is forecasting the human behaviour. Epilepsy is a central nervous system disorder in which nerve cell activity in the brain becomes disrupted, causing seizures or periods of unusual behaviour, sensations and sometimes loss of consciousness. An estimated 5% of the world population has epileptic seizure but there is not any method to cure it. More than 30% of people with epilepsy cannot control seizure. Epileptic seizure prediction, refers to forecasting the occurrence of epileptic seizures, is one of the most important but challenging problems in biomedical sciences, across the world. In this research we propose a new methodology which is based on studying the EEG signals using two measures, the Hurst exponent and fractal dimension. In order to validate the proposed method, it is applied to epileptic EEG signals of patients by computing the Hurst exponent and fractal dimension, and then the results are validated versus the reference data. The results of these analyses show that we are able to forecast the onset of a seizure on average of 25.76 seconds before the time of occurrence.

  16. Massively multiplayer online role-playing game-induced seizures: a neglected health problem in Internet addiction.

    Chuang, Yao-Chung


    As the Internet has become rapidly and widely integrated into society, Internet addiction has become a growing psychosocial problem. However, epileptic seizure, another out-of-the-ordinary health problem, is often neglected in this regard. Ten patients who experienced epileptic seizures while playing the newest genre of electronic games -- Massively Multiplayer Online Role-Playing Games (MMORPGs) -- were investigated. Patients were predominantly male young adults, and most of the events were generalized tonic-clonic seizures, myoclonic seizures, and absences. These patients should be categorized into idiopathic generalized epilepsies. Even though photosensitivity was an important factor, behavioral and higher mental activities also seemed to be significant seizure precipitants. Results demonstrated that MMORPG-induced seizures were not analogous to the ordinary video game-induced seizures. Significantly, an epileptic seizure warning did not always appear on the websites of MMORPGs and instructions for the software. While the prevalence of MMORPG-induced seizures remains unknown, it may exceed our expectations and impact our society. Not only for clinical neurologists but also for the primary physicians, educators, sociologists, and global online game publishers, there should be an awareness of this special form of reflex seizures in order to provide an appropriate health warning to MMORPG players.

  17. Acquired epileptic opercular syndrome related to a heterozygous deleterious substitution in GRIN2A.

    Sculier, Claudine; Tilmant, Anne-Sophie; De Tiège, Xavier; Giurgea, Sanda; Paquier, Philippe; Rudolf, Gabrielle; Lesca, Gaetan; Van Bogaert, Patrick


    Epileptic encephalopathies with continuous spike-and-waves during sleep (CSWS) are characterized by cognitive or language impairment, and are occasionally associated with pathogenic variants of the GRIN2A gene. In these disorders, speech dysfunction could be either related to cerebral dysfunction caused by the GRIN2A deleterious variant or intense interictal epileptic activity. Here, we present a patient with apraxia of speech, clearly linked to severity of epilepsy, carrying a GRIN2A variant. A 6-year-old boy developed acute regression of expressive language following epileptic seizures, leading to complete mutism, at which time EEG revealed CSWS. MEG showed bilateral superior parietal and opercular independent CSWS onsets and PET with fluorodeoxyglucose demonstrated significant increase in relative glucose metabolism in bilateral superior parietal regions. Corticosteroids induced a regression of CSWS together with impressive improvement in speech abilities. This case supports the hypothesis of a triggering role for epileptic discharges in speech deterioration observed in children carrying a deleterious variant of GRIN2A. When classic antiepileptic drugs fail to control epileptic activity, corticosteroids should be considered. Multimodal functional neuroimaging suggests a role for opercular and superior parietal areas in acquired epileptic opercular syndrome. [Published with video sequences on].

  18. Synaptic Reorganization of the Perisomatic Inhibitory Network in Hippocampi of Temporal Lobe Epileptic Patients

    Wittner, Lucia


    GABAergic inhibition and particularly perisomatic inhibition play a crucial role in controlling the firing properties of large principal cell populations. Furthermore, GABAergic network is a key element in the therapy attempting to reduce epileptic activity. Here, we present a review showing the synaptic changes of perisomatic inhibitory neuronal subtypes in the hippocampus of temporal lobe epileptic patients, including parvalbumin- (PV-) containing and cannabinoid Type 1 (CB1) receptor-expressing (and mainly cholecystokinin-positive) perisomatic inhibitory cells, known to control hippocampal synchronies. We have examined the synaptic input of principal cells in the dentate gyrus and Cornu Ammonis region in human control and epileptic hippocampi. Perisomatic inhibitory terminals establishing symmetric synapses were found to be sprouted in the dentate gyrus. Preservation of perisomatic input was found in the Cornu Ammonis 1 and Cornu Ammonis 2 regions, as long as pyramidal cells are present. Higher density of CB1-immunostained terminals was found in the epileptic hippocampus of sclerotic patients, especially in the dentate gyrus. We concluded that both types of (PV- and GABAergic CB1-containing) perisomatic inhibitory cells are mainly preserved or showed sprouting in epileptic samples. The enhanced perisomatic inhibitory signaling may increase principal cell synchronization and contribute to generation of epileptic seizures and interictal spikes. PMID:28116310

  19. The effects of glycemic control on seizures and seizure-induced excitotoxic cell death

    Schauwecker Paula


    Full Text Available Abstract Background Epilepsy is the most common neurological disorder after stroke, affecting more than 50 million persons worldwide. Metabolic disturbances are often associated with epileptic seizures, but the pathogenesis of this relationship is poorly understood. It is known that seizures result in altered glucose metabolism, the reduction of intracellular energy metabolites such as ATP, ADP and phosphocreatine and the accumulation of metabolic intermediates, such as lactate and adenosine. In particular, it has been suggested that the duration and extent of glucose dysregulation may be a predictor of the pathological outcome of status. However, little is known about neither the effects of glycemic control on brain metabolism nor the effects of managing systemic glucose concentrations in epilepsy. Results In this study, we examined glycemic modulation of kainate-induced seizure sensitivity and its neuropathological consequences. To investigate the relationship between glycemic modulation, seizure susceptibility and its neuropathological consequences, C57BL/6 mice (excitotoxin cell death resistant were subjected to hypoglycemia or hyperglycemia, followed by systemic administration of kainic acid to induce seizures. Glycemic modulation resulted in minimal consequences with regard to seizure severity but increased hippocampal pathology, irrespective of whether mice were hypoglycemic or hyperglycemic prior to kainate administration. Moreover, we found that exogenous administration of glucose following kainic acid seizures significantly reduced the extent of hippocampal pathology in FVB/N mice (excitotoxin cell death susceptible following systemic administration of kainic acid. Conclusion These findings demonstrate that modulation of the glycemic index can modify the outcome of brain injury in the kainate model of seizure induction. Moreover, modulation of the glycemic index through glucose rescue greatly diminishes the extent of seizure

  20. Seizure semiology in males with psychogenic nonepileptic seizures is associated with somatic complaints.

    Gale, Shawn D; Hill, Stacy W; Pearson, Caleb


    Psychopathology has been studied in patients with epileptic or psychogenic non-epileptic seizures in the context of diagnosis and treatment. Unfortunately, most PNES studies include few males and do not consider possible gender differences, making findings less generalizable to males with PNES. In this study we specifically compare males with PNES to females with PNES and to males with epilepsy. Males with PNES (n=58), males with epilepsy (n=86), females with PNES (n=147), and females with ES (n=142) were evaluated on an inpatient epilepsy monitoring unit. Self-reported objective measures of psychopathology, demographics, and PNES seizure semiology were compared. Personality Assessment Inventory profiles revealed marked differences, particularly in somatic symptoms, between PNES and epilepsy. Females with PNES had higher levels of physiological depressive symptoms but lower antisocial features. Males with PNES who had clinically significant elevations on the somatic complaints scale were much more likely to have motor seizures while females with PNES classified similarly were equally likely to have either motor or non-motor events. Gender difference in PNES seizure semiology was associated with whether or not clinically significant somatic symptoms were present; males with elevated somatic symptoms were much more likely to have motor PNES. However, we did not find evidence of greater psychopathology in males with PNES compared to females with PNES. Gender differences in the behavioral manifestation of PNES in the context of presence or absence of somatization may have implications for diagnosis and treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Seizure characteristics in multiple sclerosis patients

    Vahid Shaygannejad


    Full Text Available Background: To evaluate seizure characteristic among multiple sclerosis patients with coexistent seizure activity compared to control group. Materials and Methods : This study is a cross-sectional study which was conducted by reviewing the clinical records of patients with definite diagnosis of MS according to McDonald′s criteria from March 2007 to June 2011, who referred to the MS clinic of the university. Results : A total of 920 patients with a diagnosis of MS were identified, among whom 29 patients (3.15% with seizure activity (case due to MS with the mean age of 32.6 ± 6.23 years were analyzed. Also, fifty MS patients without any seizure occurrence with the mean age of 33.7 ± 7.4 years were used as our control group. In case group, seizure was general tonic clonic in 23 patients (79.3%, complex partial in four (13.8%, and simple partial in two (5.9%. The 26 available interictal EEGs in MS patients showed abnormal EEG pattern in 22 (84.6% of them, including focal epileptic form discharge or focal slowing in 10 (38.5%, generalized discharge (spike-wave, polyspike, or general paroxysmal fast activity in 10 (38.5%, and general slowing activity in 10 record (38.5%. MRI reviews of the 26 available brain MRIs showed subcortical white mater lesions in 22 (84.6% of patients with seizure. All MRIs were performed within one month after the first seizure episode. Amongst 48 available MRIs in our control group, 91.7% (44 cases showed periventricular lesions and in 8.3% (4 cases subcortical white matter lesions were reported. Conclusion : The result of this study demonstrated the higher rate of subcortical whit matter lesion in MS patients with seizure occurrence compared to control group.

  2. Seizure risk from cavernous or arteriovenous malformations

    Josephson, C.B.; Leach, J.-P.; Duncan, R.; Roberts, R.C.; Counsell, C.E.


    Objectives: To determine the risk of epileptic seizures due to a brain arteriovenous malformation (AVM) or cavernous malformation (CM). Methods: In a prospective population-based study of new diagnoses of AVMs (n = 229) or CMs (n = 139) in adults in Scotland in 1999–2003, we used annual medical records surveillance, general practitioner follow-up, and patient questionnaires to quantify the risk of seizures between clinical presentation and AVM/CM treatment, last follow-up, or death. Results: The 5-year risk of first-ever seizure after presentation was higher for AVMs presenting with intracranial hemorrhage or focal neurologic deficit (ICH/FND: n = 119; 23%, 95% confidence interval [CI] 9%–37%) than for incidental AVMs (n = 40; 8%, 95% CI 0%–20%), CMs presenting with ICH/FND (n = 38; 6%, 95% CI 0%–14%), or incidental CMs (n = 57; 4%, 95% CI 0%–10%). For adults who had never experienced ICH/FND, the 5-year risk of epilepsy after first-ever seizure was higher for CMs (n = 23; 94%, 95% CI 84%–100%) than AVMs (n = 37; 58%, 95% CI 40%–76%; p = 0.02). Among adults who never experienced ICH/FND and presented with or developed epilepsy, there was no difference in the proportions achieving 2-year seizure freedom over 5 years between AVMs (n = 43; 45%, 95% CI 20%–70%) and CMs (n = 35; 47%, 95% CI 27%–67%). Conclusions: AVM-related ICH confers a significantly higher risk of a first-ever seizure compared to CMs or incidental AVMs. Adults with a CM have a high risk of epilepsy after a first-ever seizure but achieve seizure freedom as frequently as those with epilepsy due to an AVM. PMID:21536634

  3. Can venous blood gas analysis be used for predicting seizure recurrence in emergency department?

    Kılıc, Turgay Yılmaz; Yesilaras, Murat; Atilla, Ozge Duman; Sever, Mustafa; Aksay, Ersin


    Epileptic seizures account for 1%-2% of all admissions of patients to the emergency department (ED). The present study aimed to determine whether venous blood pH, bicarbonate, base excess, and lactate levels taken within 1 hour of the last seizure episode help to determine seizure recurrence in emergency departments. A cross-sectional study was conducted in the emergency department (ED) between January and July, 2012. Patients who were admitted to the emergency department consecutively were included in the study if they were 14 years or older and within 1 hour after last seizure. Demographics, seizure type, use of antiepileptic drugs, observation period at the emergency department, seizure recurrence, pH, bicarbonate, base excess, and lactate levels from venous blood gas analysis were determined. A total of 94 patients aged 14 years or older were included in the study. Of these patients, 10.6% (n=10) experienced recurrent seizures in the observation period at the emergency department. To predict recurrent seizures in ED, threshold venous blood gas values were determined as follows: pH7.65 mmol/L [sensitivity 80% (95%CI: 44-96), negative predictive value 96.6% (95%CI: 87-99)]. If venous blood gas analysis is made on pH, base excess, lactate and bicarbonate immediately one hour after the last epileptic seizure episode, it is possible to predict whether the patient will have seizure recurrence.

  4. Mutations affecting GABAergic signaling in seizures and epilepsy

    Galanopoulou, Aristea S.


    The causes of epilepsies and epileptic seizures are multifactorial. Genetic predisposition may contribute in certain types of epilepsies and seizures, whether idiopathic or symptomatic of genetic origin. Although these are not very common, they have offered a unique opportunity to investigate the molecular mechanisms underlying epileptogenesis and ictogenesis. Among the implicated gene mutations, a number of GABAA receptor subunit mutations have been recently identified that contribute to several idiopathic epilepsies, febrile seizures, and rarely to certain types of symptomatic epilepsies, like the severe myoclonic epilepsy of infancy. Deletion of GABAA receptor genes has also been linked to Angelman syndrome. Furthermore, mutations of proteins controlling chloride homeostasis, which indirectly defines the functional consequences of GABAA signaling, have been identified. These include the chloride channel 2 (CLCN2) and the potassium chloride cotransporter KCC3. The pathogenic role of CLCN2 mutations has not been clearly demonstrated and may represent either susceptibility genes or, in certain cases, innocuous polymorphisms. KCC3 mutations have been associated with hereditary motor and sensory polyneuropathy with corpus callosum agenesis (Andermann syndrome) that often manifests with epileptic seizures. This review summarizes the recent progress in the genetic linkages of epilepsies and seizures to the above genes and discusses potential pathogenic mechanisms that contribute to the age, sex, and conditional expression of these seizures in carriers of these mutations. PMID:20352446

  5. Recognition and management of seizures in children in emergency departments.

    Caplan, Edward; Dey, Indranil; Scammell, Andrea; Burnage, Katy; Paul, Siba Prosad


    Seizure is defined as 'a sudden surge of electrical activity in the brain, which usually affects how a person appears or acts for a short time'. Children who have experienced seizures commonly present to emergency departments (EDs), and detailed history taking will usually help differentiate between epileptic and non-epileptic events. ED nurses are often the first health professionals to manage children with seizures, and this is best done by following the ABCDE approach. Treatment involves termination of seizures with anticonvulsants, and children may need other symptomatic management. Seizures in children can be an extremely distressing experience for parents, who should be supported and kept informed by experienced ED nurses. Nurses also play a vital role in educating parents on correct administration of anticonvulsants and safety advice. This article discusses the aetiology, clinical presentation, diagnosis and management of children with seizures, with particular emphasis on epilepsy. It includes two reflective case studies to highlight the challenges faced by healthcare professionals managing children who present with convulsions.

  6. Complex dynamics of epileptic EEG.

    Kannathal, N; Puthusserypady, Sadasivan K; Choo Min, Lim


    Electroencephalogram (EEG) - the recorded representation of electrical activity of the brain contain useful information about the state of the brain. Recent studies indicate that nonlinear methods can extract valuable information from neuronal dynamics. We compare the dynamical properties of EEG signals of healthy subjects with epileptic subjects using nonlinear time series analysis techniques. Chaotic invariants like correlation dimension (D2) , largest Lyapunov exponent (lambda1), Hurst exponent (H) and Kolmogorov entropy (K) are used to characterize the signal. Our study showed clear differences in dynamical properties of brain electrical activity of the normal and epileptic subjects with a confidence level of more than 90%. Furthermore to support this claim fractal dimension (FD) analysis is performed. The results indicate reduction in value of FD for epileptic EEG indicating reduction in system complexity.

  7. Pyridoxine-dependent seizures: a review.

    Rajesh, R; Girija, A S


    Pyridoxine-dependent seizure is a rare autosomal recessive disorder that usually presents with neonatal intractable seizures. This syndrome results from an inborn abnormality of the enzyme glutamic acid decarboxylase, which results in reduced pyridazine-dependent synthesis of the inhibitory neurotransmitter gamma amino butyric acid. The full range of symptomatology is unknown; but can be associated with autism, breath holding and severe mental retardation, bilious vomiting, transient visual agnosia, severe articulatory apraxia motor dyspraxia, microcephaly and intrauterine seizures. Parenteral pyridine injection test is a highly effective and reproducible test in confirming the diagnosis. Pyridoxine should be administered as a diagnostic test in all cases of convulsive disorders of infancy in which no other diagnosis is evident. Epileptic seizure discharges subside within 2-6 minutes after the intravenous injection of 50-100 mg of pyridaoxine. Once the diagnosis is confirmed, maintenance therapy should be continued indefinitely and doses increased with age or intercurrent illnesses. The maintenance dose of Bg needed is still not clear. There is a relatively wide range for the daily B6 dose necessary to control the seizure i.e., 10-200 mg/day.

  8. Liposteroid therapy for refractory seizures in children.

    Yoshikawa, H; Yamazaki, S; Abe, T; Oda, Y


    Liposteroid is dexamethasone palmitate incorporated into liposomes and was developed as an anti-inflammatory drug for targeting therapy mainly for rheumatoid arthritis. Recently, it was reported that liposteroid might be effective for the treatment of West syndrome, with fewer side effects than those of corticotropin therapy. We describe three patients, a 2-month-old boy with early infantile epileptic encephalopathy, a 4-month-old girl with symptomatic West syndrome, and a 2-year-old girl with symptomatic localization-related epilepsy, whose refractory seizures were treated with liposteroid according to the original method reported by Yamamoto and colleagues in 1998. Uncontrollable seizures ceased completely in two patients and the seizure frequency decreased markedly in the other patient. Electroencephalograms revealed marked improvement in all patients. They showed no relapse of the seizures, and all showed no adverse effects except for mild brain shrinkage in one patient. Our experience with these three patients suggests that liposteroid therapy might be a new option for the treatment of refractory seizures in children, as well as for West syndrome.

  9. Treating Lennox–Gastaut syndrome in epileptic pediatric patients with third-generation rufinamide

    Gresham, Jessica; Eiland, Lea S; Chung, Allison M


    Lennox–Gastaut syndrome (LGS) is a rare but debilitating pediatric epileptic encephalopathy characterized by multiple intractable seizure types. Treatment of LGS is challenging because of the small number of antiepileptic drugs (AEDs) which are effective for this syndrome, as well as the need for polytherapy in the majority of patients. This review focuses on the treatment of LGS with rufinamide, a recently approved third-generation AED with reported efficacy as adjunctive therapy for LGS. All relevant papers identified through a PubMed search on the treatment of LGS with rufinamide were reviewed. To date, the literature suggests improvements in seizure frequency for pediatric patients with LGS on rufinamide. Rufinamide appears to be especially effective for atonic or drop attack seizures. Rufinamide also displays a favorable adverse event profile compared with the older anticonvulsants, as well as a minimal number of drug interactions, making it a promising option for the adjunctive treatment of seizures associated with LGS. PMID:20957124

  10. Treating Lennox-Gastaut syndrome in epileptic pediatric patients with third-generation rufinamide.

    Gresham, Jessica; Eiland, Lea S; Chung, Allison M


    Lennox-Gastaut syndrome (LGS) is a rare but debilitating pediatric epileptic encephalopathy characterized by multiple intractable seizure types. Treatment of LGS is challenging because of the small number of antiepileptic drugs (AEDs) which are effective for this syndrome, as well as the need for polytherapy in the majority of patients. This review focuses on the treatment of LGS with rufinamide, a recently approved third-generation AED with reported efficacy as adjunctive therapy for LGS. All relevant papers identified through a PubMed search on the treatment of LGS with rufinamide were reviewed. To date, the literature suggests improvements in seizure frequency for pediatric patients with LGS on rufinamide. Rufinamide appears to be especially effective for atonic or drop attack seizures. Rufinamide also displays a favorable adverse event profile compared with the older anticonvulsants, as well as a minimal number of drug interactions, making it a promising option for the adjunctive treatment of seizures associated with LGS.

  11. Rufinamide: a new anti-epileptic medication.

    Hakimian, Shahin; Cheng-Hakimian, Andrea; Anderson, Gail D; Miller, John W


    Rufinamide (1-[2,6-difluorobenzyl]-1H-1,2,3-triazole-4-carboxamide) is a new anti-epileptic drug with a novel triazole derivative structure. The suspected mechanism of action is limitation of sodium-dependent action potentials, thought to result in a membrane stabilizing effect. Rufinamide is extensively metabolized in the liver by non-CYP450 enzymes with an elimination half-life of 8 - 12 h. Three randomized, placebo-controlled trials have shown that rufinamide is effective against partial seizures in adults. Efficacy in the Lennox-Gastaut syndrome, a severe, disabling childhood onset epilepsy syndrome, was shown in a single, randomized, placebo-controlled trial. It has recently been approved for treatment of Lennox-Gastaut syndrome in Europe. In the US it is under regulatory review. Most common adverse effects are somnolence, fatigue, dizziness, dipolopia, nausea and ataxia. Rufinamide has shown promise as adjunctive treatment for Lennox-Gastaut syndrome and may have some role in localization related epilepsies as well.

  12. Oral health status in epileptic children.

    Gurbuz, Taskin; Tan, Huseyin


    The aim of the present study was to evaluate the oral hygiene status and dental treatment requirements in children with epilepsy. The treatment group consisted of 211 children with epilepsy (120 boys and 91 girls, 4-15 years old, mean age 7.85 + or - 2.98 years). The control group consisted of healthy children, matched by age and gender. Clinical features of the patients were obtained from hospital records. Clinical examinations were conducted, under standard light, using a plane buccal mirror, a dental probe and air drying to evaluate caries experience and to record the periodontal health of each child. Statistical analysis was performed using chi(2) test, Fisher exact test and anova. The number of decayed and missing teeth, the degree of abrasion and periodontal indexes were significantly worse in patients with epilepsy, compared to the control group (P oral disorders. Generalized tonic-clonic seizures often cause minor oral injuries and traumatized anterior teeth. Epileptic children are at an increased risk of developing caries and gingivitis compared with healthy subjects.

  13. Management of a high risk epileptic patient under conscious sedation: A multidisciplinary approach

    Burnice Nalina Kumari Chellathurai


    Full Text Available Epilepsy, characterized by the risk of recurrent seizures, is a chronic disease that afflicts about 5% of the world's population. The main dental problems associated with epileptic patients include gingival hyperplasia, minor oral injuries, tooth trauma, and prosthodontic problems, which require the dental treatment. Stress and fear are the most common triggering factors for the epilepsy in dental chair. Therefore, a more appropriate method of treating such epileptic patients may be warranted. Conscious sedation is a technique of providing good anesthesia and analgesia to patients, the main advantage of which is the patient's rapid return to presentation levels. Midazolam used as a sedative agent has anticonvulsant properties. This case report highlights a case requiring multiple dental procedures carried out in a high risk epileptic patient under conscious sedation.

  14. Management of a high risk epileptic patient under conscious sedation: A multidisciplinary approach.

    Chellathurai, Burnice Nalina Kumari; Thiagarajan, Ramakrishnan; Jayakumaran, SelvaKumar; Devadoss, Pradeep; Elavazhagan


    Epilepsy, characterized by the risk of recurrent seizures, is a chronic disease that afflicts about 5% of the world's population. The main dental problems associated with epileptic patients include gingival hyperplasia, minor oral injuries, tooth trauma, and prosthodontic problems, which require the dental treatment. Stress and fear are the most common triggering factors for the epilepsy in dental chair. Therefore, a more appropriate method of treating such epileptic patients may be warranted. Conscious sedation is a technique of providing good anesthesia and analgesia to patients, the main advantage of which is the patient's rapid return to presentation levels. Midazolam used as a sedative agent has anticonvulsant properties. This case report highlights a case requiring multiple dental procedures carried out in a high risk epileptic patient under conscious sedation.

  15. The Lombrosian prejudice in medicine. The case of epilepsy. Epileptic psychosis. Epilepsy and aggressiveness.

    Granieri, Enrico; Fazio, Patrik


    In the nineteenth century, epilepsy became subject of experimental research. Lombroso established a relationship between epilepsy and criminality believing in the existence of epileptoid traits and atavism. He tried to demonstrate the common origin of epilepsy, criminality, and genius; factors deteriorating the CNS would act upon centers, which control behavior and ethics. This impairment would cause a lack of control on the lower nervous centers, reducing restraints of instincts and criminal behavior. He described developmental frontal cortex lesions in epileptic patients (today Taylor's dysplasia) and these observations supported the erroneous conviction of a relationship between criminality and epilepsy. Neurological, behavioral, and criminological sciences analyzed Lombroso's doctrine, whereas it was controversial that epileptic patients should be prone to violent actions and aggressive behavior. Today, there is an international panel of experts on epilepsy, which suggests five relevant criteria to determine if a crime committed with aggressiveness could result from epileptic seizures.

  16. Computed Tomography Findings in Patients with Seizure Disorder

    Sumnima Acharya


    Full Text Available Introduction: Seizure occurs in up to 10% of the population, whereas epilepsy is a chronic disease characterized by recurrent seizures that may affect up to 2% of the population. Modern neuroimaging is useful in diagnosis of  abnormalities underlying the epilepsies, but the information provided by imaging techniques can also contribute to proper classification of certain epileptic disorders and can delineate the genetics of some underlying syndromes. Neuroimaging is even more important for those patients who have medically intractable seizures. This study was carried out to establish different etiologies of seizures, to correlate the clinical data and radiological findings in cases of seizure, and to identify the common etiologies in different types of seizures.   Methods: This was a retrospective hospital-based study conducted in the Department of Radiodiagnosis of Lumbini Medical College Teaching Hospital. Records of patients of past two years, admitted in any department of the hospital with history of seizure disorder and underwent a Computed Tomography  (CT of brain were included. The CT patterns were assessed and the data were tabulated and statistically analyzed.   Results: There were a total of 480 cases out of which 263 (55% were male and 217 (45% were female with M:F ratio of 1.2:1. Generalized seizure was more frequent than partial seizure in both gender. In 274 cases of generalized seizures, CT scan findings were abnormal in 151 cases and normal finding observed in 123 cases. In 206 cases of partial seizures, 125 cases were abnormal and 81 having normal CT scan findings. Age wise distribution showed highest number (n=218 of cases in young group (60 yr. The most common cause of seizure  was  calcified granuloma (n=79, 16.5% followed by neurocysticercosis (NCC, n=64, 13%. Diffuse cerebral edema, sub-arachnoid hemorrhage, and hydrocephalus was seen only in lower age group particularly among 1-20 years. Infarct and diffuse cortical

  17. Evaluation of selected recurrence measures in discriminating pre-ictal and inter-ictal periods from epileptic EEG data

    Ngamga, Eulalie Joelle; Bialonski, Stephan; Marwan, Norbert; Kurths, Jürgen; Geier, Christian; Lehnertz, Klaus


    We investigate the suitability of selected measures of complexity based on recurrence quantification analysis and recurrence networks for an identification of pre-seizure states in multi-day, mul