Sample records for catastrophic seizure disorders

  1. Athletes with seizure disorders. (United States)

    Knowles, Byron Don; Pleacher, Michael D


    Individuals with seizure disorders have long been restricted from participation in certain sporting activities. Those with seizure disorders are more likely than their peers to have a sedentary lifestyle and to develop obesity. Regular participation in physical activity can improve both physical and psychosocial outcomes for persons with seizure disorders. Seizure activity often is reduced among those patients who regularly engage in aerobic activity. Recent literature indicates that the diagnosis of seizure disorders remains highly stigmatizing in the adolescent population. Persons with seizure disorders may be more accepted by peer groups if they are allowed to participate in sports and recreational activities. Persons with seizure disorders are encouraged to participate in regular aerobic activities. They may participate in team sports and contact or collision activities provided that they utilize appropriate protective equipment. There seems to be no increased risk of injury or increasing seizure activity as the result of such participation. Persons with seizure disorders still are discouraged from participating in scuba diving and skydiving. The benefits of participation in regular sporting activity far outweigh any risk to the athlete with a seizure disorder who chooses to participate in sports.

  2. Seizure disorders and epilepsy. (United States)

    Ozuna, J


    Seizures are uncontrolled hypersynchronous electrical discharges of neurons in the brain that interfere with normal function. They are a symptom of an underlying disorder. Epilepsy is a condition of recurring seizures that do not have a reversible metabolic cause. Seizures can be confused with a variety of other conditions, so an understanding of seizure manifestations is crucial in making an accurate diagnosis. Drug therapy is the mainstay of epilepsy treatment, but surgery and vagal nerve stimulation are options for selected refractory cases. Psychosocial consequences of recurring seizures are often more significant to patients than the seizures themselves.

  3. Seizure Disorders in Pregnancy (United States)

    ... Can taking antiseizure medications during pregnancy harm my baby? • Should I stop taking my antiseizure medications during pregnancy? • What extra steps may my health care provider take when monitoring my pregnancy? • If I have a seizure disorder, ...

  4. Seizures and Epilepsy and Their Relationship to Autism Spectrum Disorders (United States)

    Matson, Johnny L.; Neal, Daniene


    Autism spectrum disorders (ASD) are serious neurodevelopmental disorders which often co-occur with intellectual disabilities. A disorder which is strongly correlated with both of these disabilities are seizures and epilepsy. The purpose of this review was to provide an overview of available research on seizures and epilepsy in the ASD population…

  5. Teachers' knowledge and attitudes towards seizure disorder: A ...

    African Journals Online (AJOL)


    Oct 22, 2012 ... Materials and Methods: A self-administered questionnaire on knowledge and attitudes to seizure disorder were filled .... This study therefore was aimed at examining the influence of urban residence on knowledge and attitudes of school teachers towards children with seizure ..... disorder is encouraging.

  6. Seizure disorders: update of medical and dental considerations. (United States)

    Stoopler, Eric T; Sollecito, Thomas P; Greenberg, Martin S


    Seizure disorders and epilepsy represent neurologic conditions that commonly are seen among patients requiring dental treatment. When dentists possess a working knowledge of seizures, in addition to an understanding of updated therapies for seizure management and oral complications associated with pharmacological therapy, they are able to treat patients with these disorders more effectively. Neurologic consultations and selecting an appropriate venue for treatment may need to be addressed prior to treatment, depending on the level of seizure control. Laboratory tests designed to evaluate medication levels, leukocyte counts, and clotting ability also may be required. Frequent recall visits may be necessary for seizure disorder patients who display adverse oral complications from medication, such as gingival hypertrophy, xerostomia, and oral yeast infections.

  7. Attention-deficit/hyperactivity disorder medication and seizures. (United States)

    Wiggs, Kelsey K; Chang, Zheng; Quinn, Patrick D; Hur, Kwan; Gibbons, Robert; Dunn, David; Brikell, Isabell; Larsson, Henrik; D'Onofrio, Brian M


    Individuals with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of seizures, but there is uncertainty about whether ADHD medication treatment increases risk among patients with and without preexisting seizures. We followed a sample of 801,838 patients with ADHD who had prescribed drug claims from the Truven Health MarketScan Commercial Claims and Encounters databases to examine whether ADHD medication increases the likelihood of seizures among ADHD patients with and without a history of seizures. First, we assessed overall risk of seizures among patients with ADHD. Second, within-individual concurrent analyses assessed odds of seizure events during months when a patient with ADHD received ADHD medication compared with when the same individual did not, while adjusting for antiepileptic medications. Third, within-individual long-term analyses examined odds of seizure events in relation to the duration of months over the previous 2 years patients received medication. Patients with ADHD were at higher odds for any seizure compared with non-ADHD controls (odds ratio [OR] = 2.33, 95% confidence interval [CI] = 2.24-2.42 males; OR = 2.31, 95% CI = 2.22-2.42 females). In adjusted within-individual comparisons, ADHD medication was associated with lower odds of seizures among patients with (OR = 0.71, 95% CI = 0.60-0.85) and without (OR = 0.71, 95% CI = 0.62-0.82) prior seizures. Long-term within-individual comparisons suggested no evidence of an association between medication use and seizures among individuals with (OR = 0.87, 95% CI = 0.59-1.30) and without (OR = 1.01, 95% CI = 0.80-1.28) a seizure history. Results reaffirm that patients with ADHD are at higher risk of seizures. However, ADHD medication was associated with lower risk of seizures within individuals while they were dispensed medication, which is not consistent with the hypothesis that ADHD medication increases risk of seizures. © 2018 American Academy of Neurology.

  8. 75 FR 38599 - Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders (United States)


    ... diagnosed with a seizure disorder after brain surgery in 1976. He experienced his last seizure in 1995, and... in 1999, and is currently taking anti- seizure medication Dilantin. His neurologist states that he... anti- seizure medication Lamictal. His neurologist certified that he has been seizure-free for three...

  9. Thalamus lesions in chronic and acute seizure disorders

    International Nuclear Information System (INIS)

    Tschampa, Henriette J.; Greschus, Susanne; Urbach, Horst; Sassen, Robert; Bien, Christian G.


    Transient signal changes in the pulvinar have been described following status epilepticus. However, we observed persistent thalamus changes after seizures. The purpose of this study was to characterize thalamus changes in patients with seizure disorders and to correlate imaging findings with clinical features. We searched among 5,500 magnetic resonance imaging (MRI) exams performed in patients with seizures and identified 43 patients. The MRI scans of these patients were reviewed and correlated with clinical data. We identified four patterns of thalamus lesions: (a) fluid attenuated inversion recovery-hyperintense pulvinar lesions (20 patients), as known from status epilepticus. Ten patients in this group had a status epilepticus. Among the remaining patients, three had frequent seizures and seven had sporadic seizures. Twelve patients had follow-up exams for a median of 11 months. The lesions had persisted in 11/12 cases in the last available exam and were reversible in one case only. In seven cases, cone-shaped thalamus atrophy resulted, (b) linear defects in the medial and anterior thalamus (five patients), accompanied by atrophy of the mamillary body and the fornix in patients with chronic epilepsy, (c) extensive bilateral thalamus lesions in two patients with a syndrome caused by mutation in the mitochondrial polymerase gamma, and (d) other thalamus lesions not associated with the seizure disorder (16 patients). The spectrum of thalamus lesions in patients with seizure disorders is wider than previously reported. Postictal pulvinar lesions can persist and may result in thalamic atrophy. Linear defects in the anterior thalamus are associated with limbic system atrophy. (orig.)

  10. Thalamus lesions in chronic and acute seizure disorders

    Energy Technology Data Exchange (ETDEWEB)

    Tschampa, Henriette J.; Greschus, Susanne; Urbach, Horst [University of Bonn, Department of Radiology (Neuroradiology), Bonn (Germany); Sassen, Robert; Bien, Christian G. [University of Bonn, Department of Epileptology, Bonn (Germany)


    Transient signal changes in the pulvinar have been described following status epilepticus. However, we observed persistent thalamus changes after seizures. The purpose of this study was to characterize thalamus changes in patients with seizure disorders and to correlate imaging findings with clinical features. We searched among 5,500 magnetic resonance imaging (MRI) exams performed in patients with seizures and identified 43 patients. The MRI scans of these patients were reviewed and correlated with clinical data. We identified four patterns of thalamus lesions: (a) fluid attenuated inversion recovery-hyperintense pulvinar lesions (20 patients), as known from status epilepticus. Ten patients in this group had a status epilepticus. Among the remaining patients, three had frequent seizures and seven had sporadic seizures. Twelve patients had follow-up exams for a median of 11 months. The lesions had persisted in 11/12 cases in the last available exam and were reversible in one case only. In seven cases, cone-shaped thalamus atrophy resulted, (b) linear defects in the medial and anterior thalamus (five patients), accompanied by atrophy of the mamillary body and the fornix in patients with chronic epilepsy, (c) extensive bilateral thalamus lesions in two patients with a syndrome caused by mutation in the mitochondrial polymerase gamma, and (d) other thalamus lesions not associated with the seizure disorder (16 patients). The spectrum of thalamus lesions in patients with seizure disorders is wider than previously reported. Postictal pulvinar lesions can persist and may result in thalamic atrophy. Linear defects in the anterior thalamus are associated with limbic system atrophy. (orig.)

  11. Assessing Systems of Care for US Children with Epilepsy/Seizure Disorder (United States)

    Kenney, Mary Kay; Mann, Marie


    Background. The proportion of US children with special health care needs (CSHCN) with epilepsy/seizure disorder who receive care in high-quality health service systems was examined. Methodology. We analyzed data for 40,242 CSHCN from the 2009-2010 National Survey of CSHCN and compared CSHCN with epilepsy/seizure disorder to CSHCN without epilepsy/seizure disorder. Measures included attainment rates for 6 federal quality indicators with comparisons conducted using chi square and logistic regression methods. In addition, CSHCN with epilepsy/seizure disorder were compared to CSHCN without epilepsy/seizure disorder on the basis of 14 unmet health care needs. Results. Lower attainment rates for receiving comprehensive care in a medical home and easily accessible community-based services were found for CSHCN with epilepsy/seizure disorder versus CSHCN without epilepsy/seizure disorder (medical home: 32% versus 43%; accessible community-based services: 50% versus 66%, resp.) in unadjusted analyses. Lower adjusted odds for these indicators as well as greater unmet need for specialists, dentistry, prescriptions, therapies, and mental health care were also found for CSHCN with epilepsy/seizure disorder. Conclusions. Further efforts are needed to improve attainment of high-quality health care services for CSHCN with epilepsy/seizure disorders. PMID:24228175

  12. Seizure disorders and anemia associated with chronic borax intoxication (United States)

    Gordon, A. S.; Prichard, J. S.; Freedman, M. H.


    During the course of investigation of two infants with seizure disorders it was discovered that both had been given large amounts of a preparation of borax and honey which resulted in chronic borate intoxication. In one child a profound anemia developed as well. The symptoms of chronic borate intoxication are different from those of the acute poisoning with which we are more familiar. The borax and honey preparations are highly dangerous and should no longer be manufactured or distributed for sale. ImagesFIG. 1FIG. 2 PMID:4691106

  13. The Effect of Simple Febrile Seizure on Attention Deficit Hyperactivity Disorder (ADHD in Children

    Directory of Open Access Journals (Sweden)

    Bahman Salehi


    Full Text Available Background Febrile seizure is one of the most prevalent childhood convulsions. There are controversy about possible relation between febrile seizure and Attention Deficit Hyperactivity Disorder (ADHD. The aim of this study was to find the effect of simple febrile seizure on ADHD in children. Materials and Methods In a case-control study all children of 3-12 years old with febrile seizure referring Amir-Kabir hospital, Arak-Iran. Among these children, 103 of them with no corporeal or psychiatric disorders were compared to 103 children of the same age and gender admitted due to disease other than febrile seizure utilizing DSM-IV criteria for ADHD. Data were analyzed using SPSS 16. Results This study shows that the hyperactivity disorder in the same order were 34.3% and 16.7%, respectively, which also denotes a significant relation between simple febrile seizure and hyperactivity(P

  14. Neuropathological mechanisms of seizures in autism spectrum disorder

    Directory of Open Access Journals (Sweden)

    Richard Eugene Frye


    Full Text Available This manuscript reviews biological abnormalities shared by autism spectrum disorder (ASD and epilepsy. Two neuropathological findings are shared by ASD and epilepsy: abnormalities in minicolumn architecture and -aminobutyric acid (GABA. The peripheral neuropil, which is the region that contains the inhibition circuits of the minicolumns, has been found to be decreased in the post-mortem ASD brain. ASD and epilepsy are associated with inhibitory GABA neurotransmission abnormalities including reduced GABAA and GABAB subunit expression. These abnormalities can elevate the excitation-to-inhibition balance, resulting in hyperexcitablity of the cortex and, in turn, increases the risk of seizures. Medical abnormalities associated with both epilepsy and ASD are discussed. These include specific genetic syndromes, specific metabolic disorders including disorders of energy metabolism and GABA and glutamate neurotransmission, mineral and vitamin deficiencies, heavy metal exposures and immune dysfunction. Many of these medical abnormalities can result in an elevation of the excitatory-inhibitory balance. Fragile X is linked to dysfunction of the mGluR5 receptor and Fragile X, Angelman and Rett syndromes are linked to a reduction in GABAA receptor expression. Defects in energy metabolism can reduce GABA interneuron function. Both pyridoxine dependent seizures and succinic semialdehyde dehydrogenase deficiency cause GABA deficiencies while urea cycle defects and phenylketonuria cause abnormalities in glutamate neurotransmission. Mineral deficiencies can cause glutamate and GABA neurotransmission abnormalities and heavy metals can cause mitochondrial dysfunction which disrupts GABA metabolism. Thus, both ASD and epilepsy are associated with similar abnormalities that may alter the excitatory-to-inhibitory balance of the cortex. These parallels may explain the high prevalence of epilepsy in ASD and the elevated prevalence of ASD features in individuals with

  15. Seizures and movement disorders induced by hyperglycemia without ketosis in elderly. (United States)

    Younes, Samia; Cherif, Yousra; Aissi, Mouna; Alaya, Wafa; Berriche, Olfa; Boughammoura, Amel; Frih-Ayed, Mahbouba; Zantour, Baha; Habib Sfar, Mohamed


    Non-ketotic hyperglycemia (NKHG) may increase the probability of seizures and movement disorders. We describe a series of 14 elders admitted for seizures and movement disorders linked to NKHG. Twelve patients developed motor seizures and two others movement disorders. Glucose levels varied 9.28 to 32 mmol/l, while osmolarity values varied from 302.28 to 328 mosmol/l. All patients responded well to insulin therapy and four of them needed anti-epileptic drugs. Seizures or movement disorders in elderly with NKHG could be misdiagnosed as neurological diseases. Blood glucose must be audited whenever patients with seizures or movement disorders are encountered, as the condition may quickly resolve when NKHG is controlled.

  16. Catastrophic Misinterpretations as a Predictor of Symptom Change during Treatment for Panic Disorder (United States)

    Teachman, Bethany A.; Marker, Craig D.; Clerkin, Elise M.


    Objective: Cognitive models of panic disorder suggest that change in catastrophic misinterpretations of bodily sensations will predict symptom reduction. To examine change processes, we used a repeated measures design to evaluate whether the trajectory of change in misinterpretations over the course of 12-week cognitive behavior therapy is related…

  17. Computed tomography and childhood seizure disorder in Ibadan ...

    African Journals Online (AJOL)

    Background: Computed Tomography (CT) is an important tool for neuroimaging, it offers an opportunity to investigate structural lesions as a cause of seizures with little morbidity. This study is designed to evaluate it's applicability in children with epileptic seizures. Method: It is a descriptive study of the CT scans of the 103 ...

  18. Anxiety sensitivity, catastrophic misinterpretations and panic self-efficacy in the prediction of panic disorder severity: towards a tripartite cognitive model of panic disorder. (United States)

    Sandin, Bonifacio; Sánchez-Arribas, Carmen; Chorot, Paloma; Valiente, Rosa M


    The present study examined the contribution of three main cognitive factors (i.e., anxiety sensitivity, catastrophic misinterpretations of bodily symptoms, and panic self-efficacy) in predicting panic disorder (PD) severity in a sample of patients with a principal diagnosis of panic disorder. It was hypothesized that anxiety sensitivity (AS), catastrophic misinterpretation of bodily sensations, and panic self-efficacy are uniquely related to panic disorder severity. One hundred and sixty-eight participants completed measures of AS, catastrophic misinterpretations of panic-like sensations, and panic self-efficacy prior to receiving treatment. Results of multiple linear regression analyses indicated that AS, catastrophic misinterpretations and panic self-efficacy independently predicted panic disorder severity. Results of path analyses indicated that AS was direct and indirectly (mediated by catastrophic misinterpretations) related with panic severity. Results provide evidence for a tripartite cognitive account of panic disorder. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. A systematic review of the incidence and prevalence of sleep disorders and seizure disorders in multiple sclerosis

    DEFF Research Database (Denmark)

    Marrie, Ruth Ann; Reider, Nadia; Cohen, Jeffrey


    BACKGROUND: Several studies have suggested that comorbid neurologic disorders are more common than expected in multiple sclerosis (MS). OBJECTIVE: To estimate the incidence and prevalence of comorbid seizure disorders and sleep disorders in persons with MS and to evaluate the quality of studies...... was 3.09% (95% CI: 2.01-4.16%). For sleep disorders we evaluated 18 studies; none were population-based. The prevalence ranged from 0-1.6% for narcolepsy, 14.4-57.5% for restless legs syndrome, 2.22-3.2% for REM behavior disorder, and 7.14-58.1% for obstructive sleep apnea. CONCLUSION: This review...... suggests that seizure disorders and sleep disorders are common in MS, but highlights gaps in the epidemiological knowledge of these conditions in MS worldwide. Other than central-western Europe and North America, most regions are understudied....

  20. The spectrum of neuropathologic findings in deaths associated with seizure disorders. (United States)

    Blisard, K S; McFeeley, P J


    The pathologic and neuropathologic findings in 90 autopsied cases of death associated with a seizure disorder or complication thereof were reviewed. Most (69%) of the deceased individuals were between 21 and 40 years of age; two thirds were male. In 58% of patients, no cause of death other than seizure disorder was found. The ultimate cause of death in those patients was assumed to be a cardiac arrhythmia or respiratory arrest. Drowning accounted for 19% of deaths, and 17% of patients died of other contributory causes such as suicide, exposure, or atherosclerotic coronary vascular disease. Aspiration was found in the remaining 6%. Tongue lacerations or bite marks were observed in only one third of cases. The brain was normal in approximately two thirds of cases, with no focus for the origination of seizure found on neuropathologic examination. In the remainder of cases, a variety of lesions was found, with cavitary lesions, contusions, and dural lesions being the most common ones.

  1. Febrile Seizures and Epilepsy: Association With Autism and Other Neurodevelopmental Disorders in the Child and Adolescent Twin Study in Sweden. (United States)

    Gillberg, Christopher; Lundström, Sebastian; Fernell, Elisabeth; Nilsson, Gill; Neville, Brian


    There is a recently well-documented association between childhood epilepsy and earlysymptomaticsyndromeselicitingneurodevelopmentalclinicalexaminations (ESSENCE) including autism spectrum disorder, but the relationship between febrile seizures and ESSENCE is less clear. The Child and Adolescent Twin Study in Sweden (CATSS) is an ongoing population-based study targeting twins born in Sweden since July 1, 1992. Parents of 27,092 twins were interviewed using a validated DSM-IV-based interview for ESSENCE, in connection with the twins' ninth or twelfth birthday. Diagnoses of febrile seizures (n = 492) and epilepsy (n = 282) were based on data from the Swedish National Patient Register. Prevalence of ESSENCE in individuals with febrile seizures and epilepsy was compared with prevalence in the twin population without seizures. The association between febrile seizures and ESSENCE was considered before and after adjustment for epilepsy. Age of diagnosis of febrile seizures and epilepsy was considered as a possible correlate of ESSENCE in febrile seizures and epilepsy. The rate of ESSENCE in febrile seizures and epilepsy was significantly higher than in the total population without seizures (all P < 0.001). After adjusting for epilepsy, a significant association between febrile seizures and autism spectrum disorder, developmental coordination disorder, and intellectual disability remained. Earlier age of onset was associated with all ESSENCE except attention-deficit/hyperactivity disorder in epilepsy but not with ESSENCE in febrile seizures. In a nationally representative sample of twins, there was an increased rate of ESSENCE in childhood epilepsy and in febrile seizures. Febrile seizures alone could occur as a marker for a broader ESSENCE phenotype. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Failure of the Nemo trial: bumetanide is a promising agent to treat many brain disorders but not newborn seizures

    Directory of Open Access Journals (Sweden)

    Yehezkel eBen-Ari


    Full Text Available The diuretic bumetanide failed to treat acute seizures due to hypoxic ischemic encephalopathy (HIE in newborn babies and was associated with hearing loss (NEMO trial; 1. On the other hand, clinical and experimental observations suggest that the diuretic might provide novel therapy for many brain disorders including autistic spectrum disorder, schizophrenia, Rett syndrome and Parkinson disease. Here, we discuss the differences between the pathophysiology of severe recurrent seizures in the neonates and neurological and psychiatric disorders stressing the uniqueness of severe seizures in newborn in comparison to other disorders.

  3. Seizures and epilepsy among children with language regression and autistic spectrum disorders. (United States)

    Trevathan, Edwin


    Clinical and subclinical seizures occur frequently among children with autistic spectrum disorders. Electrographic status epilepticus in sleep, or continuous spike-wave in slow-wave sleep, is a typical feature of acquired epileptic aphasia and Landau-Kleffner syndrome. Seizures and epilepsy are more common among children with autistic spectrum disorder who experience language regression, especially those who experience language regression after the age of 2 years. Although the seizures associated with Landau-Kleffner syndrome and with acquired epileptic aphasia can be easily treated, improvement in language function often does not follow successful treatment of seizures. There are no published randomized clinical trials of treatments for Landau-Kleffner syndrome or for autistic language regression. Broad-spectrum antiepileptic drugs not associated with cognitive slowing are probably the treatment of choice for epilepsy among children with autistic spectrum disorder. Large multisite trials are needed to determine treatment efficacy among children with Landau-Kleffner syndrome and acquired epileptic aphasia and to establish whether there is a cause-effect relationship between electrographic status epilepticus in sleep or continuous spike-wave in slow-wave sleep and autistic language regression.

  4. Traditional and non-traditional treatments for autism spectrum disorder with seizures: an on-line survey

    Directory of Open Access Journals (Sweden)

    Sreenivasula Swapna


    Full Text Available Abstract Background Despite the high prevalence of seizure, epilepsy and abnormal electroencephalograms in individuals with autism spectrum disorder (ASD, there is little information regarding the relative effectiveness of treatments for seizures in the ASD population. In order to determine the effectiveness of traditional and non-traditional treatments for improving seizures and influencing other clinical factor relevant to ASD, we developed a comprehensive on-line seizure survey. Methods Announcements (by email and websites by ASD support groups asked parents of children with ASD to complete the on-line surveys. Survey responders choose one of two surveys to complete: a survey about treatments for individuals with ASD and clinical or subclinical seizures or abnormal electroencephalograms, or a control survey for individuals with ASD without clinical or subclinical seizures or abnormal electroencephalograms. Survey responders rated the perceived effect of traditional antiepileptic drug (AED, non-AED seizure treatments and non-traditional ASD treatments on seizures and other clinical factors (sleep, communication, behavior, attention and mood, and listed up to three treatment side effects. Results Responses were obtained concerning 733 children with seizures and 290 controls. In general, AEDs were perceived to improve seizures but worsened other clinical factors for children with clinical seizure. Valproic acid, lamotrigine, levetiracetam and ethosuximide were perceived to improve seizures the most and worsen other clinical factors the least out of all AEDs in children with clinical seizures. Traditional non-AED seizure and non-traditional treatments, as a group, were perceived to improve other clinical factors and seizures but the perceived improvement in seizures was significantly less than that reported for AEDs. Certain traditional non-AED treatments, particularly the ketogenic diet, were perceived to improve both seizures and other clinical

  5. A clinical study on seizure disorder in intellectually disabled patients in Barak Valley, North-Eastern India

    Directory of Open Access Journals (Sweden)

    Kamal Nath


    Full Text Available Background: Intellectual disability (ID is a state of developmental deficit, beginning in childhood which results in significant limitation of intellect or cognition and poor adaption to the demands of everyday life. The relationship between seizure disorders and ID, and their socio-demographic correlations is a current topic of research to implement proper psychosocial interventions and to eliminate the preventable causes of ID as well as seizure disorder. Aims: To find out the prevalence of seizure disorders and their types in the intellectually disabled patients, and find out their socio-demographic correlations. Materials and methods: A cross-sectional study sample comprising of 100 intellectually disabled patients of Silchar Medical College and Hospital was taken, and the study was conducted after obtaining institutional ethical committee approval and permission from the college. Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5 criteria were used for diagnosing ID. A standardised proforma describing socio-demographic variables, Malin’s Intelligence Scale for Indian Children (MISIC for children in age group six to 17 years, Wechsler Adult Intelligence Scale, third edition for subjects above 18 years, and the Vineland Social Maturity Scale were applied to diagnose and classify ID. International League Against Epilepsy guidelines were used to classify seizure disorder. Results: Prevalence of seizure disorder was found to be 22% among the intellectually disabled population in our sample. A significant association was found between the severity of ID and increased incidence of seizure disorder (p=0.0045. Seizure disorder was more prevalent in the low intelligence quotient (IQ group (p=0.0067. Generalised tonic clonic seizure (GTCS was the commonest among the types of seizure disorder (n=11, 50%. Among the GTCS cases, eight out of 11 (72.7% were from severe/profound ID group and from an IQ range of one to 35

  6. Psychogenic nonepileptic seizures and psychogenic movement disorders: two sides of the same coin?

    Directory of Open Access Journals (Sweden)

    Luciano De Paola


    Full Text Available Psychogenic nonepileptic seizures (PNES and psychogenic movement disorders (PMD are commonly seen in Neurology practice and are categorized in the DSM-5 as functional neurological disorders/conversion disorders. This review encompasses historical and epidemiological data, clinical aspects, diagnostic criteria, treatment and prognosis of these rather challenging and often neglected patients. As a group they have puzzled generations of neurologists and psychiatrists and in some ways continue to do so, perhaps embodying and justifying the ultimate and necessary link between these specialties.

  7. Autism Spectrum Disorder: Correlation between aberrant behaviors, EEG abnormalities and seizures

    Directory of Open Access Journals (Sweden)

    Michelle Elena Hartley-McAndrew


    Full Text Available The relationship between epilepsy, epileptiform discharges, cognitive, language and behavioral symptoms is not clearly understood. Since difficulties with socialization and maladaptive behaviors are found in children with Autism Spectrum Disorder (ASD, we inquired whether epileptiform activity and seizures are associated with adverse behavioral manifestations in this population. We reviewed our EEG database between 1999-2006, and identified 123 children with ASD. EEG abnormalities were found in 39 children (31%. A control group of age and gender matched ASD children with normal EEG’s was obtained. Packets of questionnaires including the Vineland Adaptive Behavior Scale II (VABS, Aberrant Behavior Checklist (ABC and the Childhood Autism Rating Scale (CARS were sent by mail. Out of 21 packets received, 11 had normal and 10 had abnormal EEG’s. There were no statistically significant differences in behavior between the two groups. Statistical analysis of discharge location and frequency did not reveal a significant trend. However, children with ASD and seizures had statistically significant lower scores in VABS daily living (P=0.009 and socialization (P=0.007 as compared to those without seizures. ASD children with seizures had higher ABC levels of hyperactivity and irritability. Differences in irritability scores nearly reached statistical significance (P=0.058. There was no significant difference in the degree of CARS autism rating between the groups. Our study did not reveal statistically significant differences in behaviors between ASD children with and without EEG abnormalities. However, ASD children with seizures revealed significantly worse behaviors as compared to counterparts without seizures.

  8. Neonatal seizures: the overlap between diagnosis of metabolic disorders and structural abnormalities. Case report

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    Freitas Alessandra


    Full Text Available Inborn metabolic errors (IME and cortical developmental malformations are uncommon etiologies of neonatal seizures, however they may represent treatable causes of refractory epilepsy and for this reason must be considered as possible etiological factors. This case report aims to demonstrate the importance of neuroimaging studies in one patient with neonatal seizures, even when there are clues pointing to a metabolic disorder. CASE REPORT: A previously healthy 14 day-old child started presenting reiterated focal motor seizures (FMS which evolved to status epilepticus. Exams showed high serum levels of ammonia and no other abnormalities. A metabolic investigation was conducted with normal results. During follow-up, the patient presented developmental delay and left side hemiparesia. Seizures remained controlled with anti-epileptic drugs for four months, followed by relapse with repetitive FMS on the left side. Temporary improvement was obtained with anti-epileptic drug adjustment. At the age of 6 months, during a new episode of status epilepticus, high ammonia levels were detected. Other metabolic exams remained normal. The child was referred to a video-electroencephalographic monitoring and continuous epileptiform discharges were recorded over the right parasagittal and midline regions, with predominance over the posterior quadrant. A new neuroimaging study was performed and displayed a malformation of cortical development. Our case illustrates that because newborns are prone to present metabolic disarrangement, an unbalance such as hyperammonemia may be a consequence of acute events and conduct to a misdiagnosis of IME.

  9. Single photon emission computed tomography (SPECT) in seizure disorders in childhood

    International Nuclear Information System (INIS)

    Vles, J.S.H.; Demandt, E.; Ceulemans, B.; de Roo, M.; Casaer, P.J.M.


    In 38 children with partial seizures, the EEG, CT and NMR findings were compared to the results obtained with Tc99m HMPAO single photon emission computed tomography (SPECT) in order to determine whether SPECT is a useful adjunct to EEG, CT and NMR in this age group. In 3 out of 7 patients with a normal EEG, SPECT showed focal abnormalities. Nine patients whose EEGs did not show adequate lateralization had an abnormal SPECT which revealed a focus. In 14 out of 21 patients with a normal CT, SPECT showed focal changes in 13 patients and diffuse changes in the other one. In 7 out of 12 patients with a normal NMR, SPECT showed focal abnormalities. Although clinical history and a careful description of the seizures are the most valuable information in partial seizure disorders, SPECT imaging gives valuable additional information, which might target treatment. SPECT was superior to CT and NMR with respect to the depiction of some kind of abnormality. (author)

  10. Clinical intrafamilial variability in lethal familial neonatal seizure disorder caused by TBC1D24 mutations. (United States)

    Lozano, Reymundo; Herman, Kristin; Rothfuss, Melanie; Rieger, Hillary; Bayrak-Toydemir, Pinar; Aprile, Davide; Fruscione, Floriana; Zara, Federico; Fassio, Anna


    TBC1D24-related disorders include a wide phenotypic ranging from mild to lethal seizure disorders, non-syndromic deafness, and composite syndromes such as DOORS (deafness, onychodystrophy, osteodystrophy, mental retardation, and seizures). The TBC1D24 gene has a role in cerebral cortex development and in presynaptic neurotransmission. Here, we present a familial case of a lethal early-onset epileptic encephalopathy, associated with two novel compound heterozygous missense variants on the TBC1D24 gene, which were detected by exome sequencing. The detailed clinical data of the three siblings is summarized in order to support the variability of the phenotype, severity, and progression of this disorder among these family members. Functional studies demonstrated that the identified novel missense mutations result in a loss of expression of the protein, suggesting a correlation between residual expression, and the disease severity. This indicates that protein expression analysis is important for interpreting genetic results when novel variants are found, as well as for complementing clinical assessment by predicting the functional impact. Further analysis is necessary to delineate the clinical presentation of individuals with TBC1D24 pathogenic variants, as well as to develop markers for diagnosis, prognosis, and potential targeted treatments. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  11. Basal transethmoidal encephalocele and malignant hypertension in a parturient with a seizure disorder. A case report. (United States)

    Yee, Lynn M; Kacmar, Rachel M; Bolden, Janelle R


    Nasal encephaloceles are uncommon in North America and may be diagnosed only as incidental findings. The presence of an encephalocele and malignant hypertension in the parturient requires complex coordination of care. We present a case of severe chronic hypertension in a pregnant patient with a seizure disorder and new finding of a basal transethmoidal encephalocele. She required 5 antihypertensive agents and cesarean delivery at 34 weeks' gestation under general anesthesia. The obstetric and anesthetic management of encephalocele are reviewed. Nasal encephaloceles are rarely reported in pregnancy and present additional peripartum obstetric and anesthetic considerations that require multidisciplinary planning for optimization of maternal and fetal outcomes.

  12. A cost comparison of alternative regimens for treatment-refractory partial seizure disorder: an econometric analysis. (United States)

    Lee, Won Chan; Hoffmann, Marc S; Arcona, Steve; D'Souza, Joseph; Wang, Qin; Pashos, Chris L


    Partial seizure disorder is typically treated by monotherapy with antiepileptic drugs (AEDs). However, when the condition is refractory to the initial treatment regimen, patients may be switched to monotherapy with another AED or to combination therapy with the initial AED plus a second AED. The purpose of this study was to examine the economic costs associated with treatment-refractory partial seizure disorder and to compare the costs of 2 alternative approaches: a switch to oxcarbazepine (OXC) monotherapy or the addition to the regimen of another AED (AED add-on). Adult patients with a diagnosis of partial seizure disorder who received initial AED monotherapy between January 1, 2000, and March 31, 2003, were identified from the PharMetrics Patient-Centric Database, a health plan administrative claims database. The medical and pharmacy history of these patients was analyzed from 6 months before a change to either OXC monotherapy or AED add-on therapy through 12 months after the change in treatment. Total health care resource utilization and the associated costs were compared within each cohort before and after the change, as well as between cohorts, with statistical differences tested using Wilcoxon rank sum tests. Multivariate econometric analyses were performed to examine the impact of age, sex, geographic location, Charlson Comorbidity Index, and the presence of specific comorbidities. Demographic and clinical characteristics 102 were similar between the OXC monotherapy cohort (n = 259) and the AED add-on cohort (n = 795). Annual direct treatment costs increased in both groups in the period after the failure of initial monotherapy, increasing from 10,462 US dollars to 11,360 US dollars in the OXC cohort and from 10,137 US dollars to 12,201 US dollars in the AED add on cohort (P < 0.01). Increased pharmacy costs were the primary driver behind cost increases in both cohorts. Patients in the AED add-on cohort were significantly more likely to have an emergency

  13. Psychogenic nonepileptic seizures as a manifestation of psychological distress associated with undiagnosed autism spectrum disorder

    Directory of Open Access Journals (Sweden)

    Miyawaki D


    Full Text Available Dai Miyawaki,1 Yoshihiro Iwakura,1 Toshiyuki Seto,2 Hiroto Kusaka,1 Ayako Goto,1 Yu Okada,1 Nobuyoshi Asada,1 Erika Yanagihara,1 Koki Inoue1 1Department of Neuropsychiatry, 2Department of Pediatrics, Osaka City University Graduate School of Medicine, Asahi-machi, Abeno-ku, Osaka, Japan Abstract: Psychogenic nonepileptic seizures (PNES are observable changes in behavior or consciousness that are similar to epileptic seizures but are not associated with electrophysiologic changes. PNES occur in children with underlying psychological distress and are especially frequent in those with epilepsy. Because PNES are heterogeneous, comprehensive treatment tailored to each patient is required to reduce psychosocial stress. Currently, reports regarding children with PNES concomitant with autism spectrum disorder (ASD do not exist, and effective treatment strategies for these children are lacking. In this case report, we describe a 10-year-old Japanese girl with undiagnosed ASD who developed PNES while undergoing treatment for benign childhood epilepsy with centrotemporal spikes. She exhibited hypersensitivity to sound and interpersonal conflicts caused by social communication deficits. The PNES symptoms improved shortly after our intervention, which was designed to reduce her distress caused by auditory hypersensitivity and impaired social communication, both characteristics of ASD. To the best of our knowledge, this is the first report describing PNES in a child with ASD. Our findings suggest that PNES can result from psychological distress in children with undiagnosed ASD and highlight the importance of examining ASD traits in patients with PNES. Keywords: pseudoseizures, autism spectrum disorders, undiagnosed, children

  14. Investigation of obsessive-compulsive disorder and assessment of obsessionality as a personality trait in patients with complex partial seizure

    Directory of Open Access Journals (Sweden)

    Banihashemian K


    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Behavioral changes in patients with epilepsy could cause comorbid psychiatric disorders such as anxiety disorders. This study is concerned with investigation of obsessive-compulsive disorders and assessment of obsessionality as a personality trait in patients with complex partial seizure. "n"nMethods: Seventy six patients with complex partial seizure, 74 patients with generalized epilepsy that referred to Shiraz psychiatric professional center during three month (from July to September 2009, and 76 matched healthy controls were randomly selected and evaluated using the Yale-Brown obsessive compulsive scale (Y-BOCS, short form of Minnesota multiphasic personality inventory (MMPI and clinical interview. "n"nResults: Complex partial seizure and obsessive-compulsive disorder (%13.15 are significantly more prevalent than generalized seizure (%2.70 and than control groups (%1.31 (p<0.001, and mean of psychasthenia scale (Pt scale scores in patients with complex partial seizure is more than mean of Pt scores in generalized epilepsy and control groups (p<0.001. There is significant relationship between total score of Yale-Brown scale and Pt scale in MMPI (r=0.79, p<0.01."n"nConclusions: Patients with complex

  15. Are psychogenic non-epileptic seizures just another symptom of conversion disorder? (United States)

    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.

  16. Conversion disorder as psychogenic nonepileptic seizures in suspected cancer: a case report. (United States)

    Jimenez, Xavier F; Sharma, Jennifer S; Dar, Syma A


    Psychogenic nonepileptic seizures (PNES), a form of conversion disorder, are paroxysmal episodes resembling epilepsy while lacking electrographic correlation. The phenomenon has rarely been reported in elderly patients and has not been associated with a new-onset medical diagnosis. We present the case of an 81-year-old female with no past psychiatric or traumatic history who developed PNES within the context of a new, suspected cancer. To our knowledge, this is the first such reported case of a suspected cancer (or otherwise medical) diagnosis contributing directly and temporally to the development of PNES. Discussion of involved psychosocial variables follows the vignette, and a brief review of relevant literature is offered. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Seizure semiology: value in identifying seizure origin. (United States)

    Jan, Mohammed M S; Girvin, John P


    The diagnosis of epilepsy depends upon a number of factors, particularly detailed and accurate seizure history, or semiology. Other diagnostic data, consisting of electroencephalography, video-monitoring of the seizures, and magnetic resonance imaging, are important in any comprehensive epilepsy program, particularly with respect to lateralizing and localizing the seizure focus, if such a focus exists, and with respect to determining the type of seizure or seizure syndrome. The aim of this review is to present a survey of important semiologic characteristics of various seizures that provide the historian with observations, which help to lateralize and localize epileptic zones. Clinical semiology is the starting point of understanding a seizure disorder and making the diagnosis of epilepsy. While it may not provide unequivocal evidence of localization of the epileptic focus, nevertheless it usually directs subsequent investigations, whose concordance is necessary for the ultimate localization.

  18. Value and limitations of seizure semiology in localizing seizure onset. (United States)

    So, Elson L


    Seizure semiology has been the foundation of clinical diagnosis of seizure disorders. This article discusses the value and the limitations of behavioral features of seizure episodes in localizing seizure onset. Studies have shown that some semiologic features of seizures are highly accurate in the hemispheric lateralization and lobar localization of seizures. There is good agreement between blinded reviewers in lateralizing video-recorded seizures in temporal lobe and extratemporal lobe epilepsies. However, seizure semiology alone should not be used to determine the site of seizure onset. Each semiologic feature may falsely localize seizure onset. Seizure semiology in some patients may signify the site of seizure propagation rather than origination. Moreover, seizure semiology may not be as reliable in multifocal epilepsies as it is in unifocal epilepsies. Many semiologic features of seizures of adults are often missing in seizures of children. Seizure semiology should be analyzed and integrated with EEG and neuroimaging data to localize the seizure focus. A sample of the recorded seizures should be shown to the patient's relatives or friends to verify that it is representative of habitual seizures.

  19. Febrile Seizure Simulation

    Directory of Open Access Journals (Sweden)

    Victor Cisneros


    Full Text Available Audience: This simulation session is appropriate for medical students, community physicians, or residents in emergency medicine, neurology, pediatrics, or family medicine. Introduction: Febrile seizures are the most common form of seizures in childhood; they are thought to occur in 2-5% of all children.1-3 Febrile seizures are defined as a seizure in association with a febrile illness in children without a central nervous system infection, previous afebrile seizure, known brain disorder, or electrolyte abnormalities. 1,2 They typically occur between 6 months and 18 months of age though they can occur up to 5 years of age.3 Febrile seizures are categorized as: simple (generalized seizure lasting less than 15 minutes in a child aged 6 months to 5 years, and less than 1 in a 24 hour period or complex (a focal seizure or generalized seizure lasting greater than 15 minutes, or multiple seizures in a 24 hour period. 1,3 Treatment for febrile seizures is based on treating the underlying cause of the fever and giving reassurance and education to the parents.2 Mortality is extremely rare, and there is no difference in the patient’s cognitive abilities after a febrile seizure, even when the seizure is prolonged.1 Objectives: At the end of this simulation session, the learner will be able to: 1 discuss the management of febrile seizures 2 discuss when placement of an advanced airway is indicated in the management of a febrile seizure 3 list the risk factors for febrile seizures 4 prepare a differential diagnosis for the causes of febrile seizures 5 educate family members on febrile seizures. Methods: This educational session is a high-fidelity simulation.

  20. Rapamycin prevents seizures after depletion of STRADA in a rare neurodevelopmental disorder. (United States)

    Parker, Whitney E; Orlova, Ksenia A; Parker, William H; Birnbaum, Jacqueline F; Krymskaya, Vera P; Goncharov, Dmitry A; Baybis, Marianna; Helfferich, Jelte; Okochi, Kei; Strauss, Kevin A; Crino, Peter B


    A rare neurodevelopmental disorder in the Old Order Mennonite population called PMSE (polyhydramnios, megalencephaly, and symptomatic epilepsy syndrome; also called Pretzel syndrome) is characterized by infantile-onset epilepsy, neurocognitive delay, craniofacial dysmorphism, and histopathological evidence of heterotopic neurons in subcortical white matter and subependymal regions. PMSE is caused by a homozygous deletion of exons 9 to 13 of the LYK5/STRADA gene, which encodes the pseudokinase STRADA, an upstream inhibitor of mammalian target of rapamycin complex 1 (mTORC1). We show that disrupted pathfinding in migrating mouse neural progenitor cells in vitro caused by STRADA depletion is prevented by mTORC1 inhibition with rapamycin or inhibition of its downstream effector p70 S6 kinase (p70S6K) with the drug PF-4708671 (p70S6Ki). We demonstrate that rapamycin can rescue aberrant cortical lamination and heterotopia associated with STRADA depletion in the mouse cerebral cortex. Constitutive mTORC1 signaling and a migration defect observed in fibroblasts from patients with PMSE were also prevented by mTORC1 inhibition. On the basis of these preclinical findings, we treated five PMSE patients with sirolimus (rapamycin) without complication and observed a reduction in seizure frequency and an improvement in receptive language. Our findings demonstrate a mechanistic link between STRADA loss and mTORC1 hyperactivity in PMSE, and suggest that mTORC1 inhibition may be a potential treatment for PMSE as well as other mTOR-associated neurodevelopmental disorders.

  1. Psychological correction of neurotic disorders in children, suffered from the Chernobyl catastrophe

    International Nuclear Information System (INIS)

    Obukhov, S.G.; Gavrilik, L.L.; Zimatkina, O.S.


    The necessity of psychological correction program is justified by the fact that 34.4% of the children showed certain clinical symptoms of neurotic disorders, in the first place somatoform and adaptation disorders. All these children have undergone different programs of psychological correction and psychotherapy. As the result in children with somatoform disorders psychosthenity (p=0,042), emotional unstability (p=0,031) and dependency (p=0,040) certainly reduced. In children with adaptation disorders personal harmonizing and communicative attainments were distinguished. In all participants of the psychocorrectional programs clinical symptoms of neurotic disorders disappeared. We recommend to include psychocorrection and psychotherapy in the base complexes of sanatoriums for children, residing in the contaminating regions. (Authors)

  2. Resounding Catastrophe

    DEFF Research Database (Denmark)

    Kristensen, Thomas Bjørnsten


    The article discusses specific aesthetic strategies for articulating and describing the catastrophic event of 9/11 by focusing on its auditory aspects. This is done through a reading of the American media- and sound artist Stephen Vitiello’s work and novelist Don DeLillo’s Falling Man.......The article discusses specific aesthetic strategies for articulating and describing the catastrophic event of 9/11 by focusing on its auditory aspects. This is done through a reading of the American media- and sound artist Stephen Vitiello’s work and novelist Don DeLillo’s Falling Man....

  3. The importance of the concepts of disaster, catastrophe, violence, trauma and barbarism in defining posttraumatic stress disorder in clinical practice

    Directory of Open Access Journals (Sweden)

    Mello Marcelo F


    Full Text Available Abstract Background Several terms in the scientific literature about posttraumatic stress disorder are used with different meanings in studies conducted by different authors. Words such as trauma, violence, catastrophe, disaster and barbarism are often used vaguely or confusingly, and their meanings change in different articles. The lack of conceptual references for these expressions complicates the organization of literature. Furthermore, the absence of clear concepts may be an obstacle to clinical treatment because the use of these words by the patients does not necessarily point to a diagnosis of posttraumatic stress disorder. Discussion A critical review of scientific literature showed that stress can be divided in stages to facilitate specific terminological adjustments to the event itself, to the subject-event interaction and to psychological responses. Moreover, it demonstrated that the varying concept of trauma expands into fundamental psychotherapeutic definitions and that the meanings of violence associated with barbarism are an obstacle to resilience. Therefore, this study updates the etymological origins and applications of these words, connects them to the expansions of meanings that can be operated in the clinical care of patients with posttraumatic stress disorder, and analyzes them critically according to the criterion A of DSM-IV and ICD-10. Summary The terminology in the literature about posttraumatic stress disorder includes a plethora of terms whose meanings are not fully understood, and that, therefore, limit this terminology. The analysis of these terms suggested that the transformation of the concept of trauma led to a broader understanding of this phenomenon in its psychic dimensions, that a barbarian type of violence constitutes an obstacle to resilience, and that the criterion A of the DSM-IV and ICD-10 shows imprecision and conceptual fragilities. Methods To develop this debate article, a current specialized literature

  4. Replication Catastrophe

    DEFF Research Database (Denmark)

    Toledo, Luis; Neelsen, Kai John; Lukas, Jiri


    Proliferating cells rely on the so-called DNA replication checkpoint to ensure orderly completion of genome duplication, and its malfunction may lead to catastrophic genome disruption, including unscheduled firing of replication origins, stalling and collapse of replication forks, massive DNA...... increased DNA replication stress....

  5. Seizing Catastrophes

    DEFF Research Database (Denmark)

    Kublitz, Anja


    of the Nakba in 2008 and clashes between the police and young Palestinians in 2006, the article demonstrates how Palestinians in Denmark seek to reverse the reverse myth of 1948 by seizing contemporary catastrophes to enact not only past and present Nakbas, but also potential futures. The article concludes...

  6. On sociological catastrophe analysis

    International Nuclear Information System (INIS)

    Clausen, L.


    The present paper deals with standard terms of sociological catastrophe theory hitherto existing, collective behaviour during the catastrophe, and consequences for the empiric catastrophe sociology. (RW) [de

  7. 78 FR 68144 - Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders (United States)


    ... CMV. His physician states he is supportive of Mr. Bretey receiving an exemption. Montie Bullis Mr. Bullis is a 56 year-old driver in Oklahoma. He has a history of epilepsy and has remained seizure free... he is supportive of Mr. Bullis receiving an exemption. Rick Cote Mr. Cote is a 55 year-old class A...

  8. [Idiopathic generalized epilepsies with absence seizures with valproic acid treatment: neuropsychological disorders]. (United States)

    Conde-Guzon, P A; Cancho-Candela, R


    To analyze the neuropsychological profile of children with absence seizures treated with valproate. Sample of 34 children from 7 to 12 years with absence seizures treated with valproate (median dose: 30 mg/kg/day) and 28 controls. We get the neuropsychological profile by applying the Wechsler Intelligence Scale for Children-Revised (WISC-R) and Luria-DNI Battery. Children with absence seizures manifest verbal IQ significantly lower (p grammar. This is a serious deterioration profile in the areas of logical memory, short-term memory, arithmetic, numerical structure, reading, writing, naming, and articulation. Children with absence seizures have a significant memory deficit. Memory profile measured with the Luria-DNI Battery and the WISC-R appears generally deteriorated when compared with the control group (p < 0.001) although there is a paradoxical preservation of shape memory. The short-term auditory and visual memory and logical memory are particularly affected. In the epileptic group, the attentional profile (estimated by the 'third factor of the WISC-R') is generally deteriorated when compared with the control group. We consider in children with this diagnosis and treatment, the neuropsychological profile described to strengthen deficient neuropsychological and psychoeducational areas. Above, we claim the need, in the consultations of neuropediatrics, the neuropsychlogists to ensure the systematic analysis of neuropsychological and cognitive difficulties both at the time of the diagnosis and follow-up of epilepsy.

  9. 77 FR 537 - Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders (United States)


    ... AVM (Arteriovenous Malformation), a brain congenital condition. He underwent surgery to remove the... Wisconsin. In December 2007 he underwent surgery to remove a right parietal vascular malformation. His... diagnosed with a Cavernoma, a brain malformation, in October 2010, causing her to have three seizures within...

  10. Prolonged exposure therapy for the treatment of patients diagnosed with psychogenic non-epileptic seizures (PNES) and post-traumatic stress disorder (PTSD). (United States)

    Myers, Lorna; Vaidya-Mathur, Urmi; Lancman, Marcelo


    Although there is general consensus that psychogenic non-epileptic seizures (PNES) are treated with psychotherapy, the effectiveness of most psychotherapeutic modalities remains understudied. In this treatment series of 16 patients dually diagnosed with PNES and post-traumatic stress disorder (PTSD), we evaluated the effect of prolonged exposure therapy (PE) on reduction of PNES. Secondary measures included Beck Depression Inventory (BDI-II) and Post-Traumatic Disorder Diagnostic Scale (PDS). Subjects diagnosed with video EEG-confirmed PNES and PTSD confirmed through neuropsychological testing and clinical interview were treated with traditional PE psychotherapy with certain modifications for the PNES. Treatment was conducted over the course of 12-15 weekly sessions. Seizure frequency was noted in each session by examining the patients' seizure logs, and mood and PTSD symptomatology was assessed at baseline and on the final session. Eighteen subjects enrolled, and 16 (88.8%) completed the course of treatment. Thirteen of the 16 (81.25%) therapy completers reported no seizures by their final PE session, and the other three reported a decline in seizure frequency (Z=-3.233, p=0.001). Mean scores on scales of depression (M=-13.56, SD=12.27; t (15)=-4.420, ptraumatic symptomatology. Follow-up revealed that gains made in seizure control on the last day of treatment were maintained over time. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  11. Catastrophe medicine; Medecine de catastrophe

    Energy Technology Data Exchange (ETDEWEB)

    Lebreton, A. [Service Technique de l`Energie Electrique et des Grands Barrages (STEEGB), (France)


    The `Catastrophe Medicine` congress which took place in Amiens (France) in December 5 to 7 1996 was devoted to the assessment and management of risks and hazards in natural and artificial systems. The methods of risk evaluation and prevision were discussed in the context of dams accidents with the analysis of experience feedbacks and lessons gained from the organisation of emergency plans. Three round table conferences were devoted to the importance of psychological aspects during such major crises. (J.S.)

  12. Cosmic Catastrophes (United States)

    Wheeler, J. Craig


    Preface; 1. Setting the stage: star formation and hydrogen burning in single stars; 2. Stellar death: the inexorable grip of gravity; 3. Dancing with stars: binary stellar evolution; 4. Accretion disks: flat stars; 5. White Dwarfs: quantum dots; 6. Supernovae: stellar catastrophes; 7. Supernova 1987A: lessons and enigmas; 8. Neutron stars: atoms with attitude; 9. Black holes in theory: into the abyss; 10. Black holes in fact: exploring the reality; 11. Gamma-ray bursts, black holes and the universe: long, long ago and far, far away; 12. Supernovae and the universe; 13. Worm holes and time machines: tunnels in space and time; 14. Beyond: the frontiers; Index.

  13. Update on the mechanisms and roles of high-frequency oscillations in seizures and epileptic disorders

    Czech Academy of Sciences Publication Activity Database

    Jiruška, Přemysl; Alvarado-Rojas, C.; Schevon, C.A.; Staba, R.; Stacey, W.; Wendling, F.; Avoli, M.


    Roč. 58, č. 8 (2017), s. 1330-1339 ISSN 0013-9580 R&D Projects: GA MZd(CZ) NV15-29835A; GA ČR(CZ) GA14-02634S Institutional support: RVO:67985823 Keywords : high-frequency oscillations * epilepsy * ripples * fast ripples * ictogenesis * epileptogenesis * seizures * interneurons * computer models Subject RIV: FH - Neurology OBOR OECD: Neurosciences (including psychophysiology Impact factor: 5.295, year: 2016

  14. A review of traditional and novel treatments for seizures in autism spectrum disorder: Findings from a systematic review and expert panel.

    Directory of Open Access Journals (Sweden)

    Richard Eugene Frye


    Full Text Available Despite the fact that seizures are commonly associated with autism spectrum disorder (ASD, the effectiveness of treatments for seizures has not been well studied in individuals with ASD. This manuscript reviews both traditional and novel treatments for seizures associated with ASD. Studies were selected by systematically searching major electronic databases and by a panel of experts that treat ASD individuals. Only a few anti-epileptic drugs (AEDs have undergone carefully controlled trials in ASD, but these trials examined outcomes other than seizures. Several lines of evidence point to valproate, lamotrigine and levetiracetam as the most effective and tolerable AEDs for individuals with ASD. Limited evidence supports the use of traditional non-AED treatments, such as the ketogenic and modified Atkins diet, multiple subpial transections and immunomodulation and neurofeedback treatments. Although specific treatments may be more appropriate for specific genetic and metabolic syndromes associated with ASD and seizures, there are few studies which have documented the effectiveness of treatments for seizures for specific syndromes. Limited evidence supports L-carnitine, multivitamins and N-acetyl-L-cysteine in mitochondrial disease and dysfunction, folinic acid in cerebral folate abnormalities and early treatment with vigabatrin in tuberous sclerosis complex. Finally, there is limited evidence for a number of novel treatments, particularly magnesium with pyridoxine, omega-3 fatty acids, the gluten-free casein-free diet and transcranial magnetic simulation. Zinc and L-carnosine are potential novel treatments supported by basic research but not clinical studies. This review demonstrates the wide variety of treatments used to treat seizures in individuals with ASD as well as the striking lack of clinical trials performed to support the use these treatments. Additional studies concerning these treatments for controlling seizures in individuals with ASD

  15. Unusual 4p16.3 deletions suggest an additional chromosome region for the Wolf-Hirschhorn syndrome-associated seizures disorder

    NARCIS (Netherlands)

    Zollino, M.; Orteschi, D.; Ruiter, M.; Pfundt, R.P.; Steindl, K.; Cafiero, C.; Ricciardi, S.; Contaldo, I.; Chieffo, D.; Ranalli, D.; Acquafondata, C.; Murdolo, M.; Marangi, G.; Asaro, A.; Battaglia, D.


    OBJECTIVE: Seizure disorder is one of the most relevant clinical manifestations in Wolf-Hirschhorn syndrome (WHS) and it acts as independent prognostic factor for the severity of intellectual disability (ID). LETM1, encoding a mitochondrial protein playing a role in K(+) /H(+) exchange and in Ca(2+)

  16. Volcanic Catastrophes (United States)

    Eichelberger, J. C.


    The big news from 20th century geophysics may not be plate tectonics but rather the surprise return of catastrophism, following its apparent 19th century defeat to uniformitarianism. Divine miracles and plagues had yielded to the logic of integrating observations of everyday change over time. Yet the brilliant interpretation of the Cretaceous-Tertiary Boundary iridium anomaly introduced an empirically based catastrophism. Undoubtedly, decades of contemplating our own nuclear self-destruction played a role in this. Concepts of nuclear winter, volcanic winter, and meteor impact winter are closely allied. And once the veil of threat of all-out nuclear exchange began to lift, we could begin to imagine slower routes to destruction as "global change". As a way to end our world, fire is a good one. Three-dimensional magma chambers do not have as severe a magnitude limitation as essentially two-dimensional faults. Thus, while we have experienced earthquakes that are as big as they get, we have not experienced volcanic eruptions nearly as great as those preserved in the geologic record. The range extends to events almost three orders of magnitude greater than any eruptions of the 20th century. Such a calamity now would at the very least bring society to a temporary halt globally, and cause death and destruction on a continental scale. At maximum, there is the possibility of hindering photosynthesis and threatening life more generally. It has even been speculated that the relative genetic homogeneity of humankind derives from an evolutionary "bottleneck" from near-extinction in a volcanic cataclysm. This is somewhat more palatable to contemplate than a return to a form of Original Sin, in which we arrived at homogeneity by a sort of "ethnic cleansing". Lacking a written record of truly great eruptions, our sense of human impact must necessarily be aided by archeological and anthropological investigations. For example, there is much to be learned about the influence of

  17. Reverse Catastrophe

    Directory of Open Access Journals (Sweden)

    Przemysław Czapliński


    Full Text Available The principal notion of the article–a “backward catastrophe”– stands for a catastrophe which occurs unseen until it becomes recognized and which broadens its destructive activity until it has been recognized. This concept in the article has been referred to the Shoah. The main thesis is that the recognition of the actual influence of the Holocaust began in Polish culture in the mid-1980s (largely it started with the film by Claude Lanzmann Shoah and the essay by Jan Błoński Biedni Polacy patrzą na getto [“The Poor Poles Look at the Ghetto”], that is when the question: “What happened to the Jews”, assumes the form: “Did the things that happened to the Jews, also happened to the Poles?”. Cognitive and ethical reorientation leads to the revealing of the hidden consequences of the Holocaust reaching as far as the present day and undermining the foundations of collective identity. In order to understand this situation (and adopt potentially preventive actions Polish society should be recognized as a postcatastrophic one.

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

    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. © 2013 Elsevier

  19. [Abdominal catastrophe--surgeon's view]. (United States)

    Vyhnánek, F


    Abdominal catastrophe is a serious clinical condition, usually being a complication arising during treatment of intraabdominal nontraumatic disorders or abdominal injuries. Most commonly, inflamation- secondary peritonitis, is concerned. Abdominal catastrophe also includes secondary signs of sepsis, abdominal compartment syndrome and enterocutaneous fistules. Most septic abdominal disorders which show signs of abdominal catastrophy, require surgical intervention and reinterventions--planned or "on demand" laparotomies. During the postoperative period, the patient requires intensive care management, including steps taken to stabilize his/hers condition, management of sepsis and metabolic and nutritional support measures, as well as adequate indication for reoperations. New technologies aimed at prevention of complications in laparostomies and to improve conditions for final laparotomy closure are used in phase procedures for surgical management of intraabdominal infections. Despite the new technologies, abdominal catastrophe has higher morbidity and lethality risk rates.

  20. 99mTc-HMPAO Brain SPECT in Seizure Disorder: Comparison Brain SPECT, MRI / CT and EEG

    International Nuclear Information System (INIS)

    Yang, Hyung In; Im, Ju Hyuk; Choi, Chang Woon; Lee, Dong Soo; Chung, June Key; No, Jae Kyu; Lee, Myung Chul; Koh, Chang Soon


    We studied 115 patients with seizure who had been performed brain SPECT brain MRI of CT and EEG. To evaluate the pattern of brain SPECT in seizure patients 28 of them had secondary epilepsies, 87 had primary epilepsies. In primary epilepsies, 42 were generalized seizure and 45 were partial seizure. The causes of secondary epilepsies were congenital malformation, cerebromalacia, cerebral infarction ultiple sclerosis, AV-malformation. granuloma and etc, in order. In 28 secondary epilepsies, 25 of them, brain SPECT lesions was concordant with MRI or CT lesions. 3 were disconcordant. The brain SPECT findings of generalized seizure were normal in 22 patients, diffuse irregular decreased perfusion in 8, decreased in frontal cortex in 4. temporal in 5 and frontotemporal in 3. In 45 partial seizure, 19 brain SPECT were concordant with EEG (42.4%).

  1. Catastrophes control problem

    International Nuclear Information System (INIS)

    Velichenko, V.V.


    The problem of catastrophe control is discussed. Catastrophe control aims to withdraw responsible engineering constructions out of the catastrophe. The mathematical framework of catastrophes control systems is constructed. It determines the principles of systems filling by the concrete physical contents and, simultaneously, permits to employ modern control methods for the synthesis of optimal withdrawal strategy for protected objects

  2. Fibromyalgia and seizures. (United States)

    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.

  3. Rapamycin Prevents Seizures After Depletion of STRADA in a Rare Neurodevelopmental Disorder

    NARCIS (Netherlands)

    Parker, Whitney E.; Orlova, Ksenia A.; Parker, William H.; Birnbaum, Jacqueline F.; Krymskaya, Vera P.; Goncharov, Dmitry A.; Baybis, Marianna; Helfferich, Jelte; Okochi, Kei; Strauss, Kevin A.; Crino, Peter B.


    A rare neurodevelopmental disorder in the Old Order Mennonite population called PMSE (polyhydramnios, megalencephaly, and symptomatic epilepsy syndrome; also called Pretzel syndrome) is characterized by infantile-onset epilepsy, neurocognitive delay, craniofacial dysmorphism, and histopathological

  4. Febrile Seizures (United States)

    ... chance that the child may be injured by falling or may choke on food or saliva in the mouth. Using proper first aid for seizures can help avoid these hazards. There is no evidence that short febrile seizures cause brain damage. Large studies have found that even children ...

  5. Seizures Induced by Music

    Directory of Open Access Journals (Sweden)

    A. O. Ogunyemi


    Full Text Available Musicogenic epilepsy is a rare disorder. Much remains to be learned about the electroclinical features. This report describes a patient who has been followed at our institution for 17 years, and was investigated with long-term telemetered simultaneous video-EEG recordings. She began to have seizures at the age of 10 years. She experienced complex partial seizures, often preceded by elementary auditory hallucination and complex auditory illusion. The seizures occurred in relation to singing, listening to music or thinking about music. She also had occasional generalized tonic clonic seizures during sleep. There was no significant antecedent history. The family history was negative for epilepsy. The physical examination was unremarkable. CT and MRI scans of the brain were normal. During long-term simultaneous video-EEG recordings, clinical and electrographic seizure activities were recorded in association with singing and listening to music. Mathematical calculation, copying or viewing geometric patterns and playing the game of chess failed to evoke seizures.

  6. Infantile Spasms: Little Seizures, BIG Consequences (United States)

    Shields, W Donald


    Infantile spasms is one of the “catastrophic childhood epilepsies” because of the difficulty in controlling seizures and the association with mental retardation. However, early recognition, a careful diagnostic evaluation, and proper treatment may allow some children to attain seizure control and to achieve a normal, or at least much improved, level of development. Thus, there is the opportunity to have an important impact in the lives of these unfortunate children and their families. PMID:16761063

  7. Rapamycin Prevents Seizures After Depletion of STRADA in a Rare Neurodevelopmental Disorder


    Parker, Whitney E.; Orlova, Ksenia A.; Parker, William H.; Birnbaum, Jacqueline F.; Krymskaya, Vera P.; Goncharov, Dmitry A.; Baybis, Marianna; Helfferich, Jelte; Okochi, Kei; Strauss, Kevin A.; Crino, Peter B.


    A rare neurodevelopmental disorder in the Old Order Mennonite population called PMSE (polyhydramnios, megalencephaly, and symptomatic epilepsy syndrome; also called Pretzel syndrome) is characterized by infantile-onset epilepsy, neurocognitive delay, craniofacial dysmorphism, and histopathological evidence of heterotopic neurons in subcortical white matter and subependymal regions. PMSE is caused by a homozygous deletion of exons 9 to 13 of the LYK5/STRADA gene, which encodes the pseudokinase...

  8. Major depressive disorder as a predictor of a worse seizure outcome one year after surgery in patients with temporal lobe epilepsy and mesial temporal sclerosis. (United States)

    de Araújo Filho, Gerardo Maria; Gomes, Francinaldo Lobato; Mazetto, Lenon; Marinho, Murilo Martinez; Tavares, Igor Melo; Caboclo, Luís Otávio Sales Ferreira; Yacubian, Elza Márcia Targas; Centeno, Ricardo Silva


    The association between pre-surgical psychiatric disorders (PDs) and worse seizure outcome in patients with refractory epilepsy submitted to surgery has been increasingly recognized in the literature. The present study aimed to verify the impact of pre- and post-surgical PD on seizure outcome in a series of patients with refractory temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS). Data from 115 TLE-MTS patients (65 females; 56.5%) who underwent cortico-amygdalohippocampectomy (CAH) were analyzed. Pre- and post-surgical psychiatric evaluations were performed using DSM-IV and ILAE criteria. The outcome subcategory Engel IA was considered as corresponding to a favorable prognosis. A multivariate logistic regression model was applied to identify possible risk factors associated with a worse seizure outcome. Pre-surgical PDs, particularly major depressive disorder (MDD), anxiety and psychotic disorders, were common, being found in 47 patients (40.8%). Fifty-six patients (48.7%) were classified as having achieved an Engel IA one year after CAH. According to the logistic regression model, the presence of pre-surgical MDD (OR=5.23; p=0.003) appeared as the most important risk factor associated with a non-favorable seizure outcome. Although epilepsy surgery may be the best treatment option for patients with refractory TLE-MTS, our findings emphasize the importance of performing a detailed psychiatric examination as part of the pre-surgical evaluation protocol. Copyright © 2012 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  9. Elevated Urinary Glyphosate and Clostridia Metabolites With Altered Dopamine Metabolism in Triplets With Autistic Spectrum Disorder or Suspected Seizure Disorder: A Case Study. (United States)

    Shaw, William


    Autism is a neurodevelopmental disorder for which a number of genetic, environmental, and nutritional causes have been proposed. Glyphosate is used widely as a crop desiccant and as an herbicide in fields of genetically modified foods that are glyphosate resistant. Several researchers have proposed that it may be a cause of autism, based on epidemiological data that correlates increased usage of glyphosate with an increased autism rate. The current study was intended to determine if excessive glyphosate was present in the triplets and their parents and to evaluate biochemical findings for the family to determine the potential effects of its presence. The author performed a case study with the cooperation of the parents and the attending physician. The study took place at The Great Plains Laboratory, Inc (Lenexa, KS, USA). Participants were triplets, 2 male children and 1 female, and their parents. The 2 male children had autism, whereas the female had a possible seizure disorder. All 3 had elevated urinary glyphosate, and all of the triplets and their mother had elevated values of succinic acid or tiglylglycine, which are indicators of mitochondrial dysfunction. The participants received a diet of organic food only. The study performed organic acids, glyphosate, toxic chemicals and tiglylglycine, and creatinine testing of the participants' urine. The 2 male triplets with autism had abnormalities on at least 1 organic acids test, including elevated phenolic compounds such as 4-cresol, 3-[3-hydroxyphenyl]-3-hydroxypropionic acid and 4-hydroxyphenylacetic acid, which have been previously associated with Clostridia bacteria and autism. The female, who was suspected of having a seizure disorder but not autism, did not have elevated phenolic compounds but did have a significantly elevated value of the metabolite tiglylglycine, a marker for mitochondrial dysfunction and/or mutations. One male triplet was retested postintervention and was found to have a markedly lower

  10. Masticatory sensory-motor changes after an experimental chewing test influenced by pain catastrophizing and neck-pain-related disability in patients with headache attributed to temporomandibular disorders. (United States)

    La Touche, Roy; Paris-Alemany, Alba; Gil-Martínez, Alfonso; Pardo-Montero, Joaquín; Angulo-Díaz-Parreño, Santiago; Fernández-Carnero, Josué


    Recent research has shown a relationship of craniomandibular disability with neck-pain-related disability has been shown. However, there is still insufficient information demonstrating the influence of neck pain and disability in the sensory-motor activity in patients with headache attributed to temporomandibular disorders (TMD). The purpose of this study was to investigate the influence of neck-pain-related disability on masticatory sensory-motor variables. An experimental case-control study investigated 83 patients with headache attributed to TMD and 39 healthy controls. Patients were grouped according to their scores on the neck disability index (NDI) (mild and moderate neck disability). Initial assessment included the pain catastrophizing scale and the Headache Impact Test-6. The protocol consisted of baseline measurements of pressure pain thresholds (PPT) and pain-free maximum mouth opening (MMO). Individuals were asked to perform the provocation chewing test, and measurements were taken immediately after and 24 hours later. During the test, patients were assessed for subjective feelings of fatigue (VAFS) and pain intensity. VAFS was higher at 6 minutes (mean 51.7; 95% CI: 50.15-53.26) and 24 hours after (21.08; 95% CI: 18.6-23.5) for the group showing moderate neck disability compared with the mild neck disability group (6 minutes, 44.16; 95% CI 42.65-45.67/ 24 hours after, 14.3; 95% CI: 11.9-16.7) and the control group. The analysis shows a decrease in the pain-free MMO only in the group of moderate disability 24 hours after the test. PPTs of the trigeminal region decreased immediately in all groups, whereas at 24 hours, a decrease was observed in only the groups of patients. PPTs of the cervical region decreased in only the group with moderate neck disability 24 hours after the test. The strongest negative correlation was found between pain-free MMO immediately after the test and NDI in both the mild (r = -0.49) and moderate (r = -0.54) neck disability

  11. Febrile seizures (United States)

    ... cry or moan. If standing, the child will fall. The child may vomit or bite their tongue. Sometimes, children ... of febrile seizures is not related to future risk of epilepsy. Children who would develop epilepsy anyway will sometimes have ...

  12. Dopey's seizure. (United States)

    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. Copyright 1999 BEA Trading Ltd.

  13. Envenomation Seizures. (United States)

    Kharal, Ghulam Abbas; Darby, Richard Ryan; Cohen, Adam B


    Insect sting-related envenomation rarely produces seizures. We present a patient with confusion and seizures that began 24 hours after a yellow jacket (wasp) sting. Given the rapid onset and resolution of symptoms, as well as accompanying dermatological and orbital features, and the lack of any infectious or structural abnormalities identified, the toxic effect of the wasp venom (and related anaphylaxis reaction) was believed to be the cause of his presentation.

  14. Electroencephalography after a single unprovoked seizure. (United States)

    Debicki, Derek B


    Electroencephalography (EEG) is an essential diagnostic tool in the evaluation of seizure disorders. In particular, EEG is used as an additional investigation for a single unprovoked seizure. Epileptiform abnormalities are related to seizure disorders and have been shown to predict recurrent unprovoked seizures (i.e., a clinical definition of epilepsy). Thus, the identification of epileptiform abnormalities after a single unprovoked seizure can inform treatment options. The current review addresses the relationship between EEG abnormalities and seizure recurrence. This review also addresses factors that are found to improve the yield of recording epileptiform abnormalities including timing of EEG relative to the new-onset seizure, use of repeat studies, use of sleep deprivation and prolonged recordings. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  15. Predicting epileptic seizures in advance.

    Directory of Open Access Journals (Sweden)

    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.

  16. The Ongoing Catastrophe

    DEFF Research Database (Denmark)

    Kublitz, Anja


    as camps. Based on fieldwork among Palestinians in the Danish camps, this article explores why my interlocutors describe their current lives as a catastrophe. Al-Nakba literally means the catastrophe and, in Palestinian national discourse, it is used to designate the event of 1948, when the Palestinians...... argue that, unlike the spectacular catastrophes in Palestine and later in Lebanon, life in the Danish camps is characterized by minor mundane catastrophes that are each so small that they barely register or elicit a moral response, but nevertheless erode the lives of my interlocutors....

  17. Febrile seizures. Update and controversies. (United States)

    Jan, Mohammed M; Girvin, John P


    Febrile seizures are the most common seizure disorder in children younger than 5 years of age. Most febrile seizures are brief, do not require any specific treatment or workup, and have benign prognoses. Generalists and pediatricians are frequently faced with anxious parents and are required to make rational decisions regarding the need to investigate and treat such a child. They subsequently need to provide further prognostic information and counseling to the families. The aim of this article is to provide an updated overview of febrile seizures and review the most recent diagnostic and therapeutic recommendations. Despite the progress in the understanding of this benign syndrome, a wide variation in physician evaluation and management persists. However, there is recent evidence that pediatricians are becoming more selective in admitting and investigating children with febrile seizures. Admitted children frequently had complex seizures, status epilepticus, or were ill looking. Considering the full scope of febrile seizures, the yield of investigations that might alter management remains low and does not justify extensive work-up or prolonged hospitalization.

  18. Catastrophic Antiphospholipid Syndrome

    Directory of Open Access Journals (Sweden)

    Rawhya R. El-Shereef


    Full Text Available This paper reports one case of successfully treated patients suffering from a rare entity, the catastrophic antiphospholipid syndrome (CAPS. Management of this patient is discussed in detail.

  19. Catastrophe Theory and Caustics

    DEFF Research Database (Denmark)

    Gravesen, Jens


    It is shown by elementary methods that in codimension two and under the assumption that light rays are straight lines, a caustic is the catastrophe set for a time function. The general case is also discussed.......It is shown by elementary methods that in codimension two and under the assumption that light rays are straight lines, a caustic is the catastrophe set for a time function. The general case is also discussed....

  20. Breakthrough seizures after starting vilazodone for depression. (United States)

    McKean, James; Watts, Hannah; Mokszycki, Robert


    Vilazodone is a new selective serotonin reuptake inhibitor (SSRI) and serotonin 5-HT1a partial agonist that is approved by the United States Food and Drug Administration to treat major depression. SSRI-induced seizures are rare and are more likely to be associated with larger doses and severe symptoms such as those present in serotonin syndrome. Several case reports have implicated SSRIs, buspirone, or the combination of these agents as the cause of seizures, but these reports were confounded with either coingestions or doses that exceeded FDA recommendations. We describe a 22-year-old woman with a history of seizure disorder who had been seizure free for the previous 8 years and experienced two breakthrough seizures shortly after starting vilazodone. Her dose of vilazodone had recently been titrated to 40 mg/day when she experienced the first seizure. She was instructed to taper vilazodone over the next several days, then discontinue the drug, and then follow up with her neurologist. Based on the patient's history, physical examination, and recent dose increase, it was plausible that vilazodone was the cause of the seizures. Use of the Naranjo adverse drug reaction probability scale indicated a possible relationship (score of 4) between her development of seizures and vilazodone therapy. The pharmacodynamics of this particular class of SSRI has both proconvulsive and anticonvulsive mechanisms. This is of particular concern in patients with a history of seizure disorder who are starting antidepressive therapy. In persons with epilepsy who are taking vilazodone and experience breakthrough seizures, practitioners should consider this drug as a potential cause of these seizures. Thus, until future research and experience with vilazodone can provide a definitive answer, clinicians should be cautious when prescribing this medication to treat depression in patients with a history of seizure disorder. © 2015 Pharmacotherapy Publications, Inc.

  1. Epilepsy or seizures - discharge (United States)

    ... this page: // Epilepsy or seizures - discharge To use the sharing features on this page, please enable JavaScript. You have epilepsy . People with epilepsy have seizures. A seizure is ...

  2. A Neonate with persistent hypoglycemia and seizures.

    African Journals Online (AJOL)


    disorder was diagnosed and managed with limited success as the episodes hydroglycemic seizures persisted. ... the presence of hyperinsulinemia as the cause of the hypoglycemic dependent seizures. Case Presentation. A three day old girl was admitted to the neonatal .... the Prader-Willi syndrome, has been reported.

  3. Flumazenil and seizures: analysis of 43 cases. (United States)

    Spivey, W H


    Flumazenil is a new drug indicated for the reversal of the sedative effects of benzodiazepines mediated at the benzodiazepine-receptor site. Worldwide sources to date have disclosed 43 cases of seizures related, at least temporally, to the intravenous administration of flumazenil. There was no apparent relationship between the dose of flumazenil and the development of seizures, which occurred at doses ranging from 0.2 to 10.0 mg. The seizures were not considered to be a toxic effect of flumazenil, but many of them probably were due to an unmasking of the anticonvulsant effect of the previously used benzodiazepine or to a severe benzodiazepine-withdrawal syndrome. Eighteen (42%) of the patients had ingested overdoses of cyclic antidepressants, which were considered responsible for the seizures. In addition to patients with concurrent cyclic antidepressant poisoning, high-risk populations include patients who have been treated with benzodiazepines for a seizure disorder or an acute convulsive episode, patients with concurrent major sedative-hypnotic drug withdrawal, patients who have recently been treated with repeated doses of parenteral benzodiazepines, and overdose patients with myoclonic jerking or seizure activity before flumazenil administration. To minimize the likelihood of a seizure, it is recommended that flumazenil not be administered to patients who have used benzodiazepines for the treatment of seizure disorders or to patients who have ingested drugs (eg, cyclic antidepressants, cocaine, lithium, methylxanthines, isoniazid, propoxyphene, monoamine oxidase inhibitors, buproprion HCl, and cyclosporine) that place them at risk for the development of seizures.

  4. Seizures and Teens: Stress, Sleep, & Seizures (United States)

    Shafer, Patricia Osborne


    Most parents are used to erratic sleep patterns and mood swings in their teenagers. When these occur in an adolescent with seizures, however, the parent may wonder if sleep and mood problems are related to seizures. Sorting out the cause and effects of sleep in an adolescent with seizures can be confusing. Since stress can be a contributor to both…

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

    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.

  6. Protocols of a catastrophe

    International Nuclear Information System (INIS)

    Stscherbak, J.


    In unusually frank terms the author, a journalist and epidemiologist, describes the catastrophe of Chernobyl as the 'most pathetic and important' experience of the Soviet people after World War II. Documents, interviews and statements of persons concerned trace the disaster of those days that surpasses imagination and describe how individual persons witnessed the coming true of visions of terror. (orig./HSCH) [de

  7. Clues from stellar catastrophes

    NARCIS (Netherlands)

    Rimoldi, Alexander


    This thesis uses catastrophic stellar events (supernovae and stellar collisions) to investigate different aspects of their environment. The first part of the thesis examines what happens to supernova remnants near supermassive black holes like the one in the Milky Way Galaxy. To do so, a technique

  8. Direct catastrophic injury in sports. (United States)

    Boden, Barry P


    Catastrophic sports injuries are rare but tragic events. Direct (traumatic) catastrophic injury results from participating in the skills of a sport, such as a collision in football. Football is associated with the greatest number of direct catastrophic injuries for all major team sports in the United States. Pole vaulting, gymnastics, ice hockey, and football have the highest incidence of direct catastrophic injuries for sports in which males participate. In most sports, the rate of catastrophic injury is higher at the collegiate than at the high school level. Cheerleading is associated with the highest number of direct catastrophic injuries for all sports in which females participate. Indirect (nontraumatic) injury is caused by systemic failure as a result of exertion while participating in a sport. Cardiovascular conditions, heat illness, exertional hyponatremia, and dehydration can cause indirect catastrophic injury. Understanding the common mechanisms of injury and prevention strategies for direct catastrophic injuries is critical in caring for athletes.

  9. Catastrophic primary antiphospholipid syndrome

    International Nuclear Information System (INIS)

    Kim, Dong Hun; Byun, Joo Nam; Ryu, Sang Wan


    Catastrophic antiphospholipid syndrome (CAPLS) was diagnosed in a 64-year-old male who was admitted to our hospital with dyspnea. The clinical and radiological examinations showed pulmonary thromboembolism, and so thromboembolectomy was performed. Abdominal distension rapidly developed several days later, and the abdominal computed tomography (CT) abdominal scan revealed thrombus within the superior mesenteric artery with small bowel and gall bladder distension. Cholecystectomy and jejunoileostomy were performed, and gall bladder necrosis and small bowel infarction were confirmed. The anticardiolipin antibody was positive. Anticoagulant agents and steroids were administered, but the patient expired 4 weeks after surgery due to acute respiratory distress syndrome (ARDS). We report here on a case of catastrophic APLS with manifestations of pulmonary thromboembolism, rapidly progressing GB necrosis and bowel infarction

  10. Catastrophic primary antiphospholipid syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Hun; Byun, Joo Nam [Chosun University Hospital, Gwangju (Korea, Republic of); Ryu, Sang Wan [Miraero21 Medical Center, Gwangju (Korea, Republic of)


    Catastrophic antiphospholipid syndrome (CAPLS) was diagnosed in a 64-year-old male who was admitted to our hospital with dyspnea. The clinical and radiological examinations showed pulmonary thromboembolism, and so thromboembolectomy was performed. Abdominal distension rapidly developed several days later, and the abdominal computed tomography (CT) abdominal scan revealed thrombus within the superior mesenteric artery with small bowel and gall bladder distension. Cholecystectomy and jejunoileostomy were performed, and gall bladder necrosis and small bowel infarction were confirmed. The anticardiolipin antibody was positive. Anticoagulant agents and steroids were administered, but the patient expired 4 weeks after surgery due to acute respiratory distress syndrome (ARDS). We report here on a case of catastrophic APLS with manifestations of pulmonary thromboembolism, rapidly progressing GB necrosis and bowel infarction.

  11. Vivre la catastrophe


    Favreau, Yohan


    Le mot catastrophe a ceci d’intéressant et de pratique que l’on peut l’employer pour désigner un ensemble de situations hétéroclites, ayant pour point commun un caractère dit sensationnel, médiatiquement porteur et pour autant sans commune mesure. Une catastrophe pour les uns peut ne pas en être une pour les autres. On a ainsi pu lire dans la presse que le réchauffement climatique met en péril des populations entières que l’on nomme déjà les futurs « réfugiés climatiques » en rendant leur mil...

  12. Out-of-body experiences associated with seizures

    Directory of Open Access Journals (Sweden)

    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.

  13. Vaccination, seizures and 'vaccine damage'. (United States)

    Brown, Natasha J; Berkovic, Samuel F; Scheffer, Ingrid E


    Concerns about the safety of vaccination have plagued the community, with reduction in vaccine uptake resulting in increased risk of epidemics. Vaccination has been implicated in the cause of febrile seizures, 'vaccine encephalopathy' and autistic spectrum disorders. Evaluation of alleged associations is complicated by evolution in the vaccination field. This review focuses on the risk of seizures following vaccination and the alleged associations of vaccination with vaccine encephalopathy and also with autism spectrum disorders. Over the last decade the introduction of new vaccines such as the acellular pertussis vaccine has produced a reduction in seizures following vaccination, the outcome of which was benign even with older vaccines. New evidence emerged in 2006 showing that cases of alleged 'vaccine encephalopathy' are due to mutations within a sodium channel gene. The weight of epidemiological evidence does not support a relationship between vaccination and childhood epileptic encephalopathies or autism spectrum disorders. Vaccines are safer than ever before, but the challenge remains to convey this message to society in such a way that produces change in attitudes to vaccination and subsequent increase in vaccine coverage.

  14. A unified approach of catastrophic events

    Directory of Open Access Journals (Sweden)

    S. Nikolopoulos


    Full Text Available Although there is an accumulated charge of theoretical, computational, and numerical work, like catastrophe theory, bifurcation theory, stochastic and deterministic chaos theory, there is an important feeling that these matters do not completely cover the physics of real catastrophic events. Recent studies have suggested that a large variety of complex processes, including earthquakes, heartbeats, and neuronal dynamics, exhibits statistical similarities. Here we are studying in terms of complexity and non linear techniques whether isomorphic signatures emerged indicating the transition from the normal state to the both geological and biological shocks. In the last 15 years, the study of Complex Systems has emerged as a recognized field in its own right, although a good definition of what a complex system is, actually is eluded. A basic reason for our interest in complexity is the striking similarity in behaviour close to irreversible phase transitions among systems that are otherwise quite different in nature. It is by now recognized that the pre-seismic electromagnetic time-series contain valuable information about the earthquake preparation process, which cannot be extracted without the use of important computational power, probably in connection with computer Algebra techniques. This paper presents an analysis, the aim of which is to indicate the approach of the global instability in the pre-focal area. Non-linear characteristics are studied by applying two techniques, namely the Correlation Dimension Estimation and the Approximate Entropy. These two non-linear techniques present coherent conclusions, and could cooperate with an independent fractal spectral analysis to provide a detection concerning the emergence of the nucleation phase of the impending catastrophic event. In the context of similar mathematical background, it would be interesting to augment this description of pre-seismic electromagnetic anomalies in order to cover biological

  15. Paraboles et catastrophes

    CERN Document Server

    Thom, René


    René Thom, mathématicien français, membre de l'Académie des Sciences, s'est vu décerner en 1958 la médaille Field, équivalent du Prix Nobel en mathématiques, pour ses créations intellectuelles, la " théorie des catastrophes ", regard nouveau sur toutes les transformations qui adviennent de manière brusque, imprévisible, dramatique. Dans ces entretiens qui vont de la mathématique à l'embryologie, de la linguistique à l'anthropologie et à l'histoire, René Thom expose les grandes lignes de la théorie des catastrophes et passe en revue, avec un esprit à la fois critique et passionné, les grands thèmes scientifiques de notre époque, de la physique atomique à la biologie moléculaire, du " progrès " scientifique et technologique aux connexions complexes entre la société et la science. " Ce petit livre est une extraordinaire réussite en vulgarisation ". (Jean Largeault)

  16. Fukushinobyl, the impossible catastrophe

    International Nuclear Information System (INIS)

    Boceno, Laurent


    With the emergence of variety of health and environmental crisis or catastrophes (Seveso, Bhopal, Chernobyl, AIDS, contaminated blood, mad cow, influenzas), the author proposes thoughts about the fact that it seems we are not in the era of industrial societies any longer, but in that of societies of risk. He more particularly focuses on Chernobyl and Fukushima to analyse how a social framework is built up to integrate forms of institutionalisation of multifaceted vulnerability, these institutional logics becoming latent social pathologies. In this respect, he more particularly discusses the catastrophic share of nuclear. He shows how what can be considered as a risk is socialised, dissimulated by priority, and then addresses the management of consequences of Chernobyl and how it is used to address the Japanese present situation. He notably outlines a kind of collusion between the WHO and the IAEA about nuclear issues. In his respect, he recalls a statement made by the WHO saying that, from a mental health point of view, the most satisfying solution for the future of pacific uses of nuclear energy would be the emergence of a new generation who would have learned to cope with ignorance and uncertainty

  17. Cosmic impacts, cosmic catastrophes. II (United States)

    Chapman, Clark R.; Morrison, David


    The role of extraterrestrial impacts in shaping the earth's history is discussed, arguing that cosmic impacts represent just one example of a general shift in thinking that has made the idea of catastrophes respectable in science. The origins of this view are presented and current catastrophic theory is discussed in the context of modern debate on the geological formation of the earth. Various conflicting theories are reviewed and prominent participants in the ongoing scientific controversy concerning catastrophism are introduced.

  18. Management of a First Seizure. (United States)

    Bergey, Gregory K


    Assessment of the patient with a first seizure is a common and important neurologic issue. Less than 50% of patients who have a first unprovoked seizure have a second seizure; thus, the evaluation should focus on determining the patient's risk of seizure recurrence. A number of population studies, including some classic reports, have identified the relative risk factors for subsequent seizure recurrence. The 2014 update of the International League Against Epilepsy definition of epilepsy incorporates these findings, and in 2015, the American Academy of Neurology published a guideline that analyzed the available data. Provoked or acute symptomatic seizures do not confer increased risk for subsequent unprovoked seizure recurrence. Multiple seizures in a given 24-hour period do not increase the risk of seizure recurrence. Remote symptomatic seizures, an epileptiform EEG, a significant brain imaging abnormality, and nocturnal seizures are risk factors for seizure recurrence. Antiepileptic drug therapy delays the time to second seizure but may not influence long-term remission.

  19. Seizure semiology and aging. (United States)

    Silveira, Diosely C; Jehi, Lara; Chapin, Jessica; Krishnaiengar, Suparna; Novak, Eric; Foldvary-Schaefer, Nancy; Najm, Imad


    The incidence of epilepsy is high in older individuals. However, epilepsy in the elderly may be underdiagnosed and undertreated because of diagnostic difficulties. The main goal of this study was to determine whether seizure semiology differs between older and younger adults with epilepsy in the outpatient setting. Fifty patients with focal epilepsy aged 55 years and older and 50 patients aged between 18 and 45 years were included. Review of medical records contained detailed seizure description. There were no differences in seizure semiology between groups, except that subtle perceptions of transient confusion were seen in older patients but not in younger patients (P=0.0028). Older patients had less generalized motor seizures, but the differences between groups did not reach significance (P=0.01). Older patients may present with subtle symptoms of seizures characterized by brief periods of confusion, which may contribute to greater difficulty diagnosing seizures in the elderly. Copyright © 2010 Elsevier Inc. All rights reserved.

  20. Generalized tonic-clonic seizure (United States)

    ... tonic-clonic seizures have vision, taste, smell, or sensory changes, hallucinations, or dizziness before the seizure. This ... longer (called the post-ictal state) Loss of memory (amnesia) about the seizure episode Headache Weakness of ...

  1. Complex partial seizure with severe depression and conduct ...

    African Journals Online (AJOL)

    Complex partial seizure complicated by psychiatric comorbidities like depression and conduct disorder presents management challenges for both the physician and parents. The etiology of such psychiatric comorbidities may be related to the seizure or to several other unrelated risk factors. The psychiatric comorbidities and ...

  2. Catastrophic antiphospholipid Syndrome

    International Nuclear Information System (INIS)

    Medina Velasquez, Yimy; Felix Restrepo Suarez, Jose; Iglesias Gamarra, Antonio


    The antiphospholipid syndrome (APS) is characterized by venous, arterial thrombosis and miscarriages along with lupic anticoagulant and antibodies against anticardiolipin. The catastrophic antiphospholipid syndrome (CAPS) has been described since 1992 like a multiple organic dysfunction caused by multiple vascular thrombosis in three or more organs. The patients who suffer from this syndrome may have or not history of APS. There are two or three mechanisms that may cause the CAPS, alone or in combination: These are: 1. The multisystemic thrombotic disease with emphasis in microvasculature occlusion of the organs and occlusion of big arterial or veins 2. The disseminated intravascular coagulation (DIC) superimpose in 15% to 50% of the patients that, of course, conducted to an occlusive disease of arterioles, veins or capillaries. 3. A systemic inflammatory response syndrome (SIRS) induced by citoquines. In this review it is described clinical and laboratory features, pathogenesis and treatment of CAPS. For this purpose, it was searched for Medline from 1993 to 2000 and revised the most significant issues obtained by this medium

  3. Viruses and febrile seizures

    NARCIS (Netherlands)

    Zeijl, J.H. van


    We conclude that viral infections are the main cause of febrile seizures, with an important role for influenza A, HHV-6 and HHV-7. We showed that several viral infections not only contribute to initial febrile seizures, but also to recurrences. Viruses could not be detected in the CSF of children

  4. Management of provoked seizure

    Directory of Open Access Journals (Sweden)

    Misra Usha


    Full Text Available A provoked seizure may be due to structural damage (resulting from traumatic brain injury, brain tumor, stroke, tuberculosis, or neurocysticercosis or due to metabolic abnormalities (such as alcohol withdrawal and renal or hepatic failure. This article is a part of the Guidelines for Epilepsy in India. This article reviews the problem of provoked seizure and its management and also provides recommendations based on currently available information. Seizure provoked by metabolic disturbances requires correction of the triggering factors. Benzodiazepines are recommended for treatment of seizure due to alcohol withdrawal; gabapentin for seizure seen in porphyria; and antiepileptic drugs (AED, that are not inducer of hepatic enzymes, in the seizures seen in hepatic dysfunction. In severe traumatic brain injury, with or without seizure, phenytoin (PHT may be given for 7 days. In ischemic or hemorrhagic stroke one may individualize the AED therapy. In cerebral venous sinus thrombosis (CVST, AED may be prescribed if there is seizure or computed tomographic (CT abnormalities or focal weakness; the treatment, in these cases, has to be continued for 1 year. Prophylactic AED is not recommended in cases of brain tumor and neurosurgical procedures and if patient is on an AED it can be stopped after 1 week.

  5. Epilepsy after Febrile Seizures

    DEFF Research Database (Denmark)

    Seinfeld, S. A.; Pellock, J M; Kjeldsen, Lone Marianne Juel


    Background A history of complex febrile seizures can increase the risk of epilepsy, but the role of genetic factors is unclear. This analysis evaluated the relationship between febrile seizures and epilepsy. Methods Information on the history of seizures was obtained by a questionnaire from twin...... epilepticus. There were 78 twins who developed epilepsy. The highest rate of epilepsy (22.2%) occurred in the febrile status epilepticus group. Concordance was highest in simple group. Conclusion A twin with febrile status epilepticus is at the highest risk of developing epilepsy, but simple febrile seizures...... and emotional burden. It is currently not possible to accurately identify which children will develop recurrent febrile seizures, epilepsy, or neuropsychological comorbidities. © 2016 Elsevier Inc. All rights reserved....

  6. Intravenous Carbamazepine for Adults With Seizures. (United States)

    Vickery, P Brittany; Tillery, Erika E; DeFalco, Alicia Potter


    To review the pharmacology, pharmacokinetics, efficacy, safety, dosage and administration, potential drug-drug interactions, and place in therapy of the intravenous (IV) formulation of carbamazepine (Carnexiv) for the treatment of seizures in adult patients. A comprehensive PubMed and EBSCOhost search (1945 to August 2017) was performed utilizing the keywords carbamazepine, Carnexiv, carbamazepine intravenous, IV carbamazepine, seizures, epilepsy, and seizure disorder. Additional data were obtained from literature review citations, manufacturer's product labeling, and Lundbeck website as well as and governmental sources. All English-language trials evaluating IV carbamazepine were analyzed for this review. IV carbamazepine is FDA approved as temporary replacement therapy for treatment of adult seizures. Based on a phase I trial and pooled data from 2 open-label bioavailability studies comparing oral with IV dosing, there was no noted indication of loss of seizure control in patients switched to short-term replacement antiepileptic drug therapy with IV carbamazepine. The recommended dose of IV carbamazepine is 70% of the patient's oral dose, given every 6 hours via 30-minute infusions. The adverse effect profile of IV carbamazepine is similar to that of the oral formulation, with the exception of added infusion-site reactions. IV carbamazepine is a reasonable option for adults with generalized tonic-clonic or focal seizures, previously stabilized on oral carbamazepine, who are unable to tolerate oral medications for up to 7 days. Unknown acquisition cost and lack of availability in the United States limit its use currently.

  7. Epileptic Seizures Prediction Using Machine Learning Methods

    Directory of Open Access Journals (Sweden)

    Syed Muhammad Usman


    Full Text Available Epileptic seizures occur due to disorder in brain functionality which can affect patient’s health. Prediction of epileptic seizures before the beginning of the onset is quite useful for preventing the seizure by medication. Machine learning techniques and computational methods are used for predicting epileptic seizures from Electroencephalograms (EEG signals. However, preprocessing of EEG signals for noise removal and features extraction are two major issues that have an adverse effect on both anticipation time and true positive prediction rate. Therefore, we propose a model that provides reliable methods of both preprocessing and feature extraction. Our model predicts epileptic seizures’ sufficient time before the onset of seizure starts and provides a better true positive rate. We have applied empirical mode decomposition (EMD for preprocessing and have extracted time and frequency domain features for training a prediction model. The proposed model detects the start of the preictal state, which is the state that starts few minutes before the onset of the seizure, with a higher true positive rate compared to traditional methods, 92.23%, and maximum anticipation time of 33 minutes and average prediction time of 23.6 minutes on scalp EEG CHB-MIT dataset of 22 subjects.

  8. Anoxic seizures: self-terminating syncopes. (United States)

    Stephenson, J B


    This review focuses on anoxic seizures induced by self terminating syncopes in the young. Anoxic seizures are nonepileptic events consequent upon abrupt interruption of the energy supply to metabolically active cerebral neurones. Anoxic seizures are the most common paroxysmal events misdiagnosed as epilepsy. Neurally mediated syncopes have numerous appellations, especially in the young. This proliferation of terminology likely results from uncertainty regarding pathophysiology. The most important type of self-limiting syncope from the point of view of diagnostic difficulty has been called neurocardiogenic or vasovagal syncope and reflex anoxic seizure, amongst other names: this review includes a video clip of such a child with prolonged asystole. It also includes a detailed case history emphasising the feelings of a patient with this type of syncope who was misdiagnosed as having epilepsy for many years. The second class of self-terminating syncope discussed and illustrated on video is the so-called breath-holding spell of young children. The third example illustrated is the compulsive Valsalva manoeuvre of individuals with autistic spectrum disorder, in which anoxic seizures - as shown on the video clips - are easily misdiagnosed as epileptic seizures, with unfortunate consequences.

  9. Reliability of seizure semiology in patients with 2 seizure foci. (United States)

    Rathke, Kevin M; Schäuble, Barbara; Fessler, A James; So, Elson L


    To determine whether seizure semiology is reliable in localizing and distinguishing seizures at 2 independent brain foci in the same patient. Two masked reviewers localized seizures from 2 foci by their clinical semiology and intracranial electroencephalograms (EEGs). Epilepsy monitoring unit of referral comprehensive epilepsy program. Seventeen consecutive patients (51 seizures) with sufficient video and intracranial EEG data were identified by reviewing medical records of 366 patients older than 10 years. The primary outcome measures were interobserver agreement between the 2 masked reviewers; the proportion of seizures localized by semiology; the proportion of localized seizures concordant with intracranial EEG localization; and comparison between concordant and nonconcordant seizures in latency of intracranial EEG seizure spread. Interobserver agreement was 41% (κ score, 0.16). Only 30 of 51 seizures (59%) were localized by seizure semiology. The focus localized by semiology was concordant with the location of intracranial EEG seizure onset in 16 of 30 seizures (53%). No significant difference was observed between concordant and nonconcordant seizures in relation to the speed with which the EEG discharge spread from the location of seizure onset to another lobar region (P = .09, Wilcoxon rank sum test). Clinical seizure semiology is not as useful as intracranial EEG in localizing seizure onset in patients with dual seizure foci.

  10. Psychogenic non-epileptic seizures: our video-EEG experience. (United States)

    Nežádal, Tomáš; Hovorka, Jiří; Herman, Erik; Němcová, Iveta; Bajaček, Michal; Stichová, Eva


    The aim of our study was to assess the number of psychogenic non-epileptic seizures (PNES) in our patients with a refractory seizure disorder, to determine the 'typical' PNES semiology using video-EEG monitoring and describe other PNES parameters. We evaluated prospectively 596 patients with pharmacoresistant seizures. All these patients underwent continuous video-EEG monitoring. In consenting patients, we used suggestive seizure provocation. We assessed seizure semiology, interictal EEG, brain MRI, psychiatric co-morbidities, personality profiles, and seizure outcome. In the sample of 596 monitored patients, we detected 111 (19.3%) patients with PNES. Of the 111 patients with PNES, 86.5% had spontaneous and 76.5% had provoked seizures. The five most typical symptoms were: initially closed eyelids (67.6%), rapid tremor (47.7%), asynchronous limb movement (37.8%), preictal pseudosleep (33.3%), and side-to-side head movement (32.4%). Interictal EEG was rated as abnormal in 46.2% and with epileptiform abnormality in 9%. Brain MRI was abnormal in 32 (28.8%) patients. Personality disorders (46.8%), anxiety (39.6%), and depression (12.6%) were the most frequent additional psychiatric co-morbidities. PNES outcome after at least 2 years is reported; 22.5% patients was seizure-free; one-third had markedly reduced seizure frequency. We have not seen any negative impact of the provocative testing on the seizure outcome. Video-EEG monitoring with suggestive seizure provocation supported by clinical psychiatric and psychological evaluation significantly contributes to the correct PNES diagnosis, while interictal EEG and brain MRI are frequently abnormal. Symptoms typical for PNES, as opposed to epileptic seizures, could be distinguished.

  11. Protection against generalised seizured by Dalbergia saxatilis ...

    African Journals Online (AJOL)

    The aqueous root decoction of Dalbergia saxatilis (DS) is used to manage convulsive disorders in African herbal medicine practice. We had previously reported the anticonvulsant effects of the aqueous root extract of DS against strychnine and picrotoxin seizures. In this study, DS was tested against pentylenetetrazole (PTZ) ...

  12. Distress tolerance is linked to unhealthy eating through pain catastrophizing. (United States)

    Emami, Ashley S; Woodcock, Anna; Swanson, Heidi E; Kapphahn, Teresa; Pulvers, Kim


    Low distress tolerance, an important component of emotion regulation, is a risk factor for unhealthy eating. Identifying factors which explain the link between distress tolerance and unhealthy eating can advance the understanding of problematic eating and inform prevention and treatment of obesity and eating disorders. The present study examines pain catastrophizing as a mediator between distress tolerance and unhealthy eating in a nonclinical population, which has received little attention despite being a risk factor for unhealthy eating behaviors. The Distress Tolerance Scale (DTS), Pain Catastrophizing Scale (PCS), and the Dutch Eating Behavior Questionnaire (DEBQ), were administered to 171 college students (62.6% female, 38.6% White, 28.1% Hispanic). There was no evidence of a significant direct effect of distress tolerance on unhealthy eating. However, as hypothesized, there was a significant indirect or mediated effect of pain catastrophizing on the relationship between distress tolerance and unhealthy eating. Individuals low in distress tolerance reported higher pain catastrophizing, and a result, these individuals also reported higher levels of unhealthy eating. These findings introduce pain catastrophizing as an influential variable in the link between distress tolerance and unhealthy eating. Findings suggest that reducing catastrophic thinking about pain may be a worthy target of intervention in reducing unhealthy eating. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Evidence of brain abnormality in patients with psychogenic nonepileptic seizures.

    NARCIS (Netherlands)

    Reuber, M.; Fernandez, G.S.E.; Bauer, J.; Singh, D.D.; Elger, C.E.


    Markers of brain abnormalities in patients with psychogenic nonepileptic seizures (PNES) were studied to explore whether physical brain disorder is associated with an increased risk of PNES. Evidence of epileptiform EEG changes, MRI abnormalities, and neuropsychological (NPS)

  14. Patients with intractable epilepsy have low melatonin, which increases following seizures (United States)

    Bazil, Carl W.; Short, Douglas; Crispin, David; Zheng, Wei


    Melatonin, which is used to treat sleep disorders, has anticonvulsant properties. The authors measured salivary melatonin and cortisol, at baseline and following seizures, in patients with intractable temporal lobe epilepsy and controls. Melatonin was reduced in patients with epilepsy at baseline compared with controls, and increased threefold following seizures. Cortisol also increased following seizures. Patients with intractable epilepsy have low baseline melatonin levels that increase dramatically following seizures. PMID:11113238

  15. Temporal Lobe Seizure (United States)

    ... pregnancy Temporal lobe seizure Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  16. Supplementary Sensorimotor Seizures


    J Gordon Millichap


    The electroclinical and neuroimaging features, and response to antiepileptic drugs in 12 children with seizures involving the supplementary sensory motor area (SSMA) are reported from the British Columbia’s Children’s Hospital, Vancouver, BC, Canada.

  17. Energy catastrophes and energy consumption

    International Nuclear Information System (INIS)

    Davis, G.


    The possibility of energy catastrophes in the production of energy serves to make estimation of the true social costs of energy production difficult. As a result, there is a distinct possibility that the private marginal cost curve of energy producers lies to the left or right of the true cost curve. If so, social welfare will not be maximized, and underconsumption or overconsumption of fuels will exist. The occurrence of energy catastrophes and observance of the market reaction to these occurrences indicates that overconsumption of energy has been the case in the past. Postulations as to market reactions to further energy catastrophes lead to the presumption that energy consumption levels remain above those that are socially optimal

  18. Onset of action and seizure control in Lennox-Gaustaut syndrome: focus on rufinamide

    Directory of Open Access Journals (Sweden)

    Russell P Saneto


    seizure reduction in patients with Lennox-Gaustaut syndrome.Keywords: Lennox-Gaustaut syndrome, catastrophic pediatric epilepsy, rufinamide


    Directory of Open Access Journals (Sweden)

    Dr. Vaibhav Chewoolkar


    Full Text Available Catastrophic antiphospholipid syndrome is an acute and life threatening variant of antiphospholipid syndrome with a high mortality rate. Many infections are known to be accompanied by the thrombotic manifestations of this syndrome. We came across a patient of leprosy who developed bowel ischaemia secondary to mesenteric venous thrombosis as a part of catastrophic antiphospholipid syndrome and later on succumbed. We thereby wish to highlight the need for early diagnosis and aggressive treatment of this potentially fatal condition in patients with infections.

  20. MMR Vaccination and Febrile Seizures

    DEFF Research Database (Denmark)

    Vestergaard, Mogens; Hviid, Anders; Madsen, Kreesten Meldgaard


    CONTEXT: The rate of febrile seizures increases following measles, mumps, and rubella (MMR) vaccination but it is unknown whether the rate varies according to personal or family history of seizures, perinatal factors, or socioeconomic status. Furthermore, little is known about the long-term outcome...... of febrile seizures following vaccination. OBJECTIVES: To estimate incidence rate ratios (RRs) and risk differences of febrile seizures following MMR vaccination within subgroups of children and to evaluate the clinical outcome of febrile seizures following vaccination. DESIGN, SETTING, AND PARTICIPANTS......: Incidence of first febrile seizure, recurrent febrile seizures, and subsequent epilepsy. RESULTS: A total of 439,251 children (82%) received MMR vaccination and 17,986 children developed febrile seizures at least once; 973 of these febrile seizures occurred within 2 weeks of MMR vaccination. The RR...

  1. Haploinsufficiency of CELF4 at 18q12.2 is associated with developmental and behavioral disorders, seizures, eye manifestations, and obesity

    DEFF Research Database (Denmark)

    Hansen, Christina Halgren; Bache, Iben; Bak, Mads


    Only 20 patients with deletions of 18q12.2 have been reported in the literature and the associated phenotype includes borderline intellectual disability, behavioral problems, seizures, obesity, and eye manifestations. Here, we report a male patient with a de novo translocation involving chromosomes......, and it adds to the growing evidence, including a transgenic mouse model, that CELF4 is important for human brain development.European Journal of Human Genetics advance online publication, 23 May 2012; doi:10.1038/ejhg.2012.92....

  2. Patterns of epileptic seizure occurrence. (United States)

    Amengual-Gual, Marta; Sánchez Fernández, Iván; Loddenkemper, Tobias


    The occurrence of epileptic seizures in seemingly random patterns takes a great toll on persons with epilepsy and their families. Seizure prediction may markedly improve epilepsy management and, therefore, the quality of life of persons with epilepsy. Literature review. Seizures tend to occur following complex non-random patterns. Circadian oscillators may contribute to the rhythmic patterns of seizure occurrence. Complex mathematical models based on chaos theory try to explain and even predict seizure occurrence. There are several patterns of epileptic seizure occurrence based on seizure location, seizure semiology, and hormonal factors, among others. These patterns are most frequently described for large populations. Inter-individual variability and complex interactions between the rhythmic generators continue to make it more difficult to predict seizures in any individual person. The increasing use of large databases and machine learning techniques may help better define patterns of seizure occurrence in individual patients. Improvements in seizure detection -such as wearable seizure detectors- and in seizure prediction -such as machine learning techniques and artificial as well as biological intelligence- promise to provide further progress in the field of epilepsy and are being applied to closed-loop systems for the treatment of epilepsy. Seizures tend to occur following complex and patient-specific patterns despite their apparently random occurrence. A better understanding of these patterns and current technological advances may allow the implementation of closed-loop detection, prediction, and treatment systems in routine clinical practice. Copyright © 2018. Published by Elsevier B.V.

  3. Improving early seizure detection. (United States)

    Jouny, Christophe C; Franaszczuk, Piotr J; Bergey, Gregory K


    Over the last decade, the search for a method able to reliably predict seizures hours in advance has been largely replaced by the more realistic goal of very early detection of seizure onset, which would allow therapeutic or warning devices to be triggered prior to the onset of disabling clinical symptoms. We explore in this article the steps along the pathway from data acquisition to closed-loop applications that can and should be considered to design the most efficient early seizure detection. Microelectrodes, high-frequency oscillations, high sampling rate, high-density arrays, and modern analysis techniques are all elements of the recording and detection process that in combination with modeling studies can provide new insights into the dynamics of seizure onsets. Each of these steps needs to be considered if detection devices that will favorably impact the quality of life of patients are to be implemented. This article is part of a Supplemental Special Issue entitled The Future of Automated Seizure Detection and Prediction. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Nonepileptic Seizures: An Updated Review (United States)

    Perez, David L.; LaFrance, W. Curt


    Psychogenic nonepileptic seizures are a Functional Neurological Disorder/ Conversion Disorder subtype, which are neurobehavioral conditions at the interface of Neurology and Psychiatry. Significant advancements over the past decade have been made in the diagnosis, management and neurobiological understanding of PNES. This article reviews published PNES research focusing on semiologic features that distinguish PNES from epileptic seizures, consensus diagnostic criteria, the intersection of PNES and other comorbidities, neurobiological studies, evidence-based treatment interventions and outcome studies. Epidemiology and health care utilization studies highlight a continued unmet medical need in the comprehensive care of PNES. Consensus guidelines for diagnostic certainty are based on clinical history, semiology of witnessed typical event(s), and EEG findings. While certain semiologic features may aid the diagnosis of PNES, the gold standard remains capturing a typical event on video electroencephalography (EEG) showing the absence of epileptiform activity with history and semiology consistent with PNES. Medical-neurologic and psychiatric comorbidities are prevalent in PNES and should be assessed in diagnostic evaluations, and integrated into treatment interventions and prognostic considerations. Several studies, including a pilot multicenter, randomized clinical trial, have now demonstrated that a cognitive behavioral therapy informed psychotherapy is an efficacious treatment for PNES, and additional efforts are necessary to evaluate the utility of pharmacologic and other psychotherapy treatments. Neuroimaging studies, while requiring replication, suggest that PNES may occur in the context of alterations within and across sensorimotor, emotion regulation/processing, cognitive control and multimodal integration brain systems. Future research could investigate similarities and differences between PNES and other somatic symptom disorders. PMID:26996600

  5. Seizure-specific wavelet (Seizlet) design for epileptic seizure detection using CorrEntropy ellipse features based on seizure modulus maximas patterns. (United States)

    Behnam, Morteza; Pourghassem, Hossein


    EEG signal analysis of pediatric patients plays vital role for making a decision to intervene in presurgical stages. In this paper, an offline seizure detection algorithm based on definition of a seizure-specific wavelet (Seizlet) is presented. After designing the Seizlet, by forming cone of influence map of the EEG signal, four types of layouts are analytically designed that are called Seizure Modulus Maximas Patterns (SMMP). By mapping CorrEntropy Induced Metric (CIM) series, four structural features based on least square estimation of fitted non-tilt conic ellipse are extracted that are called CorrEntropy Ellipse Features (CEF). The parameters of the SMMP and CEF are tuned by employing a hybrid optimization algorithm based on honeybee hive optimization in combination with Las Vegas randomized algorithm and Elman recurrent classifier. Eventually, the optimal features by AdaBoost classifiers in a cascade structure are classified into the seizure and non-seizure signals. The proposed algorithm is evaluated on 844h signals with 163 seizure events recorded from 23 patients with intractable seizure disorder and accuracy rate of 91.44% and false detection rate of 0.014 per hour are obtained by 7-channel EEG signals. To overcome the restrictions of general kernels and wavelet coefficient-based features, we designed the Seizlet as an exclusive kernel of seizure signal for first time. Also, the Seizlet-based patterns of EEG signals have been modeled to extract the seizure. The reported results demonstrate that our proposed Seizlet is effectiveness to extract the patterns of the epileptic seizure. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Guidance for Catastrophic Emergency Situations Involving Asbestos (United States)

    This document addresses the types of asbestos issues that may arise during catastrophic events and how EPA has addressed such issues. It replaces the Guidelines for Catastrophic Emergency Situations Involving Asbestos which was issued in 1992.

  7. The Relation Between Catastrophizing and Occupational Disability in Individuals with Major Depression: Concurrent and Prospective Associations. (United States)

    Adams, Heather; Thibault, Pascal; Ellis, Tamra; Moore, Emily; Sullivan, Michael


    Background Catastrophic thinking has been associated with occupational disability in individuals with debilitating pain conditions. The relation between catastrophic thinking and occupational disability has not been previously examined in individuals with debilitating mental health conditions. The present study examined the relation between catastrophic thinking and occupational disability in individuals with major depression. Methods The study sample consisted of 80 work-disabled individuals with major depressive disorder (MDD) who were referred to an occupational rehabilitation service. Participants completed measures of depressive symptom severity, catastrophic thinking and occupational disability at admission and termination of a rehabilitation intervention. Return-to-work outcomes were assessed 1 month following the termination of the rehabilitation intervention. Results Cross-sectional analyses of admission data revealed that catastrophic thinking contributed significant variance to the prediction of self-reported occupational disability, beyond the variance accounted for by depressive symptom severity. Prospective analyses revealed that reductions in catastrophic thinking predicted successful return to work following the rehabilitation intervention, beyond the variance accounted for by reductions in depressive symptom severity. Conclusions The findings suggest that catastrophic thinking is a determinant of occupational disability in individuals with major depressive disorder. The findings further suggest that interventions designed to reduce catastrophic thinking might promote occupational re-integration in individuals with debilitating mental health conditions.

  8. Terminology of psychogenic nonepileptic seizures. (United States)

    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. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

  9. Seizures Complicating Bacterial Meningitis

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available The clinical data of 116 patients, 1 month to <5 years of age, admitted for bacterial meningitis, and grouped according to those with and without seizures during hospitalization, were compared in a study at Buddhist Dalin Tzu Chi General Hospital, Chang Gung Memorial Hospital and other centers in Taiwan.

  10. ASPM mutations identified in patients with primary microcephaly and seizures


    Shen, J; Eyaid, W; Mochida, G; Al-Moayyad, F; Bodell, A; Woods, C; Walsh, C


    Background: Human autosomal recessive primary microcephaly (MCPH) is a heterogeneous disorder with at least six genetic loci (MCPH1–6), with MCPH5, caused by ASPM mutation, being the most common. Despite the high prevalence of epilepsy in microcephaly patients, microcephaly with frequent seizures has been excluded from the ascertainment of MCPH. Here, we report a pedigree with multiple affected individuals with microcephaly and seizures.

  11. Catastrophic fires in Russian forests (United States)

    A. I. Sukhinin; D. J. McRae; B. J. Stocks; S. G. Conard; WeiMin Hao; A. J. Soja; D. Cahoon


    We evaluated the contribution of catastrophic fires to the total burned area and the amount of tree mortality in Russia since the 1970’s. Such fires occurred in the central regions of European Russia (1972, 1976, 1989, 2002, 2010), Khabarovsk krai (1976, 1988, 1998), Amur region (1997-2002), Republics of Yakutia and Tuva (2002), Magadan and Kamchatka oblast (1984, 2001...

  12. The impact of seizures on epilepsy outcomes: A national, community-based survey. (United States)

    Josephson, Colin B; Patten, Scott B; Bulloch, Andrew; Williams, Jeanne V A; Lavorato, Dina; Fiest, Kirsten M; Secco, Mary; Jette, Nathalie


    The aim of this study was to examine the impact of seizures on persons living with epilepsy in a national, community-based setting. The data source was the Survey of Living with Neurological Conditions in Canada (SLNCC), a cohort derived from a national population-based survey of noninstitutionalized persons aged 15 or more years. Participants had to be on a seizure drug or to have had a seizure in the past 5 years to meet the definition of active epilepsy. The respondents were further stratified by seizure status: the seizure group experienced ≥1 seizure in the past 5 years versus the no seizure group who were seizure-free in the past ≥5 years regardless of medication status. Weighted overall and stratified prevalence estimates and odds ratios were used to estimate associations. The SLNCC included 713 persons with epilepsy with a mean age of 45.4 (standard deviation 18.0) years. Fewer people in the seizure group (42.7%) reported being much better than a year ago versus those in the no seizure group (70.1%). Of those with seizures, 32.1% (95% confidence interval [95% CI] 18.8-45.3) had symptoms suggestive of major depression (as per the Patient Health Questionnaire-9) compared to 7.7% (95% CI 3.4-11.9) of those without seizures. Driving, educational, and work opportunities were also significantly limited, whereas stigma was significantly greater in those with seizures. This community-based study emphasizes the need for seizure freedom to improve clinical and psychosocial outcomes in persons with epilepsy. Seizure freedom has an important influence on overall health, as those with at least one seizure over the prior 5 years had an increased risk of mood disorders, worse quality of life, and faced significantly more stigma. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  13. Seizure semiology and EEG findings in mitochondrial diseases. (United States)

    Chevallier, Justyna A; Von Allmen, Gretchen K; Koenig, Mary Kay


    Seizures constitute a frequent yet under-described manifestation of mitochondrial disorders (MDs). The aim of this study was to describe electroencephalography (EEG) findings and clinical seizure types in a population of children and adults with mitochondrial disease. Retrospective chart review of 165 records of children and adults with mitochondrial disease seen in the University of Texas Houston Mitochondrial Center between 2007 and 2012 was performed; all subjects were diagnosed with confirmed mitochondrial disease. EEG findings and clinical data, including seizure semiology and response to antiepileptic drugs (AEDs), were analyzed and categorized. Sixty-six percent (109/165) of subjects had a routine EEG performed. Sixty-one percent (67/109) of EEG studies were abnormal and 85% (56/67) had epileptiform discharges. The most common EEG finding was generalized slowing (40/67, 60%). The most frequent category of epileptiform activity seen was multifocal discharges (41%), followed by focal (39%) and generalized (39%) discharges. Clinical seizures were seen in 55% of subjects and the most common types of seizures observed were complex partial (37%) and generalized tonic-clonic (GTC; 37%). The most common seizure type in patients with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) was GTC (33%), with generalized or focal discharges seen on EEG. In Leigh syndrome GTC (11%) and complex partial (11%) seizures were the most frequent types. Of 60 subjects with clinical seizures, 28% were intractable to medical treatment. Mitochondrial disorder should be included in the list of differential diagnosis in any child that presents with encephalopathy, seizures, and a fluctuating clinical course. Given the relatively high prevalence of EEG abnormalities in patients with MD, EEG should be performed during initial evaluation in all patients with MD, not only upon clinical suspicion of epilepsy. Wiley Periodicals, Inc. © 2014 International

  14. Coping with ecological catastrophe: crossing major thresholds

    Directory of Open Access Journals (Sweden)

    John Cairns, Jr.


    Full Text Available The combination of human population growth and resource depletion makes catastrophes highly probable. No long-term solutions to the problems of humankind will be discovered unless sustainable use of the planet is achieved. The essential first step toward this goal is avoiding or coping with global catastrophes that result from crossing major ecological thresholds. Decreasing the number of global catastrophes will reduce the risks associated with destabilizing ecological systems, which could, in turn, destabilize societal systems. Many catastrophes will be local, regional, or national, but even these upheavals will have global consequences. Catastrophes will be the result of unsustainable practices and the misuse of technology. However, avoiding ecological catastrophes will depend on the development of eco-ethics, which is subject to progressive maturation, comments, and criticism. Some illustrative catastrophes have been selected to display some preliminary issues of eco-ethics.

  15. Parental Perspectives of the Impact of Epilepsy and Seizures on Siblings of Children with Epilepsy. (United States)

    Kroner, Barbara L; Ardini, Mary-Anne; Bumbut, Adrian; Gaillard, William D


    To assess parental perspectives of the impact of epilepsy and seizures on siblings of children in the Seizures and Outcomes Study. Parents completed surveys about their child with epilepsy, their own health and well-being, and the impact of epilepsy on unaffected siblings. The most common parental responses about the sibling were witnessing a seizure, protectiveness of the child with epilepsy, worry about seizures, belief that seizures cause pain, and pride toward the child with epilepsy. Embarrassment and keeping epilepsy a secret were rare. Parent reports supported that siblings that worried were more likely to have witnessed a seizure, feel sad or angry, think seizures cause pain, and have a parent with anxiety disorder. Some siblings of children with epilepsy are at risk for psychosocial problems. Primary and specialty care providers are well positioned to identify and monitor these children through evaluations and referrals as necessary. Copyright © 2017 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  16. Substantial and sustained seizure reduction with ketogenic diet in a patient with Ohtahara syndrome

    Directory of Open Access Journals (Sweden)

    Adithya Sivaraju


    Full Text Available Ketogenic diet has been shown to be efficacious in some epileptic encephalopathies but rarely reported as being useful in children with Ohtahara syndrome. This could possibly be attributed to the rarity of the disease and associated short survival period. We report on a 5-year-old child with Ohtahara syndrome, whose seizures failed to improve with all known medications, continued to show persistent suppression-burst pattern on the electroencephalography (EEG and had substantial reduction in seizure frequency for one year post-initiation of ketogenic diet. He has not had a single visit to the emergency room because of seizures in the last one year, and more importantly, there has been a clear improvement noted in his level of interaction and temperament. Patients with Ohtahara syndrome invariably have medically intractable seizures and catastrophic neurodevelopmental outcome. Ketogenic diet is a treatment modality that might be worth considering even in this group of patients.

  17. Electrographic Changes Accompanying Recurrent Seizures under Ketogenic Diet Treatment

    Directory of Open Access Journals (Sweden)

    Chiara Lucchi


    Full Text Available The ketogenic diet (KD is increasingly used to treat epilepsy refractory to antiepileptic drugs and other neurological disorders. In animal models, the KD was found to increase the threshold to seizures induced by different convulsive stimulations. However, in models in which suprathreshold stimuli were used, a paradoxical seizure worsening was consistently observed in KD-fed animals. To better define this phenomenon, we characterized the electrographic response to seizures induced in mice which were treated with the KD, and then corneally stimulated at 6-Hz in four different sessions. We also evaluated the electroencephalogram (EEG in three patients in which the KD was associated with a paradoxical worsening of epileptic seizures. Although seizures were initially less severe, a remarkable prolongation of the electrographic response was observed in mice receiving the KD from the second session of 6-Hz corneal stimulation and onwards. The EEG was also markedly altered in the presence of progressive seizure aggravation observed in children treated with the KD, specifically one affected by Lennox–Gastaut syndrome and two by type I lissencephaly. These results suggest that when seizures are induced or recur because of resistance to therapeutic interventions, the KD may change the EEG by potentiating the electrographic epileptic activity.

  18. A Catastrophe in Quantum Mechanics

    CERN Document Server

    Ignatovich, V K


    The standard scattering theory (SST) in nonrelativistic quantum mechanics (QM) is analyzed. Self-contradictions of SST are deconstructed. A direct way to calculate scattering probability without introduction of a finite volume is discussed. Substantiation of SST in textbooks with the help of wave packets is shown to be incomplete. A complete theory of wave packet scattering on a fixed center is presented, and its similarity to the plane wave scattering is demonstrated. The neutron scattering on a monatomic gas is investigated, and several problems are pointed out. A catastrophic ambiguity of the cross section is revealed, and a way to resolve this ambiguity is discussed.

  19. The Climate Catastrophe as Blockbuster

    DEFF Research Database (Denmark)

    Eskjær, Mikkel Fugl


    Modern disaster films constitute a specific cultural form that speaks to the anxieties of the “risk society.” This essay looks at how risks like climate change is presented and constructed in popular culture. It regards blockbuster representations as part of a wider discourse of “catastrophism......” within the realm of public climate change communication. For that reason, the essay centers on the interplay between news media and entertainment. It argues that blockbuster disaster films represent an inversion of traditional risk and disaster news....

  20. SB 334867, a selective orexin receptor type 1 antagonist, elevates seizure threshold in mice. (United States)

    Socała, Katarzyna; Szuster-Ciesielska, Agnieszka; Wlaź, Piotr


    Orexins A and B are hypothalamic neuropeptides involved in a number of physiological and behavioral processes. They work via OX1 and OX2 receptors. Recent studies revealed that orexins may be implicated in seizure activity. Therefore, the present study was undertaken to evaluate the influence of SB 334867 (a selective OX1 receptor antagonist) and EMPA (a selective OX2 receptor antagonist) on the seizure thresholds in mice. We also aimed to determine the changes of orexin A level following different types of seizures. The intravenous pentylenetetrazole (i.v. PTZ) seizure test, the maximal electroshock seizure threshold (MEST) test and the 6 Hz seizure test were used in the present study. Brain orexin A level was determined via enzyme-linked immunoassay (ELISA). SB 334867 did not affect the seizure threshold for myoclonic twitches and tonic seizures in the i.v. PTZ seizure test. This compound, however, significantly raised the threshold for the PTZ-induced clonic seizures, for tonic hindlimb extension in the MEST test as well as for psychomotor seizures induced by 6 Hz stimulation. In comparison, EMPA did not alter the seizure thresholds in the i.v. PTZ test. Both EMPA and SB 334867 did not affect motor coordination and muscular strength. ELISA showed the increase of total brain orexin A level following different types of seizures. Our results provide further evidence for the role of orexins in seizure activity and suggest that pharmacological blockade of the OX1 receptors may represent a novel therapeutic approach in the treatment of seizure disorders. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Monitor for status epilepticus seizures (United States)

    Johnson, Mark; Simkins, Thomas


    This paper describes the sensor technology and associated electronics of a monitor designed to detect the onset of a seizure disorder called status epilepticus. It is a condition that affects approximately 3-5 percent of those individuals suffering from epilepsy. This form of epilepsy does not follow the typical cycle of start-peak-end. The convulsions continue until medically interrupted and are life threatening. The mortality rate is high without prompt medical treatment at a suitable facility. The paper describes the details of a monitor design that provides an inexpensive solution to the needs of those responsible for the care of individuals afflicted with this disorder. The monitor has been designed as a cooperative research and development effort involving the United States Army Armament Research, Development, and Engineering Center's Benet Laboratories (Benet) and the Cerebral Palsy Center for the Disabled (Center), in association with the Department of Neurology at Albany Medical College (AMC). Benet has delivered a working prototype of the device for field testing, in collaboration with Albany Medical College. The Center has identified several children in need of special monitoring and has agreed to pursue commercialization of the device.

  2. Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome


    Devinsky, O.; Cross, J. H.; Laux, L.; Marsh, E.; Miller, I.; Nabbout, R.; Scheffer, I. E.; Thiele, E. A.; Wright, S.


    BACKGROUND: The Dravet syndrome is a complex childhood epilepsy disorder that is associated with drug-resistant seizures and a high mortality rate. We studied cannabidiol for the treatment of drug-resistant seizures in the Dravet syndrome. METHODS: In this double-blind, placebo-controlled trial, we randomly assigned 120 children and young adults with the Dravet syndrome and drug-resistant seizures to receive either cannabidiol oral solution at a dose of 20 mg per kilogram...

  3. Patients with intractable epilepsy have low melatonin, which increases following seizures


    Bazil, Carl W.; Short, Douglas; Crispin, David; Zheng, Wei


    Melatonin, which is used to treat sleep disorders, has anticonvulsant properties. The authors measured salivary melatonin and cortisol, at baseline and following seizures, in patients with intractable temporal lobe epilepsy and controls. Melatonin was reduced in patients with epilepsy at baseline compared with controls, and increased threefold following seizures. Cortisol also increased following seizures. Patients with intractable epilepsy have low baseline melatonin levels that increase dra...

  4. Definition and classification of epilepsy. Classification of epileptic seizures 2016

    Directory of Open Access Journals (Sweden)

    K. Yu. Mukhin


    Full Text Available Epilepsy is one of the most common neurological diseases, especially in childhood and adolescence. The incidence varies from 15 to 113 cases per 100 000 population with the maximum among children under 1 year old. The prevalence of epilepsy is high, ranging from 5 to 8 cases (in some regions – 10 cases per 1000 children under 15 years old. Classification of the disease has great importance for diagnosis, treatment and prognosis. The article presents a novel strategy for classification of epileptic seizures, developed in 2016. It contains a number of brand new concepts, including a very important one, saying that some seizures, previously considered as generalized or focal only, can be, in fact, both focal and generalized. They include tonic, atonic, myoclonic seizures and epileptic spasms. The term “secondarily generalized seizure” is replace by the term “bilateral tonic-clonic seizure” (as soon as it is not a separate type of epileptic seizures, and the term reflects the spread of discharge from any area of cerebral cortex and evolution of any types of focal seizures. International League Against Epilepsy recommends to abandon the term “pseudo-epileptic seizures” and replace it by the term “psychogenic non-epileptic seizures”. If a doctor is not sure that seizures have epileptic nature, the term “paroxysmal event” should be used without specifying the disease. The conception of childhood epileptic encephalopathies, developed within this novel classification project, is one of the most significant achievements, since in this case not only the seizures, but even epileptiform activity can induce severe disorders of higher mental functions. In addition to detailed description of the new strategy for classification of epileptic seizures, the article contains a comprehensive review of the existing principles of epilepsy and epileptic seizures classification.

  5. Gravothermal catastrophe of finite amplitude

    International Nuclear Information System (INIS)

    Hachisu, Izumi; Sugimoto, Daiichiro; Nakada, Yoshikazu; Nomoto, Ken-ichi.


    Development of the gravothermal catastrophe is followed numerically for self-gravitating gas system enclosed by an adiabatic wall, which is isothermal in the initial state. It is found that the final fate of the catastrophe is in two ways depending on the initial perturbations. When the initial perturbation produces a temperature distribution decreasing outward, the contraction proceeds in the central region and the central density increases unlimitedly, as the heat flows outward. When the initial temperature distribution is increasing outward, on the other hand, the central region expands as the heat flows into the central region. Then the density contrast is reduced and finally the system reaches another isothermal configuration with the same energy but with a lower density contrast and a higher entropy. This final configuration is gravothermally stable and may be called a thermal system. In the former case of the unlimited contraction, the final density profile is determined essentially by the density and temperature dependence of the heat conductivity. In the case of a system under the force of the inverse square law, the final density distribution is well approximated by a power law so that the mass contained in the condensed core is relatively small. A possibility of formation of a black hole in stellar systems is also discussed. (author)

  6. Extensional rheometer based on viscoelastic catastrophes outline

    DEFF Research Database (Denmark)


    The present invention relates to a method and a device for determining viscoelastic properties of a fluid. The invention resides inter alia in the generation of viscoelastic catastrophes in confined systems for use in the context of extensional rheology. The viscoelastic catastrophe is according ...... to the invention generated in a bistable fluid system, and the flow conditions for which the catastrophe occurs can be used as a fingerprint of the fluid's viscoelastic properties in extensional flow....

  7. How are the catastrophical risks quantifiable

    International Nuclear Information System (INIS)

    Chakraborty, S.


    For the assessment and evaluation of industrial risks the question must be asked how are the catastrophical risks quantifiable. Typical real catastrophical risks and risk assessment based on modelling assumptions have been placed against each other in order to put the risks into proper perspective. However, the society is risk averse when there is a catastrophic potential of severe accidents in a large scale industrial facility even though there is extremely low probability of occurence. (orig.) [de

  8. A Triplet Repeat Expansion Genetic Mouse Model of Infantile Spasms Syndrome, Arx(GCG)10+7, with Interneuronopathy, Spasms in Infancy, Persistent Seizures, and Adult Cognitive and Behavioral Impairment (United States)

    Price, Maureen G.; Yoo, Jong W.; Burgess, Daniel L.; Deng, Fang; Hrachovy, Richard A.; Frost, James D.; Noebels, Jeffrey L.


    Infantile spasms syndrome (ISS) is a catastrophic pediatric epilepsy with motor spasms, persistent seizures, mental retardation, and in some cases, autism. One of its monogenic causes is an insertion mutation (c.304ins (GCG)7) on the X chromosome, expanding the first polyalanine tract of the interneuron-specific transcription factor ARX from 16 to 23 alanine codons. Null mutation of the Arx gene impairs GABA- and cholinergic interneuronal migration but results in a neonatal lethal phenotype. We developed the first viable genetic mouse model of ISS that spontaneously recapitulates salient phenotypic features of the human triplet-repeat expansion mutation. Arx (GCG)10+7 (“Arx Plus7”) pups display abnormal spasm-like myoclonus and other key EEG features, including multifocal spikes, electrodecremental episodes, and spontaneous seizures persisting into maturity. The neurobehavioral profile of Arx mutants was remarkable for lowered anxiety, impaired associative learning, and abnormal social interaction. Laminar decreases of Arx+ cortical interneurons and a selective reduction of calbindin-, but not parvalbumin- or calretinin-expressing interneurons in neocortical layers and hippocampus indicate that specific classes of synaptic inhibition are missing from the adult forebrain, providing a basis for the seizures and cognitive disorder. A significant reduction of calbindin, NPY-expressing and cholinergic interneurons in the mutant striatum suggest that dysinhibition within this network may contribute to the dyskinetic motor spasms. This mouse model narrows the range of critical pathogenic elements within brain inhibitory networks essential to recreate this complex neurodevelopmental syndrome. PMID:19587282

  9. Academic Training: Predicting Natural Catastrophes

    CERN Multimedia

    Françoise Benz


    2005-2006 ACADEMIC TRAINING PROGRAMME LECTURE SERIES 12, 13, 14, 15, 16 December from 11:00 to 12:00 - Main Auditorium, bldg. 500 Predicting Natural Catastrophes E. OKAL / Northwestern University, Evanston, USA 1. Tsunamis -- Introduction Definition of phenomenon - basic properties of the waves Propagation and dispersion Interaction with coasts - Geological and societal effects Origin of tsunamis - natural sources Scientific activities in connection with tsunamis. Ideas about simulations 2. Tsunami generation The earthquake source - conventional theory The earthquake source - normal mode theory The landslide source Near-field observation - The Plafker index Far-field observation - Directivity 3. Tsunami warning General ideas - History of efforts Mantle magnitudes and TREMOR algorithms The challenge of 'tsunami earthquakes' Energy-moment ratios and slow earthquakes Implementation and the components of warning centers 4. Tsunami surveys Principles and methodologies Fifteen years of field surveys and re...

  10. Crise, catastrophe, risque et adaptation


    Yiou , Pascal; Jézéquel , Aglae


    International audience; L'histoire de la Terre est jalonnée de crises et de catastrophes environnementales, qui ont conduit à la disparition d'espèces et de sociétés, et parfois à l'émergence de nouveaux systèmes. Nous ne reviendrons pas sur ces événements géologiques ou historiques, mais nous concentrons sur le changement climatique en cours et ses événements extrêmes. Du fait de l'expansion démographique, la surface habitable de la Terre est de plus en plus densément peuplée, ce qui augment...


    Energy Technology Data Exchange (ETDEWEB)

    Keane, Jacqueline V.; Kleyna, Jan T.; Riesen, Timm-Emmanuel; Meech, Karen J. [Institute for Astronomy, University of Hawaii, 2680 Woodlawn Drive, Honolulu, HI 96822 (United States); Milam, Stefanie N.; Charnley, Steven B. [Astrochemistry Laboratory, NASA GSFC, MS 690, Greenbelt, MD 20771 (United States); Coulson, Iain M. [Joint Astronomy Center, 660 North Aohoku Place, Hilo, HI 96720 (United States); Sekanina, Zdenek [Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, CA 91109 (United States); Kracht, Rainer, E-mail: [Ostlandring 53, D-25335 Elmshorn, Schleswig-Holstein (Germany)


    We report submillimeter 450 and 850 μ m dust continuum observations for comet C/2012 S1 (ISON) obtained at heliocentric distances 0.31–0.08 au prior to perihelion on 2013 November 28 ( r {sub h} = 0.0125 au). These observations reveal a rapidly varying dust environment in which the dust emission was initially point-like. As ISON approached perihelion, the continuum emission became an elongated dust column spread out over as much as 60″ (>10{sup 5} km) in the anti-solar direction. Deconvolution of the November 28.04 850 μ m image reveals numerous distinct clumps consistent with the catastrophic disruption of comet ISON, producing ∼5.2 × 10{sup 10} kg of submillimeter-sized dust. Orbital computations suggest that the SCUBA-2 emission peak coincides with the comet's residual nucleus.

  12. Catastrophic Disruption of Comet ISON (United States)

    Keane, Jacqueline V.; Milam, Stefanie N.; Coulson, Iain M.; Kleyna, Jan T.; Sekanina, Zdenek; Kracht, Rainer; Riesen, Timm-Emmanuel; Meech, Karen J.; Charnley, Steven B.


    We report submillimeter 450 and 850 microns dust continuum observations for comet C/2012 S1 (ISON) obtained at heliocentric distances 0.31-0.08 au prior to perihelion on 2013 November 28 (rh?=?0.0125 au). These observations reveal a rapidly varying dust environment in which the dust emission was initially point-like. As ISON approached perihelion, the continuum emission became an elongated dust column spread out over as much as 60? (greater than 10(exp 5) km in the anti-solar direction. Deconvolution of the November 28.04 850 microns image reveals numerous distinct clumps consistent with the catastrophic disruption of comet ISON, producing approximately 5.2?×?10(exp 10) kg of submillimeter-sized dust. Orbital computations suggest that the SCUBA-2 emission peak coincides with the comet's residual nucleus.

  13. Climate Catastrophe - The Giant Swindle

    International Nuclear Information System (INIS)

    Doerell, P. E.


    Energy is the life-blood of civilization. More than 80% of global energy is supplied by fossil fuels. And this will continue for the foreseeable future - if an implementation of the Kyoto Protocol does not lead to a dramatic decrease of these fuels causing worldwide turmoil of unprecedented dimensions. However, the scaremongering with a 'climate catastrophe' allegedly caused by 'greenhouse gas' emissions from the burning of fossil fuels is a huge hoax. Its only 'scientific' base is the IPCC management's enigmatic assessment: 'The balance of evidence suggests a discernable human influence on climate'. But even IPCC had to admit at the World Energy Conference in Tokyo in 1996: 'We have no evidence'. And all the scaremongering assertions of the protagonists of 'global warming' have been convincingly refuted by the world elite of scientists. This paper will: - show how the whole anti-CO 2 campaign has been manipulated from the very beginning till today; - give great many scientific and logical reason why the arguments of the scaremongers are incorrect; - outline the catastrophic economic and social consequences of the proposed anti-CO 2 measures - without any benefit for the environment of climate; - name the driving forces behind this campaign and their interests. The witchhunt against CO 2 is an incredible scientific and political scandal, CO 2 does not damage the environment at all, and labelling it a 'climate killer' is absurd. On the contrary, this gas is vital for the life on our plant, and a stronger concentration of CO 2 will be beneficial by doubling plant growth and with this combatting global famine. And to pretend that we could influence - with a CO 2 tax - the climate, is insane arrogance. Man is absolutely helpless when confronted with the forces of nature. The squandering of multimillions USD of taxpayer's money for the travelling circus of 'Climate summits' and the stultification of the population must stop. The 'global warming' lie is the biggest

  14. Recurrent seizures after lidocaine ingestion. (United States)

    Aminiahidashti, Hamed; Laali, Abolghasem; Nosrati, Nazanin; Jahani, Fatemeh


    Lidocaine has a concentration-dependent effect on seizures. Concentrations above 15 μg/mL frequently result in seizures in laboratory animals and human. We report a case of central nervous system (CNS) lidocaine toxicity and recurrent seizure after erroneous ingestion of lidocaine solution. A 4-year-old boy presented to the Emergency Department of Imam Hospital of Sari in December 2013 due to tonic-clonic generalized seizures approximately 30 min ago. 3 h before seizure, his mother gave him 2 spoons (amount 20-25 cc) lidocaine hydrochloride 2% solution instead of pediatric gripe by mistake. Seizure with generalized tonic-clonic occurred 3 times in home. Neurological examination was essentially unremarkable except for the depressed level of consciousness. Personal and medical history was unremarkable. There was no evidence of intracranial ischemic or hemorrhagic lesions in computed tomography scan. There were no further seizures, the condition of the patient remained stable, and he was discharged 2 days after admission. The use of viscous lidocaine may result in cardiovascular and CNS toxicity, particularly in children. Conservative management is the best option for treatment of lidocaine induced seizure.

  15. Localization of pediatric seizure semiology. (United States)

    Vendrame, Martina; Zarowski, Marcin; Alexopoulos, Andreas V; Wyllie, Elaine; Kothare, Sanjeev V; Loddenkemper, Tobias


    The aim of this study was to evaluate the relationship between semiology of seizures in children and adolescents to the corresponding EEG localization. Charts of 225 consecutive pediatric epilepsy patients undergoing Video-EEG monitoring (VEM) over 2 years were reviewed. Seizure semiology recorded during VEM was classified according to ILAE seizure semiology terminology and EEG localization, and analyzed based on onset as defined by the EEG data (generalized, frontal, temporal, parietal, occipital or multilobar). A total of 1008 seizures were analyzed in 225 children (mean age 8.5 years, range 0-20), with 50% boys. Auras and seizures with automatisms arose predominantly from the temporal lobes (psemiologies relate to specific brain regions, with overlap between focal and generalized semiological seizure types, as identified electrographically. Semiology of seizures can provide important information for epilepsy localization, and should not be overlooked, especially in patients undergoing pre-surgical evaluation. Separation of clinical seizure description and EEG findings may be useful, in particular when only incomplete information is available. i.e. during the first office visit. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  16. Similar semiology of epileptic and psychogenic nonepileptic seizures recorded during stereo-EEG. (United States)

    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.

  17. Adaptation to and Recovery from Global Catastrophe

    Directory of Open Access Journals (Sweden)

    Seth D. Baum


    Full Text Available Global catastrophes, such as nuclear war, pandemics and ecological collapse threaten the sustainability of human civilization. To date, most work on global catastrophes has focused on preventing the catastrophes, neglecting what happens to any catastrophe survivors. To address this gap in the literature, this paper discusses adaptation to and recovery from global catastrophe. The paper begins by discussing the importance of global catastrophe adaptation and recovery, noting that successful adaptation/recovery could have value on even astronomical scales. The paper then discusses how the adaptation/recovery could proceed and makes connections to several lines of research. Research on resilience theory is considered in detail and used to develop a new method for analyzing the environmental and social stressors that global catastrophe survivors would face. This method can help identify options for increasing survivor resilience and promoting successful adaptation and recovery. A key point is that survivors may exist in small isolated communities disconnected from global trade and, thus, must be able to survive and rebuild on their own. Understanding the conditions facing isolated survivors can help promote successful adaptation and recovery. That said, the processes of global catastrophe adaptation and recovery are highly complex and uncertain; further research would be of great value.

  18. Does catastrophic thinking enhance oesophageal pain sensitivity?

    DEFF Research Database (Denmark)

    Martel, M O; Olesen, A E; Jørgensen, D


    that catastrophic thinking exerts an influence on oesophageal pain sensitivity, but not necessarily on the magnitude of acid-induced oesophageal sensitization. WHAT DOES THIS STUDY ADD?: Catastrophizing is associated with heightened pain sensitivity in the oesophagus. This was substantiated by assessing responses...

  19. Catastrophe theory with application in nuclear technology

    International Nuclear Information System (INIS)

    Valeca, Serban Constantin


    The monograph is structured on the following seven chapters: 1. Correlation of risk, catastrophe and chaos at the level of polyfunctional systems with nuclear injection; 1.1 Approaching the risk at the level of power systems; 1.2 Modelling the chaos-catastrophe-risk correlation in the structure of integrated classical and nuclear processes; 2. Catastrophe theory applied in ecosystems models and applications; 2.1 Posing the problems in catastrophe theory; 2.2 Application of catastrophe theory in the engineering of the power ecosystems with nuclear injection; 4.. Decision of abatement of the catastrophic risk based on minimal costs; 4.1 The nuclear power systems sensitive to risk-catastrophe-chaos in the structure of minimal costs; 4.2 Evaluating the market structure on the basis of power minimal costs; 4.3 Decisions in power systems built on minimal costs; 5. Models of computing the minimal costs in classical and nuclear power systems; 5.1 Calculation methodologies of power minimal cost; 5.2 Calculation methods of minimal costs in nuclear power sector; 6. Expert and neuro expert systems for supervising the risk-catastrophe-chaos correlation; 6.1 The structure of expert systems; 6.2 Application of the neuro expert program; 7. Conclusions and operational proposals; 7.1 A synthesis of the problems presented in this work; 7.2 Highlighting the novel aspects applicable in the power systems with nuclear injection

  20. Epilepsy: accuracy of patient seizure counts. (United States)

    Hoppe, Christian; Poepel, Annkathrin; Elger, Christian E


    To evaluate the effects of a daily patient reminder on seizure documentation accuracy. Randomized controlled trial. Monitoring unit of an academic department of epileptology. Patients Consecutive sample of 91 adult inpatients with focal epilepsies undergoing video-electroencephalographic monitoring. Intervention While all patients were asked to document seizures at the beginning of the monitoring period, patients from the experimental group were reminded each day to document seizures. Main Outcome Measure Documentation accuracy (percentage of documented seizures). A total of 582 partial seizures were recorded. Patients failed to document 55.5% of all recorded seizures, 73.2% of complex partial seizures, 26.2% of simple partial seizures, 41.7% of secondarily generalized tonic-clonic seizures, 85.8% of all seizures during sleeping, and 32.0% of all seizures during the awake state. The group medians of individual documentation accuracies for overall seizures, simple partial seizures, complex partial seizures, and secondarily generalized tonic-clonic seizures were 33.3%, 66.7%, 0%, and 83.3%, respectively. Neither the patient reminder nor cognitive performance affected documentation accuracy. A left-sided electroencephalographic focus or lesion, but not the site (frontal or temporal), contributed to documentation failure. Patient seizure counts do not provide valid information. Documentation failures result from postictal seizure unawareness, which cannot be avoided by reminders. Unchanged documentation accuracy is a prerequisite for the use of patient seizure counts in clinical trials and has to be demonstrated in a subsample of patients undergoing electroencephalographic monitoring.

  1. [Reflex seizures, cinema and television]. (United States)

    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.

  2. Cardiac asystole in partial seizures. (United States)

    Scott, C A; Fish, D R


    Literature review shows many anecdotal case reports of cardiac asystole in ictal recordings of partial seizures. We have reviewed our data from the last five years, of patients who are being assessed for epilepsy surgery and found 2 out of more than 1,500 complex partial seizures, recorded in 589 consecutive patients, showing a significant period of asystole (13 and 15 seconds). Our previous studies of cardiac and respiratory parameters during partial seizures showed that a central apnoea occurred in 39%. It is probable that sudden death during seizures is due to the interaction of both cardiac and respiratory irregularities. Although rare (occurrence cardiac asystole occurring in an epilepsy monitoring unit highlights the need for resuscitation equipment to be readily available and for trained nursing staff. Furthermore, it is important to recognize that the semiology of seizures may be affected by the consequences of secondary cardiac asystole.

  3. A physiology-based seizure detection system for multichannel EEG.

    Directory of Open Access Journals (Sweden)

    Chia-Ping Shen

    Full Text Available BACKGROUND: Epilepsy is a common chronic neurological disorder characterized by recurrent unprovoked seizures. Electroencephalogram (EEG signals play a critical role in the diagnosis of epilepsy. Multichannel EEGs contain more information than do single-channel EEGs. Automatic detection algorithms for spikes or seizures have traditionally been implemented on single-channel EEG, and algorithms for multichannel EEG are unavailable. METHODOLOGY: This study proposes a physiology-based detection system for epileptic seizures that uses multichannel EEG signals. The proposed technique was tested on two EEG data sets acquired from 18 patients. Both unipolar and bipolar EEG signals were analyzed. We employed sample entropy (SampEn, statistical values, and concepts used in clinical neurophysiology (e.g., phase reversals and potential fields of a bipolar EEG to extract the features. We further tested the performance of a genetic algorithm cascaded with a support vector machine and post-classification spike matching. PRINCIPAL FINDINGS: We obtained 86.69% spike detection and 99.77% seizure detection for Data Set I. The detection system was further validated using the model trained by Data Set I on Data Set II. The system again showed high performance, with 91.18% detection of spikes and 99.22% seizure detection. CONCLUSION: We report a de novo EEG classification system for seizure and spike detection on multichannel EEG that includes physiology-based knowledge to enhance the performance of this type of system.

  4. Patients' and neurologists' perception of epilepsy and psychogenic nonepileptic seizures. (United States)

    Whitehead, Kimberley; Kandler, Rosalind; Reuber, Markus


    Although differences in illness perceptions between neurologists and patients with epilepsy or psychogenic nonepileptic seizures (PNES) are likely to be clinically relevant, this is the first study to attempt a direct comparison. In addition, this study compares the illness perceptions of patients with epilepsy with those of patients with PNES. Thirty-four patients with epilepsy, 40 patients with PNES, and 45 neurologists were recruited. All patient participants completed versions of the illness perception questionnaire revised (IPQ-R) adapted for epileptic or nonepileptic seizure disorders, single-item symptom attribution question (SAQ), Hospital Anxiety and Depression Scale (HADS), Quality of Life in Epilepsy-31 (QOLIE-31), and Liverpool Seizure Severity Scale (LSSS). Participating neurologists completed two versions of the IPQ-R and two SAQs for epileptic and nonepileptic seizure disorders. Differences in illness perceptions between patients with epilepsy and patients with PNES were minor compared to those between patients with either seizure disorder and neurologists. Neurologists considered both seizure disorders more treatable and more amenable to personal control than did the patients themselves. Neurologists had much more polarized views of the etiology of both conditions; whereas patients mostly considered the causes of their seizure disorders as partially "physical" and partially "psychological," neurologists perceived epilepsy as an essentially "physical" and PNES as a clearly "psychological" problem. There are considerable differences between the illness perceptions of patients with seizure disorders and their doctors, which could represent barriers to successful clinical management. In particular, a discrepancy between neurologists' and patients' beliefs about the personal control that patients may be able to exert over PNES could contribute to the confusion or anger some patients report after the diagnosis has been explained to them. Furthermore

  5. A case for cannabidiol in Wolf-Hirschhorn syndrome seizure management. (United States)

    Ho, Karen S; Wassman, E Robert


    Complex, and sometimes intractable, seizures affect the quality of life and cognitive development of over 90% of individuals with Wolf-Hirschhorn syndrome (WHS). Fine resolution genotype-phenotype mapping of the WHS locus recently identified a candidate gene whose probable function has led to insights into a mechanism connecting WHS seizures with those of Dravet syndrome, a distinct condition caused by mutations in SCN1A and SCN1B. In addition to this possible molecular mechanistic connection, these disorders' seizures share a strikingly similar constellation of features, including clinical presentation, seizure types, early age of onset, EEG pattern, and responses to specific anti-epileptic drugs. Based in part on these similarities, we suggest that a highly successful Phase III clinical trial of a formulation of cannabidiol for Dravet syndrome seizures may be directly translatable into possible benefits for WHS individuals with challenging seizure patterns. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  6. First seizure: EEG and neuroimaging following an epileptic seizure. (United States)

    Pohlmann-Eden, Bernd; Newton, Mark


    An early EEG (within 48 h) and high-resolution magnetic resonance imaging (hr_MRI) are the methods of choice for an accurate diagnosis after a first seizure presentation. Together with a careful history and examination, they will allow definition of the epilepsy syndrome in two-thirds of patients and help assess the individual risk for seizure recurrence, which is determined by the specific syndrome and is highest with focal epileptiform activity on EEG. Despite the heterogeneity of first seizure studies, EEG and etiology are consistently found to be the best predictors for seizure recurrence and prognosis. The additional yield of sleep-deprived EEG and sleep EEG is uncertain; yet MRI is essential for detecting brain tumors and other structural bases for new epilepsy. The rate occurrence of remote symptomatic seizures increases significantly with age and the most common etiology in the elderly with a first seizure is stroke; however, its exact relevance to epileptogenicity is yet to be defined. There is a striking lack of systematic studies using early EEG and hr_MRI in order to better characterize epileptogenic areas and elucidate the mechanisms of seizure provocation.

  7. Protective effect of Terminalia chebula against seizures, seizure-induced cognitive impairment and oxidative stress in experimental models of seizures in rats. (United States)

    Kumar, Ritesh; Arora, Renu; Agarwal, Amit; Gupta, Y K


    Teminalia chebula (TC) has been traditionally used in the Ayurvedic system of medicine primarily for gastrointestinal disorders. Its fruit extract has also been used to treat epilepsy and other CNS disorders. To evaluate the effect of hydroalcoholic fruit extract of Terminalia chebula (HETC) on experimental models of seizures, seizure-induced cognitive impairment and oxidative stress in rats. In vitro antioxidant activity of HETC was evaluated by using ABTS, NO and DPPH radical scavenging assay. For in-vivo study, seizures were induced in Wistar rats (200-225g) by pentylenetetrazole (PTZ) and maximal-electroshock. (MES). The anticonvulsant effect of the HETC (250, 500, and 1000mg/kg, orally) was evaluated in seizure models. The therapeutic and sub-therapeutic dose of valproate and phenytoin were also assayed. The potential effect of co-administration of HETC (500mg/kg) with sub-therapeutic dose of valproate and phenytoin were also evaluated in PTZ and MES seizures model respectively. Effect on cognition was assessed using elevated plus maze (EPM) and passive avoidance test (PA). The in- vivo oxidative stress parameters (malondialdehyde and glutathione) were assessed in the cerebral cortex and hippocampus part of rat brain. The IC50 value of HETC in in vitro antioxidant assays i.e. ABTS, DPPH and NO radical scavenging assay was found to be 2.27μg/ml, 6.04μg/ml and 4.37μg/ml respectively. In experimental study, PTZ and MES treated groups exhibited 100% seizures with increased oxidative stress (p < 0.001) and cognitive deficits (p < 0.01) as compared to control group. HETC at highest dose (1000mg/kg) showed 83.33% (5/6) protection in MES induced seizures while 66.66% (4/6) protection in PTZ induced seizures. However, HETC (1000mg/kg) and co-administration of sub-therapeutic dose of HETC with valproate and phenytoin showed complete protection. In addition, it also attenuated the seizure induced oxidative stress and cognitive impairment as indicated by significant (p

  8. Psychogenic Nonepileptic Seizures after Head Injury: A Case Report

    Directory of Open Access Journals (Sweden)

    Laura Scévola


    another medical illness. The gold standard for PNES diagnosis is video electroencephalogram (Video-EEG. PNESs are defined by modern psychiatry as conversion and dissociative disorders but these disorders may coexist with many others psychiatric disorders, including depression, posttraumatic stress disorder, and personality disorders. It is well known that epileptic seizures are a frequent and well-studied complication of traumatic head injury (THI. However, THI may also generate psychic symptoms including PNES. In this paper we describe a patient who developed PNES after THI in a bus accident and received a diagnosis of refractory epilepsy for 24 years until she underwent Video-EEG.

  9. Personality and temperament correlates of pain catastrophizing in young adolescents

    NARCIS (Netherlands)

    P.E.H.M. Muris (Peter); C.M.G. Meesters (Cor); M.F.C.M. Van Den Hout (Mari F. C. M.); S. Wessels (Sylvia); I.H.A. Franken (Ingmar); E.G.C. Rassin (Eric)


    textabstractPain catastrophizing is generally viewed as an important cognitive factor underlying chronic pain. The present study examined personality and temperament correlates of pain catastrophizing in a sample of young adolescents (N = 132). Participants completed the Pain Catastrophizing Scale

  10. Valproic Acid Suppositories for Management of Seizures for Geriatric Patients. (United States)

    DiScala, Sandra L; Tran, Nhi N; Silverman, Michael A

    This case describes the use of valproic acid suppositories for secondary seizure prophylaxis in a geriatric veteran with a feeding and swallowing disorder. The effectiveness of valproic acid suppositories is outlined to reinforce the need for compounding pharmacies to have this formulation available to meet the needs of geriatric patients.

  11. Occasional seizures, epilepsy, and inborn errors of metabolism

    NARCIS (Netherlands)

    Dulac, O.; Plecko, B.; Gataullina, S.; Wolf, N.I.


    Seizures are a common paediatric problem, with inborn errors of metabolism being a rare underlying aetiology. The clinical presentation of inborn errors of metabolism is often associated with other neurological symptoms, such as hypotonia, movement disorders, and cognitive disturbances. However, the

  12. Effects of Cognitive-Behavioral Therapy (CBT) on Brain Connectivity Supporting Catastrophizing in Fibromyalgia. (United States)

    Lazaridou, Asimina; Kim, Jieun; Cahalan, Christine M; Loggia, Marco L; Franceschelli, Olivia; Berna, Chantal; Schur, Peter; Napadow, Vitaly; Edwards, Robert R


    Fibromyalgia (FM) is a chronic, common pain disorder characterized by hyperalgesia. A key mechanism by which cognitive-behavioral therapy (CBT) fosters improvement in pain outcomes is via reductions in hyperalgesia and pain-related catastrophizing, a dysfunctional set of cognitive-emotional processes. However, the neural underpinnings of these CBT effects are unclear. Our aim was to assess CBT's effects on the brain circuitry underlying hyperalgesia in FM patients, and to explore the role of treatment-associated reduction in catastrophizing as a contributor to normalization of pain-relevant brain circuitry and clinical improvement. In total, 16 high-catastrophizing FM patients were enrolled in the study and randomized to 4 weeks of individual treatment with either CBT or a Fibromyalgia Education (control) condition. Resting state functional magnetic resonance imaging scans evaluated functional connectivity between key pain-processing brain regions at baseline and posttreatment. Clinical outcomes were assessed at baseline, posttreatment, and 6-month follow-up. Catastrophizing correlated with increased resting state functional connectivity between S1 and anterior insula. The CBT group showed larger reductions (compared with the education group) in catastrophizing at posttreatment (PCBT produced significant reductions in both pain and catastrophizing at the 6-month follow-up (PCBT group also showed reduced resting state connectivity between S1 and anterior/medial insula at posttreatment; these reductions in resting state connectivity were associated with concurrent treatment-related reductions in catastrophizing. The results add to the growing support for the clinically important associations between S1-insula connectivity, clinical pain, and catastrophizing, and suggest that CBT may, in part via reductions in catastrophizing, help to normalize pain-related brain responses in FM.

  13. Semiology of hypermotor (hyperkinetic) seizures. (United States)

    Alqadi, Khalid; Sankaraneni, Ram; Thome, Ursula; Kotagal, Prakash


    Hypermotor seizures (HMSs) consist of complex movements involving proximal segments of the limbs and trunk that appear violent and inappropriate for the situation. We analyzed hypermotor seizure videos in seizure-free patients (Engel class I) following resective epilepsy surgery. After completion of video analysis, we reviewed EEG and neuroimaging data. Search of our epilepsy surgery database yielded 116 patients classified as having hypermotor seizures between 1996 and 2013. From this subset, 17/31 (55%) patients had been seizure-free for >6months (mean follow-up: 3.3years). Mean seizure duration was 35s (range: 6-91s), of which the HM phase lasted a mean of 22s (range: 3-53s). In 16 patients (95%), hypermotor activity was seen at or within 10s of clinical seizure onset. Type I semiology occurred in 6 patients, type II semiology in 10 patients, and 1 patient exhibited features of both. Type I and type II semiologies were noted in patients who had frontal lobe as well as extrafrontal resections. Nonversive head and body turning occurred in 10 patients (ranging from 90° to 270°) which was ipsilateral to the side of resection in all patients and seen both in frontal and extrafrontal resections. Six out of eleven patients with abnormal MRI and 4/6 patients with nonlesional MRI underwent invasive EEG evaluation. Eight patients (47%) had frontal lobe resection, 4/17 (23%) patients had temporal lobe resection, and one patient each had parietal lobe, insular, temporoparietooccipital, or motor sparing resection; 1 patient had functional hemispherectomy. Hypermotor semiology typically occurs at or within 10s after seizure onset. Ipsilateral head/body turning appears to be of lateralizing value whereas asymmetry of limb movement was not lateralizing. Hypermotor semiology is most often seen in frontal lobe epilepsy but may occur in seizures arising from other locations. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. A hypothesis regarding the molecular mechanism underlying dietary soy-induced effects on seizure propensity.

    Directory of Open Access Journals (Sweden)

    Cara Jean Westmark


    Full Text Available Numerous neurological disorders including fragile X syndrome, Down syndrome, autism and Alzheimer’s disease are comorbid with epilepsy. We have observed elevated seizure propensity in mouse models of these disorders dependent on diet. Specifically, soy-based diets exacerbate audiogenic-induced seizures in juvenile mice. We have also found potential associations between the consumption of soy-based infant formula and seizure incidence, epilepsy comorbidity and autism diagnostic scores in autistic children by retrospective analyses of medical record data. In total, these data suggest that consumption of high levels of soy protein during postnatal development may affect neuronal excitability. Herein, we present our theory regarding the molecular mechanism underlying soy-induced effects on seizure propensity. We hypothesize that soy phytoestrogens interfere with metabotropic glutamate receptor signaling through an estrogen receptor-dependent mechanism, which results in elevated production of key synaptic proteins and decreased seizure threshold.

  15. Treatment of catastrophic antiphospholipid syndrome (United States)

    Kazzaz, Nayef M.; McCune, W. Joseph; Knight, Jason S.


    Purpose of review Catastrophic antiphospholipid syndrome (CAPS) is a severe manifestation of APS. While affecting only 1% of patients with APS, the condition is frequently fatal if not recognized and treated early. Here, we will review the current approach to diagnosis and treatment of CAPS. Recent findings Data from the international “CAPS registry,” spearheaded by the European Forum on Antiphospholipid Antibodies, have improved our understanding of at-risk patients, typical clinical features, and associated/precipitating diagnoses. Current guidelines also continue to support a role for anticoagulants and glucocorticoids as foundation therapy in all patients. Finally, new basic science and case series suggest that novel therapies, such as rituximab and eculizumab warrant further study. Summary Attention to associated diagnoses such as infection and systemic lupus erythematosus (SLE) are critical at the time of diagnosis. All patients should be treated with anticoagulation, corticosteroids, and possibly plasma exchange. In patients with SLE, cyclophosphamide should also be considered. In refractory or relapsing cases, new therapies such as rituximab and possibly eculizumab may be options, but need further study. PMID:26927441

  16. Autonomic epileptic seizures, autonomic effects of seizures, and SUDEP. (United States)

    Moseley, Brian; Bateman, Lisa; Millichap, John J; Wirrell, Elaine; Panayiotopoulos, Chrysostomos P


    Many generalized tonic-clonic seizures are accompanied by profound autonomic changes. However, autonomic seizures and autonomic status epilepticus can also be seen with specific electroclinical syndromes (Panayiotopoulos syndrome), etiologies, and localizations. Such autonomic symptoms may impact cardiorespiratory function. While it is likely that several factors contribute to SUDEP, further study of both ictal respiratory and cardiac changes and underlying neuroanatomical mechanisms involved in autonomic seizure semiology are likely to provide important data to improve our understanding of the pathophysiology of this devastating condition. This paper will review the association between autonomic symptoms and epileptic seizures and will highlight the work of three young investigators. Drs. Lisa Bateman and Brian Moseley will review their work on cardiorespiratory effects of recorded seizures and how this assists in our understanding of SUDEP. Dr. John Millichap will review autonomic seizures and autonomic dysfunctions related to childhood epilepsy and will discuss the importance of expanded research efforts in this field. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. [Iodine and thyroid gland with or without nuclear catastrophe]. (United States)

    Dilas, Ljiljana Todorović; Bajkin, Ivana; Icin, Tijana; Paro, Jovanka Novaković; Zavisić, Branka Kovacev


    Iodine, as a trace element, is a necessary and limiting substrate for thyroid gland hormone synthesis. It is an essential element that enables the thyroid gland to produce thyroid hormones thyroxine (T4) and triiodothyronine (T3). Synthesis of Thyroid Hormones and Iodine Metabolism. Three iodine molecules are added to make triiodothyronine, and four for thyroxine - the two key hormones produced by the thyroid gland. Iodine deficiency The proper daily amount of iodine is required for optimal thyroid function. Iodine deficiency can cause hypothyroidism, developmental brain disorders and goiter. Iodine deficiency is the single most common cause of preventable mental retardation and brain damage in the world. It also decreases child survival, causes goiters, and impairs growth and development. Iodine deficiency disorders in pregnant women cause miscarriages, stillbirths, and other complications. Children with iodine deficiency disorders can grow up stunted, apathetic, mentally retarded, and incapable of normal movements, speech or hearing. Excessive Iodine Intake. Excessive iodine intake, which can trigger a utoimmune thyroid disease and dysfunction. is on the other side. Iodine use in Case of Nuclear Catastrophe. In addition to other severe consuquences of radioactivity, high amount of radioactive iodine causes significant increase in incidence of thyroid gland carcinoma after some of the nuclear catastrophes (Hiroshima, Nagasaki, Chernobyl, Fukushima). The incidence of thyroid carcinoma was increased mostly in children. This paper was aimed at clarifying some of the possibilities of prevention according to the recommendations given by the World Health Organization.

  18. Catastrophic event modeling. [lithium thionyl chloride batteries (United States)

    Frank, H. A.


    A mathematical model for the catastrophic failures (venting or explosion of the cell) in lithium thionyl chloride batteries is presented. The phenomenology of the various processes leading to cell failure is reviewed.

  19. Cosmic Impacts, Cosmic Catastrophes. Part 2. (United States)

    Chapman, Clark R.; Morrison, David


    Examined is the science of catastrophism and its role in planetary and earth science. The effects of impacts on earth with extraterrestrial origins are discussed. Perspectives on the age and dynamics of the earth's crust are presented. (CW)

  20. Transient pseudohypoparathyroidism and neonatal seizure. (United States)

    Manzar, S


    The case of a neonate is presented who had late onset seizure associated with hypocalcemia, hyperphosphatemia, and raised parathyroid hormone. The infant did not have any stigmata of pseudohypoparathyroidism. The hypocalcemia was initially resistant to calcium therapy, but responded to vitamin D analog therapy. The diagnosis of 'transient neonatal pseudohypoparathyroidism' was entertained, as the infant remained stable and seizure-free with normal serum biochemistry during 8 months of follow-up.

  1. Catastrophic avalanches and methods of their control

    Directory of Open Access Journals (Sweden)

    N. A. Volodicheva


    Full Text Available Definition of such phenomenon as “catastrophic avalanche” is presented in this arti-cle. Several situations with releases of catastrophic avalanches in mountains of Caucasus, Alps, and Central Asia are investigated. Materials of snow-avalanche ob-servations performed since 1960s at the Elbrus station of the Lomonosov Moscow State University (Central Caucasus were used for this work. Complex-valued measures of engineering protection demonstrating different efficiencies are consid-ered.

  2. Management Of Post Stroke Seizures

    Directory of Open Access Journals (Sweden)

    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

  3. Mindfulness, acceptance and catastrophizing in chronic pain.

    Directory of Open Access Journals (Sweden)

    Maaike J de Boer

    Full Text Available OBJECTIVES: Catastrophizing is often the primary target of the cognitive-behavioral treatment of chronic pain. Recent literature on acceptance and commitment therapy (ACT suggests an important role in the pain experience for the concepts mindfulness and acceptance. The aim of this study is to examine the influence of mindfulness and general psychological acceptance on pain-related catastrophizing in patients with chronic pain. METHODS: A cross-sectional survey was conducted, including 87 chronic pain patients from an academic outpatient pain center. RESULTS: The results show that general psychological acceptance (measured with the AAQ-II is a strong predictor of pain-related catastrophizing, independent of gender, age and pain intensity. Mindfulness (measured with the MAAS did not predict levels of pain-related catastrophizing. DISCUSSION: Acceptance of psychological experiences outside of pain itself is related to catastrophizing. Thus, acceptance seems to play a role in the pain experience and should be part of the treatment of chronic pain. The focus of the ACT treatment of chronic pain does not necessarily have to be on acceptance of pain per se, but may be aimed at acceptance of unwanted experiences in general. Mindfulness in the sense of "acting with awareness" is however not related to catastrophizing. Based on our research findings in comparisons with those of other authors, we recommend a broader conceptualization of mindfulness and the use of a multifaceted questionnaire for mindfulness instead of the unidimensional MAAS.

  4. Pain catastrophizing and interpersonal problems: a circumplex analysis of the communal coping model. (United States)

    Lackner, Jeffrey M; Gurtman, Michael B


    Using the circumplex model of interpersonal behavior [Handbook of research methods in clinical psychology, 1982], this study tested the communal coping model of catastrophizing (CCM) in a large (N = 179) sample of patients with irritable bowel syndrome (IBS), a common, benign chronic pain disorder associated with significant painful extraintestinal comorbidity (e.g. headache, low back pain). Patients completed the Coping Strategies Questionnaire, the Brief Symptom Inventory, and the Inventory of Interpersonal Problems. The main findings were: (1) individuals who reported higher levels of catastrophizing described greater interpersonal problems; (2) the interpersonal problems described by catastrophizers fell within the friendly and friendly submissive quadrants of the circumplex supporting the notion that they have an interpersonal style demanding support and care-taking [Pain 103 (2003) 151]; (3) the pain coping behavior most strongly associated with interpersonal problems was catastrophizing; and (4) the relationship between interpersonal problems and catastrophizing remained after removing the influence of general symptomatic distress (i.e. an overall tendency to complain of psychological problems in general). In general, data provide evidence supporting the interpersonal distinctiveness of pain catastrophizing as postulated by the CCM. Advantages of a circumplex model and of interpersonal theory for understanding and testing the CCM are discussed.

  5. EEG and CT findings of infant partial seizures

    International Nuclear Information System (INIS)

    Kajitani, Takashi; Kumanomido, Yoshiaki; Nakamura, Makoto; Ueoka, Kiyotaka


    Examination of EEG and cranial CT were performed in 19 cases of partial seizures with elementary symptomatology (PSES), 6 cases of partial seizures with complex symptomatology (PSCS), and 17 cases of benign focal pilepsy of childhood with Rolandic spikes (BFECRS). The results were as follows. 1) In 16 of 19 cases of PSES (84%), various abnormal CT findings such as localized cerebral atrophy (7 cases), localized cerebral atrophy complicated with porencephaly (4 cases), porencephaly alone (2 cases), and diffuse cerebral atrophy (3 cases) were found. 2) Of 6 cases of PSCS localized cerebral atrophy was found in 3 cases, porencephaly in one case, and localized calcification in one case. Normal CT findings were obtained in one case. 3) In comparison of EEG findings with CT findings in 25 cases of partial seizures CT findings correlated with the basic waves rather than the paroxysmal ones. 4) The fact that CT findings in patients with BFECRS were mostly normal suggests the functional origin of the seizures. 5) CT was valuable in partial seizures for detecting underlying disorders and predicting the prognosis. (Ueda, J.)

  6. Refractory Seizures in Tramadol Poisoning: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohammad Majidi


    Full Text Available Background: Tramadol, an analgesic drug abused by opioid addicts, is also abused accidentally or for suicidal purposes. Tramadol poisoning can induce CNS depression, seizures, coma, and ultimately death. Case: In this report, a 30-year-old male was admitted to the emergency department due to suicidal attempt with ingestion of 14000 mg (140 tablet 100 mg of tramadol. He had history of suicidal attempts in past years as well as depression in his past medical history, but he had not abused tramadol and other drugs in his history. There was no history of epilepsy or head trauma in. He presented with generalized seizures two hours post ingestion, and, then, he was referred to hospital four hours later. Generalized seizures were poorly controlled by multiple medications. Due to respiratory arrest, endotracheal tube was inserted and he was admitted to the ICU immediately. At admission, he experienced hypovolemic shock, hypoglycemia, coma, apnea, refractory seizures, muscle spasms, acute respiratory distress syndrome, coagolative disorder, rhabdomyolysis, and acute renal failure. Despite medical managements, he died 38 days after ingestion. Conclusion: In this report, despite using inhalational anesthetic drugs, seizures continued and were very poorly controlled. Cause of death in this patient can be seen as the side effects of tramadol poisoning.

  7. Creating catastrophes in the classroom (United States)

    Andersson, Thommy


    Buildings, infrastructure and human life are being destroyed by wind and landslides. To interest and motivate pupils and to help them understand abstract knowledge, a practical experiment could be useful. These experiments will show why strong winds circulate around tropical cyclones and how fluvial geological processes affect nature and communities. The experiments are easy to set up and the equipment is not expensive. Experiment 1: Exogenic processes of water are often slow processes. This experiment will simulate water processes that can take thousands of years, in less than 40 minutes. This experiment can be presented for and understood by pupils at all levels. Letting the pupils build up the scenery will make them more curious about the course of events. During that time they will see the geomorphological genesis of landforms such as landslides, sandurs, deltas, canyons sedimentations, selective erosions. Placing small houses, bridges etc. we can lead to discussions about natural catastrophes and community planning. Material needed for the experiment is a water bucket, erosion gutter, clay (simulating rock), sand and smaller pebbles (simulating the soil), houses of "Monopoly" size and tubes. By using a table with wheels it is easy to reuse the result for other lessons. Installation of a pump can make the experiment into a closed loop system. This installation can be used for presentations outside the classroom. Experiment 2: The Coriolis Effect explains why the wind (moving objects) deflects when moving. In the northern hemisphere the deflection is clockwise and anti-clockwise in the southern hemisphere. This abstract effect is often hard for upper secondary pupils to understand. This experiment will show the effect and thus make the theory real and visible. Material needed for this experiment is a bucket, pipes, a string. At my school we had cooperation with pupils from the Industrial Technology programme who made a copper pipe construction. During the

  8. Non-catastrophic and catastrophic fractures in racing Thoroughbreds at the Hong Kong Jockey Club. (United States)

    Sun, T C; Riggs, C M; Cogger, N; Wright, J; Al-Alawneh, J I


    Reports of fractures in racehorses have predominantly focused on catastrophic injuries, and there is limited data identifying the location and incidence of fractures that did not result in a fatal outcome. To describe the nature and the incidence of non-catastrophic and catastrophic fractures in Thoroughbreds racing at the Hong Kong Jockey Club (HKJC) over seven racing seasons. Retrospective cohort study. Data of fractures sustained in horses while racing and of race characteristics were extracted from the HKJC Veterinary Management Information System (VMIS) and Racing Information System (RIS) respectively. The fracture event was determined from the first clinical entry for each specific injury. The incidence rates of non-catastrophic and catastrophic fractures were calculated per 1000 racing starts for racetrack, age, racing season, sex and trainer. 179 first fracture events occurred in 64,807 racing starts. The incidence rate of non-catastrophic fractures was 2.2 per 1000 racing starts and of catastrophic fractures was 0.6 per 1000 racing starts. Fractures of the proximal sesamoid bones represented 55% of all catastrophic fractures while the most common non-catastrophic fractures involved the carpus and the first phalanx. Significant associations were detected between the incidence of non-catastrophic fractures and sex, trainer and racing season. The first fracture event was used to calculate the incidence rate in this study and may have resulted in underestimation of the true incidence rate of fractures in this population. However, given the low number of recorded fracture events compared to the size of the study population, this underestimation is likely to be small. There were 3.6 times as many non-catastrophic fractures as catastrophic fractures in Thoroughbreds racing in Hong Kong between 2004 and 2011. Non-catastrophic fractures interfere with race training schedules and may predispose to catastrophic fracture. Future analytical studies on non-catastrophic


    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Quanhao; Wang, Yuming; Hu, Youqiu; Liu, Rui, E-mail: [CAS Key Laboratory of Geospace Environment, Department of Geophysics and Planetary Sciences, University of Science and Technology of China, Hefei 230026 (China)


    2.5-dimensional time-dependent ideal magnetohydrodynamic (MHD) models in Cartesian coordinates were used in previous studies to seek MHD equilibria involving a magnetic flux rope embedded in a bipolar, partially open background field. As demonstrated by these studies, the equilibrium solutions of the system are separated into two branches: the flux rope sticks to the photosphere for solutions at the lower branch but is suspended in the corona for those at the upper branch. Moreover, a solution originally at the lower branch jumps to the upper, as the related control parameter increases and reaches a critical value, and the associated jump is here referred to as an upward catastrophe. The present paper advances these studies in three aspects. First, the magnetic field is changed to be force-free; the system still experiences an upward catastrophe with an increase in each control parameter. Second, under the force-free approximation, there also exists a downward catastrophe, characterized by the jump of a solution from the upper branch to the lower. Both catastrophes are irreversible processes connecting the two branches of equilibrium solutions so as to form a cycle. Finally, the magnetic energy in the numerical domain is calculated. It is found that there exists a magnetic energy release for both catastrophes. The Ampère's force, which vanishes everywhere for force-free fields, appears only during the catastrophes and does positive work, which serves as a major mechanism for the energy release. The implications of the downward catastrophe and its relevance to solar activities are briefly discussed.


    International Nuclear Information System (INIS)

    Zhang, Quanhao; Wang, Yuming; Hu, Youqiu; Liu, Rui


    2.5-dimensional time-dependent ideal magnetohydrodynamic (MHD) models in Cartesian coordinates were used in previous studies to seek MHD equilibria involving a magnetic flux rope embedded in a bipolar, partially open background field. As demonstrated by these studies, the equilibrium solutions of the system are separated into two branches: the flux rope sticks to the photosphere for solutions at the lower branch but is suspended in the corona for those at the upper branch. Moreover, a solution originally at the lower branch jumps to the upper, as the related control parameter increases and reaches a critical value, and the associated jump is here referred to as an upward catastrophe. The present paper advances these studies in three aspects. First, the magnetic field is changed to be force-free; the system still experiences an upward catastrophe with an increase in each control parameter. Second, under the force-free approximation, there also exists a downward catastrophe, characterized by the jump of a solution from the upper branch to the lower. Both catastrophes are irreversible processes connecting the two branches of equilibrium solutions so as to form a cycle. Finally, the magnetic energy in the numerical domain is calculated. It is found that there exists a magnetic energy release for both catastrophes. The Ampère's force, which vanishes everywhere for force-free fields, appears only during the catastrophes and does positive work, which serves as a major mechanism for the energy release. The implications of the downward catastrophe and its relevance to solar activities are briefly discussed.

  11. Severe catastrophes and public reactions

    International Nuclear Information System (INIS)

    Osmachkin, Vitaly


    nuclear opposition. Economical basis of nuclear energy stagnation is in not very successful competition of nuclear engineering with fossil energy production technologies. Much money has been spent for improvement of safety of NPPs. Social roots of the opposition are linked with a bad experience of the public with demonstration of the nuclear energy- The explosion of atomic bombs, some contamination of the territories after nuclear arm tests, misfortunes with TMI-2 and Chernobyl have created a stable enmity and non-acceptance of the all connected with 'atom'. The mass media have strongly promoted the dissemination of the fear of radiation exposures. There is also an influence on that attitude the radiation protection regulation via the declaration of the linear no-threshold dependence of the radiation detriments and dose of exposure. Such concept ignores the adoptive features of all living. But modem studies have showed that protracted irradiation at the same dose is much less dangerous compared with sharp one. It could change public attitude to nuclear energy in the society. Role of nuclear communication for public informing: The reactions of public on various technological and man-made events differ significantly and are being determined not scales of catastrophes but the mental impression and a multiplication of psychological stresses in the society by mass -media. In present situation a nuclear community has to improve the contacts with the pubic, to launch more effective campaign for explanation of real adventures of nuclear power. It needs to compare the risks of climate warming and health detriments from different electricity production technologies and to show that nuclear power is a single alternative all fossil burning techniques of electricity production. It's the truth the nuclear power is a real method of fight for suppression of emission the greenhouse gases, isn't it? (author)

  12. Vigabatrin and mental retardation in tuberous sclerosis: infantile spasms vs focal seizures (United States)

    Yum, Mi-Sun; Lee, Eun Hye; Ko, Tae-Sung


    Tuberous sclerosis complex is a genetic disorder resulting in epilepsy and mental retardation. Vigabatrin has shown efficacy in the treatment of infantile spasms caused by tuberous sclerosis complex, but its effects on focal seizures caused by tuberous sclerosis complex have not been determined. We compared the efficacy of vigabatrin in patients with tuberous sclerosis complex-induced focal seizures and infantile spasms and assessed the mental outcomes in both groups. We retrospectively evaluated 31 children with tuberous sclerosis complex and epilepsy, who were treated with vigabatrin in single tertiary center in Seoul, Korea. Vigabatrin treatment resulted in spasms cessation in 16 of 18 (88.9%) patients with infantile spasms, whereas 6 of 13 (46.2%) patients with focal seizures became seizure-free. Initial response to vigabatrin had no effect on intellectual disability. Vigabatrin was highly effective in eliminating infantile spasms caused by tuberous sclerosis complex, but was less effective in patients with focal seizures. PMID:22752486

  13. Vigabatrin and mental retardation in tuberous sclerosis: infantile spasms versus focal seizures. (United States)

    Yum, Mi-Sun; Lee, Eun Hye; Ko, Tae-Sung


    Tuberous sclerosis complex is a genetic disorder resulting in epilepsy and mental retardation. Vigabatrin has shown efficacy in the treatment of infantile spasms caused by tuberous sclerosis complex, but its effects on focal seizures caused by tuberous sclerosis complex have not been determined. We compared the efficacy of vigabatrin in patients with tuberous sclerosis complex-induced focal seizures and infantile spasms and assessed the mental outcomes in both groups. We retrospectively evaluated 31 children with tuberous sclerosis complex and epilepsy, who were treated with vigabatrin in a single tertiary center in Seoul, Korea. Vigabatrin treatment resulted in spasms cessation in 16 of 18 (88.9%) patients with infantile spasms, whereas 6 of 13 (46.2%) patients with focal seizures became seizure free. Initial response to vigabatrin had no effect on intellectual disability. Vigabatrin was highly effective in eliminating infantile spasms caused by tuberous sclerosis complex but was less effective in patients with focal seizures.

  14. Cognitive-behavioral therapy for psychogenic nonepileptic seizures (United States)

    Goldstein, L.H.; Chalder, T.; Chigwedere, C.; Khondoker, M.R.; Moriarty, J.; Toone, B.K.; Mellers, J.D.C.


    Objective: To compare cognitive-behavioral therapy (CBT) and standard medical care (SMC) as treatments for psychogenic nonepileptic seizures (PNES). Methods: Our randomized controlled trial (RCT) compared CBT with SMC in an outpatient neuropsychiatric setting. Sixty-six PNES patients were randomized to either CBT (plus SMC) or SMC alone, scheduled to occur over 4 months. PNES diagnosis was established by video-EEG telemetry for most patients. Exclusion criteria included comorbid history of epilepsy, <2 PNES/month, and IQ <70. The primary outcome was seizure frequency at end of treatment and at 6-month follow-up. Secondary outcomes included 3 months of seizure freedom at 6-month follow-up, measures of psychosocial functioning, health service use, and employment. Results: In an intention-to-treat analysis, seizure reduction following CBT was superior at treatment end (group × time interaction p < 0.0001; large to medium effect sizes). At follow-up, the CBT group tended to be more likely to have experienced 3 months of seizure freedom (odds ratio 3.125, p = 0.086). Both groups improved in some health service use measures and on the Work and Social Adjustment Scale. Mood and employment status showed no change. Conclusions: Our findings suggest that cognitive-behavioral therapy is more effective than standard medical care alone in reducing seizure frequency in PNES patients. Classification of evidence: This study provides Class III evidence that CBT in addition to SMC, as compared to SMC alone, significantly reduces seizure frequency in patients with PNES (change in median monthly seizure frequency: baseline to 6 months follow-up, CBT group, 12 to 1.5; SMC alone group, 8 to 5). GLOSSARY AED = antiepileptic drug; CBT = cognitive-behavioral therapy; CI = confidence interval; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, 4th edition; HADS = Hospital Anxiety and Depression Scale; IQR = interquartile range; ITT = intention-to-treat; OR = odds ratio; PNES

  15. Explosive Blast Neuropathology and Seizures

    Directory of Open Access Journals (Sweden)

    S. Krisztian eKovacs


    Full Text Available Traumatic brain injury (TBI due to explosive blast exposure is a leading combat casualty. It is also implicated as a key contributor to war related mental health diseases. A clinically important consequence of all types of TBI is a high risk for development of seizures and epilepsy. Seizures have been reported in patients who have suffered blast injuries in the Global War on Terror but the exact prevalence is unknown. The occurrence of seizures supports the contention that explosive blast leads to both cellular and structural brain pathology. Unfortunately, the exact mechanism by which explosions cause brain injury is unclear, which complicates development of meaningful therapies and mitigation strategies. To help improve understanding, detailed neuropathological analysis is needed. For this, histopathological techniques are extremely valuable and indispensable. In the following we will review the pathological results, including those from immunohistochemical and special staining approaches, from recent preclinical explosive blast studies.

  16. Intraoperative seizures during craniotomy under general anesthesia. (United States)

    Howe, John; Lu, Xiaoying; Thompson, Zoe; Peterson, Gordon W; Losey, Travis E


    An acute symptomatic seizure is a clinical seizure occurring at the time of or in close temporal association with a brain insult. We report an acute symptomatic seizure occurring during a surgical procedure in a patient who did not have a prior history of epilepsy and who did not have a lesion associated with an increased risk of epilepsy. To characterize the incidence and clinical features of intraoperative seizures during craniotomy under general anesthesia, we reviewed cases where continuous EEG was acquired during craniotomy. Records of 400 consecutive cases with propofol as general anesthesia during craniotomy were reviewed. Demographic data, indication for surgery, clinical history, history of prior seizures, duration of surgery and duration of burst suppression were recorded. Cases where seizures were observed were analyzed in detail. Two out of 400 patients experienced intraoperative seizures, including one patient who appeared to have an acute symptomatic seizure related to the surgical procedure itself and a second patient who experienced two seizures likely related to an underlying diagnosis of epilepsy. This is the first report of an acute symptomatic seizure secondary to a neurosurgical procedure. Overall, 0.5% of patients monitored experienced seizures, indicating that intraoperative seizures are rare, and EEG monitoring during craniotomies is of low yield in detecting seizures. Copyright © 2016. Published by Elsevier Ltd.

  17. Varying seizure semiology according to age. (United States)

    Nordli, Douglas R


    The clinical manifestations of seizures change in a predictable fashion with advancing age. For focal seizures these changes can be summarized into domains similar to those used in developmental models. These include fine motor, communication, and gross motor manifestations. Instead of socialization the fourth domain for seizure semiology concerns synchronization. Focal seizures in the very young tend to be simpler with fewer fine motor manifestations. Auras are uncommon, even in young children with some linguistic skill and it is often difficult to discern alteration of consciousness. Infantile focal seizures can present with spasms or even diffuse tonic seizures. In terms of synchronization, orderly secondary generalization is rarely seen so that primary generalized clonic seizures are rarely recorded in infants. Amongst so-called "generalized" seizures spasms are most often seen in the first year of life. Absence seizures, myoclonic-astatic and generalized tonic-clonic seizures are all usually not seen until after age 2 years. A full description of the clinical details of seizures is probably the most important part of the epilepsy history. A detailed knowledge of seizure semiology can make the history more effective and also in the identification of the correct seizure classification. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. Seizure semiology: an important clinical clue to the diagnosis of autoimmune epilepsy. (United States)

    Lv, Rui-Juan; Ren, Hai-Tao; Guan, Hong-Zhi; Cui, Tao; Shao, Xiao-Qiu


    The purpose of this study is to analyze the seizure semiologic characteristics of patients with autoimmune epilepsy (AE) and describe the investigation characteristics of AE using a larger sample size. This observational retrospective case series study was conducted from a tertiary epilepsy center between May 2014 and March 2017. Cases of new-onset seizures were selected based on laboratory evidence of autoimmunity. At the same time, typical mesial temporal lobe epilepsy (MTLE) patients with hippocampal sclerosis (HS) were recruited as the control group from the subjects who underwent presurgical evaluation during the same period. A total of 61 patients with AE were identified. Specific autoimmune antibodies were detected in 39 patients (63.93%), including anti-VGKC in 23 patients (37.70%), anti-NMDA-R in 9 patients (14.75%), anti-GABA B -R in 6 patients (9.84%), and anti-amphiphysin in 1 patient (1.64%). Regarding the seizure semiology, no significant differences were noted between AE patients with autoantibody and patients with suspected AE without antibody. Compared to typical MTLE patients with HS, both AE patients with autoantibody and patients with suspected AE without antibody had the same seizure semiologic characteristics, including more frequent SPS or CPS, shorter seizure duration, rare postictal confusion, and common sleeping SGTC seizures. This study highlights important seizure semiologic characteristics of AE. Patients with autoimmune epilepsy had special seizure semiologic characteristics. For patients with autoimmune epilepsy presenting with new-onset seizures in isolation or with a seizure-predominant neurological disorder, the special seizure semiologic characteristics may remind us to test neuronal nuclear/cytoplasmic antibodies early and initiate immunomodulatory therapies as soon as possible. Furthermore, the absence of neural-specific autoantibodies does not rule out AE.

  19. The catastrophic antiphospholipid syndrome in children. (United States)

    Go, Ellen J L; O'Neil, Kathleen M


    To review the difficult syndrome of catastrophic antiphospholipid syndrome, emphasizing new developments in the diagnosis, pathogenesis and treatment. Few recent publications directly address pediatric catastrophic antiphospholipid syndrome (CAPS). Most articles are case reports or are data from adult and pediatric registries. The major factors contributing to most pediatric catastrophic antiphospholipid syndrome include infection and the presence of antiphospholipid antibodies, but complement activation also is important in creating diffuse thrombosis in the microcirculation. Treatment of the acute emergency requires anticoagulation, suppression of the hyperinflammatory state and elimination of the triggering infection. Inhibition of complement activation appears to improve outcome in limited studies, and suppression of antiphospholipid antibody formation may be important in long-term management. CAPS, an antibody-mediated diffuse thrombotic disease of microvasculature, is rare in childhood but has high mortality (33-50%). It requires prompt recognition and aggressive multimodality treatment, including anticoagulation, anti-inflammatory therapy and elimination of inciting infection and pathogenic autoantibodies.

  20. Orthogonality catastrophe and fractional exclusion statistics. (United States)

    Ares, Filiberto; Gupta, Kumar S; de Queiroz, Amilcar R


    We show that the N-particle Sutherland model with inverse-square and harmonic interactions exhibits orthogonality catastrophe. For a fixed value of the harmonic coupling, the overlap of the N-body ground state wave functions with two different values of the inverse-square interaction term goes to zero in the thermodynamic limit. When the two values of the inverse-square coupling differ by an infinitesimal amount, the wave function overlap shows an exponential suppression. This is qualitatively different from the usual power law suppression observed in the Anderson's orthogonality catastrophe. We also obtain an analytic expression for the wave function overlaps for an arbitrary set of couplings, whose properties are analyzed numerically. The quasiparticles constituting the ground state wave functions of the Sutherland model are known to obey fractional exclusion statistics. Our analysis indicates that the orthogonality catastrophe may be valid in systems with more general kinds of statistics than just the fermionic type.

  1. Orthogonality catastrophe and fractional exclusion statistics (United States)

    Ares, Filiberto; Gupta, Kumar S.; de Queiroz, Amilcar R.


    We show that the N -particle Sutherland model with inverse-square and harmonic interactions exhibits orthogonality catastrophe. For a fixed value of the harmonic coupling, the overlap of the N -body ground state wave functions with two different values of the inverse-square interaction term goes to zero in the thermodynamic limit. When the two values of the inverse-square coupling differ by an infinitesimal amount, the wave function overlap shows an exponential suppression. This is qualitatively different from the usual power law suppression observed in the Anderson's orthogonality catastrophe. We also obtain an analytic expression for the wave function overlaps for an arbitrary set of couplings, whose properties are analyzed numerically. The quasiparticles constituting the ground state wave functions of the Sutherland model are known to obey fractional exclusion statistics. Our analysis indicates that the orthogonality catastrophe may be valid in systems with more general kinds of statistics than just the fermionic type.

  2. Phenomenology and psychiatric origin of psychogenic nonepileptic seizures

    Directory of Open Access Journals (Sweden)

    Ristić Aleksandar J.


    Full Text Available INTRODUCTION Psychogenic nonepileptic seizure (PNES is a sudden change in a person's behavior, perception, thinking, or feeling that is usually time limited and resembles, or is mistaken for, epilepsy but does not have the characteristic electroencephalographic (EEG changes that accompanies a true epileptic seizure [1]. It is considered that PNES is a somatic manifestation of mental distress, in response to a psychological conflict or other Stressors [2]. A wide spectrum of clinical presentation includes syncope, generalized tonic-clonic seizure, simple and complex partial seizure, myoclonic seizure, frontal lobe seizures and status epilepticus [3]. Coexistence of epilepsy and PNES is seen in approximately 9% of cases [5]. Between 25-30% of patients referred to tertiary centers and initially diagnosed as refractory epilepsy were on further examination diagnosed as PNES [6,7]. In DSM-IV [12] PNES are usually categorized under conversion disorder with seizures or convulsions. However, psychiatric basis of PNES may be anxiousness (panic attack, somatization or factitious disorder, simulation, dissociative disorders and psychosis [1]. AIM The aim of the study was to establish clinical phenomenology and EEG characteristics as well as basic psychiatric disorder in patients with PNES. METHOD In a retrospective study covering the period from January 1st 1999 till April 31 st 2003, 24 patients (22 female, 2 male treated at the Institute of Neurology in Belgrade were analyzed. PNES were defined as sudden change in behavior incoherent with epileptiform activity registered on EEG. Possible PNES were determined on the basis of history data and clinical examination during the attack but definitive confirmation was established only by the finding of no ictal EEG changes during typical seizure of each patient. Patients with coexisting epilepsy were included in the study, too. At least two standard EEG (range 2-6, median 4 were performed at the beginning of

  3. Mouse epileptic seizure detection with multiple EEG features and simple thresholding technique (United States)

    Tieng, Quang M.; Anbazhagan, Ashwin; Chen, Min; Reutens, David C.


    Objective. Epilepsy is a common neurological disorder characterized by recurrent, unprovoked seizures. The search for new treatments for seizures and epilepsy relies upon studies in animal models of epilepsy. To capture data on seizures, many applications require prolonged electroencephalography (EEG) with recordings that generate voluminous data. The desire for efficient evaluation of these recordings motivates the development of automated seizure detection algorithms. Approach. A new seizure detection method is proposed, based on multiple features and a simple thresholding technique. The features are derived from chaos theory, information theory and the power spectrum of EEG recordings and optimally exploit both linear and nonlinear characteristics of EEG data. Main result. The proposed method was tested with real EEG data from an experimental mouse model of epilepsy and distinguished seizures from other patterns with high sensitivity and specificity. Significance. The proposed approach introduces two new features: negative logarithm of adaptive correlation integral and power spectral coherence ratio. The combination of these new features with two previously described features, entropy and phase coherence, improved seizure detection accuracy significantly. Negative logarithm of adaptive correlation integral can also be used to compute the duration of automatically detected seizures.

  4. Modeling glial contributions to seizures and epileptogenesis: cation-chloride cotransporters in Drosophila melanogaster.

    Directory of Open Access Journals (Sweden)

    Zeid M Rusan

    Full Text Available Flies carrying a kcc loss-of-function mutation are more seizure-susceptible than wild-type flies. The kcc gene is the highly conserved Drosophila melanogaster ortholog of K+/Cl- cotransporter genes thought to be expressed in all animal cell types. Here, we examined the spatial and temporal requirements for kcc loss-of-function to modify seizure-susceptibility in flies. Targeted RNA interference (RNAi of kcc in various sets of neurons was sufficient to induce severe seizure-sensitivity. Interestingly, kcc RNAi in glia was particularly effective in causing seizure-sensitivity. Knockdown of kcc in glia or neurons during development caused a reduction in seizure induction threshold, cell swelling, and brain volume increase in 24-48 hour old adult flies. Third instar larval peripheral nerves were enlarged when kcc RNAi was expressed in neurons or glia. Results suggest that a threshold of K+/Cl- cotransport dysfunction in the nervous system during development is an important determinant of seizure-susceptibility in Drosophila. The findings presented are the first attributing a causative role for glial cation-chloride cotransporters in seizures and epileptogenesis. The importance of elucidating glial cell contributions to seizure disorders and the utility of Drosophila models is discussed.

  5. Gelastic seizures associated with hypothalamic hamartomas. An update in the clinical presentation, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    José F. Tellez-Zenteno


    Full Text Available José F. Tellez-Zenteno1, Cesar Serrano-Almeida2, Farzad Moien-Afshari11Division of Neurology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; 2Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, CanadaAbstract: Gelastic seizures are epileptic events characterized by bouts of laughter. Laughter-like vocalization is usually combined with facial contraction in the form of a smile. Autonomic features such as flushing, tachycardia, and altered respiration are widely recognized. Conscious state may not be impaired, although this is often difficult to asses particularly in young children. Gelastic seizures have been associated classically to hypothalamic hamartomas, although different extrahypothalamic localizations have been described. Hypothalamic hamartomas are rare congenital lesions presenting with the classic triad of gelastic epilepsy, precocious puberty and developmental delay. The clinical course of patients with gelastic seizures associated with hypothalamic hamartomas is progressive, commencing with gelastic seizures in infancy, deteriorating into more complex seizure disorder resulting in intractable epilepsy. Electrophysiological, radiological, and pathophysiological studies have confirmed the intrinsic epileptogenicity of the hypothalamic hamartoma. Currently the most effective surgical approach is the trancallosal anterior interforniceal approach, however newer approaches including the endoscopic and other treatment such as radiosurgery and gamma knife have been used with success. This review focuses on the syndrome of gelastic seizures associated with hypothalamic hamartomas, but it also reviews other concepts such as status gelasticus and some aspects of gelastic seizures in other locations.Keywords: epilepsy, gelastic seizures, epilepsy surgery, hypothalamic hamartoma, intractable epilepsy

  6. Etiology and Outcome of Neonatal Seizures

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available The prognostic value of seizure etiology, neurologic examination, EEG, and neuroimaging in the neurodevelopmental outcome of 89 term infants with neonatal seizures was determined at the Children’s Hospital and Harvard Medical School, Boston, MA.

  7. On a new global catastrophic ICT model

    DEFF Research Database (Denmark)

    Riaz, M. Tahir; Bhalerao, Dipashree M.; Madsen, Ole Brun


    Many parts of India are prone to natural disasters, particularly caused by earthquakes and floods because of its geographical location. The Catastrophic areas can be rural, remote or urban anywhere in the world. It has been understood that earthquakes directly do not cause causalities but instead...... of the world's population suffers from affordable ICT solutions and the presence of sufficient ICT infrastructure. The main goal of this paper is to create a framework to define catastrophic areas from an ICT point of view. QOS features like packet loss rate, delay, throughput and delivery ratio for 50 nodes...

  8. Clinical profile of patients with nascent alcohol related seizures

    Directory of Open Access Journals (Sweden)

    P Sandeep


    Full Text Available Aim: The aim of this study is to characterize the clinical profile of patients with alcohol related seizures (ARS and to identify the prevalence of idiopathic generalized epilepsy (IGE in the same. Materials and Methods: 100 consecutive male patients presenting to a tertiary care center in South India with new onset ARS were analyzed with alcohol use disorders identification test (AUDIT score. All underwent 19 channel digital scalp electroencephalography (EEG and at least computed tomography (CT scan. Results: A total of 27 patients (27% who had cortical atrophy on CT had a mean duration of alcohol intake of 23.62 years compared with 14.55 years in patients with no cortical atrophy (P < 0.001. Twenty-two patients (22% had clustering in the current episode of whom 18 had cortical atrophy. Nearly, 88% patients had generalized tonic clonic seizures while 12% who had partial seizures underwent magnetic resonance imaging (MRI, which identified frontal focal cortical dysplasia in one. Mean lifetime duration of alcohol intake in patients presenting with seizures within 6 hours (6H-gp of intake of alcohol was significantly lower (P = 0.029. One patient in the 6H-gp with no withdrawal symptoms had EEG evidence for IGE and had a lower AUDIT score compared with the rest. Conclusion: CT evidence of cortical atrophy is related to the duration of alcohol intake and portends an increased risk for clustering. Partial seizures can be a presenting feature of ARS and those patients may benefit from MRI to identify underlying symptomatic localization related epilepsy (8.3% of partial seizures. IGE is more likely in patients presenting with ARS within first 6 hours especially if they do not have alcohol withdrawal symptoms and scalp EEG is helpful to identify this small subgroup (~1% who may require long-term anti-epileptic medication.

  9. Epileptic seizure, as the first symptom of hypoparathyroidism in children, does not require antiepileptic drugs. (United States)

    Liu, Meng-Jia; Li, Jiu-Wei; Shi, Xiu-Yu; Hu, Lin-Yan; Zou, Li-Ping


    Patients with hypoparathyroidism exhibit metabolic disorders (hypocalcemia) and brain structural abnormalities (brain calcifications). Currently, studies have determined whether antiepileptic drug (AED) treatment is required for epileptic seizures in children with hypoparathyroidism. This study aims to evaluate the data of two medical centers in Beijing based on the diagnosis of epileptic seizures as the first symptom of hypoparathyroidism in children. A total of 42 patients were included and assigned into AED and non-AED treatment groups in a 1:2 matched case-control study. Results show that the seizure outcome after 1 year of AED treatment is not significantly different from that of the control. In the subgroup analysis of patients with subcortical calcifications, the seizure outcome is still not significantly different from that of the control. Thus, AED treatment cannot improve the seizure outcomes in children with parathyroid disorder, even in such cases as suspected structural seizure caused by subcortical calcifications. Clinicians must take adequate considerations on the use of AEDs in these patients. Epileptic seizures, as the first symptom of hypoparathyroidism in children, do not require epilepsy drugs.

  10. Drosophila as a Model for Intractable Epilepsy: Gilgamesh Suppresses Seizures in parabss1 Heterozygote Flies (United States)

    Howlett, Iris C.; Rusan, Zeid M.; Parker, Louise; Tanouye, Mark A.


    Intractable epilepsies, that is, seizure disorders that do not respond to currently available therapies, are difficult, often tragic, neurological disorders. Na+ channelopathies have been implicated in some intractable epilepsies, including Dravet syndrome (Dravet 1978), but little progress has been forthcoming in therapeutics. Here we examine a Drosophila model for intractable epilepsy, the Na+ channel gain-of-function mutant parabss1 that resembles Dravet syndrome in some aspects (parker et al. 2011a). In particular, we identify second-site mutations that interact with parabss1, seizure enhancers, and seizure suppressors. We describe one seizure-enhancer mutation named charlatan (chn). The chn gene normally encodes an Neuron-Restrictive Silencer Factor/RE1-Silencing Transcription factor transcriptional repressor of neuronal-specific genes. We identify a second-site seizure-suppressor mutation, gilgamesh (gish), that reduces the severity of several seizure-like phenotypes of parabss1/+ heterozygotes. The gish gene normally encodes the Drosophila ortholog of casein kinase CK1g3, a member of the CK1 family of serine-threonine kinases. We suggest that CK1g3 is an unexpected but promising new target for seizure therapeutics. PMID:23797108

  11. Migrating Partial Seizures of Infancy

    Directory of Open Access Journals (Sweden)

    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.

  12. Continuing education in neurometabolic disorders--serine deficiency disorders

    NARCIS (Netherlands)

    de Koning, T. J.; Poll-The, B. T.; Jaeken, J.


    Serine deficiency disorders comprise a new group of inborn errors of serine metabolism. Patients affected with these disorders present with major neurological symptoms including congenital microcephaly, seizures, psychomotor retardation or polyneuropathy. The diagnosis of serine deficiency is based

  13. Catastrophizing and Causal Beliefs in Whiplash

    NARCIS (Netherlands)

    Buitenhuis, J.; de Jong, P. J.; Jaspers, J. P. C.; Groothoff, J. W.


    Study Design. Prospective cohort study. Objective. This study investigates the role of pain catastrophizing and causal beliefs with regard to severity and persistence of neck complaints after motor vehicle accidents. Summary of Background Data. In previous research on low back pain, somatoform

  14. Catastrophic antiphospholipid syndrome in leprosy | Chewoolkar ...

    African Journals Online (AJOL)

    Catastrophic antiphospholipid syndrome is an acute and life threatening variant of antiphospholipid syndrome with a high mortality rate. Many infections are known to be accompanied by the thrombotic manifestations of this syndrome. We came across a patient of leprosy who developed bowel ischaemia secondary to ...

  15. Catastrophic antiphospholipid syndrome: task force report summary. (United States)

    Cervera, R; Rodríguez-Pintó, I


    The Task Force on Catastrophic Antiphospholipid Syndrome (CAPS) aimed to assess the current knowledge on pathogenesis, clinical and laboratory features, diagnosis and classification, precipitating factors and treatment of CAPS. This article summarizes the main aspects of its final report. © The Author(s) 2014 Reprints and permissions:

  16. Thoracic aortic catastrophes : towards the endovascular solution

    NARCIS (Netherlands)

    Jonker, F.H.W.


    Descending thoracic aortic catastrophes include a variety of acute pathologies of the descending thoracic aorta, which are all associated with high morbidity and mortality rates, requiring immediate intervention. For this thesis, we explored the management and outcomes of several thoracic aortic

  17. Catastrophic risk : Social influences on insurance decisions

    NARCIS (Netherlands)

    Krawczyk, Michal; Trautmann, Stefan; van de Kuilen, Gijs

    We study behavioral patterns of insurance demand for low-probability large-loss events (catastrophic losses). Individual patterns of belief formation and risk attitude that were suggested in the behavioral decisions literature emerge robustly in the current set of insurance choices. However, social

  18. Preventing catastrophes in spatially extended systems through ...

    Indian Academy of Sciences (India)

    Further, we outline our analysis on the possible mechanisms behind the occurrence of catastrophes and how the ... The equation has also been utilized in seismology to model the two plates in a geological fault [4]. .... now the central results obtained from our extensive numerical simulations [7]. 3. Spatiotemporal patterns in ...

  19. Timber price dynamics following a natural catastrophe (United States)

    Jeffrey P. Prestemon; Thomas P. Holmes


    Catastrophic shocks to existing stocks of a renewable resource can cause long-run price shifts. With timber, these long-run price shifts may be accompanied by a short-run price drop due to salvage. Hurricane Hugo damaged 20 percent of southern pine timber in the South Carolina Coastal Plain in 1989. To estimate the...

  20. What Is the Price of Catastrophic Wildfire? (United States)

    David T. Butry; D. Evan Mercer; Jeffrey P. Prestemon; John M. Pye; Thomas P. Holmes


    We modeled and analyzed the economic impacts of the six weeks of large, catastrophic wild-fires in northeastern Florida in June and July 1998, among Florida's most devastating in recent history. The result of the unusually strong El Níño-Southern Oscillation (ENSO) in 1998, the Florida wildfires produced economic impacts of at least $600 million, similar in...

  1. 78 FR 52832 - Catastrophic Risk Protection Endorsement (United States)


    ... Management Agency, United States Department of Agriculture, Beacon Facility, Stop 0812, Room 421, P.O. Box... 12866 The Office of Management and Budget (OMB) has determined that this rule is not-significant for the... is definite, and whether ACRSI will be implemented before the Catastrophic Risk Protection...

  2. A Confusing Coincidence: Neonatal Hypoglycemic Seizures and Hyperekplexia

    Directory of Open Access Journals (Sweden)

    Nihat Demir


    Full Text Available Hyperekplexia is a rare, nonepileptic, genetic, or sporadic neurologic disorder characterized by startle responses to acoustic, optic, or tactile stimuli. Genetic defects in glycine receptors as well as encephalitis, tumors, inflammation, and disgenesis are among the etiologic causes of the disease. The main problem in hyperekplexia is the incomplete development of inhibitory mechanisms or exaggerated stimulation of excitatory mediators. Hyperekplexia is often confused with epileptic seizures. Here we present a case with hypoglycemic convulsions coexisting with hyperekplexia, causing diagnostic difficulty.

  3. Pretreatment seizure semiology in childhood absence epilepsy. (United States)

    Kessler, Sudha Kilaru; Shinnar, Shlomo; Cnaan, Avital; Dlugos, Dennis; Conry, Joan; Hirtz, Deborah G; Hu, Fengming; Liu, Chunyan; Mizrahi, Eli M; Moshé, Solomon L; Clark, Peggy; Glauser, Tracy A


    To determine seizure semiology in children with newly diagnosed childhood absence epilepsy and to evaluate associations with short-term treatment outcomes. For participants enrolled in a multicenter, randomized, double-blind, comparative-effectiveness trial, semiologic features of pretreatment seizures were analyzed as predictors of treatment outcome at the week 16 to 20 visit. Video of 1,932 electrographic absence seizures from 416 participants was evaluated. Median seizure duration was 10.2 seconds; median time between electrographic seizure onset and clinical manifestation onset was 1.5 seconds. For individual seizures and by participant, the most common semiology features were pause/stare (seizure 95.5%, participant 99.3%), motor automatisms (60.6%, 86.1%), and eye involvement (54.9%, 76.5%). The interrater agreement for motor automatisms and eye involvement was good (72%-84%). Variability of semiology features between seizures even within participants was high. Clustering analyses revealed 4 patterns (involving the presence/absence of eye involvement and motor automatisms superimposed on the nearly ubiquitous pause/stare). Most participants experienced more than one seizure cluster pattern. No individual semiologic feature was individually predictive of short-term outcome. Seizure freedom was half as likely in participants with one or more seizure having the pattern of eye involvement without motor automatisms than in participants without this pattern. Almost all absence seizures are characterized by a pause in activity or staring, but rarely is this the only feature. Semiologic features tend to cluster, resulting in identifiable absence seizure subtypes with significant intraparticipant seizure phenomenologic heterogeneity. One seizure subtype, pause/stare and eye involvement but no motor automatisms, is specifically associated with a worse treatment outcome. © 2017 American Academy of Neurology.

  4. Comparative potency of sensory-induced brainstem activation to trigger spreading depression and seizures in the cortex of awake rats: Implications for the pathophysiology of migraine aura. (United States)

    Vinogradova, Lyudmila V


    Migraine and epilepsy are highly co-morbid neurological disorders associated with episodic dysfunction of both cortical and subcortical networks. The study examined the interrelation between cortical spreading depression, the electrophysiological correlate of migraine aura and seizures triggered at cortical and brainstem levels by repeated sound stimulation in rats with acoustic hypersensitivity (reflex audiogenic epilepsy). In awake, freely moving rats with innate audiogenic epilepsy, 25 episodes of running seizure (brainstem seizures) were induced by repeated sound stimulation. Spreading depression and seizures were recorded using implanted cortical electrodes. The first sound-induced brainstem seizures evoked neither spreading depression nor seizures in the cortex. With repetition, brainstem seizures began to be followed by a single cortical spreading depression wave and an epileptiform discharge. Spreading depression was more frequent an early cortical event than seizures: spreading depression appeared after 8.4 ± 1.0 repeated stimulations in 100% rats (n = 24) while cortical seizures were recorded after 12.9 ± 1.2 tests in 46% rats. Brainstem seizure triggered unilateral long-latency spreading depression. Bilateral short-latency cortical spreading depression was recorded only after intense cortical seizures. These data show that episodic brainstem activation is a potent trigger of unilateral cortical spreading depression. Development of intense seizures in the cortex leads to initiation of spreading depression in multiple cortical sites of both hemispheres. © International Headache Society 2014.

  5. Binge drinking during pregnancy and risk of seizures in childhood: a study based on the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Sun, Yuelian; Strandberg-Larsen, Katrine; Vestergaard, Mogens


    Seizures are often found in children with fetal alcohol syndrome, but it is not known whether binge drinking during pregnancy by nonalcoholic women is associated with an increased risk of seizure disorders in children. The authors conducted a population-based cohort study of 80,526 liveborn......, and febrile seizures was retrieved from the Danish National Hospital Register. Results showed that exposure to binge drinking episodes during pregnancy was not associated with an increased risk of seizure disorders in children, except for those exposed at 11-16 gestational weeks. These children had a 3...... singletons in the Danish National Birth Cohort (1996-2002). Information on maternal binge drinking (intake of > or = 5 drinks on a single occasion) was collected in 2 computer-assisted telephone interviews during pregnancy. Children were followed for up to 8 years. Information on neonatal seizures, epilepsy...

  6. Epileptic seizure as the first sign of hypoparathyroidism

    Directory of Open Access Journals (Sweden)

    Pešić Milica


    Full Text Available Background. Hypoparathyroidism refers to a group of disorders in which extracellular calcium levels cannot be maintained within the normal range due to relative or absolute deficiency of parathyroid hormone (PTH. The clinical features of hypoparathyroidism are consistent with hypocalcaemia and, predominantly, neuromuscular dysfunction. Although hypocalcaemia-induced seizures are well documented hypoparathyroidism-induced epilepsy is often misdiagnosed as idiopathic epilepsy. Case report. We reported a 57-year-old woman with new-onset seizure due to hypoparathyroidism. At first, diagnosis of epilepsy was established and the antiepileptic therapy was initiated with gradual increase of the dose. Computerized tomography scan of the head revealed bilateral basal ganglia and cerebellar calcification and many punctiform calcifications between cortical and subcortical parts. During hospitalization, laboratory tests showed hypocalcemia, hyperphosphatemia and low PTH level. Once the diagnosis of hypoparathyroidism was established, a proper treatment with calcium and vitamin D was started, and the patient was discharged from hospital with full seizure control. Conclusion. Standard evaluation of serum calcium levels in patients with new-onset epileptic seizures should be obligatory part of a diagnostic algoritam to avoid misdiagnosis of idiopathic epilepsy.

  7. Electroconvulsive Therapy In Neuropsychiatry : Relevance Of Seizure Parameters

    Directory of Open Access Journals (Sweden)

    Gangadhar BN


    Full Text Available Electroconvulsive therapy (ECT is used to induce therapeutic seizures in various clinical conditions. It is specifically useful in depression, catatonia, patients with high suicidal risk, and those intolerant to drugs. Its beneficial effects surpass its side effects. Memory impairment is benign and transient. Its mechanism of action is unknown, though numerous neurotransmitters and neuroreceptors have been implicated. The standards of ECT practice are well established but still evolving in some particularly in unilateral ECT. Assessment of threshold by formula method may deliver higher stimulus dose compared with titration method. Cerebral seizure during ECT procedure is necessary. Motor (cuff method and EEG seizure monitoring are mandatory. Recent studies have shown some EEG parameters (amplitude, fractal dimension, symmetry, and post ictal suppression to be associated with therapeutic outcome. Besides seizure monitoring, measuring other physiological parameters such as heart rate (HR and blood pressure (BP may be useful indicators of therapeutic response. Use of ECT in neurological conditions as well as its application in psychiatric illnesses associated with neurological disorders has also been reviewed briefly.

  8. Chernobyl catastrophe: Information for people living in the contaminated areas

    International Nuclear Information System (INIS)

    Borisevich, Nikolaj


    The radioactive blow-outs after the Chernobyl Nuclear Power Plant catastrophe reached many states. The largest amount of them (according to experts' estimations - 70%) fell out on the Belarus territory. The estimation of radioecological, medico-biological, economic and social consequences of the Chernobyl catastrophe has shown that unimaginable damage was incurred on Belarus and its territory became the zone of ecological calamity. More than 14 years have passed since the Chernobyl NPP accident but some of the problems caused by the catastrophe have not been solved. This is bound up, first of all, with a high collective dosage absorbed by the population, with difficulties in forecasting and prophylactics of remote radiological effects, with ecological and economic crisis. The consequences of the disaster greatly affect all the aspects of vital activities of the affected regions and the state as a whole. Destructive tendencies have been revealed in all spheres of the life activity of people who experienced radiation effects. The processes of social adaptation and socio-psychological support of the population inhabiting the contaminated territory and resettled as well, require considerable optimisation. Negative factors of the Chernobyl catastrophe, which are significant for human health can be divided into two groups as follows: radiation-based, directly related to influence of ionising radiation and non radiation based, related to changes in habitat and prolonged psychological stress. The specific peculiarities of psychogenic disorders caused by the catastrophe are determined by the following reasons: insufficient knowledge of radiation effects; constant apprehension for the health and well-being of themselves and their families, especially children; unexpected change of the life stereotype (forced resettlement, the break of the former life, changing the place and the character of work, etc.); the necessity of constant keeping precaution measures and prophylactic

  9. The role of the basal ganglia in the control of seizure. (United States)

    Vuong, J; Devergnas, Annaelle


    Epilepsy is a network disorder and each type of seizure involves distinct cortical and subcortical network, differently implicated in the control and propagation of the ictal activity. The role of the basal ganglia has been revealed in several cases of focal and generalized seizures. Here, we review the data that show the implication of the basal ganglia in absence, temporal lobe, and neocortical seizures in animal models (rodent, cat, and non-human primate) and in human. Based on these results and the advancement of deep brain stimulation for Parkinson's disease, basal ganglia neuromodulation has been tested with some success that can be equally seen as promising or disappointing. The effect of deep brain stimulation can be considered promising with a 76% in seizure reduction in temporal lobe epilepsy patients, but also disappointing, since only few patients have become seizure free and the antiepileptic effects have been highly variable among patients. This variability could probably be explained by the heterogeneity among the patients included in these clinical studies. To illustrate the importance of specific network identification, electrophysiological activity of the putamen and caudate nucleus has been recorded during penicillin-induced pre-frontal and motor seizures in one monkey. While an increase of the firing rate was found in putamen and caudate nucleus during pre-frontal seizures, only the activity of the putamen cells was increased during motor seizures. These preliminary results demonstrate the implication of the basal ganglia in two types of neocortical seizures and the necessity of studying the network to identify the important nodes implicated in the propagation and control of each type of seizure.

  10. Nonlinear analysis of EEG for epileptic seizures

    Energy Technology Data Exchange (ETDEWEB)

    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.


    Directory of Open Access Journals (Sweden)

    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.

  12. Treatment of refractory neonatal seizures with topiramate. (United States)

    Riesgo, Rudimar; Winckler, Maria Isabel; Ohlweiler, Lygia; Ranzan, Josiane; Becker, Michele; Salvador, Socrates; Magalhaes, Luiza; Ribeiro, Ricardo


    The objective of this study is to describe the usefulness of topiramate in refractory neonatal seizures. We reported the clinical off-label use of topiramate in three cases of refractory neonatal seizures of unclear origin with no response to conventional antiepileptic drugs. In all cases, the seizures were completely controlled with adding topiramate. All patients became seizure free during hospitalization and were followed by approximately 1 year after hospital discharge, with monotherapy with topiramate. The clinical off-label use of topiramate in neonatal seizures is still incipient. When searching publications in this matter, only one report was identified. Because of its efficacy for both seizures and neuroprotection, topiramate could be a useful choice in refractory neonatal seizures. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  13. Ruminative and catastrophizing cognitive styles mediate the association between daily hassles and high anxiety in Hong Kong adolescents. (United States)

    Chan, Siu Mui; Chan, Sau Kam; Kwok, Wai Wai


    This study assessed rumination, catastrophizing and daily hassles as predictors of anxiety when controlling for depressive symptoms in a community sample of adolescents reporting high anxiety. Adolescents aged 12-18 (N = 2,802, mean age of 14.9) completed the Screen For Child Anxiety-Related Emotional Disorders. With a total score of 30 as the cutoff, a group of high anxiety adolescents was identified (a prevalence rate of 28.02%). Path analyses results showed that amongst the high anxiety boys, catastrophizing but not rumination was a positive predictor of anxiety and it mediated the effects of daily hassles on anxiety. In the high anxiety girls, both rumination and catastrophizing predicted anxiety but only catastrophizing was the mediator between daily hassles and anxiety. It is suggested that such gender differences in cognitive responses styles should be considered in cognitive-behavioral therapeutic approaches designed to help adolescents showing high anxiety.

  14. Personality and Temperament Correlates of Pain Catastrophizing in Young Adolescents (United States)

    Muris, Peter; Meesters, Cor; van den Hout, Anja; Wessels, Sylvia; Franken, Ingmar; Rassin, Eric


    Pain catastrophizing is generally viewed as an important cognitive factor underlying chronic pain. The present study examined personality and temperament correlates of pain catastrophizing in a sample of young adolescents (N = 132). Participants completed the Pain Catastrophizing Scale for Children, as well as scales for measuring sensitivity of…

  15. Axial and focal-plane diffraction catastrophe integrals

    International Nuclear Information System (INIS)

    Berry, M V; Howls, C J


    Exact expressions in terms of Bessel functions are found for some of the diffraction catastrophe integrals that decorate caustics in optics and mechanics. These are the axial and focal-plane sections of the elliptic and hyperbolic umbilic diffraction catastrophes, and symmetric elliptic and hyperbolic unfoldings of the X 9 diffraction catastrophes. These representations reveal unexpected relations between the integrals.

  16. Market Dynamics and Optimal Timber Salvage After a Natural Catastrophe (United States)

    Jeffrey P. Prestemon; Thomas P. Holmes


    Forest-based natural catastrophes are regular features of timber production in the United States, especially from hurricanes, fires, and insect and disease outbreaks. These catastrophes affect timber prices and result in economic transfers. We develop a model of timber market dynamics after such a catastrophe that shows how timber salvage affects the welfare of...

  17. Seizure characteristics of epilepsy in childhood after acute encephalopathy with biphasic seizures and late reduced diffusion. (United States)

    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

  18. Ictal speech and language dysfunction in adult epilepsy: Clinical study of 95 seizures. (United States)

    Dussaule, C; Cauquil, C; Flamand-Roze, C; Gagnepain, J-P; Bouilleret, V; Denier, C; Masnou, P


    To analyze the semiological characteristics of the language and speech disorders arising during epileptic seizures, and to describe the patterns of language and speech disorders that can predict laterality of the epileptic focus. This study retrospectively analyzed 95 consecutive videos of seizures with language and/or speech disorders in 44 patients admitted for diagnostic video-EEG monitoring. Laterality of the epileptic focus was defined according to electro-clinical correlation studies and structural and functional neuroimaging findings. Language and speech disorders were analyzed by a neurologist and a speech therapist blinded to these data. Language and/or speech disorders were subdivided into eight dynamic patterns: pure anterior aphasia; anterior aphasia and vocal; anterior aphasia and "arthria"; pure posterior aphasia; posterior aphasia and vocal; pure vocal; vocal and arthria; and pure arthria. The epileptic focus was in the left hemisphere in more than 4/5 of seizures presenting with pure anterior aphasia or pure posterior aphasia patterns, while discharges originated in the right hemisphere in almost 2/3 of seizures presenting with a pure vocal pattern. No laterality value was found for the other patterns. Classification of the language and speech disorders arising during epileptic seizures into dynamic patterns may be useful for the optimal analysis of anatomo-electro-clinical correlations. In addition, our research has led to the development of standardized tests for analyses of language and speech disorders arising during seizures that can be conducted during video-EEG sessions. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  19. Smartphone applications for seizure management. (United States)

    Pandher, Puneet Singh; Bhullar, Karamdeep Kaur


    Technological advancements continue to provide innovative ways of enhancing patient care in medicine. In particular, the growing popularity of smartphone technology has seen the recent emergence of a myriad of healthcare applications (or apps) that promise to help shape the way in which health information is delivered to people worldwide. While limited research already exists on a range of such apps, our study is the first to examine the salient features of smartphone applications as they apply to the area of seizure management. For the purposes of this review, we conducted a search of the official online application stores of the five major smartphone platforms: iPhone, Android, Blackberry, Windows Mobile and Nokia-Symbian. Apps were included if they reported to contain some information or tools relating to seizure management and excluded if they were aimed exclusively at health professionals. A total of 28 applications met these criteria. Overall, we found an increasing number of epilepsy apps available on the smartphone market, but with only a minority offering comprehensive educational information alongside tools such as seizure diaries, medication tracking and/or video recording. © The Author(s) 2014.

  20. The chemical induction of seizures in psychiatric therapy: were flurothyl (indoklon) and pentylenetetrazol (metrazol) abandoned prematurely? (United States)

    Cooper, Kathryn; Fink, Max


    Camphor-induced and pentylenetetrazol-induced brain seizures were first used to relieve psychiatric illnesses in 1934. Electrical inductions (electroconvulsive therapy, ECT) followed in 1938. These were easier and less expensive to administer and quickly became the main treatment method. In 1957, seizure induction with the inhalant anesthetic flurothyl was tested and found to be clinically effective.For many decades, complaints of memory loss have stigmatized and inhibited ECT use. Many variations of electricity in form, electrode placement, dosing, and stimulation method offered some relief, but complaints still limit its use. The experience with chemical inductions of seizures was reviewed based on searches for reports of each agent in Medline and in the archival files of original studies by the early investigators. Camphor injections were inefficient and were rapidly replaced by pentylenetetrazol. These were effective but difficult to administer. Flurothyl inhalation-induced seizures were as clinically effective as electrical inductions with lesser effects on memory functions. Flurothyl inductions were discarded because of the persistence of the ethereal aroma and the fears induced in the professional staff that they might seize. Persistent complaints of memory loss plague electricity induced seizures. Flurothyl induced seizures are clinically as effective without the memory effects associated with electricity. Reexamination of seizure inductions using flurothyl in modern anesthesia facilities is encouraged to relieve medication-resistant patients with mood disorders and catatonia.

  1. Diagnosis and management of catastrophic antiphospholipid syndrome. (United States)

    Carmi, Or; Berla, Maya; Shoenfeld, Yehuda; Levy, Yair


    Catastrophic antiphospholipid syndrome (CAPS) is a rare, life-threatening disease. In 1992, Asherson defined it as a widespread coagulopathy related to the antiphospholipid antibodies (aPL). CAPS requires rapid diagnosis and prompt initiation of treatment. Areas covered: This paper discusses all aspects of CAPS, including its pathophysiology, clinical manifestations, diagnostic approaches, differential diagnoses, management and treatment of relapsing CAPS, and its prognosis. To obtain the information used in this review, scientific databases were searched using the key words antiphospholipid antibodies, catastrophic antiphospholipid syndrome, hemolytic anemia, lupus anticoagulant, and thrombotic microangiopathic hemolytic anemia. Expert commentary: CAPS is a rare variant of the antiphospholipid syndrome (APS). It is characterized by thrombosis in multiple organs and a cytokine storm developing over a short period, with histopathologic evidence of multiple microthromboses, and laboratory confirmation of high aPL titers. This review discusses the diagnostic challenges and current approaches to the treatment of CAPS.

  2. Tackling The Global Challenge: Humanitarian Catastrophes

    Directory of Open Access Journals (Sweden)

    Kenneth V. Iserson


    Full Text Available “Humanitarian catastrophes,” conflicts and calamities generating both widespread human suffering and destructive events, require a wide range of emergency resources. This paper answers a number of questions that humanitarian catastrophes generate: Why and how do the most-developed countries—those with the resources, capabilities, and willingness to help—intervene in specific types of disasters? What ethical and legal guidelines shape our interventions? How well do we achieve our goals? It then suggests a number of changes to improve humanitarian responses, including better NGO-government cooperation, increased research on the best disaster response methods, clarification of the criteria and roles for humanitarian (military interventions, and development of post-2015 Millennium Development Goals with more accurate progress measures. [West J Emerg Med. 2014;15(2:231–240.

  3. Synchronizing Federal Operational Planning for National Catastrophes (United States)


    overwhelm human capacity. A developing genre is developing in the literature that advocates the shift from interagency planning to multi-sector...catastrophe absorbed these resources as if there was no end; everyone watched the response effort on TV and witnessed the level of confusion Katrina. Publius: The Journal of Federalism, 38 (4), 692–714. Bongar, B., Brown, L. M., Beutler, L. E., Breckenridge, J. N., & Zimbardo, P. G

  4. Catastrophe risks: the case of seisms


    Kast, Robert


    Catastrophes and risks have had a great influence on the evolution of human development. We analyze behaviors in front of risks, then we consider some basic principles that have guided private and public behaviors. Managing risks has become a specialty for finance and insurance, but they are not the only institutions that allow to confront them. We conclude on an example of how public funds, private insurance and reinsurance companies can work together and use financial markets...

  5. Epileptic Seizure, Postictal Hemiparesis, and Hyperleukocytosis (United States)

    Olivieri, Martin; Kurnik, Karin; Heinen, Florian; Schmid, Irene; Hoffmann, Florian; Reiter, Karl; Gerstl, Lucia


    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. PMID:28229095

  6. Epileptic Seizure, Postictal Hemiparesis, and Hyperleukocytosis

    Directory of Open Access Journals (Sweden)

    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.

  7. Assessing Anticonvulsant Effect of Aqueous Extract of Datura Stramonium Seed on PTZ-Induced Seizures in the Male Mice

    Directory of Open Access Journals (Sweden)

    S Namvar Aghdash


    Full Text Available Background: Epilepsy is one of the most common neurological disorders that affect social, economic and biological aspects of the human life. Many epileptic patients have uncontrolled seizures and medication-related side effects despite adequate pharmacological treatment. The use of plant extracts is proposed as a therapeutic modality in order to treat different diseases. Datura plant has long been used in the traditional medicine in regard with some nervous disorders like epilepsy. Thus, this study aimed to provide a scientific basis investigating the effect of Datura aqueous extract on PTZ-induced seizures in the male mice. Methods: In this experimental study, 40 male mice were randomly allocated into 5 equal groups including: one control group, one sham group and three experimental groups. The experimental groups received 50, 100 and 150 mg/kg of aqueous extract of Datura Stramonium seed via gavage for 30 days, and the sham group received stilled water via gavage. Pentylenetetrazol (PTZ 35 mg/kg, i.p were injected into control, sham and experimental groups 30 minutes after gavage in order to induce the seizure. Then latency time of seizure onset, seizure duration and seizure phases were measured and recorded in the experimental, sham and control groups. The data analysis was carried out via one way ANOVA and Tukey post-hoc tests.  Moreover, difference less than 0.05 (P<0.05 was considered significant. Results: The study findings revealed that the aqueous extract of Datura Stramonium seed produced a significant effect on PTZ-induced seizure. In addition, Datura increases latency time of seizure onset (P˂0.01, inhibits progress of seizure stages (P˂0.05 and decreases seizure duration (P˂0.001. Conclusion: The results obtained from the present study indicated that extract of this plant has anticonvulsant effects on PTZ-induced seizure. As a result, it seems to be beneficial to the epilepsy treatment.

  8. Catastrophic antiphospholipid syndrome and pregnancy. Clinical report. (United States)

    Khizroeva, J; Bitsadze, V; Makatsariya, A


    We have observed the development of a catastrophic antiphospholipid syndrome (CAPS) in a pregnant woman hospitalized at 28 weeks of gestation with a severe preeclampsia. On the same day, an eclampsia attack developed, and an emergency surgical delivery was performed. On the third day, multiorgan failure developed. Examination showed a persistent circulation of lupus anticoagulant, high level of antibodies to cardiolipin, b2-glycoprotein I, and prothrombin. The usual diagnosis of the severe preeclampsia masked a catastrophic antiphospholipid syndrome, exacerbated by the coincident presence of several types of antiphospholipid antibodies. The first pregnancy resulted in a premature birth at 25 weeks, possibly also due to the circulation of antiphospholipid antibodies. The trigger of the catastrophic form development was the pregnancy itself, surgical intervention, and hyperhomocysteinemia. CAPS is the most severe form of antiphospholipid syndrome, manifested in multiple microthrombosis of microcirculation of vital organs and in the development of multiorgan failure against the background of the high level of antiphospholipid antibodies. CAPS is characterized by renal, cerebral, gastrointestinal, adrenal, ovarian, skin, and other forms of microthrombosis. Thrombosis recurrence is typical. Thrombotic microvasculopathy lies at the heart of multiorgan failure and manifests clinically in central nervous system lesions, adrenal insufficiency, and ARDS development. CAPS is a life-threatening condition, therefore, requires an urgent treatment. Optimal treatment of CAPS is not developed. CAPS represent a general medical multidisciplinary problem.

  9. A critical look at catastrophe risk assessments

    CERN Document Server

    Kent, A


    Recent papers by Busza et al. (BJSW) and Dar et al. (DDH) argue that astrophysical data can be used to establish bounds on the risk of a catastrophe in forthcoming collider experiments. The safety case set out by BJSW does not rely on these bounds, but on theoretical arguments, which BJSW find sufficiently compelling. However, DDH and other commentators (initially including BJSW) have suggested that the astrophysical bounds alone do give sufficient reassurance. This seems unsupportable when the bounds are expressed in terms of expected cost. For example, DDH's main bound, $p_{\\rm catastrophe} < 2 \\times 10^{-8}$, implies only that the expectation value of the number of deaths is bounded by 120. We thus reappraise the DDH and BJSW risk bounds by comparing risk policy in other areas. We find that requiring a catastrophe risk of no higher than 10^{-15} is necessary to be consistent with established policy for risk optimisation from radiation hazards, even if highly risk tolerant assumptions are made. A respec...

  10. Performance studies – the theory of catastrophes?

    Directory of Open Access Journals (Sweden)

    Konrad Wojnowski


    Full Text Available The author of Performatyka – teoria katastrof? [“Performance studies – the theory of catastrophes?”], which is a cross-sectional investigation into performance studies, tracks the trains of thought about catastrophes in different theories of performativity, ranging from J. L. Austin’s to Jon McKenzie’s ideas. Of particular interest is how particular theoreticians integrate the term ‘catastrophe’ into their conceptual frameworks and how they evaluate it. By criticizing the approach taken by Judith Butler, who postulates “melancholic performance studies”, which brings to mind Adorno’s idea that is explicated in Minima Moralia (traurige Wissenschaft, the author tries to show how we can productively use Austin’s theses that are presented in the first chapters of his famous How to Do Things with Words. In the author’s opinion, Austin allows us to approach communicational catastrophes from a different perspective, which is often forgotten, i.e. of the functioning of contextual systems. It is shown that the tension between felicity and infelicity may be at the core of the popularity of performativity which is understood as a tool for researching contemporary cultural phenomena.

  11. Fitting the Cusp Catastrophe in R: A cusp Package Primer

    Directory of Open Access Journals (Sweden)

    Raoul P. P. P. Grasman


    Full Text Available Of the seven elementary catastrophes in catastrophe theory, the “cusp” model is the most widely applied. Most applications are however qualitative. Quantitative techniques for catastrophe modeling have been developed, but so far the limited availability of flexible software has hindered quantitative assessment. We present a package that implements and extends the method of Cobb (Cobb and Watson 1980; Cobb, Koppstein, and Chen 1983, and makes it easy to quantitatively fit and compare different cusp catastrophe models in a statistically principled way. After a short introduction to the cusp catastrophe, we demonstrate the package with two instructive examples.

  12. Seizures as an Atypical Feature of Beal’s Syndrome

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    Nazreen B. K. Jaman


    Full Text Available Congenital contractural arachnodactyly, commonly known as Beal’s syndrome, is an extremely rare genetic disorder caused by mutations in the fibrillin-2 (FBN2 gene located on chromosome 5q23. It is an autosomal dominant inherited connective tissue disorder characterised by a Marfan-like body habitus, contractures, abnormally shaped ears and kyphoscoliosis. We report a seven-year-old Omani male who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in 2014 with seizures. He was noted to have certain distinctive facial features and musculoskeletal manifestations; he was subsequently diagnosed with Beal’s syndrome. Sequencing of the FBN2 gene revealed that the patient had a novel mutation which was also present in his mother; however, she had only a few facial features indicative of Beal’s syndrome and no systemic involvement apart from a history of childhood seizures. To the best of the authors’ knowledge, this is the first report of Beal’s syndrome with seizure symptoms as a potential feature.

  13. Orexin Receptor Antagonism Improves Sleep and Reduces Seizures in Kcna1-null Mice. (United States)

    Roundtree, Harrison M; Simeone, Timothy A; Johnson, Chaz; Matthews, Stephanie A; Samson, Kaeli K; Simeone, Kristina A


    Comorbid sleep disorders occur in approximately one-third of people with epilepsy. Seizures and sleep disorders have an interdependent relationship where the occurrence of one can exacerbate the other. Orexin, a wake-promoting neuropeptide, is associated with sleep disorder symptoms. Here, we tested the hypothesis that orexin dysregulation plays a role in the comorbid sleep disorder symptoms in the Kcna1-null mouse model of temporal lobe epilepsy. Rest-activity was assessed using infrared beam actigraphy. Sleep architecture and seizures were assessed using continuous video-electroencephalography-electromyography recordings in Kcna1-null mice treated with vehicle or the dual orexin receptor antagonist, almorexant (100 mg/kg, intraperitoneally). Orexin levels in the lateral hypothalamus/perifornical region (LH/P) and hypothalamic pathology were assessed with immunohistochemistry and oxygen polarography. Kcna1-null mice have increased latency to rapid eye movement (REM) sleep onset, sleep fragmentation, and number of wake epochs. The numbers of REM and non-REM (NREM) sleep epochs are significantly reduced in Kcna1-null mice. Severe seizures propagate to the wake-promoting LH/P where injury is apparent (indicated by astrogliosis, blood-brain barrier permeability, and impaired mitochondrial function). The number of orexin-positive neurons is increased in the LH/P compared to wild-type LH/P. Treatment with a dual orexin receptor antagonist significantly increases the number and duration of NREM sleep epochs and reduces the latency to REM sleep onset. Further, almorexant treatment reduces the incidence of severe seizures and overall seizure burden. Interestingly, we report a significant positive correlation between latency to REM onset and seizure burden in Kcna1-null mice. Dual orexin receptor antagonists may be an effective sleeping aid in epilepsy, and warrants further study on their somnogenic and ant-seizure effects in other epilepsy models. © 2016 Associated

  14. Catastrophe theory and its application status in mechanical engineering

    Directory of Open Access Journals (Sweden)

    Jinge LIU

    Full Text Available Catastrophe theory is a kind of mathematical method which aims to apply and interpret the discontinuous phenomenon. Since its emergence, it has been widely used to explain a variety of emergent phenomena in the fields of natural science, social science, management science and some other science and technology fields. Firstly, this paper introduces the theory of catastrophe in several aspects, such as its generation, radical principle, basic characteristics and development. Secondly, it summarizes the main applications of catastrophe theory in the field of mechanical engineering, focusing on the research progress of catastrophe theory in revealing catastrophe of rotor vibration state, analyzing friction and wear failure, predicting metal fracture, and so on. Finally, it advises that later development of catastrophe theory should pay more attention to the combination of itself with other traditional nonlinear theories and methods. This paper provides a beneficial reference to guide the application of catastrophe theory in mechanical engineering and related fields for later research.

  15. Catastrophizing and poor sleep quality in early adolescent females. (United States)

    Noone, Deirdre M; Willis, Thomas A; Cox, Jenny; Harkness, Frances; Ogilvie, Jayne; Forbes, Erika; Sterr, Annette; Gregory, Alice M


    Catastrophizing about sleeplessness has been investigated in adults and children, but little is known about adolescents. This article aimed to (a) investigate whether early adolescent girls catastrophized about consequences of sleeplessness, (b) describe topics in catastrophizing sequences, (c) examine the association between sleep quality and catastrophizing, and (d) assess whether puberty moderated this association. Girls (n = 115) between 11 and 12 years old completed adapted versions of the Pittsburgh Sleep Quality Index, the Pubertal Developmental Scale, and the Catastrophizing Interview. Twenty-four (21%) participants produced catastrophizing sequences, including concerns about school and mood. Sleep quality was associated with catastrophizing (β = 0.19, p = .042); however, puberty did not moderate this association (β = 0.15, p = .126). Findings highlight the importance of sleep-related cognitions in adolescent girls.

  16. Propofol anaesthesia in electroconvulsive therapy. Reduced seizure duration may not be relevant. (United States)

    Fear, C F; Littlejohns, C S; Rouse, E; McQuail, P


    The induction agent propofol is known to reduce electroconvulsive therapy (ECT) seizure duration. It is assumed that outcome from depression is adversely affected by this agent. This study compares propofol and methohexitone as induction agents for ECT. In a prospective, randomised, double-blind study 20 subjects with major depressive disorder (DSM-III-R criteria) received propofol or methohexitone anaesthesia. The Hamilton Depression Rating Scale and Beck Depression Inventory were used to assess depression before therapy, at every third treatment, and at the end of therapy. Seizure duration was measured using the cuff technique. Mean seizure durations (P < 0.01) and mean total seizure duration (P < 0.01) were shorter in the propofol group. There was no difference in outcome. Use of propofol may not adversely affect outcome from depression and it is not necessarily contraindicated as an induction agent for ECT. Our results should be interpreted cautiously, and larger studies are needed.

  17. Marked Seizure Reduction after MCT Supplementation

    Directory of Open Access Journals (Sweden)

    Raed Azzam


    Full Text Available We report the case of a 43-year-old man with history of nonsurgical partial epilepsy who previously failed multiple trials of antiepileptic drugs. Medium-chain triglycerides (MCT were added to his regular diet in the form of pure oil. Subsequently, his seizure frequency was markedly reduced from multiple daily seizures to one seizure every four days. His seizures recurred after transient discontinuation of MCT over a period of ten days. His seizure improvement was achieved at a dose of four tablespoons of MCT twice daily with no reported side effects. He developed significant diarrhea and flatulence at higher doses. We conclude that MCT oil supplementation to regular diet may provide better seizure control in some patients. MCT oil supplementation may be a more tolerable alternative to the standard ketogenic diet.

  18. Role of neuroimaging in first seizure diagnosis. (United States)

    Crocker, Candice E; Pohlmann-Eden, Bernhard; Schmidt, Matthias H


    The primary goal of neuroimaging in a first, unprovoked seizure is to identify a lesion that can explain the seizure. Secondarily, neuroimaging may be used to predict seizure recurrence and assist with the diagnosis of epilepsy. However, the events leading from a first seizure to epilepsy, with or without an identifiable epileptogenic lesion, are not well understood, and it is not always clear which lesions are epileptogenic as opposed to incidental. Much neuroimaging research to date has focused on findings in chronic epilepsy, rather than first seizure. Dedicated epilepsy imaging with high quality MRI protocols maximizes the likelihood of a diagnosis. However, a significant proportion of patients are MRI-negative, prompting researchers in the field to continue the search for better imaging strategies. Here we describe the role of neuroimaging in the assessment of a first seizure, the current state of the art and possible future directions. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  19. Mask ventilation, hypocapnia, and seizure duration in electroconvulsive therapy. (United States)

    Choukalas, Christopher G; Walter, James; Glick, David; O'Connor, Michael F; Tung, Avery; Dinwiddie, Stephen H; Nunnally, Mark E


    To compare the Mapleson D circuit and the bag-valve-mask device for mask ventilation of patients undergoing electroconvulsive therapy (ECT). Cross-over study. Single-center academic medical center. 18 patients undergoing ECT for major depressive disorder. Patients were randomized to undergo mask ventilation by the Mapleson D circuit or the bag-valve-mask device. End-tidal CO(2), seizure duration, and airway pressure values were recorded. End-tidal CO(2) was significantly lower with the bag-valve-mask device. When compared with the bag-valve-mask device, ventilation with the Mapleson circuit resulted in rebreathing of CO(2) in nearly all patients, shorter expiratory time, and lower pressure ramp slope. Hypocapnia was not associated with longer seizures, and the user-device interaction might affect device performance. Copyright © 2010 Elsevier Inc. All rights reserved.

  20. Epileptic Seizures from Abnormal Networks: Why Some Seizures Defy Predictability (United States)


    P. Kudela), (G.K. Bergey ), (P.J. Franaszczuk). 1 Tel.: +1 443 287 4561; fax: +1 443 287 6423. 2 Tel.: +1 443 287...cle can be found, in the online version, at doi:10.1016/j.eplepsyres.2011.11.006. References Afra, P., Jouny, C.C., Bergey , G.K., 2008. Duration of...complex partial seizures: an intracranial EEG study. Epilepsia 49 (4), 677—684. Anderson, W.S., Kudela, P., Cho, R.J., Bergey , G.K., Franaszczuk, P., 2007

  1. A machine learning system for automated whole-brain seizure detection

    Directory of Open Access Journals (Sweden)

    P. Fergus


    Full Text Available Epilepsy is a chronic neurological condition that affects approximately 70 million people worldwide. Characterised by sudden bursts of excess electricity in the brain, manifesting as seizures, epilepsy is still not well understood when compared with other neurological disorders. Seizures often happen unexpectedly and attempting to predict them has been a research topic for the last 30 years. Electroencephalograms have been integral to these studies, as the recordings that they produce can capture the brain’s electrical signals. The diagnosis of epilepsy is usually made by a neurologist, but can be difficult to make in the early stages. Supporting para-clinical evidence obtained from magnetic resonance imaging and electroencephalography may enable clinicians to make a diagnosis of epilepsy and instigate treatment earlier. However, electroencephalogram capture and interpretation is time consuming and can be expensive due to the need for trained specialists to perform the interpretation. Automated detection of correlates of seizure activity generalised across different regions of the brain and across multiple subjects may be a solution. This paper explores this idea further and presents a supervised machine learning approach that classifies seizure and non-seizure records using an open dataset containing 342 records (171 seizures and 171 non-seizures. Our approach posits a new method for generalising seizure detection across different subjects without prior knowledge about the focal point of seizures. Our results show an improvement on existing studies with 88% for sensitivity, 88% for specificity and 93% for the area under the curve, with a 12% global error, using the k-NN classifier.

  2. Anticonvulsant activity of B2, an adenosine analog, on chemical convulsant-induced seizures.

    Directory of Open Access Journals (Sweden)

    Min Li

    Full Text Available Epilepsy is a chronic neurological disorder characterized by recurrent seizures. However, approximately one-third of epilepsy patients still suffer from uncontrolled seizures. Effective treatments for epilepsy are yet to be developed. N (6-(3-methoxyl-4-hydroxybenzyl adenine riboside (B2 is a N(6-substitued adenosine analog. Here we describe an investigation of the effects and mechanisms of B2 on chemical convulsant-induced seizures. Seizures were induced in mice by administration of 4-aminopyridine (4-AP, pentylenetetrazol (PTZ, picrotoxin, kainite acid (KA, or strychnine. B2 has a dose-related anticonvulsant effect in these chemical-induced seizure models. The protective effects of B2 include increased latency of seizure onset, decreased seizure occurrence, shorter seizure duration and reduced mortality rate. Radioligand binding and cAMP accumulation assays indicated that B2 might be a functional ligand for both adenosine A1 and A2A receptors. Furthermore, DPCPX, a selective A1 receptor antagonist, but not SCH58261, a selective A2A receptor antagonist, blocked the anticonvulsant effect of B2 on PTZ-induced seizure. c-Fos is a cellular marker for neuronal activity. Immunohistochemical and western blot analyses indicated that B2 significantly reversed PTZ-induced c-Fos expression in the hippocampus. Together, these results indicate that B2 has significant anticonvulsant effects. The anticonvulsant effects of B2 may be attributed to adenosine A1 receptor activation and reduced neuronal excitability in the hippocampus. These observations also support that the use of adenosine receptor agonist may be a promising approach for the treatment of epilepsy.

  3. Prenuptial seizures: a report of five cases. (United States)

    McConnell, H; Valeriano, J; Brillman, J


    The cases of 5 patients with seizures occurring the day of or shortly before their weddings are presented. Major life events may precipitate or exacerbate epileptic or nonepileptic seizures as a result of 1) missed medications, 2) sleep deprivation, 3) alcohol or concomitant medications, 4) hyperventilation, or 5) the emotional state directly or stress indirectly. Seizures occurring at times of psychological stress may be either neurological or psychiatric in origin. The physician treating patients with a new onset or exacerbation of seizures around a major life event must consider all of these factors in the evaluation.

  4. "But it might be a heart attack" : intolerance of uncertainty and panic disorder symptoms

    NARCIS (Netherlands)

    Carleton, R Nicholas; Duranceau, Sophie; Freeston, Mark H; Boelen, Paul A|info:eu-repo/dai/nl/174011954; McCabe, Randi E; Antony, Martin M

    Panic disorder models describe interactions between feared anxiety-related physical sensations (i.e., anxiety sensitivity; AS) and catastrophic interpretations therein. Intolerance of uncertainty (IU) has been implicated as necessary for catastrophic interpretations in community samples. The current

  5. Deep Recurrent Neural Networks for seizure detection and early seizure detection systems

    Energy Technology Data Exchange (ETDEWEB)

    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.

  6. Magnetic Seizure Therapy for Unipolar and Bipolar Depression: A Systematic Review


    Cretaz, Eric; Brunoni, Andr? R.; Lafer, Beny


    Objective. Magnetic seizure therapy (MST) is a novel, experimental therapeutic intervention, which combines therapeutic aspects of electroconvulsive therapy (ECT) and transcranial magnetic stimulation, in order to achieve the efficacy of the former with the safety of the latter. MST might prove to be a valuable tool in the treatment of mood disorders, such as major depressive disorder (MDD) and bipolar disorder. Our aim is to r...

  7. Unravelling the Relationship Between Parent and Child PTSD and Pediatric Chronic Pain: the Mediating Role of Pain Catastrophizing. (United States)

    Neville, Alexandra; Soltani, Sabine; Pavlova, Maria; Noel, Melanie


    Clinically elevated rates of post-traumatic stress disorder (PTSD) symptoms are found among many youth with chronic pain and their parents and are linked to worse child pain outcomes. Conceptual models of mutual maintenance in pediatric PTSD and chronic pain posit that child and parent pain catastrophizing are key mechanisms underlying this co-occurrence. To our knowledge, the current study is the first to examine child and parent pain catastrophizing as potential mediators in the child PTSD-child pain and parent PTSD-child pain relationships among a cohort of youth with chronic pain. One hundred two children (72.5% female, mean age=13.5 years), recruited from a tertiary level chronic pain program, and 1 of their parents participated. At intake, parents completed psychometrically sound self-report measures of PTSD symptoms and catastrophizing about child pain. Children completed self-report measures of PTSD symptoms, pain catastrophizing, pain interference, and pain intensity. Findings revealed that relationships between child PTSD and child pain as well as parent PTSD and child pain were mediated by child (but not parent) pain catastrophizing. This suggests that children's catastrophic thinking about pain may explain how child and parent PTSD symptoms influence children's experience of chronic pain and is a potential target in family-based interventions to improve pain and mental health outcomes. Consistent with conceptual models of co-occurring PTSD and chronic pain, children's catastrophic thinking about child pain mediated relationships between parent and child PTSD symptoms and child chronic pain outcomes. Child pain catastrophizing may be a fruitful target in interventions to improve children's chronic pain and mental health outcomes. Copyright © 2017 The American Pain Society. Published by Elsevier Inc. All rights reserved.

  8. Catastrophic winter storms. An escalating problem

    Energy Technology Data Exchange (ETDEWEB)

    Changnon, S.A. [Changnon Climatologist, Mahomet, IL 61853 (United States)


    Winter storms are a major weather problem in the USA and their losses have been rapidly increasing. A total of 202 catastrophic winter storms, each causing more than $1 million in damages, occurred during 1949-2003, and their losses totaled $35.2 billion (2003 dollars). Catastrophic winter storms occurred in most parts of the contiguous USA, but were concentrated in the eastern half of the nation where 88% of all storm losses occurred. They were most frequent in the Northeast climate district (95 storms), and were least frequent in the West district (14 catastrophic storms). The annual average number of storms is 3.7 with a 1-year high of 9 storms, and 1 year had no storms. Temporal distributions of storms and their losses exhibited considerable spatial variability across the nation. For example, when storms were very frequent in the Northeast, they were infrequent elsewhere, a result of spatial differences in storm-producing synoptic weather conditions over time. The time distribution of the nation's 202 storms during 1949-2003 had a sizable downward trend, whereas the nation's storm losses had a major upward trend for the 55-year period. This increase over time in losses, given the decrease in storm incidences, was a result of significant temporal increases in storm sizes and storm intensities. Increases in storm intensities were small in the northern sections of the nation, but doubled across the southern two-thirds of the nation, reflecting a climatic shift in conditions producing intense winter storms.

  9. Soy infant formula and seizures in children with autism: a retrospective study.

    Directory of Open Access Journals (Sweden)

    Cara J Westmark

    Full Text Available Seizures are a common phenotype in many neurodevelopmental disorders including fragile X syndrome, Down syndrome and autism. We hypothesized that phytoestrogens in soy-based infant formula were contributing to lower seizure threshold in these disorders. Herein, we evaluated the dependence of seizure incidence on infant formula in a population of autistic children. Medical record data were obtained on 1,949 autistic children from the SFARI Simplex Collection. An autism diagnosis was determined by scores on the ADI-R and ADOS exams. The database included data on infant formula use, seizure incidence, the specific type of seizure exhibited and IQ. Soy-based formula was utilized in 17.5% of the study population. Females comprised 13.4% of the subjects. There was a 2.6-fold higher rate of febrile seizures [4.2% versus 1.6%, OR = 2.6, 95% CI = 1.3-5.3], a 2.1-fold higher rate of epilepsy comorbidity [3.6% versus 1.7%, OR = 2.2, 95% CI = 1.1-4.7] and a 4-fold higher rate of simple partial seizures [1.2% versus 0.3%, OR = 4.8, 95% CI = 1.0-23] in the autistic children fed soy-based formula. No statistically significant associations were found with other outcomes including: IQ, age of seizure onset, infantile spasms and atonic, generalized tonic clonic, absence and complex partial seizures. Limitations of the study included: infant formula and seizure data were based on parental recall, there were significantly less female subjects, and there was lack of data regarding critical confounders such as the reasons the subjects used soy formula, age at which soy formula was initiated and the length of time on soy formula. Despite these limitations, our results suggest that the use of soy-based infant formula may be associated with febrile seizures in both genders and with a diagnosis of epilepsy in males in autistic children. Given the lack of data on critical confounders and the retrospective nature of the study, a prospective study is

  10. Contribution of catastrophizing to disability and pain intensity after osteoporotic vertebral compression fracture. (United States)

    Kim, Ho-Joong; Kim, Yun-Ho; Kang, Kyoung-Tak; Chang, Bong-Soon; Lee, Choon-Ki; Yeom, Jin S


    Pain catastrophizing is a key variable that contributes to disability not only in chronic pain disorders but also after trauma. However, there is little evidence concerning the effect of catastrophizing on pain intensity and disability after osteoporotic vertebral compression fracture. Therefore, the purpose of this study was to evaluate the contribution of catastrophizing to disability and pain intensity after osteoporotic vertebral compression fracture. We analyzed 35 patients with acute single-level osteoporotic vertebral compression fractures within 3 days of trauma. Data on demographics, education level, Charlson comorbidity index, pain catastrophizing scale (PCS) score, visual analog scale (VAS) score for back pain, and Oswestry Disability Index (ODI) were collected. VAS score for back pain and ODI were assessed at enrollment as well as at 2, 6, and 12 weeks after fracture. Each VAS score for back pain and ODI significantly improved compared to the initial values (P osteoporotic vertebral compression fracture. As the compression fracture heals, however, age is the critical determinant of disability. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  11. Astrophysics: is a doomsday catastrophe likely? (United States)

    Tegmark, Max; Bostrom, Nick


    The risk of a doomsday scenario in which high-energy physics experiments trigger the destruction of the Earth has been estimated to be minuscule. But this may give a false sense of security: the fact that the Earth has survived for so long does not necessarily mean that such disasters are unlikely, because observers are, by definition, in places that have avoided destruction. Here we derive a new upper bound of one per billion years (99.9% confidence level) for the exogenous terminal-catastrophe rate that is free of such selection bias, using calculations based on the relatively late formation time of Earth.

  12. Seizures (United States)

    ... the attack, such as: Fear or anxiety Nausea Vertigo (feeling as if you are spinning or moving) ... body due to liver or kidney failure Very high blood pressure ( malignant hypertension ) Venomous bites and stings ( snake bite ) ...


    Directory of Open Access Journals (Sweden)

    Chalapathi Rao


    Full Text Available BACKGROUND: Epilepsy is one of the most familiar neurological disorders which can cause bodily injury and death from inadequately treated or untreated cases. The imaging and EEG of new onset seizures is done with different indications, to identify an acute illness as the underline course for the seizure and possible neurological deficit. To this purpose we have evaluated new onset seizures in adult patients in correlation with their clinical profile, Electroencephalography (EEG and Computerized tomography (CT imaging of brain. METHODS: This cro ss sectional study was studied in 100 adult patients, presenting with seizures attending the Emergency department, General Medicine and Neurology wards and OPD of Tertiary care teaching hospital during the period of March 2006 to March 2008. All the patien ts were examined clinically and subjected to CT imaging of brain and EEG. Other necessary blood investigations were also done. Correlation between various seizures and CT scan brain and EEG were studied. Descriptive statistics were used to analyze the data . RESULTS: 63% of patients were in the age group of 20 - 39 years, 63% were males and 37% were females. 65% presented with GTCS, 35% with partial seizures. CT scan was found abnormal in 49.2% patients in GTCS, 71.4% in partial seizures. EEG showed abnormal p attern in 39% patients. 40% of the patients with partial seizures had epileptic form discharges. 33% patients had focal lesions on CT brain with normal EEG. CONCLUSION: Generalized Tonic clonic seizures were the commonest type of seizures was present, seen mostly in male patients. CT scan brain was abnormal in 57% of the patients. Neurocysticercosis and calcified granuloma were the commonest causes for seizures up to 3 rd decade of life. Majority of the patients with focal lesions on CT scan brain had epileptic form discharges on EEG which indicate a strong correlation of EEG with CT findings. Initiating the treatment with antiepileptic drugs was

  14. Evaluation of the Effect of Jobelyn® on Chemoconvulsants- Induced Seizure in Mice

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    Solomon Umukoro


    Full Text Available Introduction: Epilepsy is a common central nervous system (CNS disorder characterized by seizures resulting from episodic neuronal discharges. The incidence of toxicity and refractoriness has compromised the clinical efficacy of the drugs currently used for the treatment of convulsions. Thus, there is a need to search for new medicines from plant origin that are readily available and safer for the control of seizures. Jobelyn® (JB is a unique African polyherbal preparation used by the natives to treat seizures in children. This investigation was carried out to evaluate whether JB has anti-seizure property in mice. Methods: The animals received JB (5, 10 and 20 mg/kg, p.o 30 min before induction of convulsions with intraperitoneal (i.p. injection of picrotoxin (6 mg/kg, strychnine (2 mg/ kg and pentylenetetrazole (85 mg/kg respectively. Diazepam (2 mg/kg, p.o. was used as the reference drug. Anti-seizure activities were assessed based on the ability of test drugs to prevent convulsions, death or to delay the onset of seizures in mice. Results: JB (5, 10 and 20 mg/kg, p.o could only delay the onset of seizures induced by pentylenetetrazole (85 mg/kg, i.p. in mice. However, it did not offer any protection against seizure episodes, as it failed to prevent the animals, from exhibiting tonic-clonic convulsions caused by pentylenetetrazole (85 mg/kg, i.p., strychnine (2 mg/kg or picrotoxin (6 mg/kg, i.p.. On the other hand, diazepam (2 mg/kg, p.o., offered 100% protection against convulsive seizures, induced by pentylenetetrazole (85 mg/kg, i.p.. However, it failed to prevent seizures produced by strychnine (2 mg/kg, i.p. or picrotoxin (6 mg/kg, i.p.. Discussion: Our results suggest that JB could not prevent the examined chemoconvulsants-induced convulsions. However, its ability to delay the latency to seizures induced by pentylenetetrazole suggests that JB might be effective in the control of the seizure spread in epileptic brains.

  15. The effective connectivity of the seizure onset zone and ictal perfusion changes in amygdala kindled rhesus monkeys. (United States)

    Cleeren, Evy; Premereur, Elsie; Casteels, Cindy; Goffin, Karolien; Janssen, Peter; Van Paesschen, Wim


    Epileptic seizures are network-level phenomena. Hence, epilepsy may be regarded as a circuit-level disorder that cannot be understood outside this context. Better insight into the effective connectivity of the seizure onset zone and the manner in which seizure activity spreads could lead to specifically-tailored therapies for epilepsy. We applied the electrical amygdala kindling model in two rhesus monkeys until these animals displayed consistent stage IV seizures. At this stage, we investigated the effective connectivity of the amygdala by means of electrical microstimulation during fMRI (EM-fMRI). In addition, we imaged changes in perfusion during a seizure using ictal SPECT perfusion imaging. The spatial overlap between the connectivity network and the ictal perfusion network was assessed both at the regional level, by calculating Dice coefficients using anatomically defined regions of interest, and at the voxel level. The kindled amygdala was extensively connected to bilateral cortical and subcortical structures, which in many cases were connected multisynaptically to the amygdala. At the regional level, the spatial extents of many of these fMRI activations and deactivations corresponded to the respective increases and decreases in perfusion imaged during a stage IV seizure. At the voxel level, however, some regions showed residual seizure-specific activity (not overlapping with the EM-fMRI activations) or fMRI-specific activation (not overlapping with the ictal SPECT activations), indicating that frequently, only a part of a region anatomically connected to the seizure onset zone participated in seizure propagation. Thus, EM-fMRI in the amygdala of electrically-kindled monkeys reveals widespread areas that are often connected multisynaptically to the seizure focus. Seizure activity appears to spread, to a large extent, via these connected areas.

  16. Complex partial seizures: cerebellar metabolism

    Energy Technology Data Exchange (ETDEWEB)

    Theodore, W.H.; Fishbein, D.; Deitz, M.; Baldwin, P.


    We used positron emission tomography (PET) with (/sup 18/F)2-deoxyglucose to study cerebellar glucose metabolism (LCMRglu) and the effect of phenytoin (PHT) in 42 patients with complex partial seizures (CPS), and 12 normal controls. Mean +/- SD patient LCMRglu was 6.9 +/- 1.8 mg glucose/100 g/min (left = right), significantly lower than control values of 8.5 +/- 1.8 (left, p less than 0.006), and 8.3 +/- 1.6 (right, p less than 0.02). Only four patients had cerebellar atrophy on CT/MRI; cerebellar LCMRglu in these was 5.5 +/- 1.5 (p = 0.054 vs. total patient sample). Patients with unilateral temporal hypometabolism or EEG foci did not have lateralized cerebellar hypometabolism. Patients receiving phenytoin (PHT) at the time of scan and patients with less than 5 years total PHT exposure had lower LCMRglu, but the differences were not significant. There were weak inverse correlations between PHT level and cerebellar LCMRglu in patients receiving PHT (r = -0.36; 0.05 less than p less than 0.1), as well as between length of illness and LCMRglu (r = -0.22; 0.05 less than p less than 0.1). Patients with complex partial seizures have cerebellar hypometabolism that is bilateral and due only in part to the effect of PHT.

  17. De novo psychogenic seizures after epilepsy surgery: case report

    Directory of Open Access Journals (Sweden)



    Full Text Available The occurrence of de novo psychogenic seizures after epilepsy surgery is rare, and is estimated in 1.8% to 3.6%. Seizures after epilepsy surgery should be carefully evaluated, and de novo psychogenic seizures should be considered especially when there is a change in the ictal semiology. We report a patient with de novo psychogenic seizures after anterior temporal lobe removal for refractory temporal lobe epilepsy. Once psychogenic seizures were diagnosed and psychiatric treatment was started, seizures stopped.

  18. Bankruptcy by catastrophes for major multi-nationals : Stock exchange sensitivity for three catastrophes

    NARCIS (Netherlands)

    Van Gulijk, C.; Ale, B.J.M.


    This paper investigates the effect of major catastrophes have on stock exchange values for the major multi-nationals. The paper demonstrates that the Sharpe analysis is more sensitive in identifying effects than just following the daily stock values for assessing market response. It was found that

  19. Can developmental venous anomalies cause seizures? (United States)

    Dussaule, Claire; Masnou, Pascal; Nasser, Ghaïdaa; Archambaud, Frédérique; Cauquil-Michon, Cécile; Gagnepain, Jean-Paul; Bouilleret, Viviane; Denier, Christian


    Developmental venous anomalies (DVAs) are congenital anatomical variants of normal venous drainage of normal brain. Although DVAs are often discovered on the occasion of a seizure, their involvement in epilepsy is poorly studied. Our objective was to determine whether DVA can cause seizures, in the cases where there is no associated lesion, including no cavernoma or dysplasia. Based on clinical history, cerebral MRI, EEG recording, and 18 F-FDG PET, we report 4 patients with DVA revealed by seizures. The first patient had a convulsive seizure caused by a hemorrhagic infarction due to thrombosis of her DVA. The second patient had a left temporo-parietal DVA next to a nonspecific lesion, possibly a sequelae of a venous infarction. The last two patients disclosed an isolated and uncomplicated DVA with a concordant epileptic focus confirmed on ictal video EEG recording. We reviewed literature and identified 21 other published cases of seizures caused by complications of a DVA and 9 patients that may have a direct link between epilepsy and an isolated and uncomplicated DVA. Seizures are linked to a DVA in two main situations: presence of an associated epileptogenic lesion, such as cavernoma or dysplasia, and occurrence of a complication of the DVA. Before concluding that a seizure is caused by a DVA, it is essential to perform full MRI protocols to search them. It remains rare and uncertain that isolated and uncomplicated DVA can cause seizures. In this last situation, physiopathological processes are probably different in each patient.

  20. Seizures in adults with bacterial meningitis

    NARCIS (Netherlands)

    Zoons, E.; Weisfelt, M.; de Gans, J.; Spanjaard, L.; Koelman, J. H. T. M.; Reitsma, J. B.; van de Beek, D.


    Objective: To evaluate the occurrence and prognostic relevance of seizures in adults with community-acquired bacterial meningitis. Methods: An observational cross-sectional study, in which patients with seizures are selected from a prospective nationwide cohort of 696 episodes of community-acquired

  1. Seizure complicating interscalene brachail plexus block | Idehen ...

    African Journals Online (AJOL)

    We describe a case of seizure occurring immediately after completion of interscalene brachial plexus block, using 20mls mixture of 10mls of 0.5% bupivacaine and 10mls of 2% lidocaine with adrenaline for post operative analgesia. Seizure occurred despite negative test aspiration and non response to the use of 0.5mls of ...

  2. Alternative therapies for seizures: promises and dangers. (United States)

    Sirven, Joseph I


    Complementary and alternative medicine (CAM) is increasingly being used for a multitude of medical problems, one of them being seizures. This article discusses the prevalence of CAM use for seizures and epilepsy. Evidence-based data regarding CAM for epilepsy are presented as well as potential safety concerns regarding ephedra and cannabis use.

  3. Channel selection for automatic seizure detection

    DEFF Research Database (Denmark)

    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...

  4. Effect of Seizure Clustering on Epilepsy Outcome

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available A prospective, long-term population-based study was performed to determine whether seizure clustering (3 or more afebrile seizures during a 24 hour period is associated with drug resistance and increased mortality in childhood-onset epilepsy, in a study at University of Turku, Finland, and the Epilepsy Research Group, Berlin, Germany.

  5. febrile seizures, Tripoli, Libya, knowledge, attitude

    African Journals Online (AJOL)


    aim of the audit is to assess the attitude and knowledge of parents of children with febrile seizures before .... The purpose of the study was explained to all parents and written informed consent was also obtained. Sample Description. Parents who witnessed the febrile seizure had rushed the child to the hospital as the first ...

  6. Seizure phenotypes, periodicity, and sleep-wake pattern of seizures in Kcna-1 null mice. (United States)

    Wright, Samantha; Wallace, Eli; Hwang, Youngdeok; Maganti, Rama


    This study was undertaken to describe seizure phenotypes, natural progression, sleep-wake patterns, as well as periodicity of seizures in Kcna-1 null mutant mice. These mice were implanted with epidural electroencephalography (EEG) and electromyography (EMG) electrodes, and simultaneous video-EEG recordings were obtained while animals were individually housed under either diurnal (LD) condition or constant darkness (DD) over ten days of recording. The video-EEG data were analyzed to identify electrographic and behavioral phenotypes and natural progression and to examine the periodicity of seizures. Sleep-wake patterns were analyzed to understand the distribution and onset of seizures across the sleep-wake cycle. Four electrographically and behaviorally distinct seizure types were observed. Regardless of lighting condition that animals were housed in, Kcna-1 null mice initially expressed only a few of the most severe seizure types that progressively increased in frequency and decreased in seizure severity. In addition, a circadian periodicity was noted, with seizures peaking in the first 12h of the Zeitgeber time (ZT) cycle, regardless of lighting conditions. Interestingly, seizure onset differed between lighting conditions where more seizures arose out of sleep in LD conditions, whereas under DD conditions, the majority occurred out of the wakeful state. We suggest that this model be used to understand the circadian pattern of seizures as well as the pathophysiological implications of sleep and circadian disturbances in limbic epilepsies. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Do recurrent seizure-related head injuries affect seizures in people with epilepsy? (United States)

    Friedman, David E.; Chiang, Sharon; Tobias, Ronnie S.


    Seizure-related head injuries (SRHIs) are among the most commonly encountered injuries in people with epilepsy (PWE). Whether head injury has an effect on preexisting epilepsy is not known. The purpose of this study was to systematically assess for any possible effects of SRHIs on seizure frequency and seizure semiology over a 2-year period. We identified 204 patients who have been followed at the Baylor Comprehensive Epilepsy Center from 2008 to 2010. SRHI occurred in 18.1% of the cohort. Most injuries (91%) were classified as mild. Though seizure frequency varied following head injury, overall seizure frequency was not significantly impacted by presence or absence of SRHI over the 2-year study period. Changes in seizure semiology were not observed in those with SRHIs. Although mild SRHI is common among PWE, it does not appear to have an effect on seizure characteristics over a relatively short period. PMID:22227592

  8. Death, Catastrophe, and the Significance of Tragedy

    Directory of Open Access Journals (Sweden)

    Jennifer Ballengee


    Full Text Available This NANO note will examine the tension between representation, memorial, and the catastrophe of death that emerges in the space of tragedy, as the problem arises in two quite different works: Oedipus at Colonus, a fairly typical fifth-century Greek tragedy, and Falling Man, Don DeLillo’s novel that, in its attempt to address the events of 9/11, reflects in form and subject matter many of Aristotle’s terms of tragic representation. It is not the intent of this note to engage with the recent proliferation of work in “performance theory.” Rather than being concerned with an imagined exchange between audience and actor, this study examines how the supplementary relationship of gesture and speech in tragedy disrupts the public/private distinction, and how this articulation effects and enables the public memorialization of death. Thus, this paper will consider the representation of death as an event whose catastrophic, and somewhat mysterious, collision of the public and the private lends it its tragic significance.

  9. Modeling workplace bullying using catastrophe theory. (United States)

    Escartin, J; Ceja, L; Navarro, J; Zapf, D


    Workplace bullying is defined as negative behaviors directed at organizational members or their work context that occur regularly and repeatedly over a period of time. Employees' perceptions of psychosocial safety climate, workplace bullying victimization, and workplace bullying perpetration were assessed within a sample of nearly 5,000 workers. Linear and nonlinear approaches were applied in order to model both continuous and sudden changes in workplace bullying. More specifically, the present study examines whether a nonlinear dynamical systems model (i.e., a cusp catastrophe model) is superior to the linear combination of variables for predicting the effect of psychosocial safety climate and workplace bullying victimization on workplace bullying perpetration. According to the AICc, and BIC indices, the linear regression model fits the data better than the cusp catastrophe model. The study concludes that some phenomena, especially unhealthy behaviors at work (like workplace bullying), may be better studied using linear approaches as opposed to nonlinear dynamical systems models. This can be explained through the healthy variability hypothesis, which argues that positive organizational behavior is likely to present nonlinear behavior, while a decrease in such variability may indicate the occurrence of negative behaviors at work.

  10. Inside money, procyclical leverage, and banking catastrophes. (United States)

    Brummitt, Charles D; Sethi, Rajiv; Watts, Duncan J


    We explore a model of the interaction between banks and outside investors in which the ability of banks to issue inside money (short-term liabilities believed to be convertible into currency at par) can generate a collapse in asset prices and widespread bank insolvency. The banks and investors share a common belief about the future value of certain long-term assets, but they have different objective functions; changes to this common belief result in portfolio adjustments and trade. Positive belief shocks induce banks to buy risky assets from investors, and the banks finance those purchases by issuing new short-term liabilities. Negative belief shocks induce banks to sell assets in order to reduce their chance of insolvency to a tolerably low level, and they supply more assets at lower prices, which can result in multiple market-clearing prices. A sufficiently severe negative shock causes the set of equilibrium prices to contract (in a manner given by a cusp catastrophe), causing prices to plummet discontinuously and banks to become insolvent. Successive positive and negative shocks of equal magnitude do not cancel; rather, a banking catastrophe can occur even if beliefs simply return to their initial state. Capital requirements can prevent crises by curtailing the expansion of balance sheets when beliefs become more optimistic, but they can also force larger price declines. Emergency asset price supports can be understood as attempts by a central bank to coordinate expectations on an equilibrium with solvency.

  11. Indirect Catastrophic Injuries in Olympic Styles of Wrestling in Iran


    Kordi, Ramin; Ziaee, Vahid; Rostami, Mohsen; Wallace, W. Angus


    Background: Data on indirect catastrophic injuries in wrestling are scarce. Objectives: To develop a profile of indirect catastrophic injuries in international styles of wrestling and to describe possible risk factors. Study Design: Retrospective case series; Level of evidence, 3. Methods: Indirect catastrophic injuries that occurred in wrestling clubs in Iran from July 1998 to June 2005 were identified by contacting several sources. The cases were retrospectively reviewed. Results: The injur...

  12. Febrile seizures and risk of schizophrenia

    DEFF Research Database (Denmark)

    Vestergaard, Mogens; Pedersen, Carsten Bøcker; Christensen, Jakob


    BACKGROUND: Febrile seizure is a benign condition for most children, but experiments in animals and neuroimaging studies in humans suggest that some febrile seizures may damage the hippocampus, a brain area of possible importance in schizophrenia. METHODS: A population-based cohort of all children...... with schizophrenia. A history of febrile seizures was associated with a 44% increased risk of schizophrenia [relative risk (RR)=1.44; 95% confidence interval (CI), 1.07-1.95] after adjusting for confounding factors. The association between febrile seizures and schizophrenia remained virtually unchanged when...... restricting the analyses to people with no history of epilepsy. A history of both febrile seizures and epilepsy was associated with a 204% increased risk of schizophrenia (RR=3.04; 95% CI, 1.36-6.79) as compared with people with no such history. CONCLUSIONS: We found a slightly increased risk of schizophrenia...

  13. Seizure detection algorithms based on EMG signals

    DEFF Research Database (Denmark)

    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...... the frequency-based algorithm was efficient for detecting the seizures in the third patient. Conclusion: Our results suggest that EMG signals could be used to develop an automatic seizuredetection system. However, different patients might require different types of algorithms /approaches....

  14. Source and sink nodes in absence seizures. (United States)

    Rodrigues, Abner C; Machado, Birajara S; Caboclo, Luis Otavio S F; Fujita, Andre; Baccala, Luiz A; Sameshima, Koichi


    As opposed to focal epilepsy, absence seizures do not exhibit a clear seizure onset zone or focus since its ictal activity rapidly engages both brain hemispheres. Yet recent graph theoretical analysis applied to absence seizures EEG suggests the cortical focal presence, an unexpected feature for this type of epilepsy. In this study, we explore the characteristics of absence seizure by classifying the nodes as to their source/sink natures via weighted directed graph analysis based on connectivity direction and strength estimation using information partial directed coherence (iPDC). By segmenting the EEG signals into relatively short 5-sec-long time windows we studied the evolution of coupling strengths from both sink and source nodes, and the network dynamics of absence seizures in eight patients.

  15. [Characteristics and management of epileptic seizures in emergency department and diagnostic correlation at discharge]. (United States)

    Piñol-Ripoll, G; Gómez Bitrian, J; Puerta González-Miró, I de la; Royo Hernández, R; Mauri-Llerda, J A


    Patients with seizures are common in the emergency department (ED), yet little is known regarding the management of these patients. This study was performed to define the demographic characteristics of patients with seizure disorders in the ED patient population and to determine final disposition, diagnostic and therapeutic activities, and to evaluate the concordance between provisional and definitive diagnosis. We recorded prospectively all patients which were diagnosed of seizure in ED of Hospital Clínico of Zaragoza between November 1th and April 30th. Chart review was used to gather definitive diagnosis regarding these patients. Of the 54,022 patients who presented to the ED during the study period, 137 (0.36%) had complains related to seizures. Sixty one (44%) of these patients were admitted to the hospital. New-onset seizures were thought to be present in 60% of patients. Blood work was abnormal in 12% of patients and 48% of patients had pathological findings in neuroimaging study. False positive diagnosis was present in 33% of patients. The most important trigger of seizures in epileptic patients was tapped suddenly the antiepileptic drug treatment. We found a false positive diagnosis in 33% of patients, and the most important confounding pathology was sincope and stroke. High percentaje of pathological findings in neuroimaging studies were found. Electroencefalographic and toxicological studies were performed less than is recommended.

  16. A signal processing based analysis and prediction of seizure onset in patients with epilepsy (United States)

    Namazi, Hamidreza; Kulish, Vladimir V.


    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. PMID:26586477

  17. Early-life seizures result in deficits in social behavior and learning. (United States)

    Lugo, Joaquin N; Swann, John W; Anderson, Anne E


    Children with epilepsy show a high co-morbidity with psychiatric disorders and autism. One of the critical determinants of a child's behavioral outcome with autism and cognitive dysfunction is the age of onset of seizures. In order to examine whether seizures during postnatal days 7-11 result in learning and memory deficits and behavioral features of autism we administered the inhalant flurothyl to induce seizures in C57BL/6J mice. Mice received three seizures per day for five days starting on postnatal day 7. Parallel control groups consisted of similarly handled animals that were not exposed to flurothyl and naïve mice. Subjects were then processed through a battery of behavioral tests in adulthood: elevated-plus maze, nose-poke assay, marble burying, social partition, social chamber, fear conditioning, and Morris water maze. Mice with early-life seizures had learning and memory deficits in the training portion of the Morris water maze (pbehavior in the social partition test. Together, these results indicate that early life seizures result in deficits in hippocampal-dependent memory tasks and produce long-term disruptions in social behavior. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Drosophila as a model for intractable epilepsy: gilgamesh suppresses seizures in para(bss1) heterozygote flies. (United States)

    Howlett, Iris C; Rusan, Zeid M; Parker, Louise; Tanouye, Mark A


    Intractable epilepsies, that is, seizure disorders that do not respond to currently available therapies, are difficult, often tragic, neurological disorders. Na(+) channelopathies have been implicated in some intractable epilepsies, including Dravet syndrome (Dravet 1978), but little progress has been forthcoming in therapeutics. Here we examine a Drosophila model for intractable epilepsy, the Na(+) channel gain-of-function mutant para(bss1) that resembles Dravet syndrome in some aspects (parker et al. 2011a). In particular, we identify second-site mutations that interact with para(bss1), seizure enhancers, and seizure suppressors. We describe one seizure-enhancer mutation named charlatan (chn). The chn gene normally encodes an Neuron-Restrictive Silencer Factor/RE1-Silencing Transcription factor transcriptional repressor of neuronal-specific genes. We identify a second-site seizure-suppressor mutation, gilgamesh (gish), that reduces the severity of several seizure-like phenotypes of para(bss1)/+ heterozygotes. The gish gene normally encodes the Drosophila ortholog of casein kinase CK1g3, a member of the CK1 family of serine-threonine kinases. We suggest that CK1g3 is an unexpected but promising new target for seizure therapeutics.

  19. Febrile seizures prior to sudden cardiac death

    DEFF Research Database (Denmark)

    Stampe, Niels Kjær; Glinge, Charlotte; Jabbari, Reza


    Aims: Febrile seizure (FS) is a common disorder affecting 2-5% of children up to 5 years of age. The aim of this study was to determine whether FS in early childhood are over-represented in young adults dying from sudden cardiac death (SCD). Methods and results: We included all deaths (n = 4595......; 3.0%) and also in victims of transport accidents (26/917; 2.8%). The frequency of FS among SCD cases was significantly increased by an odds ratio of 1.96 [95% confidence interval (CI) 1.14-3.36; P = 0.021] compared with the living Danish population and with an odds ratio of 2.08 (95% CI 1.07-4.04; P......) nationwide and through review of all death certificates, we identified 245 SCD in Danes aged 1-30 years in 2000-09. Through the usage of nationwide registries, we identified all persons admitted with first FS among SCD cases (14/245; 5.7%) and in the corresponding living Danish population (71 027/2 369 785...

  20. Iranian Household Financial Protection against Catastrophic Health Care Expenditures (United States)

    Moghadam, M Nekoei; Banshi, M; Javar, M Akbari; Amiresmaili, M; Ganjavi, S


    Background: Protecting households against financial risks is one of objectives of any health system. In this regard, Iran’s fourth five year developmental plan act in its 90th article, articulated decreasing household’s exposure to catastrophic health expenditure to one percent. Hence, this study aimed to measure percentage of Iranian households exposed to catastrophic health expenditures and to explore its determinants. Methods: The present descriptive-analytical study was carried out retrospectively. Households whose financial contributions to the health system exceeded 40% of disposable income were considered as exposed to catastrophic healthcare expenditures. Influential factors on catastrophic healthcare expenditures were examined by logistic regression and chi-square test. Results: Of 39,088 households, 80 were excluded due to absence of food expenditures. 2.8% of households were exposed to catastrophic health expenditures. Influential factors on catastrophic healthcare were utilizing ambulatory, hospital, and drug addiction cessation services as well as consuming pharmaceuticals. Socioeconomics characteristics such as health insurance coverage, household size, and economic status were other determinants of exposure to catastrophic healthcare expenditures. Conclusion: Iranian health system has not achieved the objective of reducing catastrophic healthcare expenditure to one percent. Inefficient health insurance coverage, different fee schedules practiced by private and public providers, failure of referral system are considered as probable barriers toward decreasing households’ exposure to catastrophic healthcare expenditures. PMID:23193508

  1. Post-stroke seizures are clinically underestimated. (United States)

    Bentes, Carla; Martins, Hugo; Peralta, Ana Rita; Casimiro, Carlos; Morgado, Carlos; Franco, Ana Catarina; Fonseca, Ana Catarina; Geraldes, Ruth; Canhão, Patrícia; Pinho E Melo, Teresa; Paiva, Teresa; Ferro, José M


    Cerebrovascular disease is the leading cause of epilepsy in adults, although post-stroke seizures reported frequency is variable and few studies used EEG in their identification. To describe and compare EEG and clinical epileptic manifestations frequency in patients with an anterior circulation ischaemic stroke. Prospective study of acute anterior circulation ischaemic stroke patients, consecutively admitted to a Stroke Unit over 24 months and followed-up for 1 year. All patients underwent standardized clinical and diagnostic assessment. Seizure occurrence was clinically evaluated during hospitalization and by a telephone interview at 6 months and a clinical appointment at 12 months after stroke. Video-EEG was performed in the first 72 h (1st EEG), daily after the 1st EEG for the first 7 days after the stroke, or later if neurological worsening, at discharge, and at 12 months. 151 patients were included (112 men) with a mean age of 67.4 (11.9) years. In the 1st year after stroke, 38 patients (25.2%) had an epileptic seizure. During hospitalization, 27 patients (17.9%) had epileptiform activity (interictal or ictal) in the EEG, 7 (25.9%) of them electrographic seizures. During the first week after stroke, 22 (14.6%) patients had a seizure and 4 (2.6%) non-convulsive status epilepticus criteria. Five (22.7%) acute symptomatic seizures were exclusively electrographic. At least one remote symptomatic seizure occurred in 23 (16%) patients. In the first 7 days after stroke, more than one-fifth of patients with seizures had exclusively electrographic seizures. Without a systematic neurophysiological evaluation the frequency of post-stroke seizures are clinically underestimated.

  2. Clinical features of poststroke epileptic seizures

    Directory of Open Access Journals (Sweden)

    T. V. Danilova


    Full Text Available Poststroke epileptic seizures are detected in 30–40% of patients over 60 years of age. Objective: to explore the clinical features of epileptic seizures in stroke, risk factors for their development to form the bases for prediction and elaboration of optimal therapy. Patients and methods. 468 patients with ischemic stroke were examined. A study group included 265 patients (176 men and 89 women aged 31–89 years with epileptic seizures; a control group comprised 203 non-epileptic patients (126 men and 77 women aged 31–91 years. The patients of both groups were matched for age, clinical characteristics, and pathogenetic subtypes of stroke. Instrumental examinations were performed in the attack-free interval. Neurological status was evaluated using the conventional procedure (the National Institute of Health Stroke Scale; brain magnetic resonance imaging (MRI, magnetic resonance angiography, electroencephalography, extraand transcranial duplex sound of cerebral vessels, by estimating the level and degree of stenosis and cerebrovascular responsiveness. Results and discussion. Focal seizures were noted to more frequently develop with a preponderance of simple partial seizures within the first 7 days of stroke, with neurological worsening in the acute period of the disease. Stroke in the left carotid and vertebrobasilar beds may provoke the development of early seizures. The cortical localization of ischemic foci and pre-stroke chronic brain ischemia with the signs of circulatory comorbidity in the anterior and posterior circulatory systems may be a risk factor of epileptic seizures. There was an association of the type of an epileptic seizure and the size of an ischemic focus, as evidenced by MRI, with a tendency towards the generalization of seizures in the extensive ischemic foci. A tendency toward the generalization of epileptic seizures was established in the development of stroke in the left carotid bed, as well as in critical stenoses and

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Auricular Acupuncture May Suppress Epileptic Seizures via Activating the Parasympathetic Nervous System: A Hypothesis Based on Innovative Methods. (United States)

    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.

  5. Madame Bovary and Catastrophism: Revolving narratives

    Directory of Open Access Journals (Sweden)

    Ruth Morris


    Full Text Available Cet article relie Madame Bovary au contexte scientifique français des années 1850, en lisant le roman de Flaubert à la lumière des théories de Cuvier. Le savant français Georges Cuvier, avec nombre de ses contemporains, explique les origines du monde à l’aide de la théorie des catastrophes. D’après cette théorie, le monde est divisé en périodes très courtes ponctuées de grandes catastrophes ou, en termes cuviériens, de « révolutions » qui ont éradiqué toute vie et ont permis au monde d’être entièrement repeuplé. Une telle conception affecte l’idée même du « temps ». Cuvier pense que la formation de la Terre est relativement récente, l’époque présente n’étant vieille que de cinq mille ans. Cette compression temporelle peut être rapportée à Madame Bovary dont le « tempo » s’accroît au fur et à mesure qu’on se rapproche du dénouement. Dans la théorie des catastrophes comme dans le roman, le temps ne suit pas une ligne chronologique. Les « révolutions » viennent briser le fil continu du temps et Emma est souvent incapable de distinguer entre le passé, le présent et le futur. Les « révolutions » servent aussi à ponctuer et à perturber le cours de la vie sur Terre en produisant des événements majeurs dans l’histoire du globe. Il en est de même dans la vie d’Emma. Son existence est marquée par des événements majeurs, comme le bal, qui créent un éclatement et une fragmentation de la temporalité, comme dans la théorie de Cuvier. Je défendrai aussi l’idée d’un lien entre la soudaineté et la violence des « révolutions » et les crises nerveuses d’Emma, qui surviennent brusquement et relèvent de l’hystérie. La conception cuviérienne de la temporalité doit enfin être envisagée au regard des théories de l’évolution, ce qui implique de réévaluer les notions d’adaptation, d’hérédité et de mort dans le roman de Flaubert.This paper locates Madame

  6. The Chernobyl catastrophe consequences in the Republic of Belarus. National report

    International Nuclear Information System (INIS)

    Konoplya, E.F.


    The estimation of radioecological, medico-biological, economic and social consequences of the Chernobyl catastrophe has shown that unimaginable damage was incurred on Belarus and its territory became the zone of ecological calamity. The Chernobyl NPP catastrophe has led to the contamination of almost the fourth part of the territory of Belarus where there lived 2,2 million people. The damage caused to the republic by the catastrophe makes up 32 annual budgets of the republic of the pre-accident period in account for the 30-years period for its overcoming. Radioecological situation in Belarus is characterized by complexity and heterogeneous contamination of the territory by different radionuclides and their presence on all the components of the environment. It stipulates the plurality of ways of external and internal irradiation of the population and jeopardizes its health. There is registered the worsening of the population's health, of evacuated and inhabiting the contaminated areas as well, with increase of a number of somatic diseases, including oncological diseases, there are disorders in the metabolic processes and functions of the main systems of the organism. The demographic indices are decreasing. Particular concern causes the children's morbidity growth and genetic consequences of the accident. The contamination of agricultural lands has stipulated in the neighboring the Chernobyl NPP zone the impossibility of their use for food production. On the other lands it has been required to re-profile the farms and create new technologies of the agricultural production. There have been revealed the destructive tendencies in all spheres of the life activity of people who experienced radiation effects. The processes of social adaptation and socio-psychological support of the population require considerable optimization. In spite of that for ten years passed after the catastrophe the discrepancy of its estimations has not been overcome completely. At the same time

  7. Randomized, controlled trial of ibuprofen syrup administered during febrile illnesses to prevent febrile seizure recurrences

    NARCIS (Netherlands)

    M. van Stuijvenberg (Margriet); G. Derksen-Lubsen (Gerarda); E.W. Steyerberg (Ewout); J.D.F. Habbema (Dik); H.A. Moll (Henriëtte)


    textabstractOBJECTIVES: Febrile seizures recur frequently. Factors increasing the risk of febrile seizure recurrence include young age at onset, family history of febrile seizures, previous recurrent febrile seizures, time lapse since previous seizure <6 months,

  8. Epileptic seizures and headache/migraine: a review of types of association and terminology. (United States)

    Cianchetti, Carlo; Pruna, Dario; Ledda, Mariagiuseppina


    There are different possible temporal associations between epileptic seizures and headache attacks which have given rise to unclear or controversial terminologies. The classification of the International League Against Epilepsy does not refer to this type of disorder, while the International Classification of Headache Disorders (ICHD-2) defines three kinds of association: (1) migraine-triggered seizure ("migralepsy"), (2) hemicrania epileptica, and (3) post-ictal headache. We performed an extensive review of the literature, not including "post-ictal" and "inter-ictal" headaches. On the basis of well-documented reports, the following clinical entities may be identified: (A) "epileptic headache (EH)" or "ictal epileptic headache (IEH)": in this condition headache (with or without migrainous features) is an epileptic manifestation per se, with onset, and cessation if isolated, coinciding with the scalp or deep EEG pattern of an epileptic seizure. EH maybe followed by other epileptic manifestations (motor/sensory/autonomic); this condition should be differentiated from "pure" or "isolated" EH, in which headache/migraine is the sole epileptic manifestation (requiring differential diagnosis from other headache forms). "Hemicrania epileptica" (if confirmed) is a very rare variant of EH, characterized by ipsilateral location of headache and ictal EEG paroxysms. (B) "Pre-ictal migraine" and "pre-ictal headache": when a headache attack is followed during, or shortly after, by a typical epileptic seizure. The migraine attack may be with or without aura, and its seizure-triggering role ("migraine-triggered seizure") is still a subject of debate. A differentiation from occipital epilepsy is mandatory. The term "migralepsy" has not been used uniformly, and may therefore led to misinterpretation. On the basis of this review we suggest definitions and a terminology which may become the basis of a forthcoming classification of headaches associated with epileptic seizures. Copyright

  9. Ilizarov treatment of humeral shaft nonunion in an antiepileptic drug patient with uncontrolled generalized tonic-clonic seizure activity

    Directory of Open Access Journals (Sweden)

    Koulouvaris Panayiotis


    Full Text Available Abstract Nonunion of the humeral shaft in patients with antiepileptic drug associated metabolic bone disorder constitute a challenging surgical problem difficult to treat due to seizure activity, osteoporosis, and poor stabilization options. We report a case of nonunion of the humeral shaft in an antiepileptic drug patient with uncontrolled generalized tonic-clonic seizure activity successfully treated with Ilizarov external fixator and a follow-up of 4 years.

  10. Classification of clinical semiology in epileptic seizures in neonates. (United States)

    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.

  11. Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome. (United States)

    Devinsky, Orrin; Cross, J Helen; Laux, Linda; Marsh, Eric; Miller, Ian; Nabbout, Rima; Scheffer, Ingrid E; Thiele, Elizabeth A; Wright, Stephen


    The Dravet syndrome is a complex childhood epilepsy disorder that is associated with drug-resistant seizures and a high mortality rate. We studied cannabidiol for the treatment of drug-resistant seizures in the Dravet syndrome. In this double-blind, placebo-controlled trial, we randomly assigned 120 children and young adults with the Dravet syndrome and drug-resistant seizures to receive either cannabidiol oral solution at a dose of 20 mg per kilogram of body weight per day or placebo, in addition to standard antiepileptic treatment. The primary end point was the change in convulsive-seizure frequency over a 14-week treatment period, as compared with a 4-week baseline period. The median frequency of convulsive seizures per month decreased from 12.4 to 5.9 with cannabidiol, as compared with a decrease from 14.9 to 14.1 with placebo (adjusted median difference between the cannabidiol group and the placebo group in change in seizure frequency, -22.8 percentage points; 95% confidence interval [CI], -41.1 to -5.4; P=0.01). The percentage of patients who had at least a 50% reduction in convulsive-seizure frequency was 43% with cannabidiol and 27% with placebo (odds ratio, 2.00; 95% CI, 0.93 to 4.30; P=0.08). The patient's overall condition improved by at least one category on the seven-category Caregiver Global Impression of Change scale in 62% of the cannabidiol group as compared with 34% of the placebo group (P=0.02). The frequency of total seizures of all types was significantly reduced with cannabidiol (P=0.03), but there was no significant reduction in nonconvulsive seizures. The percentage of patients who became seizure-free was 5% with cannabidiol and 0% with placebo (P=0.08). Adverse events that occurred more frequently in the cannabidiol group than in the placebo group included diarrhea, vomiting, fatigue, pyrexia, somnolence, and abnormal results on liver-function tests. There were more withdrawals from the trial in the cannabidiol group. Among patients with

  12. Catastrophic antiphospholipid syndrome: The current management approach. (United States)

    Rodriguez-Pintó, Ignasi; Espinosa, Gerard; Cervera, Ricard


    The current recommendation for catastrophic antiphospholipid syndrome (CAPS) management is the standard triple therapy with anticoagulation (AC), glucocorticoids (GCs), plasma exchange (PE), and/or intravenous immunoglobulins (IVIGs). Of note, only AC has a significant effect on the prognosis of these patients. However, from the experimental or basic point of view, there is only indirect evidence to advocate the use of these immunomodulatory therapies (GC, PE, and IVIG) in CAPS. Recently, there have been reports of severe or refractory CAPS patients treated with the monoclonal antibodies rituximab and eculizumab. The first blocks CD20, a surface protein expressed on the cytoplasmic membrane of B cells, and decreases the generation of pathogenic autoantibodies such as antiphospholipid (aPL) antibodies. The second binds with high affinity to C5 complement protein, inhibiting its cleavage and thus preventing the generation of C5b-C9 complex. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Microtubule dynamics: Caps, catastrophes, and coupled hydrolysis

    DEFF Research Database (Denmark)

    Flyvbjerg, H.; Holy, T.E.; Leibler, S.


    individual tubulin dimers, an ignored. In this cap model, GTP hydrolysis is assumed to be stochastic and uncoupled to microtubule growth. Different rates of hydrolysis are assumed for GTP in the cap's interior and for GTP at its boundary with hydrolyzed parts of the microtubule. Expectation values...... and probability distributions relating to available experimental data are derived. Caps are found to be short and the total rate of hydrolysis at a microtubule end is found to be dynamically coupled to growth. The so-called catastrophe rate is a simple function of the microtubule growth rare and fits experimental...... of microtubule growth before dilution. The GTP content of microtubules is found and its rare of hydrolysis is determined under the circumstances created in an experiment designed to measure this GTP content. It is concluded that this experiment's failure to register any GTP content is consistent with the model...

  14. The asteroids as outcomes of catastrophic collisions

    Energy Technology Data Exchange (ETDEWEB)

    Farinella, P. (Osservatorio Astronomico di Brera, Merate, Italy); Paolicchi, P.


    The role of catastrophic collisions in the evoloution of the asteroids is discussed in detail, employing extrapolations of experimental results on the outcome of high velocity-impacts. The probability of impacts with a given projectile-to-target mass ratio for asteroids of different sizes is derived, taking into account different mass distributions of the asteroid population at the beginning of the collision process. The extrapolations show that collisional breakup against solid-state cohesions must be a widespread process for asteroids. The influence of self-gravitation and transfer of angular momentum during collision is shown to depend strongly on the traget size, resulting in a variety of possible outcomes in the intermediate size range. Comparason of the theoretical results with observations of asteroid rotations and shapes yields favorable results.

  15. Grasshopper Population Ecology: Catastrophe, Criticality, and Critique

    Directory of Open Access Journals (Sweden)

    Dale R. Lockwood


    Full Text Available Grasshopper population dynamics are an important part of the North American rangeland ecosystem and an important factor in the economies that derive from the rangeland. Outbreak dynamics have plagued management strategies in the rangeland, and attempts to find simple, linear and mechanistic solutions to both understanding and predicting the dynamics have proved fruitless. These efforts to ground theory in a correspondence with the "real" world, including whether the population dynamics are ultimately density dependent or density independent, have generated abundant heat but little light. We suggest that a pragmatic approach, in which theories are taken to be "tools" rather than competing claims of truth, has greater promise to move ecological research in a constructive direction. Two recent non-linear approaches exploiting the tools of complexity science provide insights relevant to explaining and forecasting population dynamics. Observation and data collection were used to structure models derived from catastrophe theory and self-organized criticality. These models indicate that nonlinear processes are important in the dynamics of the outbreaks. And the conceptual structures of these approaches provide clear, albeit constrained or contingent, implications for pest managers. We show that, although these two frameworks, catastrophe theory and self-organized criticality, are very different, the frequency distributions of time series from both systems result in power law relationships. Further, we show that a simple lattice-based model, similar to SOC but structured on the biology of the grasshoppers gives a spatial time series similar to data over a 50-year span and the frequency distribution is also a power law relationship. This demonstration exemplifies how a "both-and" rather than an "either-or" approach to ecological modeling, in which the useful elements of particular theories or conceptual structures are extracted, may provide a way forward

  16. Catastrophic expenditure on medicines in Brazil. (United States)

    Luiza, Vera Lucia; Tavares, Noemia Urruth Leão; Oliveira, Maria Auxiliadora; Arrais, Paulo Sergio Dourado; Ramos, Luiz Roberto; Pizzol, Tatiane da Silva Dal; Mengue, Sotero Serrate; Farias, Mareni Rocha; Bertoldi, Andréa Dâmaso


    To describe the magnitude of the expenditure on medicines in Brazil according to region, household size and composition in terms of residents in a situation of dependency. Population-based data from the national household survey were used, with probabilistic sample, applied between September 2013 and February 2014 in urban households. The expenditure on medicines was the main outcome of interest. The prevalence and confidence intervals (95%CI) of the outcomes were stratified according to socioeconomic classification and calculated according to the region, the number of residents dependent on income, the presence of children under five years and residents in a situation of dependency by age. In about one of every 17 households (5.3%) catastrophic health expenditure was reported and, in 3.2%, the medicines were reported as one of the items responsible for this situation. The presence of three or more residents (3.6%) and resident in a situation of dependency (3.6%) were the ones that most reported expenditure on medicines. Southeast was the region with the lowest prevalence of expenditure on medicines. The prevalence of households with catastrophic health expenditure and on medicines in relation to the total of households showed a regressive tendency for economic classes. Catastrophic health expenditure was present in 5.3%, and catastrophic expenditure on medicines in 3.2% of the households. Multi-person households, presence of residents in a situation of economic dependency and belonging to the class D or E had the highest proportion of catastrophic expenditure on medicines. Although the problem is important, permeated by aspects of iniquity, Brazilian policies seem to be protecting families from catastrophic expenditure on health and on medicine. Descrever a magnitude do gasto catastrófico em medicamentos no Brasil segundo região, tamanho das famílias e composição familiar em termos de moradores em situação de dependência. Utilizados dados de inqu

  17. On the nature of seizure dynamics. (United States)

    Jirsa, Viktor K; Stacey, William C; Quilichini, Pascale P; Ivanov, Anton I; Bernard, Christophe


    Seizures can occur spontaneously and in a recurrent manner, which defines epilepsy; or they can be induced in a normal brain under a variety of conditions in most neuronal networks and species from flies to humans. Such universality raises the possibility that invariant properties exist that characterize seizures under different physiological and pathological conditions. Here, we analysed seizure dynamics mathematically and established a taxonomy of seizures based on first principles. For the predominant seizure class we developed a generic model called Epileptor. As an experimental model system, we used ictal-like discharges induced in vitro in mouse hippocampi. We show that only five state variables linked by integral-differential equations are sufficient to describe the onset, time course and offset of ictal-like discharges as well as their recurrence. Two state variables are responsible for generating rapid discharges (fast time scale), two for spike and wave events (intermediate time scale) and one for the control of time course, including the alternation between 'normal' and ictal periods (slow time scale). We propose that normal and ictal activities coexist: a separatrix acts as a barrier (or seizure threshold) between these states. Seizure onset is reached upon the collision of normal brain trajectories with the separatrix. We show theoretically and experimentally how a system can be pushed toward seizure under a wide variety of conditions. Within our experimental model, the onset and offset of ictal-like discharges are well-defined mathematical events: a saddle-node and homoclinic bifurcation, respectively. These bifurcations necessitate a baseline shift at onset and a logarithmic scaling of interspike intervals at offset. These predictions were not only confirmed in our in vitro experiments, but also for focal seizures recorded in different syndromes, brain regions and species (humans and zebrafish). Finally, we identified several possible biophysical

  18. Biotelemetry system for Epilepsy Seizure Control

    Energy Technology Data Exchange (ETDEWEB)

    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.

  19. Febrile seizures and risk of schizophrenia

    DEFF Research Database (Denmark)

    Vestergaard, Mogens; Pedersen, Carsten Bøcker; Christensen, Jakob


    BACKGROUND: Febrile seizure is a benign condition for most children, but experiments in animals and neuroimaging studies in humans suggest that some febrile seizures may damage the hippocampus, a brain area of possible importance in schizophrenia. METHODS: A population-based cohort of all children...... restricting the analyses to people with no history of epilepsy. A history of both febrile seizures and epilepsy was associated with a 204% increased risk of schizophrenia (RR=3.04; 95% CI, 1.36-6.79) as compared with people with no such history. CONCLUSIONS: We found a slightly increased risk of schizophrenia...

  20. [Semiology and propagation of epileptic seizures]. (United States)

    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.

  1. Purchase of Catastrophe Insurance by Dutch Dairy and Arable Farmers

    NARCIS (Netherlands)

    Ogurtsov, V.; Asseldonk, van M.A.P.M.; Huirne, R.B.M.


    This article analyzed the impact of risk perception, risk attitude, and other farmer personal and farm characteristics on the actual purchase of catastrophe insurance by Dutch dairy and arable farmers. The specific catastrophe insurance types considered were hail–fire–storm insurance for buildings,

  2. Cell death by mitotic catastrophe: a molecular definition

    NARCIS (Netherlands)

    Castedo, M.; Perfettini, J.-L.; Roumier, T.; Andreau, K.; Medema, R.H.; Kroemer, G.


    The current literature is devoid of a clearcut definition of mitotic catastrophe, a type of cell death that occurs during mitosis. Here, we propose that mitotic catastrophe results from a combination of deficient cell-cycle checkpoints (in particular the DNA structure checkpoints and the spindle

  3. Catastrophic medical malpractice payouts in the United States. (United States)

    Bixenstine, Paul J; Shore, Andrew D; Mehtsun, Winta T; Ibrahim, Andrew M; Freischlag, Julie A; Makary, Martin A


    Catastrophic medical malpractice payouts, $1 million or greater, greatly influence physicians' practice, hospital policy, and discussions of healthcare reform. However, little is known about the specific characteristics and overall cost burden of these payouts. We reviewed all paid malpractice claims nationwide using the National Practitioner Data Bank over a 7-year period (2004-2010) and used multivariate regression to identify risk factors for catastrophic and increased overall payouts. Claims with catastrophic payouts represented 7.9% (6,130/77,621) of all paid claims. Factors most associated with catastrophic payouts were patient age less than 1 year; quadriplegia, brain damage, or lifelong care; and anesthesia allegation group. Compared with court judgments, settlement was associated with decreased odds of a catastrophic payout (odds ratio, 0.31; 95% confidence interval [CI], 0.22-0.42) and lower estimated average payouts ($124,863; 95% CI, $101,509-144,992). A physician's years in practice and previous paid claims history had no effect on the odds of a catastrophic payout. Catastrophic payouts averaged $1.4 billion per year or 0.05% of the National Health Expenditures. Preventing catastrophic malpractice payouts should be only one aspect of comprehensive patient safety and quality improvement strategies. Future studies should evaluate the benefits of targeted interventions based on specific patient safety event characteristics. © 2013 National Association for Healthcare Quality.

  4. [Catastrophic health expenditures in Mexico: magnitude, distribution and determinants]. (United States)

    Sesma-Vázquez, Sergio; Pérez-Rico, Raymundo; Sosa-Manzano, Carlos Lino; Gómez-Dantés, Octavio


    To describe the magnitude, distribution, and determinants of catastrophic health expenditures in Mexico. The information source was the National Performance Assessment Survey and the methodology, the one developed by the World Health Organization for assessing fair financing. Households with catastrophic expenditures were defined as those with health expenditures over 30% of their ability to pay. Multivariate analysis by logistic and linear regression were used to identify the determinants of catastrophic expenditures. A total of 3.8% of the households incurred in catastrophic health expenditures. There were huge differences by state. The uninsured, poor, and rural households showed a higher impoverishment risk. Sixty percent of the catastrophic expenditures were attributable to outpatient care and medication. A 10% increase of insured households could result in a 9.6% decrease in catastrophic expenditures. Disability, adults 60 years of age and older, and pregnancy increased the probability of catastrophic expenditures. The insurance of older adults, pregnant women, and persons with disabilities could reduce catastrophic health expenditures in Mexico.

  5. Catastrophe, gender and urban experience 1648-1920

    DEFF Research Database (Denmark)

    Employing a broad definition of catastrophe, this book examines how urban communities conceived, adapted to and were transformed by catastrophes. Competing views of gender figure in the telling and retelling of these trag- edies, which are mediated by myth and memory. This is a nuanced account...

  6. Seizure variables and cognitive performance in patients with epilepsy

    African Journals Online (AJOL)

    There are scanty reports on the contributions of seizure variables like seizure types, frequency of seizures, duration of epilepsy, age at onset and anti-epileptic drugs to cognitive disturbances in Nigerian Africans. This study assessed the effects of seizure variables on the cognitive performances of patients with epilepsy.

  7. Seizure semiology identifies patients with bilateral temporal lobe epilepsy. (United States)

    Loesch, Anna Mira; Feddersen, Berend; Tezer, F Irsel; Hartl, Elisabeth; Rémi, Jan; Vollmar, Christian; Noachtar, Soheyl


    Laterality in temporal lobe epilepsy is usually defined by EEG and imaging results. We investigated whether the analysis of seizure semiology including lateralizing seizure phenomena identifies bilateral independent temporal lobe seizure onset. We investigated the seizure semiology in 17 patients in whom invasive EEG-video-monitoring documented bilateral temporal seizure onset. The results were compared to 20 left and 20 right consecutive temporal lobe epilepsy (TLE) patients who were seizure free after anterior temporal lobe resection. The seizure semiology was analyzed using the semiological seizure classification with particular emphasis on the sequence of seizure phenomena over time and lateralizing seizure phenomena. Statistical analysis included chi-square test or Fisher's exact test. Bitemporal lobe epilepsy patients had more frequently different seizure semiology (100% vs. 40%; psemiology for the identification of bilateral TLE was high (100%) with a specificity of 60%. Lateralizing seizure phenomena had a low sensitivity (59%) but a high specificity (89%). The combination of lateralizing seizure phenomena and different seizure semiology showed a high specificity (94%) but a low sensitivity (59%). The analysis of seizure semiology including lateralizing seizure phenomena adds important clinical information to identify patients with bilateral TLE. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. Managing first-time seizures and epilepsy in children

    African Journals Online (AJOL)


    Apr 4, 2011 ... diagnosis and minimises unnecessary investigations and treatment.1. Epilepsy is defined as 2 or more unprovoked seizures and also requires a logical approach to management. Stepwise approach to a child with a suspected first-time seizure. • Is this a true seizure? • If so, what type of seizure is it?

  9. Individual brain structure and modelling predict seizure propagation. (United States)

    Proix, Timothée; Bartolomei, Fabrice; Guye, Maxime; Jirsa, Viktor K


    See Lytton (doi:10.1093/awx018) for a scientific commentary on this article.Neural network oscillations are a fundamental mechanism for cognition, perception and consciousness. Consequently, perturbations of network activity play an important role in the pathophysiology of brain disorders. When structural information from non-invasive brain imaging is merged with mathematical modelling, then generative brain network models constitute personalized in silico platforms for the exploration of causal mechanisms of brain function and clinical hypothesis testing. We here demonstrate with the example of drug-resistant epilepsy that patient-specific virtual brain models derived from diffusion magnetic resonance imaging have sufficient predictive power to improve diagnosis and surgery outcome. In partial epilepsy, seizures originate in a local network, the so-called epileptogenic zone, before recruiting other close or distant brain regions. We create personalized large-scale brain networks for 15 patients and simulate the individual seizure propagation patterns. Model validation is performed against the presurgical stereotactic electroencephalography data and the standard-of-care clinical evaluation. We demonstrate that the individual brain models account for the patient seizure propagation patterns, explain the variability in postsurgical success, but do not reliably augment with the use of patient-specific connectivity. Our results show that connectome-based brain network models have the capacity to explain changes in the organization of brain activity as observed in some brain disorders, thus opening up avenues towards discovery of novel clinical interventions. © The Author (2017). Published by Oxford University Press on behalf of the Guarantors of Brain.

  10. EEG analysis of seizure patterns using visibility graphs for detection of generalized seizures. (United States)

    Wang, Lei; Long, Xi; Arends, Johan B A M; Aarts, Ronald M


    The traditional EEG features in the time and frequency domain show limited seizure detection performance in the epileptic population with intellectual disability (ID). In addition, the influence of EEG seizure patterns on detection performance was less studied. A single-channel EEG signal can be mapped into visibility graphs (VGS), including basic visibility graph (VG), horizontal VG (HVG), and difference VG (DVG). These graphs were used to characterize different EEG seizure patterns. To demonstrate its effectiveness in identifying EEG seizure patterns and detecting generalized seizures, EEG recordings of 615h on one EEG channel from 29 epileptic patients with ID were analyzed. A novel feature set with discriminative power for seizure detection was obtained by using the VGS method. The degree distributions (DDs) of DVG can clearly distinguish EEG of each seizure pattern. The degree entropy and power-law degree power in DVG were proposed here for the first time, and they show significant difference between seizure and non-seizure EEG. The connecting structure measured by HVG can better distinguish seizure EEG from background than those by VG and DVG. A traditional EEG feature set based on frequency analysis was used here as a benchmark feature set. With a support vector machine (SVM) classifier, the seizure detection performance of the benchmark feature set (sensitivity of 24%, FD t /h of 1.8s) can be improved by combining our proposed VGS features extracted from one EEG channel (sensitivity of 38%, FD t /h of 1.4s). The proposed VGS-based features can help improve seizure detection for ID patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Manipulation of pain catastrophizing: An experimental study of healthy participants

    Directory of Open Access Journals (Sweden)

    Joel E Bialosky


    Full Text Available Joel E Bialosky1*, Adam T Hirsh2,3, Michael E Robinson2,3, Steven Z George1,3*1Department of Physical Therapy; 2Department of Clinical and Health Psychology; 3Center for Pain Research and Behavioral Health, University of Florida, Gainesville, Florida, USAAbstract: Pain catastrophizing is associated with the pain experience; however, causation has not been established. Studies which specifically manipulate catastrophizing are necessary to establish causation. The present study enrolled 100 healthy individuals. Participants were randomly assigned to repeat a positive, neutral, or one of three catastrophizing statements during a cold pressor task (CPT. Outcome measures of pain tolerance and pain intensity were recorded. No change was noted in catastrophizing immediately following the CPT (F(1,84 = 0.10, p = 0.75, partial η2 < 0.01 independent of group assignment (F(4,84 = 0.78, p = 0.54, partial η2 = 0.04. Pain tolerance (F(4 = 0.67, p = 0.62, partial η2 = 0.03 and pain intensity (F(4 = 0.73, p = 0.58, partial η2 = 0.03 did not differ by group. This study suggests catastrophizing may be difficult to manipulate through experimental pain procedures and repetition of specific catastrophizing statements was not sufficient to change levels of catastrophizing. Additionally, pain tolerance and pain intensity did not differ by group assignment. This study has implications for future studies attempting to experimentally manipulate pain catastrophizing.Keywords: pain, catastrophizing, experimental, cold pressor task, pain catastrophizing scale

  12. Orexin Receptor Antagonism Improves Sleep and Reduces Seizures in Kcna1-null Mice (United States)

    Roundtree, Harrison M.; Simeone, Timothy A.; Johnson, Chaz; Matthews, Stephanie A.; Samson, Kaeli K.; Simeone, Kristina A.


    Study Objective: Comorbid sleep disorders occur in approximately one-third of people with epilepsy. Seizures and sleep disorders have an interdependent relationship where the occurrence of one can exacerbate the other. Orexin, a wake-promoting neuropeptide, is associated with sleep disorder symptoms. Here, we tested the hypothesis that orexin dysregulation plays a role in the comorbid sleep disorder symptoms in the Kcna1-null mouse model of temporal lobe epilepsy. Methods: Rest-activity was assessed using infrared beam actigraphy. Sleep architecture and seizures were assessed using continuous video-electroencephalography-electromyography recordings in Kcna1-null mice treated with vehicle or the dual orexin receptor antagonist, almorexant (100 mg/kg, intraperitoneally). Orexin levels in the lateral hypothalamus/perifornical region (LH/P) and hypothalamic pathology were assessed with immunohistochemistry and oxygen polarography. Results: Kcna1-null mice have increased latency to rapid eye movement (REM) sleep onset, sleep fragmentation, and number of wake epochs. The numbers of REM and non-REM (NREM) sleep epochs are significantly reduced in Kcna1-null mice. Severe seizures propagate to the wake-promoting LH/P where injury is apparent (indicated by astrogliosis, blood-brain barrier permeability, and impaired mitochondrial function). The number of orexin-positive neurons is increased in the LH/P compared to wild-type LH/P. Treatment with a dual orexin receptor antagonist significantly increases the number and duration of NREM sleep epochs and reduces the latency to REM sleep onset. Further, almorexant treatment reduces the incidence of severe seizures and overall seizure burden. Interestingly, we report a significant positive correlation between latency to REM onset and seizure burden in Kcna1-null mice. Conclusion: Dual orexin receptor antagonists may be an effective sleeping aid in epilepsy, and warrants further study on their somnogenic and ant-seizure effects in

  13. The impact of climate change on catastrophe risk models : implications for catastrophe risk markets in developing countries


    Seo, John; Mahul, Olivier


    Catastrophe risk models allow insurers, reinsurers and governments to assess the risk of loss from catastrophic events, such as hurricanes. These models rely on computer technology and the latest earth and meteorological science information to generate thousands if not millions of simulated events. Recently observed hurricane activity, particularly in the 2004 and 2005 hurricane seasons, i...

  14. Counselling adults who experience a first seizure. (United States)

    Legg, Karen T; Newton, Mark


    A first seizure can result in significant uncertainty, fear and apprehension. One of the key roles of the clinician in the setting of first seizure is to provide accurate, timely information and counselling. We review the numerous components to be considered when counselling an adult patient after a first seizure. We provide a framework and manner to provide that counselling. We focus on an individualized approach and provide recommendations and information on issues of diagnosis, etiology, prognosis, the role and importance of medical testing, lifestyle considerations, driving, medication and other key counselling considerations. Accurate, timely counselling can allay fears and anxieties, remove misconceptions and reduce the risk for injury in seizure recurrence. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  15. Seizures associated with Lupus during pregnancy


    Aoki, Shigeru; Kobayashi, Natsuko; Mochimaru, Aya; Takahashi, Tsuneo; Hirahara, Fumiki


    Key Clinical Message A sudden flare of previously stable SLE may give rise to CNS lupus. During pregnancy, seizures associated with CNS lupus can cause hypoxic?ischemic encephalopathy (HIE) in the infant.

  16. Seizures and Munchausen Syndrome by Proxy

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available The prevalence, morbidity and mortality, diagnosis and management of cases of fabricated seizures and child abuse (Munchausen syndrome by proxy (MSbp are assessed by pediatricians at the University of Wales College of Medicine, Cardiff, UK.

  17. Serum Prolactin in Diagnosis of Epileptic Seizures

    Directory of Open Access Journals (Sweden)

    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.

  18. Multiple Sclerosis: Can It Cause Seizures? (United States)

    ... it cause seizures? Is there any connection between multiple sclerosis and epilepsy? Answers from B Mark Keegan, M. ... article: . Mayo Clinic Footer Legal Conditions ...

  19. Detection and Prediction of Epileptic Seizures

    DEFF Research Database (Denmark)

    Duun-Henriksen, Jonas

    detected without any false positive detections. This was obtained using a generic algorithm on the signals from only a single frontal channel. Applying the same algorithm architecture on EEG data from two outpatient children monitored for approximately three entire days each, the sensitivity was 90......Approximately 50 million people worldwide suffer from epilepsy. Although 70% can control their seizures by anti-epileptic drugs, it is still a cumbersome disease to live with for a large group of patients. The current PhD dissertation investigates how these people can be helped by continous...... 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...

  20. Types of Seizures Affecting Individuals with TSC (United States)

    ... body, and upper legs. May cause person to spill what they were holding or fall off a ... reflects recent advances in our understanding of the brain and seizures. This new system will make diagnosis ...

  1. Seizures in dominantly inherited Alzheimer disease. (United States)

    Zarea, Aline; Charbonnier, Camille; Rovelet-Lecrux, Anne; Nicolas, Gaël; Rousseau, Stéphane; Borden, Alaina; Pariente, Jeremie; Le Ber, Isabelle; Pasquier, Florence; Formaglio, Maite; Martinaud, Olivier; Rollin-Sillaire, Adeline; Sarazin, Marie; Croisile, Bernard; Boutoleau-Bretonnière, Claire; Ceccaldi, Mathieu; Gabelle, Audrey; Chamard, Ludivine; Blanc, Frédéric; Sellal, François; Paquet, Claire; Campion, Dominique; Hannequin, Didier; Wallon, David


    To assess seizure frequency in a large French cohort of autosomal dominant early-onset Alzheimer disease (ADEOAD) and to determine possible correlations with causative mutations. A national multicentric study was performed in patients with ADEOAD harboring a pathogenic mutation within PSEN1, PSEN2, APP, or a duplication of APP, and a minimal follow-up of 5 years. Clinical, EEG, and imaging data were systematically recorded. We included 132 patients from 77 families: 94 PSEN1 mutation carriers (MCs), 16 APP duplication carriers, 15 APP MCs, and 7 PSEN2 MCs. Seizure frequency was 47.7% after a mean follow-up of 8.4 years (range 5-25). After 5-year follow-up and using a Cox model analysis, the percentages of patients with seizures were respectively 19.1% (10.8%-26.7%) for PSEN1, 28.6% (0%-55.3%) for PSEN2, 31.2% (4.3%-50.6%) for APP duplications, and no patient for APP mutation. APP duplication carriers showed a significantly increased seizure risk compared to both APP MCs (hazard ratio [HR] = 5.55 [95% confidence interval 1.87-16.44]) and PSEN1 MCs (HR = 4.46 [2.11-9.44]). Among all PSEN1 mutations, those within the domains of protein hydrophilic I, transmembrane II (TM-II), TM-III, TM-IV, and TM-VII were associated with a significant increase in seizure frequency compared to other domains (HR = 4.53 [1.93-10.65], p = 0.0005). Seizures are a common feature of ADEOAD. In this population, risk was significantly higher in the APP duplication group than in all other groups. Within PSEN1, 5 specific domains were associated with a higher seizure risk indicating specific correlations between causative mutation and seizures. © 2016 American Academy of Neurology.

  2. Ketogenic diet: Predictors of seizure control (United States)

    Agarwal, Nitin; Arkilo, Dimitrios; Farooq, Osman; Gillogly, Cynthia; Kavak, Katelyn S; Weinstock, Arie


    Background: The ketogenic diet is an effective non-pharmacologic treatment for medically resistant epilepsy. The aim of this study was to identify any predictors that may influence the response of ketogenic diet. Methods: A retrospective chart review for all patients with medically resistant epilepsy was performed at a tertiary care epilepsy center from 1996 to 2012. Patient- and diet-related variables were evaluated with respect to seizure reduction at 1, 3, 6, 9 and 12-month intervals and divided into four possible outcome classes. Results: Sixty-three patients met inclusion. Thirty-seven (59%) reported >50% seizure reduction at 3 months with 44% and 37% patients benefiting at 6-month and 12-month follow up, respectively. A trend toward significant seizure improvement was noted in 48% patients with seizure onset >1 year at 12-month (p = 0.09) interval and in 62% patients with >10 seizure/day at 6-month interval (p = 0.054). An ordinal logistic regression showed later age of seizure to have higher odds of favorable response at 1-month (p = 0.005) and 3-month (p = 0.013) follow up. Patients with non-fasting diet induction were more likely to have a favorable outcome at 6 months (p = 0.008) as do females (p = 0.037) and those treated with higher fat ratio diet (p = 0.034). Conclusion: Our study reports the effectiveness of ketogenic diet in children with medically resistant epilepsy. Later age of seizure onset, female gender, higher ketogenic diet ratio and non-fasting induction were associated with better odds of improved seizure outcome. A larger cohort is required to confirm these findings. PMID:28620490

  3. Ketogenic diet: Predictors of seizure control. (United States)

    Agarwal, Nitin; Arkilo, Dimitrios; Farooq, Osman; Gillogly, Cynthia; Kavak, Katelyn S; Weinstock, Arie


    The ketogenic diet is an effective non-pharmacologic treatment for medically resistant epilepsy. The aim of this study was to identify any predictors that may influence the response of ketogenic diet. A retrospective chart review for all patients with medically resistant epilepsy was performed at a tertiary care epilepsy center from 1996 to 2012. Patient- and diet-related variables were evaluated with respect to seizure reduction at 1, 3, 6, 9 and 12-month intervals and divided into four possible outcome classes. Sixty-three patients met inclusion. Thirty-seven (59%) reported >50% seizure reduction at 3 months with 44% and 37% patients benefiting at 6-month and 12-month follow up, respectively. A trend toward significant seizure improvement was noted in 48% patients with seizure onset >1 year at 12-month (p = 0.09) interval and in 62% patients with >10 seizure/day at 6-month interval (p = 0.054). An ordinal logistic regression showed later age of seizure to have higher odds of favorable response at 1-month (p = 0.005) and 3-month (p = 0.013) follow up. Patients with non-fasting diet induction were more likely to have a favorable outcome at 6 months (p = 0.008) as do females (p = 0.037) and those treated with higher fat ratio diet (p = 0.034). Our study reports the effectiveness of ketogenic diet in children with medically resistant epilepsy. Later age of seizure onset, female gender, higher ketogenic diet ratio and non-fasting induction were associated with better odds of improved seizure outcome. A larger cohort is required to confirm these findings.

  4. Administrative management of the soldier with seizures. (United States)

    Gunderson, C H


    Based on improvement in our understanding of the prognosis of young adults with new onset seizures, and cumulative experience with the rules in effect for the last 30 years, a substantial change in the regulations affecting the fitness and profiling of these soldiers has been made. In general, these liberalize retention and profiling, set limits on the duration of trials of duty, provide for fitness determinations in soldiers with pseudo-seizures, and specify when neurologic consultation is required.

  5. Predictors of acute symptomatic seizures after intracranial hemorrhage in infants. (United States)

    Bansal, Seema; Kebede, Tewodros; Dean, Nathan P; Carpenter, Jessica L


    To determine the prevalence of acute symptomatic seizures in infants with supratentorial intracranial hemorrhage, to identify potential risk factors, and to determine the effect of acute seizures on long-term morbidity and mortality. Children less than 24 months with intracranial hemorrhage were identified from a neurocritical care database. All patients who received seizure prophylaxis beginning at admission were included in the study. Risk factors studied were gender, etiology, location of hemorrhage, seizure(s) on presentation, and the presence of parenchymal injury. Acute clinical and electrographic seizures were identified from hospital medical records. Subsequent development of late seizures was determined based on clinical information from patients' latest follow-up. Patients with idiopathic neonatal intracranial hemorrhage, premature infants, and those with prior history of seizures were excluded from analysis. Seventy-two infants met inclusion criteria. None. Forty percent of infants had acute symptomatic seizures. The prevalence was similar regardless of whether etiology of hemorrhage was traumatic or nontraumatic. Seizures on presentation and parenchymal injury were independent risk factors of acute seizures (p = 0.001 and p = 0.006, respectively). Younger children and women were also at higher risk (p Acute seizures were not predictive of mortality, but nearly twice as many patients with acute seizures developed late seizures when compared with those without. Electrographic seizures and parenchymal injury were also predictive of development of late seizures (p hemorrhage are at high risk for acute symptomatic seizures. This is regardless of the etiology of hemorrhage. Younger patients, women, patients with parenchymal injury, and patients presenting with seizure are most likely to develop acute seizures. Although the benefits of seizure prophylaxis have not been studied in this specific population, these results suggest that it is an important component

  6. Resolving cognitive dissonance by acquisition of self-organizational skills may decrease drug-resistant seizures - A case report. (United States)

    Michaelis, Rosa; Andrews, Donna J; Reiter, Joel M; von Schoen-Angerer, Tido


    A recent review of psychobehavioral therapy for epilepsy recommends case reports as a research design to explore specific psychological mediators of psychobehavioral interventions for epilepsy that address the bidirectional relationship between psychological states and seizures. The report was prepared according to the consensus-based CARE guidelines for standardized clinical case reporting. This is a case of a 16-year-old male individual with a diagnosed seizure disorder and learning disability who continued to have daytime and nighttime seizures on a regular basis despite exhausting of available conventional treatment options. A psychological assessment led to the working hypothesis that cognitive dissonance between fear of failure and high expectations of self had led to a "broken" self-image and active avoidance of responsibility that resulted in intense emotional distress which correlated with the occurrence of seizures. This working hypothesis resulted in a treatment plan that employed the acquisition of self-organizational skills and relaxation techniques as the main therapeutic strategy. Motivational strategies were employed to facilitate the regulation of lifestyle-related seizure precipitants. In this case, the acquisition of self-organizational skills and the development of seizure interruption techniques correlated with a clinically significant decrease of seizures. Methodological limitations of the interpretation of the presented data are discussed.

  7. [Seizures in neurofibromatosis. What is the risk?]. (United States)

    Drouet, A


    The prevalence and the type of seizures associated with neurofibromatosis 1 (NF1) and 2 (NF2) are not adequately characterized. NF1 has a birth incidence of one in 2500, and NF2 one in 25000. Seizures are an occasional complication in NF1 patients and there is no data for NF2 patients. Central nervous system tumors are always suspected, since NF1 and NF2 are caused by mutations in tumor suppressor gene controlling cell proliferation and differentiation. The aim of this article is to provide a synthetic overview about epilepsy associated with NF1 and NF2 based on published studies. In NF1, the type of seizures and their response to therapy are reported, the heterogeneity of etiology is also discussed. For NF2 patients, no specific data are available; the current knowledge comes from series of NF2 patients for which seizures has revealed the disease or from isolated case reports of tumors associated with seizures. Cryptogenic epilepsy without anatomic defect is likely to be related to NF1, while seizures seem to be secondary to leptomeningeal tumors (meningioma, meningioangiomatosis) in NF2 patients. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  8. Evaluation of Cannabidiol in Animal Seizure Models by the Epilepsy Therapy Screening Program (ETSP). (United States)

    Klein, Brian D; Jacobson, Catherine A; Metcalf, Cameron S; Smith, Misty D; Wilcox, Karen S; Hampson, Aidan J; Kehne, John H


    Cannabidiol (CBD) is a cannabinoid component of marijuana that has no significant activity at cannabinoid receptors or psychoactive effects. There is considerable interest in CBD as a therapy for epilepsy. Almost a third of epilepsy patients are not adequately controlled by clinically available anti-seizure drugs (ASDs). Initial studies appear to demonstrate that CBD preparations may be a useful treatment for pharmacoresistant epilepsy. The National Institute of Neurological Disorders and Stroke (NINDS) funded Epilepsy Therapy Screening Program (ETSP) investigated CBD in a battery of seizure models using a refocused screening protocol aimed at identifying pharmacotherapies to address the unmet need in pharmacoresistant epilepsy. Applying this new screening workflow, CBD was investigated in mouse 6 Hz 44 mA, maximal electroshock (MES), corneal kindling models and rat MES and lamotrigine-resistant amygdala kindling models. Following intraperitoneal (i.p.) pretreatment, CBD produced dose-dependent protection in the acute seizure models; mouse 6 Hz 44 mA (ED 50 164 mg/kg), mouse MES (ED 50 83.5 mg/kg) and rat MES (ED 50 88.9 mg/kg). In chronic models, CBD produced dose-dependent protection in the corneal kindled mouse (ED 50 119 mg/kg) but CBD (up to 300 mg/kg) was not protective in the lamotrigine-resistant amygdala kindled rat. Motor impairment assessed in conjunction with the acute seizure models showed that CBD exerted seizure protection at non-impairing doses. The ETSP investigation demonstrates that CBD exhibits anti-seizure properties in acute seizure models and the corneal kindled mouse. However, further preclinical and clinical studies are needed to determine the potential for CBD to address the unmet needs in pharmacoresistant epilepsy.

  9. Klinefelter's Syndrome with Seizure, Pseudohypoparathyroidism Type Ib and Multiple Endocrine Dysfunctions

    Directory of Open Access Journals (Sweden)

    Chwen-Yi Yang


    Full Text Available Klinefelter's syndrome is rarely associated with hypocalcemia, especially pseudohypoparathyroidism (PHP type Ib. We describe a case of Klinefelter's syndrome associated with seizure, PHP type Ib and multiple endocrine dysfunctions. A 19-year-old Taiwanese male was admitted due to seizures with loss of consciousness. He had been diagnosed with Klinefelter's syndrome with seizure disorder and hypocalcemia 3 months previously. Physical examination revealed eunuchoidism but no osteodystrophy, while laboratory data revealed severe hypocalcemia, hyperphosphatemia, and elevated parathyroid hormone. Chromosomal study showed 47, XXY. Osteoporosis was found on chest and abdominal radiography. Dense calcification in the cerebrum and cerebellum was shown on brain computed tomography and magnetic resonance imaging. Elevation of the patient's serum calcium level was noted after vitamin D and calcium carbonate supplements were given. Klinefelter's syndrome is rarely associated with PHP type Ib; our patient's hypocalcemia improved after long-term aggressive treatment.

  10. Chiari 1 Malformation in a Child with Febrile Seizures, Parasomnias, and Sleep Apnea Syndrome

    Directory of Open Access Journals (Sweden)

    Marco Zaffanello


    Full Text Available Introduction. The type I is the most common Chiari malformation in children. In this condition, the lower part of the cerebellum, but not the brain stem, extends into the foramen magnum at the base of the skull leading to disturbances in cerebrospinal fluid circulation and to direct compression of nervous tissue. Case report. We describe a 4-year-old Caucasian female child with febrile seizures, headache, parasomnias, and a delay of speech. The child underwent a magnetic resonance imaging to investigate these neurological signs, disclosing a Chiari malformation type 1. The polysomnography showed a mild-moderate sleep-disordered breathing, increased number of central sleep apneas, and generalized spike waves at sleep onset. Conclusions. Seizures have been seldom described in CM1 patients. The main reasons for performing MRI in this case were frequent seizures, a delay of speech, and headache, leading to an unexpected diagnosis of CM1. Polysomnography detected a discrete SDB.

  11. Empirical Bayes Credibility Models for Economic Catastrophic Losses by Regions

    Directory of Open Access Journals (Sweden)

    Jindrová Pavla


    Full Text Available Catastrophic events affect various regions of the world with increasing frequency and intensity. The number of catastrophic events and the amount of economic losses is varying in different world regions. Part of these losses is covered by insurance. Catastrophe events in last years are associated with increases in premiums for some lines of business. The article focus on estimating the amount of net premiums that would be needed to cover the total or insured catastrophic losses in different world regions using Bühlmann and Bühlmann-Straub empirical credibility models based on data from Sigma Swiss Re 2010-2016. The empirical credibility models have been developed to estimate insurance premiums for short term insurance contracts using two ingredients: past data from the risk itself and collateral data from other sources considered to be relevant. In this article we deal with application of these models based on the real data about number of catastrophic events and about the total economic and insured catastrophe losses in seven regions of the world in time period 2009-2015. Estimated credible premiums by world regions provide information how much money in the monitored regions will be need to cover total and insured catastrophic losses in next year.

  12. Avoiding Environmental Catastrophes: Varieties of Principled Precaution

    Directory of Open Access Journals (Sweden)

    Alan R. Johnson


    Full Text Available The precautionary principle is often proposed as a guide to action in environmental management or risk assessment, and has been incorporated in various legal and regulatory contexts. For many, it reflects the common sense notion of being safe rather than sorry, but it has attracted numerous critics. At times, proponents and critics talk at cross purposes, due to the multiplicity of ways the precautionary principle has been formulated. The approach taken here is to examine four general varieties of precaution, relating each to arguments made in various contexts by others. First, I examine the parallel between the precautionary principle and an argument referred to as Pascal's wager. Critics are right to dismiss versions of the precautionary principle that follow the logic of Pascal's wager, because that argument requires assumption of an infinite catastrophe, which is seldom the case in environmental decisions. Second, I explore precaution viewed as an instance of the phenomenon of ambiguity aversion as described by Daniel Ellsberg. Third, I evaluate precautionary perspectives on our duties to future generations, drawing inspiration from the views of Gifford Pinchot. Fourth, I consider the precautionary principle as an instance of Aldo Leopold's notion of intelligent tinkering. Although controversy persists, I find that a legitimate theoretical foundation exists to implement Ellsbergian, Pinchotian and Leopoldean varieties of precaution in environmental decision making. Additionally, I remark on the role of adaptive management and maintaining resilience in ecological and social systems as an approach to implementing the precautionary principle.

  13. [Fund for Protection against Catastrophic Expenses]. (United States)

    Aracena-Genao, Belkis; González-Robledo, María Cecilia; González-Robledo, Luz María; Palacio-Mejía, Lina Sofía; Nigenda-López, Gustavo


    To document the status of operational and managerial processes of the Fund for Protection against Catastrophic Expenses (FPGC), as well as to describe its evolution, and to explore the relationship between covered diseases and the Mexican health profile. This is a joint management study, which included a qualitative and a quantitative phase. We conducted semi-structured interviews with key informants. We also analyzed the records of CNPSS, the hospital discharge and mortality data bases. Fifty two percent of the states take twice as long to report and validate the cases. From 2004-2009 the FPGC increased its coverage from 6 to 49 interventions, that means a spending increase of 2 306.4% in nominal terms and 1 659.3% in real terms. The HIV/AIDS was the intervention prioritized with 39.3% and Mexico City had the highest proportion of expenditure (25.1%). A few diseases included in the health profile are covered by the FPGC. The review of the inclusion criteria of diseases is urgent, so as to cover diseases of epidemiological importance.

  14. Alterations in sociability and functional brain connectivity caused by early-life seizures are prevented by bumetanide. (United States)

    Holmes, Gregory L; Tian, Chengju; Hernan, Amanda E; Flynn, Sean; Camp, Devon; Barry, Jeremy


    There is a well-described association between infantile epilepsy and pervasive cognitive and behavioral deficits, including a high incidence of autism spectrum disorders. Despite the robustness of the relationship between early-life seizures and the development of autism, the pathophysiological mechanism by which this occurs has not been explored. As a result of increasing evidence that autism is a disorder of brain connectivity we hypothesized that early-life seizures would interrupt normal brain connectivity during brain maturation and result in an autistic phenotype. Normal rat pups underwent recurrent flurothyl-induced seizures from postnatal (P)days 5-14 and then tested, along with controls, for developmental alterations of development brain oscillatory activity from P18-P25. Specifically we wished to understand how normal changes in rhythmicity in and between brain regions change as a function of age and if this rhythmicity is altered or interrupted by early life seizures. In rat pups with early-life seizures, field recordings from dorsal and ventral hippocampus and prefrontal cortex demonstrated marked increase in coherence as well as a decrease in voltage correlation at all bandwidths compared to controls while there were minimal differences in total power and relative power spectral densities. Rats with early-life seizures had resulting impairment in the sociability and social novelty tests but demonstrated no evidence of increased activity or generalized anxiety as measured in the open field. In addition, rats with early-life seizures had lower seizure thresholds than controls, indicating long-standing alterations in the excitatory/inhibition balance. Bumetanide, a pharmacological agent that blocks the activity of NKCC1 and induces a significant shift of ECl toward more hyperpolarized values, administration at the time of the seizures precluded the subsequent abnormalities in coherence and voltage correlation and resulted in normal sociability and seizure

  15. Optimal natural resources management under uncertainty with catastrophic risk

    International Nuclear Information System (INIS)

    Motoh, Tsujimura


    We examine an optimal natural resources management problem under uncertainty with catastrophic risk and investigate the optimal rate of use of a natural resource. For this purpose, we use stochastic control theory. We assume that, until a catastrophic event occurs, the stock of the natural resource is governed by a stochastic differential equation. We describe the catastrophic phenomenon as a Poisson process. From this analysis, we show the optimal rate of use of the natural resource in explicit form. Furthermore, we present comparative static results for the optimal rate of use of the natural resource

  16. The influence of sex hormones on seizures in dogs and humans. (United States)

    Van Meervenne, Sofie A E; Volk, Holger A; Matiasek, Kaspar; Van Ham, Luc M L


    Epilepsy is the most common chronic neurological disorder in both humans and dogs. The effect of sex hormones on seizures is well documented in human medicine. Catamenial epilepsy is defined as an increase in frequency and severity of seizures during certain periods of the menstrual cycle. Oestradiol increases seizure activity and progesterone is believed to exhibit a protective effect. The role of androgens is controversial and there is a lack of research focusing on androgens and epilepsy. Indeed, little is known about the influence of sex hormones on epilepsy in dogs. Sterilisation is believed to improve seizure control, but no systematic research has been conducted in this field. This review provides an overview of the current literature on the influence of sex hormones on seizures in humans. The literature on idiopathic epilepsy in dogs was assessed to identify potential risk factors related to sex and sterilisation status. In general, there appears to be an over-representation of male dogs with idiopathic epilepsy but no explanation for this difference in prevalence between sexes has been reported. In addition, no reliable conclusions can be drawn on the effect of sterilisation due to the lack of focused research and robust scientific evidence. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. The prevalence of orodental trauma during epileptic seizures in terms of dental treatment - Survey study. (United States)

    Gawlak, Dominika; Łuniewska, Joanna; Stojak, Wiktoria; Hovhannisyan, Anahit; Stróżyńska, Anna; Mańka-Malara, Katarzyna; Adamiec, Marcin; Rysz, Andrzej

    Epilepsy is one of the most common neurological disorders. Seizures that occur during attacks may lead to head injuries. It is crucial to establish proper prophylactic management against trauma occurrence, as nowadays prevention is not sufficient. Assessment of the frequency of head and intraoral trauma during epileptic seizures and to evaluate factors that may predispose to injuries. The questionnaire was carried out among 106 patients with epilepsy. Survey conducted questions regarding development of the disease and occurrence of orodental and head trauma. Results were statistically analyzed with the chi-square test (ptrauma during epileptic seizures. The most common were lips, tongue or cheeks injuries. 18% patients suffered from tooth crack and 17% from tooth fracture. 50% of respondents suffered from head trauma during seizures: 41% patients reported bruises, 39% burns, 37% wounds, 10% nose fractures, 7% eye socket trauma and 3% skull crack. 14.1% of respondents experienced dentist refusal to undertake treatment, while 4% of patients had epileptic attack during dental procedures. Dental trauma is common result of epileptic seizures. It is necessary to implement prophylactic management to prevent hard and soft tissues injuries, for example by using custom-made mouthguards. Moreover, specially designed dental programs for this group of patients should be provided. Copyright © 2017 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  18. Fast monitoring of epileptic seizures using recurrence time statistics of electroencephalography

    Directory of Open Access Journals (Sweden)

    Jianbo eGao


    Full Text Available Epilepsy is one of the most common disorders of the brain. Currently, determination of epileptic seizures often involves tedious, time-consuming visual inspection of electroencephalography (EEG data by medical experts. To better monitor seizures and make medications more effective, we propose a recurrence time based approach to characterize brain electrical activity. Recurrence times have a number of distinguished properties that make it very effective for forwarning epileptic seizures as well as studying propagation of seizures: 1 recurrence times amount to periods of periodic signals, 2 recurrence times are closely related to information dimension, Lyapunov exponent, and Kolmogorov entropy of chaotic signals, 3 recurrence times embody Shannon and Renyi entropies of random fields, and 4 recurrence times can readily detect bifurcation-like transitions in dynamical systems. In particular, property 4 dictates that unlike many other nonlinear methods, recurrence time method does not require the EEG data be chaotic and/or stationary. Moreover, the method only contains a few parameters that are largely signal-independent, and hence, is very easy to use. The method is also very fast—it is fast enough to on-line process multi-channel EEG data with a typical PC. Therefore, it has the potential to be an excellent candidate for real-time monitoring of epileptic seizures in a clinical setting.

  19. Fast monitoring of epileptic seizures using recurrence time statistics of electroencephalography. (United States)

    Gao, Jianbo; Hu, Jing


    Epilepsy is a relatively common brain disorder which may be very debilitating. Currently, determination of epileptic seizures often involves tedious, time-consuming visual inspection of electroencephalography (EEG) data by medical experts. To better monitor seizures and make medications more effective, we propose a recurrence time based approach to characterize brain electrical activity. Recurrence times have a number of distinguished properties that make it very effective for forewarning epileptic seizures as well as studying propagation of seizures: (1) recurrence times amount to periods of periodic signals, (2) recurrence times are closely related to information dimension, Lyapunov exponent, and Kolmogorov entropy of chaotic signals, (3) recurrence times embody Shannon and Renyi entropies of random fields, and (4) recurrence times can readily detect bifurcation-like transitions in dynamical systems. In particular, property (4) dictates that unlike many other non-linear methods, recurrence time method does not require the EEG data be chaotic and/or stationary. Moreover, the method only contains a few parameters that are largely signal-independent, and hence, is very easy to use. The method is also very fast-it is fast enough to on-line process multi-channel EEG data with a typical PC. Therefore, it has the potential to be an excellent candidate for real-time monitoring of epileptic seizures in a clinical setting.

  20. An efficient detection of epileptic seizure by differentiation and spectral analysis of electroencephalograms. (United States)

    Kang, Jae-Hwan; Chung, Yoon Gi; Kim, Sung-Phil


    Epilepsy is a critical neurological disorder resulting from abnormal hyper-excitability of neurons in the brain. Studies have shown that epilepsy can be detected in electroencephalography (EEG) recordings of patients suffering from seizures. The performance of EEG-based epileptic seizure detection relies largely on how well one can extract features from an EEG that characterize seizure activity. Conventional feature extraction methods using time-series analysis, spectral analysis and nonlinear dynamic analysis have advanced in recent years to improve detection. The computational complexity has also increased to obtain a higher detection rate. This study aimed to develop an efficient feature extraction method based on Hjorth's mobility to reduce computational complexity while maintaining high detection accuracy. A new feature extraction method was proposed by computing the spectral power of Hjorth's mobility components, which were effectively estimated by differentiating EEG signals in real-time. Using EEG data in five epileptic patients, this method resulted in a detection rate of 99.46% between interictal and epileptic EEG signals and 99.78% between normal and epileptic EEG signals, which is comparable to most advanced nonlinear methods. These results suggest that the spectral features of Hjorth's mobility components in EEG signals can represent seizure activity and may pave the way for developing a fast and reliable epileptic seizure detection method. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. An Automatic Prediction of Epileptic Seizures Using Cloud Computing and Wireless Sensor Networks. (United States)

    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 %.

  2. Metabolic Screening in Children with Neurodevelopmental Delay, Seizure and/or Regression. (United States)

    Karimzadeh, Parvaneh; Taghdiri, Mohammad Mahdi; Abasi, Ezatollah; Hassanvand Amouzadeh, Masoud; Naghavi, Zhila; Ghazavi, Ahad; Nasehi, Mohammad Mahdi; Alipour, Abbas


    Neurometabolic disorder is one of the important groups of diseases that prominently has presentation early infantile period. In this study, we evaluated the result of metabolic screening of the patient with seizure, developmental delay and/or regression in development, demographic disease clinical and radiological findings on admitted and outpatient visited children. Two-year retrospective review of 187 children with seizure, developmental delay and/or regression in the Mofid Children Hospital, Tehran, Iran was performed. The diagnosis was based on observation, findings of EEG and history of the patient, besides evaluation of patient milestones. The result of metabolic screening with Tandem mass spectrometry was evaluated using SPSS (ver.18.0) Statistical software. Totally, 187 children with seizure, regression and/or developmental delay were evaluated by metabolic screening with tandem mass spectrometry method. The results of laboratory examination had no relationship between positive results of metabolic screening and the mentioned disease. The relations between positive results of metabolic screening and seizure, regression and/or developmental delay were not statistically meaningful. Positive results of metabolic screening and seizure, regression and/or developmental delay were not statistically meaningful.

  3. Partial Seizures Are Associated with Early Increases in Signal Complexity (United States)

    Jouny, Christophe C; Bergey, Gregory K; Franaszczuk, Piotr J


    Objectives Partial seizures are often believed to be associated with EEG signals of low complexity because seizures are associated with increased neural network synchrony. The investigations reported here provide an assessment of the signal complexity of epileptic seizure onsets using newly developed quantitative measures. Methods Using the Gabor atom density (GAD) measure of signal complexity, 339 partial seizures in 45 patients with intracranial electrode arrays were analyzed. Segmentation procedures were applied to determine the timing and amplitude of GAD changes relative to the electrographic onset of the seizure. Results 330 out of 339 seizures have significant complexity level changes, with 319 (97%) having an increase in complexity. GAD increases occur within seconds of the onset of the partial seizure but are not observed in channels remote from the focus. The complexity increase is similar for seizures from mesial temporal origin, neocortical temporal and extra-temporal origin. Conclusions Partial onset seizures are associated with early increases in signal complexity as measured by GAD. This increase is independent of the location of the seizure focus. Significance Despite the often predominant rhythmic activity that characterizes onset and early evolution of epileptic seizures, partial seizure onset is associated with an early increase in complexity. These changes are common to partial seizures originating from different brain regions, indicating a similar seizure dynamic. PMID:19910249

  4. Socio-economic consequences of Chernobyl catastrophe. Social protection of the citizens, affected owing to Chernobyl catastrophe

    International Nuclear Information System (INIS)

    Kholosha, V.; Kovalchuk, V.


    The accident on Chernobyl NPP has affected the destiny of 35 million people in Ukraine. The social protection of the population affected during Chernobyl catastrophe is founded on the Law of Ukraine 'About the status and social protection of citizens affected owing to Chernobyl catastrophe' (see further - 'Law'), and is the principal direction of activity and the subject of the special state attention to total complex of problems bound to Chernobyl catastrophe consequences elimination. The current legislation stipulates partial compensation of material losses connected with resettlement of the affected population. According to the current legislation in Ukraine about 50 kinds of aid, privileges and compensations are submitted to the affected citizens

  5. Clinical characteristics of seizures associated with viral gastroenteritis in children. (United States)

    Ueda, Hitoshi; Tajiri, Hitoshi; Kimura, Sadami; Etani, Yuri; Hosoi, Gaku; Maruyama, Tomoko; Noma, Haruyoshi; Kusumoto, Yoshio; Takano, Tomoko; Baba, Yoshiko; Nagai, Toshizaburo


    We analyzed the clinical features of seizures during gastroenteritis in children by comparing the norovirus and rotavirus pathogen, and the impact of fever, if present, during the seizure episodes. Retrospective analysis was performed on 293 consecutive pediatric patients admitted with viral gastroenteritis to Osaka General Hospital between November 2007 and May 2009. Eighteen patients developed seizures, 12 of whom were positive for norovirus and six for rotavirus, as revealed by antigen detection. Of these 18 seizure patients, eight presented without fever (the aFS group) and 10 presented with febrile episodes (FS group). Seizure patients in the rotavirus group (83%) were more likely to be febrile than those in the norovirus group (58%). Compared with the aFS group, 90% of patients in the FS group presented seizures at an early stage of gastroenteritis. The frequency of clustered seizures in the FS group was considerably higher than that of febrile seizures in general and was also as high as that of "convulsions with mild gastroenteritis (CwG)". All seizure patients, whether febrile or afebrile, presented with generalized tonic clonic seizures (GTCS), complex partial seizures (CPS), or both. Diazepam (DZP) was less effective and carbamazepine (CBZ) was completely effective for the cessation of seizures in the FS group, similar to the drug response observed in CwG. The causative pathogen (norovirus or rotavirus) affected the frequency of febrile episodes during gastroenteritis, but fever had little effect on the clinical features of seizures. However, seizures occurred earlier during gastroenteritis in the FS group. On the whole, the clinical features of febrile seizures during viral gastroenteritis may closely resemble those of "convulsions with mild gastroenteritis" (CwG) than those of febrile seizures in general with respect to the frequency of clustered seizures and the antiepileptic drug responses and may have a pathogenic mechanism distinct from those of

  6. [What the patient's history tells us about their nonepileptic seizures]. (United States)

    Reuber, M; Micoulaud-Franchi, J-A; Gülich, E; Bartolomei, F; McGonigal, A


    The aetiology of "psychogenic" non-epileptic seizures (NES) remains poorly understood and the differentiation of NES from epilepsy can be a difficult. In the first part of this review article we focus on recent insights into the neurobiological underpinnings of NES. We summarise a number of studies demonstrating the importance of abnormalities of emotion regulation in patients with NES. Evidence for abnormal emotion regulation comes from both self-report and experimental studies of pre-conscious cognitive processes. These studies show that NES are not the only manifestation of abnormal mental processing in these patients and that excessive social threat avoidance and emotional dysregulation are also evident between seizures and may therefore contribute to disability beyond the seizures themselves. In the second part of this review, we describe the findings of a number of studies, which have examined differences between the communication behaviour of patients with NES and those with epilepsy. We argue, that, whilst these studies initially aimed to help clinicians with the differential diagnosis of NES and epilepsy, close sociolinguistic analysis of patient's talk can also provide clues about the aetiology of NES. We conclude that the interaction of patient with NES with the doctor can be interpreted as a manifestation of avoidance and a demonstration of helplessness perhaps intended to secure active support from the doctor. In the third part of this review, we suggest that a close reading of a transcript of the interaction between a patient with NES and her doctor (and perhaps attentive listening to how patients' talk about themselves and their disorder) can yield clues to the causes of NES in individual cases. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  7. Catastrophic Failure and Critical Scaling Laws of Fiber Bundle Material

    Directory of Open Access Journals (Sweden)

    Shengwang Hao


    Full Text Available This paper presents a spring-fiber bundle model used to describe the failure process induced by energy release in heterogeneous materials. The conditions that induce catastrophic failure are determined by geometric conditions and energy equilibrium. It is revealed that the relative rates of deformation of, and damage to the fiber bundle with respect to the boundary controlling displacement ε0 exhibit universal power law behavior near the catastrophic point, with a critical exponent of −1/2. The proportion of the rate of response with respect to acceleration exhibits a linear relationship with increasing displacement in the vicinity of the catastrophic point. This allows for the prediction of catastrophic failure immediately prior to failure by extrapolating the trajectory of this relationship as it asymptotes to zero. Monte Carlo simulations are completed and these two critical scaling laws are confirmed.

  8. An Update on Football Deaths and Catastrophic Injuries. (United States)

    Mueller, Frederick O.; Blyth, Carl S.


    The latest figures (1985) indicate a continued decline in football deaths and catastrophic injuries, which is credited to a ban on spearing and to a helmet standard. Guidelines for prevention of fatalities and injuries are listed. (Author/MT)

  9. Chernobyl: Endless horror. Late effects of the reactor catastrophe

    International Nuclear Information System (INIS)

    Roethlein, B.


    Ten years after the accident, the people of Chernobyl are trying to live a normal life, but the problems resulting from the catastrophe have not been solved. Some of them are just starting to emerge. (orig.) [de

  10. Catastrophic Failure and Critical Scaling Laws of Fiber Bundle Material. (United States)

    Hao, Shengwang; Yang, Hang; Liang, Xiangzhou


    This paper presents a spring-fiber bundle model used to describe the failure process induced by energy release in heterogeneous materials. The conditions that induce catastrophic failure are determined by geometric conditions and energy equilibrium. It is revealed that the relative rates of deformation of, and damage to the fiber bundle with respect to the boundary controlling displacement ε ₀ exhibit universal power law behavior near the catastrophic point, with a critical exponent of -1/2. The proportion of the rate of response with respect to acceleration exhibits a linear relationship with increasing displacement in the vicinity of the catastrophic point. This allows for the prediction of catastrophic failure immediately prior to failure by extrapolating the trajectory of this relationship as it asymptotes to zero. Monte Carlo simulations are completed and these two critical scaling laws are confirmed.

  11. Catastrophic Events and Mass Extinctions: Impacts and Beyond (United States)


    This volume contains extended abstracts that have been accepted for presentation at the conference on Catastrophic Events and Mass Extinctions: Impacts and Beyond, July 9-12, 2000, in Vienna, Austria.

  12. Self-Organized Patchiness and Catastrophic Shifts in Ecosystems

    NARCIS (Netherlands)

    Rietkerk, M.; Dekker, S.C.; Ruiter, de P.C.; Koppel, van de J.


    Unexpected sudden catastrophic shifts may occur in ecosystems, with concomitant losses or gains of ecological and economic resources. Such shifts have been theoretically attributed to positive feedback and bistability of ecosystem states. However, verifications and predictive power with respect to

  13. Sex Differences in Seizure Types and Symptoms (United States)

    Carlson, Chad; Dugan, Patricia; Kirsch, Heidi E; Friedman, Daniel


    Background Despite the increasing interest in sex differences in disease manifestations and responses to treatment, very few data are available on sex differences in seizure types and semiology. The Epilepsy Phenome/Genome Project (EPGP) is a large-scale, multi-institutional, collaborative study that aims to create a comprehensive repository of detailed clinical information and DNA samples from a large cohort of people with epilepsy. We used this well-characterized cohort to explore differences in seizure types as well as focal seizure symptoms between males and females. Methods We reviewed the EPGP database and identified individuals with generalized epilepsy of unknown etiology (GE) (n=760; female 446, male 314), non-acquired focal epilepsy (NAFE) (n=476; female 245, male 231), or both (n=64; female 33, male 31). Demographic data along with characterization of seizure type and focal seizure semiologies were examined. Results In GE, males reported atonic seizures more frequently than females (6.5% vs. 1.7%; p<0.001). No differences were observed in other generalized seizure types. In NAFE, no sex differences were seen for seizure types with or without alteration of consciousness or progression to secondary generalization. Autonomic (16.4% vs. 26.6%; p=0.005), psychic (26.7% vs. 40.3%; p=0.001), and visual symptoms (10.3% vs. 19.9%; p=0.002) were more frequently reported in females than males. Specifically, of psychic symptoms, more females than males endorsed déjà vu (p=0.001), but not forced thoughts, derealization/depersonalization, jamais vu, or fear. With corrections for multiple comparisons, there were no significant differences in aphasic, motor, somatosensory, gustatory, olfactory, auditory, vertiginous, or ictal headache symptoms between sexes. Conclusions Significant differences between the sexes were observed in the reporting of atonic seizures, which was more common in males with GE, and for autonomic, visual, and psychic symptoms associated with NAFE

  14. Communications en cas de catastrophe faisant appel aux TIC pour ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Communications en cas de catastrophe faisant appel aux TIC pour les collectivités vulnérables des Caraïbes. De récents événements survenus dans les Caraïbes ont mis en relief les insuffisances des mesures régionales et nationales de préparation aux catastrophes. On manque particulièrement de systèmes d'alerte ...

  15. Special software for computing the special functions of wave catastrophes

    Directory of Open Access Journals (Sweden)

    Andrey S. Kryukovsky


    Full Text Available The method of ordinary differential equations in the context of calculating the special functions of wave catastrophes is considered. Complementary numerical methods and algorithms are described. The paper shows approaches to accelerate such calculations using capabilities of modern computing systems. Methods for calculating the special functions of wave catastrophes are considered in the framework of parallel computing and distributed systems. The paper covers the development process of special software for calculating of special functions, questions of portability, extensibility and interoperability.

  16. Special software for computing the special functions of wave catastrophes


    Andrey S. Kryukovsky; Dmitry S. Lukin; Sergey V. Rogachev


    The method of ordinary differential equations in the context of calculating the special functions of wave catastrophes is considered. Complementary numerical methods and algorithms are described. The paper shows approaches to accelerate such calculations using capabilities of modern computing systems. Methods for calculating the special functions of wave catastrophes are considered in the framework of parallel computing and distributed systems. The paper covers the development process of spec...

  17. Climate change policy in a growing economy under catastrophic risks


    Tsur, Yacov; Zemel, Amos


    Under risk of catastrophic climate change, the occurrence hazard is added to the social discount rate. As a result, the social discount rate (i) increases and (ii) turns endogenous to the global warming policy. The second effect bears profound policy implications that are magnifed by economic growth. In particular, it implies that green- house gases (GHG) emission should gradually be brought to a halt. Due to the public bad nature of the catastrophic risk, the second effect is ignored in a co...

  18. Pain Catastrophizing Correlates with Early Mild Traumatic Brain Injury Outcome

    Directory of Open Access Journals (Sweden)

    Geneviève Chaput


    Full Text Available Background. Identifying which patients are most likely to be at risk of chronic pain and other postconcussion symptoms following mild traumatic brain injury (MTBI is a difficult clinical challenge. Objectives. To examine the relationship between pain catastrophizing, defined as the exaggerated negative appraisal of a pain experience, and early MTBI outcome. Methods. This cross-sectional design included 58 patients diagnosed with a MTBI. In addition to medical chart review, postconcussion symptoms were assessed by self-report at 1 month (Time 1 and 8 weeks (Time 2 after MTBI. Pain severity, psychological distress, level of functionality, and pain catastrophizing were measured by self-report at Time 2. Results. The pain catastrophizing subscales of rumination, magnification, and helplessness were significantly correlated with pain severity (r=.31 to .44, number of postconcussion symptoms reported (r=.35 to .45, psychological distress (r=.57 to .67, and level of functionality (r=-.43 to -.29. Pain catastrophizing scores were significantly higher for patients deemed to be at high risk of postconcussion syndrome (6 or more symptoms reported at both Time 1 and Time 2. Conclusions. Higher levels of pain catastrophizing were related to adverse early MTBI outcomes. The early detection of pain catastrophizing may facilitate goal-oriented interventions to prevent or minimize the development of chronic pain and other postconcussion symptoms.

  19. Risk of seizures in transcranial magnetic stimulation: a clinical review to inform consent process focused on bupropion

    Directory of Open Access Journals (Sweden)

    Dobek CE


    Full Text Available Christine E Dobek,1 Daniel M Blumberger,2 Jonathan Downar,3 Zafiris J Daskalakis,2 Fidel Vila-Rodriguez11Department of Psychiatry, Faculty of Medicine, Non-Invasive Neurostimulation Therapies (NINET Laboratory, University of British Columbia, Vancouver, BC, 2Department of Psychiatry, Centre for Addiction and Mental Health, 3Department of Psychiatry, University Health Network, University of Toronto, Toronto, ON, CanadaObjective: When considering repetitive transcranial magnetic stimulation (rTMS for major depressive disorder, clinicians often face a lack of detailed information on potential interactions between rTMS and pharmacotherapy. This is particularly relevant to patients receiving bupropion, a commonly prescribed antidepressant with lower risk of sexual side effects or weight increase, which has been associated with increased risk of seizure in particular populations. Our aim was to systematically review the information on seizures occurred with rTMS to identify the potential risk factors with attention to concurrent medications, particularly bupropion.Data sources: We conducted a systematic review through the databases PubMed, PsycINFO, and EMBASE between 1980 and June 2015. Additional articles were found using reference lists of relevant articles. Reporting of data follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.Study selection: Two reviewers independently screened articles reporting the occurrence of seizures during rTMS. Articles reporting seizures in epilepsy during rTMS were excluded. A total of 25 rTMS-induced seizures were included in the final review.Data extraction: Data were systematically extracted, and the authors of the applicable studies were contacted when appropriate to provide more detail about the seizure incidents.Results: Twenty-five seizures were identified. Potential risk factors emerged such as sleep deprivation, polypharmacy, and neurological insult. High-frequency-rTMS was

  20. Are seizures in the setting of sleep deprivation provoked? (United States)

    Lawn, Nicholas; Lieblich, Sam; Lee, Judy; Dunne, John


    It is generally accepted that sleep deprivation contributes to seizures. However, it is unclear whether a seizure occurring in the setting of sleep deprivation should be considered as provoked or not and whether this is influenced by seizure type and etiology. This information may have an important impact on epilepsy diagnosis and management. We prospectively analyzed the influence of sleep deprivation on the risk of seizure recurrence in patients with first-ever unprovoked seizures and compared the findings with patients with first-ever provoked seizures. Of 1026 patients with first-ever unprovoked seizures, 204 (20%) were associated with sleep deprivation. While the overall likelihood of seizure recurrence was slightly lower in sleep-deprived patients with first-ever seizures (log-rank p=0.03), sleep deprivation was not an independent predictor of seizure recurrence on multivariate analysis. Seizure recurrence following a first-ever unprovoked seizure associated with sleep deprivation was far more likely than for 174 patients with a provoked first-ever seizure (log-rank psleep deprivation should not be regarded as provoked. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. A new model to study sleep deprivation-induced seizure. (United States)

    Lucey, Brendan P; Leahy, Averi; Rosas, Regine; Shaw, Paul J


    A relationship between sleep and seizures is well-described in both humans and rodent animal models; however, the mechanism underlying this relationship is unknown. Using Drosophila melanogaster mutants with seizure phenotypes, we demonstrate that seizure activity can be modified by sleep deprivation. Seizure activity was evaluated in an adult bang-sensitive seizure mutant, stress sensitive B (sesB(9ed4)), and in an adult temperature sensitive seizure mutant seizure (sei(ts1)) under baseline and following 12 h of sleep deprivation. The long-term effect of sleep deprivation on young, immature sesB(9ed4) flies was also assessed. Laboratory. Drosophila melanogaster. Sleep deprivation. Sleep deprivation increased seizure susceptibility in adult sesB(9ed4)/+ and sei(ts1) mutant flies. Sleep deprivation also increased seizure susceptibility when sesB was disrupted using RNAi. The effect of sleep deprivation on seizure activity was reduced when sesB(9ed4)/+ flies were given the anti-seizure drug, valproic acid. In contrast to adult flies, sleep deprivation during early fly development resulted in chronic seizure susceptibility when sesB(9ed4)/+ became adults. These findings show that Drosophila is a model organism for investigating the relationship between sleep and seizure activity. © 2015 Associated Professional Sleep Societies, LLC.

  2. Termination patterns of complex partial seizures: An intracranial EEG study. (United States)

    Afra, Pegah; Jouny, Christopher C; Bergey, Gregory K


    While seizure onset patterns have been the subject of many reports, there have been few studies of seizure termination. In this study we report the incidence of synchronous and asynchronous termination patterns of partial seizures recorded with intracranial arrays. Data were collected from patients with intractable complex partial seizures undergoing presurgical evaluations with intracranial electrodes. Patients with seizures originating from mesial temporal and neocortical regions were grouped into three groups based on patterns of seizure termination: synchronous only (So), asynchronous only (Ao), or mixed (S/A, with both synchronous and asynchronous termination patterns). 88% of the patients in the MT group had seizures with a synchronous pattern of termination exclusively (38%) or mixed (50%). 82% of the NC group had seizures with synchronous pattern of termination exclusively (52%) or mixed (30%). In the NC group, there was a significant difference of the range of seizure durations between So and Ao groups, with Ao exhibiting higher variability. Seizures with synchronous termination had low variability in both groups. Synchronous seizure termination is a common pattern for complex partials seizures of both mesial temporal or neocortical onset. This may reflect stereotyped network behavior or dynamics at the seizure focus. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  3. Seizure metaphors differ in patients' accounts of epileptic and psychogenic nonepileptic seizures. (United States)

    Plug, Leendert; Sharrack, Basil; Reuber, Markus


    To increase understanding of the subjective symptomatology of seizure experiences and improve differential diagnosis by studying the seizure metaphors used by patients with (psychogenic) nonepileptic seizures (NES) and epilepsy. Twenty-one unselected patients taking part in this study were admitted for 48 h of video-EEG (electroenceophalography) observation because of uncertainty about the diagnosis. Eight were proven to have epilepsy, 13 to have psychogenic nonepileptic seizures (PNES). During their admission, patients were interviewed by a neurologist. A linguist blinded to the medical diagnosis identified and categorized all seizure metaphors in verbatim transcripts. Between-group comparisons and logistic regression analysis were carried out. Of 382 metaphors identified, 80.8% conceptualized seizures as an agent/force, event/situation, or space/place. Most patients used metaphors from all categories, but patients with epilepsy and PNES showed preferences for different metaphoric concepts (differences p = 0.009 to p = 0.039). Patients with epilepsy preferred metaphors depicting the seizure as an agent/force or event/situation. PNES patients more often used metaphors of space/place. Logistic regression analyses predicted the diagnosis of PNES or epilepsy correctly in 85.7% of cases (based on different metaphor types in the each category) or 81.0% (based on all metaphor tokens). Patients with epilepsy and PNES have different preferences in the metaphoric conceptualization of their seizures. Epileptic seizures are described as a more external, self-directed entity than PNES, which are depicted as a state or place patients go through. The differentiating value of metaphoric conceptualizations suggests that metaphor preference could form the basis of future diagnostic questionnaires or other diagnostic tools.

  4. Catastrophic antiphospholipid syndrome in obstetric practice

    Directory of Open Access Journals (Sweden)

    Валерий Николаевич Запорожан


    Full Text Available Thus, the Catastrophic antiphospholipid syndrome (CAPS is much more common than has been assumed until now, in all patients the authors strongly recommend screening for AFA. Furthermore, eclampsia, HELLP-syndrome premature detachment of normally located placentae (PDNSP can develop in the presence of other defects of hemostasis, in particular in mutation FV Leiden, MTHFR C677T, deficiency of protein C (PC, protein S (PS. The combination of acquired thrombophilia due to APS, with genetic defects worsen hemostasis during the pathological process leading to the development of thrombotic complications. Perhaps a combination of hereditary thrombophilia and APS creates a favorable environment in which, under certain conditions, possible decompensation of the hemostatic system and the development of CAPS. Patients with APS constitute a group of very high risk of thromboembolic complications in the perioperative period. Even a minimally invasive intervention (biopsy, curettage, tooth extraction may trigger the development of CAPS. Thus, according to Erkan et al. (2003, 40% of patients develop CAPS was provoked by surgery. The main reasons for the development of thrombotic complications in connection with surgical intervention is the damage to the vessel wall, blood stasis and the abolition of indirect anticoagulants. In the study on the presence of genetic thrombophilia was found heterozygous form of FV Leiden mutation and homozygous mutation of MTHFR C677T. He was diagnosed with pregnancy 14 weeks, APS, mixed form of thrombophilia (a combination of acquisitions and multigenic thrombophilia, hyperhomocysteinemia, weighed down by obstetric and somatic history.It is very urgent and important problem remains diagnosis CAPS, which is inconceivable without the determination of AFA. The latter should be mandatory for all pregnant women with preeclampsia habitual miscarriage, Premature detachment of normally situated placenta (PDNSP, genital herpes history

  5. A probabilistic strategy for parametric catastrophe insurance (United States)

    Figueiredo, Rui; Martina, Mario; Stephenson, David; Youngman, Benjamin


    Economic losses due to natural hazards have shown an upward trend since 1980, which is expected to continue. Recent years have seen a growing worldwide commitment towards the reduction of disaster losses. This requires effective management of disaster risk at all levels, a part of which involves reducing financial vulnerability to disasters ex-ante, ensuring that necessary resources will be available following such events. One way to achieve this is through risk transfer instruments. These can be based on different types of triggers, which determine the conditions under which payouts are made after an event. This study focuses on parametric triggers, where payouts are determined by the occurrence of an event exceeding specified physical parameters at a given location, or at multiple locations, or over a region. This type of product offers a number of important advantages, and its adoption is increasing. The main drawback of parametric triggers is their susceptibility to basis risk, which arises when there is a mismatch between triggered payouts and the occurrence of loss events. This is unavoidable in said programmes, as their calibration is based on models containing a number of different sources of uncertainty. Thus, a deterministic definition of the loss event triggering parameters appears flawed. However, often for simplicity, this is the way in which most parametric models tend to be developed. This study therefore presents an innovative probabilistic strategy for parametric catastrophe insurance. It is advantageous as it recognizes uncertainties and minimizes basis risk while maintaining a simple and transparent procedure. A logistic regression model is constructed here to represent the occurrence of loss events based on certain loss index variables, obtained through the transformation of input environmental variables. Flood-related losses due to rainfall are studied. The resulting model is able, for any given day, to issue probabilities of occurrence of loss

  6. Seizures after intravenous tramadol given as premedication

    Directory of Open Access Journals (Sweden)

    Lalit Kumar Raiger


    Full Text Available A 35-year-old, 50-kg female with a history of epilepsy was scheduled for elective breast surgery (fibroadenoma under general anaesthesia. She was given glycopyrrolate 0.2 mg, ondansetron 4 mg and tramadol 100 mg i.v. as premedication. Within 5 min, she had an acute episode of generalised tonic-clonic seizure that was successfully treated with 75 mg thiopentone i.v. and after 30 min, she was given general anaesthesia with endotracheal intubation. Surgery, intra-operative period, extubation and post-operative period were uneventful. We conclude that tramadol may provoke seizures in patients with epilepsy even within the recommended dose range.

  7. Emergence of semiology in epileptic seizures. (United States)

    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

  8. From Catastrophizing to Recovery: a pilot study of a single-session treatment for pain catastrophizing

    Directory of Open Access Journals (Sweden)

    Darnall BD


    Full Text Available Beth D Darnall, John A Sturgeon, Ming-Chih Kao, Jennifer M Hah, Sean C MackeyDivision of Pain Medicine, Stanford Systems Neuroscience and Pain Laboratory, Stanford University School of Medicine, Palo Alto, CA, USABackground: Pain catastrophizing (PC – a pattern of negative cognitive-emotional responses to real or anticipated pain – maintains chronic pain and undermines medical treatments. Standard PC treatment involves multiple sessions of cognitive behavioral therapy. To provide efficient treatment, we developed a single-session, 2-hour class that solely treats PC entitled “From Catastrophizing to Recovery”[FCR].Objectives: To determine 1 feasibility of FCR; 2 participant ratings for acceptability, understandability, satisfaction, and likelihood to use the information learned; and 3 preliminary efficacy of FCR for reducing PC.Design and methods: Uncontrolled prospective pilot trial with a retrospective chart and database review component. Seventy-six patients receiving care at an outpatient pain clinic (the Stanford Pain Management Center attended the class as free treatment and 70 attendees completed and returned an anonymous survey immediately post-class. The Pain Catastrophizing Scale (PCS was administered at class check-in (baseline and at 2, and 4 weeks post-treatment. Within subjects repeated measures analysis of variance (ANOVA with Student's t-test contrasts were used to compare scores across time points.Results: All attendees who completed a baseline PCS were included as study participants (N=57; F=82%; mean age =50.2 years; PCS was completed by 46 participants at week 2 and 35 participants at week 4. Participants had significantly reduced PC at both time points (P<0001 and large effect sizes were found (Cohen's d=0.85 and d=1.15.Conclusion: Preliminary data suggest that FCR is an acceptable and effective treatment for PC. Larger, controlled studies of longer duration are needed to determine durability of response, factors

  9. A systematic review of suggestive seizure induction for the diagnosis of psychogenic nonepileptic seizures. (United States)

    Popkirov, Stoyan; Grönheit, Wenke; Wellmer, Jörg


    Suggestive seizure induction is a widely used method for diagnosing psychogenic nonepileptic seizures (PNES). Despite seven decades of multidisciplinary research, however, there is still no unified protocol, no definitive agreement on the ethical framework and no consensus on diagnostic utility. This systematic review surveys the evidence at hand and addresses clinically relevant aspects of suggestive seizure induction. In addition to its use for facilitating the diagnostic process, its mechanism of action and utility in elucidating the psychopathology of PNES will be discussed. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  10. Hyperkinetic motor seizures: a common semiology generated by two different cortical seizure origins. (United States)

    Vaugier, Lisa; McGonigal, Aileen; Lagarde, Stanislas; Trébuchon, Agnes; Szurhaj, William; Derambure, Philippe; Bartolomei, Fabrice


    We report a 37-year-old, right-handed patient with drug-resistant focal epilepsy whose seizures were characterized by explosive hyperkinetic behaviour. Video-SEEG revealed bifocal organization of epilepsy with two distinct cortical origins of seizures: the right temporal pole and left temporal lateral and perisylvian cortex. Irrespective of the cortical pattern of seizure onset, the hyperkinetic semiology was extremely similar. This supports a major role for "final common pathway" subcortical circuits in the genesis of the hyperkinetic semiology in this patient.

  11. Genetics Home Reference: genetic epilepsy with febrile seizures plus (United States)

    ... Health Conditions Genetic epilepsy with febrile seizures plus Genetic epilepsy with febrile seizures plus Printable PDF Open ... 2017 May 2. Citation on PubMed More from Genetics Home Reference Bulletins Genetics Home Reference Celebrates Its ...

  12. Puerperal seizures: not the usual suspects | Hayes | Southern ...

    African Journals Online (AJOL)

    Abstract. We present a case of puerperal seizures and neonatal flaccidity due to abuse and abrupt withdrawal from zolpidem, following an elective Caesarean delivery at term. Keywords: zolpidem, puerperal seizures, withdrawal ...

  13. Neonatal Seizures: new developments in monitoring and therapy

    NARCIS (Netherlands)

    van Rooij, L.G.M.


    Seizures are common in the neonatal period and represent a most distinctive signal of neurological disease. Seizures in newborns are associated with an increased risk of neurodevelopmental impairment, including cerebral palsy, mental retardation and epilepsy and mortality. Controversy still exists

  14. Ictal asystole mimicking seizure deterioration in temporal lobe epilepsy. (United States)

    Guldiken, Baburhan; Hartl, Elisabeth; Rémi, Jan; Noachtar, Soheyl


    We report on a patient with temporal lobe epilepsy, secondary to a left lateral temporal cavernoma, in whom the change in seizure semiology suggested recurrence of secondary generalized seizures. Anticonvulsive medication previously controlled secondary generalized seizures over a period of years but focal seizures continued at a lower rate. Continuous video-EEG monitoring revealed ictal asystole associated with myoclonic syncope and falls during focal seizures arising from the left temporal lobe. After implantation of a cardiac pacemaker, no more falls occurred during the focal seizures. In conclusion, recurrence of seizure-associated falls is typically attributed to recurrence of secondary generalized seizures, however, ictal asystole should be considered in selected epilepsy patients as a differential diagnosis of falls. [Published with video sequence].

  15. Correlation of Tc-99m HMPAO SPECT with surface EEG, MR, and CT for noninvasive localization of seizure foci

    International Nuclear Information System (INIS)

    Engelstad, B.L.; Laxer, K.D.; Dickson, H.S.; Cooper, K.E.; Huberty, J.P.; White, D.L.


    Some patients with refractory seizure disorders are candidates for surgical management. Correct preoperative lateralization is essential. Of 19 patients with seizure disorders who underwent Tc-99m HMPAO SPECT, 14 were considered to have ultimately had definitive localization by other means: consistently abnormal surface electroencephalogram (EEG), subdural or deep electrode EEG, EEG response to resection, abnormal histopatholgy, or grossly abnormal MR image. Lateralization with SPECT was (1) focal or regional hypoperfusion (11 patients) or (2) discrete focal hyperperfusion (one patient). Correct lateralization was obtained in ten of 14 with SPECT, nine of 14 with surface EEG, seven of 12 with MR, and one of eight with CT. Preoperative evaluation of patients with medically refractory seizures can be aided by Tc-99m HMPAO SPECT

  16. Novel Vitamin K analogues suppress seizures in zebrafish and mouse models of epilepsy (United States)

    Rahn, Jennifer J.; Bestman, Jennifer E.; Josey, Benjamin J.; Inks, Elizabeth S.; Stackley, Krista D.; Rogers, Carolyn E.; Chou, C. James; Chan, Sherine S. L.


    Epilepsy is a debilitating disease affecting 1-2% of the world’s population. Despite this high prevalence, 30% of patients suffering from epilepsy are not successfully managed by current medication suggesting a critical need for new anti-epileptic drugs (AEDs). In an effort to discover new therapeutics for the management of epilepsy, we began our study by screening drugs that, like some currently used AEDs, inhibit HDACs using a well-established larval zebrafish model. In this model, 7-day post fertilization (dpf) larvae are treated with the widely used seizure-inducing compound pentylenetetrazol (PTZ) which stimulates a rapid increase in swimming behavior previously determined to be a measurable manifestation of seizures. In our first screen, we tested a number of different HDAC inhibitors and found that one, NQN1, significantly decreased swim activity to levels equal to that of VPA. We continued to screen structurally related compounds including Vitamin K3 (VK3) and a number of novel Vitamin K (VK) analogues. We found that VK3 was a robust inhibitor of the PTZ-induced swim activity, as were several of our novel compounds. Three of these compounds were subsequently tested on mouse seizure models at the National Institute of Neurological Disorders and Stroke (NINDS) Anticonvulsant Screening Program. Compound 2h reduced seizures particularly well in the minimal clonic seizure (6 Hz) and corneal kindled mouse models of epilepsy, with no observable toxicity. As VK3 affects mitochondrial function, we tested the effects of our compounds on mitochondrial respiration and ATP production in a mouse hippocampal cell line. We demonstrate that these compounds affect ATP metabolism and increase total cellular ATP. Our data indicate the potential utility of these and other VK analogues for prevention of seizures and suggest the potential mechanism for this protection may lie in the ability of these compounds to affect energy production. PMID:24291671

  17. SB-334867, an orexin receptor 1 antagonist, decreased seizure and anxiety in pentylenetetrazol-kindled rats. (United States)

    Kordi Jaz, Elham; Moghimi, Ali; Fereidoni, Masoud; Asadi, Saeedeh; Shamsizadeh, Ali; Roohbakhsh, Ali


    Convulsive seizures are due to abnormal synchronous and repetitive neuronal discharges in the central nervous system (CNS). Finding new therapeutics to overcome the side effects of the current drug therapies and to increase their effectiveness is ongoing. Orexin-A and orexin-B are brain neuropeptides originating from postero-lateral hypothalamic neurons. Studies show that orexins, through activation of OX1 and OX2 receptors, have excitatory effects in the CNS. Accordingly, this study was designed to evaluate the effect of OX1 receptor antagonist (SB-334867) on seizure- and anxiety-related behaviors of pentylenetetrazol (PTZ)-kindled rats. Kindling was induced by repeated intraperitoneal (IP) injections of PTZ (32 mg/kg) with two-day intervals for 24 days in male Wistar rats. Three groups received intracerebroventricular (ICV) injections of SB-334867 (2.5, 5, and 10 μg/rat) before PTZ injections. Two control groups received vehicle (2 μL/rat, ICV) and valproate (26 μg/rat, ICV) before PTZ injections. An extra group of control animals received saline both ICV and IP. Seizure-related behaviors were monitored for 30 min following PTZ administration. The anxiety-like behaviors were also assessed using elevated plus-maze in the first and last days of the study. The results revealed that ICV injection of SB-334867, mainly at the dose of 10 μg/rat, decreased the median of seizure stages, prolonged the latency and reduced the duration of different seizure stages, and reversed the PTZ-induced anxiety-like behaviors. Based on the presented results, it is suggested that pharmacological blockade of the OX1 receptor is a potential target in the treatment of seizure and concomitant anxiety disorders. © 2016 Société Française de Pharmacologie et de Thérapeutique.

  18. SCN2A encephalopathy: A major cause of epilepsy of infancy with migrating focal seizures. (United States)

    Howell, Katherine B; McMahon, Jacinta M; Carvill, Gemma L; Tambunan, Dimira; Mackay, Mark T; Rodriguez-Casero, Victoria; Webster, Richard; Clark, Damian; Freeman, Jeremy L; Calvert, Sophie; Olson, Heather E; Mandelstam, Simone; Poduri, Annapurna; Mefford, Heather C; Harvey, A Simon; Scheffer, Ingrid E


    De novo SCN2A mutations have recently been associated with severe infantile-onset epilepsies. Herein, we define the phenotypic spectrum of SCN2A encephalopathy. Twelve patients with an SCN2A epileptic encephalopathy underwent electroclinical phenotyping. Patients were aged 0.7 to 22 years; 3 were deceased. Seizures commenced on day 1-4 in 8, week 2-6 in 2, and after 1 year in 2. Characteristic features included clusters of brief focal seizures with multiple hourly (9 patients), multiple daily (2), or multiple weekly (1) seizures, peaking at maximal frequency within 3 months of onset. Multifocal interictal epileptiform discharges were seen in all. Three of 12 patients had infantile spasms. The epileptic syndrome at presentation was epilepsy of infancy with migrating focal seizures (EIMFS) in 7 and Ohtahara syndrome in 2. Nine patients had improved seizure control with sodium channel blockers including supratherapeutic or high therapeutic phenytoin levels in 5. Eight had severe to profound developmental impairment. Other features included movement disorders (10), axial hypotonia (11) with intermittent or persistent appendicular spasticity, early handedness, and severe gastrointestinal symptoms. Mutations arose de novo in 11 patients; paternal DNA was unavailable in one. Review of our 12 and 34 other reported cases of SCN2A encephalopathy suggests 3 phenotypes: neonatal-infantile-onset groups with severe and intermediate outcomes, and a childhood-onset group. Here, we show that SCN2A is the second most common cause of EIMFS and, importantly, does not always have a poor developmental outcome. Sodium channel blockers, particularly phenytoin, may improve seizure control. © 2015 American Academy of Neurology.

  19. Catastrophic antiphospholipid syndrome in pregnancy, a diagnosis that should not be missed. (United States)

    Hoayek, Jennifer G; Moussa, Hind N; Rehman, Hina A; Nasab, Susan Hosseini; Blackwell, Sean C; Sibai, Baha M


    Catastrophic antiphospholipid syndrome (CAPS) is an accelerated form of the antiphospholipid antibody syndrome resulting in multi-organ ischemia and failure. It is a rare and life-threatening condition that can be easily mistaken with hemolysis elevated liver enzymes low platelets syndrome, thrombotic thrombocytopenic purpura, and hemolytic uremic syndrome. In order to make a diagnosis, it is required to have multi-organ thrombosis over 1 week affecting at least three organs or systems, and to have positive antiphospholipid antibody on two occasions (6 weeks apart), and histopathologic confirmation of small vessel occlusion. However, due to similarities in clinical and laboratory findings between CAPS and some other obstetric complications, potential misdiagnosis or delay in diagnosis are common, increasing the risk of adverse maternal and perinatal outcomes. In this review we summarized information presented in previous studies, focusing on CAPS related to pregnancy. We reviewed diagnostic criteria, differential diagnosis, and common presentation ranging from malaise, abdominal pain, dyspnea, hypertension, to altered mental status and seizures. We also discussed management in pregnancy and included a detailed algorithm with steps to take. Of note, the most significant reduction in mortality was seen in patients receiving triple therapy which will be discussed in this review.

  20. A case-control study of skin conductance biofeedback on seizure frequency and emotion regulation in drug-resistant temporal lobe epilepsy. (United States)

    Kotwas, Iliana; McGonigal, Aileen; Khalfa, Stéphanie; Bastien-Toniazzo, Mireille; Bartolomei, Fabrice; Micoulaud-Franchi, Jean-Arthur


    This study investigates the physiological basis of effects of skin conductance biofeedback on anxiety disorders, depressive disorders and stress in drug-resistant temporal lobe epilepsy (TLE). This method presents an interest in seizure reduction and improvement in psychiatric comorbidities frequently associated with TLE. Our goal was to better understand the impact of biofeedback on seizure control and on emotional regulation. Fifteen patients with TLE were treated with 12 skin conductance biofeedback sessions and compared with 15 control TLE patients on a waiting list. They were evaluated in terms of seizure frequency, clinical evaluations of anxiety and depression and skin conductance responses (SCR) to five emotions: fear, disgust, sadness, happiness and peacefulness induced by short films. Biofeedback training significantly reduced seizure frequency with a mean reduction of -47.42% in the biofeedback group, while the control group did not differ at the two time measures. A significant improvement was found for depression and trait-anxiety in the biofeedback group but not in the control group. There were no differences on SCR on any emotion after biofeedback treatment. A correlation was found between mean change in SCR over the biofeedback treatment and the reduction of seizure frequency, but not between SCR changes and scores on psychiatric comorbidities. These results show independent effect of biofeedback on mood and seizure control. Improvements in anxiety and depressive symptoms were not related to SCR, whereas improved seizure control was, suggesting differential mechanisms underlying these two phenomena. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Providers' perspectives on treating psychogenic nonepileptic seizures: frustration and hope. (United States)

    McMillan, Katharine K; Pugh, Mary Jo; Hamid, Hamada; Salinsky, Martin; Pugh, Jacqueline; Noël, Polly H; Finley, Erin P; Leykum, Luci K; Lanham, Holly J; LaFrance, W Curt


    Recent diagnostic and treatment advances in psychogenic nonepileptic seizures (PNES) have the potential to improve care for patients, but little is known about the current state of PNES care delivery in the Veterans Health Administration (VA). We conducted semistructured interviews with 74 health-care clinicians and workers in the VA, eliciting provider perceptions of PNES care. Data were analyzed according to principles of Grounded Theory. The results revealed variation in care and two emergent domain themes of frustration and hope. Frustration was manifest in subthemes including Complexity, Patient Acceptance, Uncertainty About Treatment, Need for Evidence-based Treatment, and Failure of Cross-Disciplinary Collaboration between neurologists and mental health providers. Hope encompassed subthemes of Positive Attitudes, Developing Cross-Disciplinary Treatment, and Specific PNES Care. Increased resources for diagnosing, treating, and researching PNES have improved awareness of the disorder. More research is needed to understand patients' and caregivers' perceptions of PNES care. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Self‑perceived seizure precipitants among patients with epilepsy in ...

    African Journals Online (AJOL)

    Stress (41%), inadequate sleep (27%), and head trauma (26%) were the three leading seizure precipitants mentioned. Subject's age, sex, level of seizure control, and place of abode did not influence reported seizure precipitants. However, the more educated (>12 years education) patients significantly reported stress as ...

  3. The determinants of seizure severity in Nigerian epileptics | Imam ...

    African Journals Online (AJOL)

    This assesses generalisation of seizures, falls, injuries, urinary incontinence, warning interval before loss of consciousness, automatisms and time of recovery on a graded scale. Results: The most frequent indices of seizure severity in Nigerian epileptics is the generalisation of seizures in 85.7% of subjects, incontinence of ...

  4. Rapidly Learned Identification of Epileptic Seizures from Sonified EEG

    Directory of Open Access Journals (Sweden)

    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.

  5. A network analysis of the dynamics of seizure. (United States)

    Burns, Samuel P; Sritharan, Duluxan; Jouny, Christophe; Bergey, Gregory; Crone, Nathan; Anderson, William S; Sarma, Sridevi V


    Seizures are events that spread through the brain's network of connections and create pathological activity. To understand what is occurring in the brain during seizure we investigated the time progression of the brain's state from seizure onset to seizure suppression. Knowledge of a seizure's dynamics and the associated spatial structure is important for localizing the seizure foci and determining the optimal location and timing of electrical stimulation to mitigate seizure development. In this study, we analyzed intracranial EEG data recorded in 2 human patients with drug-resistant epilepsy prior to undergoing resection surgery using network analyses. Specifically, we computed a time sequence of connectivity matrices from iEEG (intracranial electroencephalography) recordings that represent network structure over time. For each patient, connectivity between electrodes was measured using the coherence in the band of frequencies with the strongest modulation during seizure. The connectivity matrices' structure was analyzed using an eigen-decomposition. The leading eigenvector was used to estimate each electrode's time dependent centrality (importance to the network's connectivity). The electrode centralities were clustered over the course of each seizure and the cluster centroids were compared across seizures. We found, for each patient, there was a consistent set of centroids that occurred during each seizure. Further, the brain reliably evolved through the same progression of states across multiple seizures including characteristic onset and suppression states.

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

    African Journals Online (AJOL)

    Background: Complex partial seizure is an epileptic seizure which results in impairment of responsiveness or awareness such as altered level of consciousness. Complex partial seizures are often preceded by an aura such as depersonalization, feelings of de javu, jamais vu and fear. The ictal phase of complex partial ...

  7. 28 CFR 0.86 - Seizure of gambling devices. (United States)


    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Seizure of gambling devices. 0.86 Section... Bureau of Investigation § 0.86 Seizure of gambling devices. The Director, Associate Director, Assistants... General to make seizures of gambling devices (18 U.S.C. 1955(d), 15 U.S.C. 1171 et seq.) and wire or oral...

  8. 19 CFR 162.21 - Responsibility and authority for seizures. (United States)


    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Responsibility and authority for seizures. 162.21 Section 162.21 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY... authority for seizures. (a) Seizures by Customs officers. Property may be seized, if available, by any...

  9. The clonic phase of seizures in patients treated with electroconvulsive therapy is related to age and stimulus intensity

    Directory of Open Access Journals (Sweden)

    Chih-Chieh eTseng


    Full Text Available Background: Electroconvulsive therapy (ECT is effective in the treatment of major depressive disorder and schizophrenia in patients who are drug-naïve or less-receptive to antipsychotic drugs. Several studies have discussed the correlation between patient characteristics, input current volume and seizure duration. According to the present principle of ECT guidelines, the therapeutic effect of ECT mostly correlates with seizure duration. As the tonic phase is different from the clonic phase with respect to brain function and activity, it is informative to analyse both the tonic and clonic phases. Thus, this study sought to clarify the relationship between the features of the two phases, and to re-examine and refine guidelines regarding ECT treatment.Method: ECT-course data from 44 schizophrenia patients were recollected, including the number of treatments that they had received, their gender, age, and the association of these characteristics with motor seizure duration was analysed. A two-factor correlation was employed to test the relationship between each of the two factors.Result: The meta-analysis results indicate that seizure duration and age are significantly correlated. Older patients had relatively short seizure durations after ECT-treatment. Notably, a negative correlation was only found between age and the clonic phase of the seizure, not between age and the tonic phase. Furthermore, this study also found an inverse relationship between ECT-intensity and the clonic phase, but not between ECT-intensity and the tonic phase.Conclusion: This study demonstrated that age and ECT-intensity are negatively correlated with seizure duration, particularly in the clonic phase. The present observations are not fully consistent with the basic guidelines of the APA-ECT practical manual. Accordingly, the predictions regarding the therapeutic effect of ECT can be based on both the seizure duration and the clonic phase.

  10. Childhood trauma and psychogenic nonepileptic seizures: A review of findings with speculations on the underlying mechanisms. (United States)

    Beghi, Massimiliano; Cornaggia, Isotta; Magaudda, Adriana; Perin, Cecilia; Peroni, Federica; Cornaggia, Cesare Maria


    The objective of this review was to examine the possible link between psychological trauma in a patient's medical history and the onset of psychogenic nonepileptic seizures (PNES). An electronic search of published reports was made using the search engines PubMed-MedLine, EBSCO, PsycINFO, SFX, and Embase and the keywords "PNES", "psychogenic seizures", "sexual abuse", and "trauma". A correlation emerged between history of childhood trauma and the presence of PNES. Antecedent trauma was more frequent in females than in males and in patients exhibiting psychiatric disorders but was inversely correlated with cognitive impairment. In the presence of PNES, it is important to accurately investigate the patient's medical history in search of psychological trauma, particularly in women and in patients with psychiatric disorders. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Orgasm Induced Seizures: A Rare Phenomenon

    African Journals Online (AJOL)

    57‑83. 3. Ferlazzo E, Zifkin BG, Andermann E, Andermann F. Cortical triggers in generalized reflex seizures and epilepsies. Brain. 2005;128(Pt 4):700‑10. 4. Hoenig J, Hamilton CM. Epilepsy and sexual orgasm. Acta. Psychiatr Neurol Scand ...

  12. Using Dictionary Pair Learning for Seizure Detection. (United States)

    Ma, Xin; Yu, Nana; Zhou, Weidong


    Automatic seizure detection is extremely important in the monitoring and diagnosis of epilepsy. The paper presents a novel method based on dictionary pair learning (DPL) for seizure detection in the long-term intracranial electroencephalogram (EEG) recordings. First, for the EEG data, wavelet filtering and differential filtering are applied, and the kernel function is performed to make the signal linearly separable. In DPL, the synthesis dictionary and analysis dictionary are learned jointly from original training samples with alternating minimization method, and sparse coefficients are obtained by using of linear projection instead of costly [Formula: see text]-norm or [Formula: see text]-norm optimization. At last, the reconstructed residuals associated with seizure and nonseizure sub-dictionary pairs are calculated as the decision values, and the postprocessing is performed for improving the recognition rate and reducing the false detection rate of the system. A total of 530[Formula: see text]h from 20 patients with 81 seizures were used to evaluate the system. Our proposed method has achieved an average segment-based sensitivity of 93.39%, specificity of 98.51%, and event-based sensitivity of 96.36% with false detection rate of 0.236/h.

  13. Search and Seizure in the Schools. (United States)

    Russo, Charles J.; Stefkovich, Jacqueline A.


    Educators concerned about school safety have resorted to searching students, their lockers, and their possessions. These searches have led to litigation over whether the Fourth Amendment's prohibition of unreasonable searches and seizures applies to public schools. Although courts have upheld reasonable searches, administrators should carefully…

  14. Hemorrhagic Retinopathy Following Spondylosis Surgery and Seizure (United States)

    Valeshabad, Ali Kord; Francis, Andrew W.; Setlur, Vikram; Chang, Peter; Mieler, William F.; Shahidi, Mahnaz


    Purpose To report bilateral hemorrhagic retinopathy in an adult female following lumbar spinal surgery and seizure. Case Report A 38 year old female presented with bilateral blurry vision and spots in the visual field. The patient had lumbar spondylosis surgery which was complicated by a dural tear with persistent cerebrospinal fluid leak. Visual symptoms started immediately following witnessed seizure-like activity. At presentation, visual acuity was 20/100 and 20/25 in the right and left eye, respectively. Dilated fundus examination demonstrated bilateral hemorrhagic retinopathy with subhyaloid, intraretinal and subretinal involvement. At 4 month follow up, visual acuity improved to 20/60 and 20/20 in the right and left eye, respectively. Dilated fundus examination and fundus photography showed resolution of retinal hemorrhages in both eyes. Conclusions The first case of bilateral hemorrhagic retinopathy following lumbar spondylosis surgery and witnessed seizure in an adult was reported. Ophthalmic examination may be warranted following episodes of seizure in adults. PMID:26099062

  15. Seizures and Teens: Maximizing Health and Safety (United States)

    Sundstrom, Diane


    As parents and caregivers, their job is to help their children become happy, healthy, and productive members of society. They try to balance the desire to protect their children with their need to become independent young adults. This can be a struggle for parents of teens with seizures, since there are so many challenges they may face. Teenagers…

  16. Lumbar Puncture for First Simple Febrile Seizure

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available Compliance with American Academy of Pediatrics consensus statement recommendations regarding lumbar puncture for infants 6-18 months of age with a first simple febrile seizure was investigated by a retrospective review of 704 infants evaluated in the pediatric emergency medicine division at Children’s Hospital Boston, MA, Oct 1995-Oct 2006.

  17. Effect of prophylactic phenobarbital on seizures, encephalopathy ...

    African Journals Online (AJOL)

    is possible neuroprotective e ect of phenobarbital has been supported by a study that reported a signi cant improvement in neurological outcome at 3 years of age. [20] ere is also a concern that early administration of phenobarbital in infants with perinatal asphyxia may be associated with an increased incidence of seizures ...

  18. Puerperal seizures: not the usual suspects

    African Journals Online (AJOL)


    Jan 24, 2011 ... during the course of their pregnancy.2 Benign forms of sleep disturbance may respond to simple interventions, but more severe insomnia may have a significant impact on patients' quality of life and ability to function. Zolpidem, a sedative-. Puerperal seizures: not the usual suspects. Hayes ID, FCARCSI.

  19. Catastrophes et consommation des substances psychoactives

    Directory of Open Access Journals (Sweden)

    Krivokapić Žilijeta


    Full Text Available (francuski Les catastrophes, les accidents, les stress, les traumatismes sont des expériences négatives de vie accompagnées de changements physiologiques, cognitifs, émotionnels et comportementaux. Les stratégies les plus courantes inefficaces à résoudre les expériences de vie négatives sont: l' agression - ouverte (physique et / ou verbale, passive et latente, le retrait social, le placage, la dépression, l'impuissance, l' isolement et l' abus de médicaments, en particulier de drogues. Les personnes se trouvant dans des situations stressantes essayent de s' aider elles-mêmes souvent en recourant à des substances qui procurent une amélioration de leur état et suppriment le malaise momentané. Cette 'thérapie par auto-thérapie' comporte de graves risques La personne qui, après une période de consommation de ces substances devenaient dépendante, manifeste des changements visibles au niveau physique et psychologique. Elle se dérobe à ses obligations, rompt avec les activités auxquelles elle prenait plaisir autrefois de même qu' avec ses loisirs et ses intérêts; elle change des amis, ses relations familiales et amicales deviennent pauvres et remplies de nombreux conflits; elle devient moins critique et plus manipulative, commence à mentir, trompe pour dissimuler sa toxicomanie, rejoint un groupe de ses semblables, se livre à des activités criminogènes, de plus en plus se dégrade physiquement. L' alcool qui, étant le plus accessible et par conséquent généralement 'la première mesure d' auto-thérapie', a un impact particulièrement dévastateur sur l' organisme sensible au point de vue psycho-physique. Nous assistons à de nombreuses difficultés et des problèmes qui, à la suite de la consommation d' alcool, aggravent ceux liés à des expériences des événements traumatisants. De même l' efficacité de certains comprimés de réduire les tensions ou d' améliorer l' état du patient conduit fréquemment

  20. Targeting the Mitotic Catastrophe Signaling Pathway in Cancer (United States)

    Mc Gee, Margaret M.


    Mitotic catastrophe, as defined in 2012 by the International Nomenclature Committee on Cell Death, is a bona fide intrinsic oncosuppressive mechanism that senses mitotic failure and responds by driving a cell to an irreversible antiproliferative fate of death or senescence. Thus, failed mitotic catastrophe can promote the unrestrained growth of defective cells, thereby representing a major gateway to tumour development. Furthermore, the activation of mitotic catastrophe offers significant therapeutic advantage which has been exploited in the action of conventional and targeted anticancer agents. Yet, despite its importance in tumour prevention and treatment, the molecular mechanism of mitotic catastrophe is not well understood. A better understanding of the signals that determine cell fate following failed or defective mitosis will reveal new opportunities to selectively target and enhance the programme for therapeutic benefit and reveal biomarkers to predict patient response. This review is focused on the molecular mechanism of mitotic catastrophe induction and signalling and highlights current strategies to exploit the process in cancer therapy. PMID:26491220

  1. Association between Iron Deficiency Anemia and Febrile Seizure: a Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Mohammad Mehdi Nasehi


    Full Text Available Febrile seizure is the most common convulsive disorder in children and different studies reported controversial results about the association between this disorder and iron deficiency. In some studies, iron level in children with febrile seizure is higher than control and in some reports it is less than the control group. So, we systematically reviewed all the studies in this field and analyzed their findings using meta-analysis methods. This review and meta-analysis was conducted by iron and fever keywords on articles published in the databases PubMed, Google Scholar and Federated search of medical digital library that includes a variety of international databases. All articles dated at the end of March 2012 were studied. Case-control studies were selected and quality assessment of studies were surveyed by STROB criteria and information requirements, including the status of iron deficiency anemia, iron levels and ferritin level of eligible studies were extracted and analyzed by Comprehensive Meta-Analysis Version 2.0 software and the Forest and Funnel chart was drawn. Finally 11 studies included 1357 children with febrile seizure and 1347 children in the control group were evaluated. The odds ratio of iron deficiency anemia in children with febrile seizure in comparison to the control group was 1.27 (OR = 1.27, CI95%: 1.03 -1.56. Ferritin level was not significant between the two groups (p=0.08, but the iron level in the two groups was significant (p=0.000. Iron deficiency is considered as a risk factor in the incidence of febrile seizure and interventional studies can be helpful to confirm this hypothesis.

  2. Critical Evaluation of P2X7 Receptor Antagonists in Selected Seizure Models (United States)

    Fischer, Wolfgang; Franke, Heike; Krügel, Ute; Müller, Heiko; Dinkel, Klaus; Lord, Brian; Letavic, Michael A.; Henshall, David C.; Engel, Tobias


    The ATP-gated P2X7 receptor (P2X7R) is a non-selective cation channel which senses high extracellular ATP concentrations and has been suggested as a target for the treatment of neuroinflammation and neurodegenerative diseases. The use of P2X7R antagonists may therefore be a viable approach for treating CNS pathologies, including epileptic disorders. Recent studies showed anticonvulsant potential of P2X7R antagonists in certain animal models. To extend this work, we tested three CNS-permeable P2X7R blocker (Brilliant Blue G, AFC-5128, JNJ-47965567) and a natural compound derivative (tanshinone IIA sulfonate) in four well-characterized animal seizure models. In the maximal electroshock seizure threshold test and the pentylenetetrazol (PTZ) seizure threshold test in mice, none of the four compounds demonstrated anticonvulsant effects when given alone. Notably, in combination with carbamazepine, both AFC-5128 and JNJ-47965567 increased the threshold in the maximal electroshock seizure test. In the PTZ-kindling model in rats, useful for testing antiepileptogenic activities, Brilliant Blue G and tanshinone exhibited a moderate retarding effect, whereas the potent P2X7R blocker AFC-5128 and JNJ-47965567 showed a significant and long-lasting delay in kindling development. In fully kindled rats, the investigated compounds revealed modest effects to reduce the mean seizure stage. Furthermore, AFC-5128- and JNJ-47965567-treated animals displayed strongly reduced Iba 1 and GFAP immunoreactivity in the hippocampal CA3 region. In summary, our results show that P2X7R antagonists possess no remarkable anticonvulsant effects in the used acute screening tests, but can attenuate chemically-induced kindling. Further studies would be of interest to support the concept that P2X7R signalling plays a crucial role in the pathogenesis of epileptic disorders. PMID:27281030

  3. Critical Evaluation of P2X7 Receptor Antagonists in Selected Seizure Models.

    Directory of Open Access Journals (Sweden)

    Wolfgang Fischer

    Full Text Available The ATP-gated P2X7 receptor (P2X7R is a non-selective cation channel which senses high extracellular ATP concentrations and has been suggested as a target for the treatment of neuroinflammation and neurodegenerative diseases. The use of P2X7R antagonists may therefore be a viable approach for treating CNS pathologies, including epileptic disorders. Recent studies showed anticonvulsant potential of P2X7R antagonists in certain animal models. To extend this work, we tested three CNS-permeable P2X7R blocker (Brilliant Blue G, AFC-5128, JNJ-47965567 and a natural compound derivative (tanshinone IIA sulfonate in four well-characterized animal seizure models. In the maximal electroshock seizure threshold test and the pentylenetetrazol (PTZ seizure threshold test in mice, none of the four compounds demonstrated anticonvulsant effects when given alone. Notably, in combination with carbamazepine, both AFC-5128 and JNJ-47965567 increased the threshold in the maximal electroshock seizure test. In the PTZ-kindling model in rats, useful for testing antiepileptogenic activities, Brilliant Blue G and tanshinone exhibited a moderate retarding effect, whereas the potent P2X7R blocker AFC-5128 and JNJ-47965567 showed a significant and long-lasting delay in kindling development. In fully kindled rats, the investigated compounds revealed modest effects to reduce the mean seizure stage. Furthermore, AFC-5128- and JNJ-47965567-treated animals displayed strongly reduced Iba 1 and GFAP immunoreactivity in the hippocampal CA3 region. In summary, our results show that P2X7R antagonists possess no remarkable anticonvulsant effects in the used acute screening tests, but can attenuate chemically-induced kindling. Further studies would be of interest to support the concept that P2X7R signalling plays a crucial role in the pathogenesis of epileptic disorders.

  4. Characteristics of seizure-induced signal changes on MRI in patients with first seizures. (United States)

    Kim, Si Eun; Lee, Byung In; Shin, Kyong Jin; Ha, Sam Yeol; Park, JinSe; Park, Kang Min; Kim, Hyung Chan; Lee, Joonwon; Bae, Soo-Young; Lee, Dongah; Kim, Sung Eun


    The aim of this study was to investigate the predictive factors and identify the characteristics of the seizure-induced signal changes on MRI (SCM) in patients with first seizures. We conducted a retrospective study of patients with first seizures from March 2010 to August 2014. The inclusion criteria for this study were patients with 1) first seizures, and 2) MRI and EEG performed within 24h of the first seizures. The definition of SCM was hyper-intensities in the brain not applying to cerebral arterial territories. Multivariate logistic regression was performed with or without SCM as a dependent variable. Of 431 patients with seizures visiting the ER, 69 patients met the inclusion criteria. Of 69 patients, 11 patients (15.9%) had SCM. Epileptiform discharge on EEG (OR 29.7, 95% CI 1.79-493.37, p=0.018) was an independently significant variable predicting the presence of SCM in patients with first seizures. In addition, the topography of SCM was as follows; i) ipsilateral hippocampus, thalamus and cerebral cortex (5/11), ii) unilateral cortex (4/11), iii) ipsilateral thalamus and cerebral cortex (1/11), iv) bilateral hippocampus (1/11). Moreover, 6 out of 7 patients who underwent both perfusion CT and MRI exhibited unilateral cortical hyperperfusion with ipsilateral thalamic involvement reflecting unrestricted vascular territories. There is an association between epileptiform discharges and SCM. Additionally, the involvement of the unilateral cortex and ipsilateral thalamus in SCM and its hyperperfusion state could be helpful in differentiating the consequences of epileptic seizures from other pathologies. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  5. Effectiveness of the psychological and pharmacological treatment of catastrophization in patients with fibromyalgia: a randomized controlled trial (United States)

    García-Campayo, Javier; Serrano-Blanco, Antoni; Rodero, Baltasar; Magallón, Rosa; Alda, Marta; Andrés, Eva; Luciano, Juan V; del Hoyo, Yolanda López


    Background Fibromyalgia is a prevalent and disabling disorder characterized by widespread pain and other symptoms such as insomnia, fatigue or depression. Catastrophization is considered a key clinical symptom in fibromyalgia; however, there are no studies on the pharmacological or psychological treatment of catastrophizing. The general aim of this study is to assess the effectiveness of cognitive-behaviour therapy and recommended pharmacological treatment for fibromyalgia (pregabalin, with duloxetine added where there is a comorbid depression), compared with usual treatment at primary care level. Method/design Design: A multi-centre, randomized controlled trial involving three groups: the control group, consisting of usual treatment at primary care level, and two intervention groups, one consisting of cognitive-behaviour therapy, and the other consisting of the recommended pharmacological treatment for fibromyalgia. Setting: 29 primary care health centres in the city of Zaragoza, Spain. Sample: 180 patients, aged 18–65 years, able to understand and read Spanish, who fulfil criteria for primary fibromyalgia, with no previous psychological treatment, and no pharmacological treatment or their acceptance to discontinue it two weeks before the onset of the study. Intervention: Psychological treatment is based on the manualized protocol developed by Prof. Escobar et al, from the University of New Jersey, for the treatment of somatoform disorders, which has been adapted by our group for the treatment of fibromyalgia. It includes 10 weekly sessions of cognitive-behaviour therapy. Pharmacological therapy consists of the recommended pharmacological treatment for fibromyalgia: pregabalin (300–600 mg/day), with duloxetine (60–120 mg/day) added where there is a comorbid depression). Measurements: The following socio-demographic data will be collected: sex, age, marital status, education, occupation and social class. The diagnosis of psychiatric disorders will be made

  6. Study of inter-relationship of depression, seizure frequency and quality of life of people with epilepsy in India

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    Shubham Mehta


    Full Text Available Epilepsy is a chronic neurological disorder that can have profound physical, social and psychological consequences. We aimed to assess the clinical predictors of quality of life of people with epilepsy. We recruited 31 patients suffering from epilepsy in this cross-sectional study. Their clinical profile was recorded. Quality Of Life in Epilepsy (QOLIE-31 was used to assess quality of life of our patients. Depression was screened by Neurological Disorders Depression Inventory in Epilepsy (NDDI-E. Among all the clinical variables, only seizure frequency significantly correlated with seizure worry (P=0.002, emotional well-being (P=0.026 and social functions (P=0.013 subscales of QOLIE-31. NDDI-E score showed a significant negative correlation with all the subscales of QOLIE-31 except medication effects (P=0.993. A significant positive correlation was also noted between seizure frequency and NDDI-E score (r=0.417, P=0.020. Seizure frequency and depression are the most important predictors of quality of life in epilepsy patients. The management of patients with epilepsy should not only be aimed at just preventing seizures but the treating clinicians should also be cognizant about depression which itself can significantly affect the quality of life of patients.

  7. Evaluation of Seizure Attacks in Patients with Cerebrovascular Accident

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    Ebrahim Koochaki


    Full Text Available Background: The most common reason for seizure in elderly duration is the stroke. This study was conducted aiming to assess the frequency of seizure attack occurrence in those patients. Materials and Methods: This investigation was carried out through a cross-sectional method for one year on 330 patients admitted to the neurology ward as diagnosed with stroke. The required data was collected through the researcher-made questionnaire from the patients suffering from stoke which was diagnosed based on clinical findings, CT-Scan and MRI as required. Results: Among 330 patient suffering from stroke (162 men and 168 women, 48 cases (14.5% were suffering from seizure. Six percent of the patients had early seizure and another 8.5% had late seizure. Among 162 men suffering from the stroke, 32 ones were without seizures and 30 men were suffering the seizure. A number of 150 women out of total 168 ones suffering from the stroke, had no seizure and 18 others had seizures; frequency of seizure occurrence was more in male samples (p=0.044. In the people under 60 year, there were mostly early types of seizure (45% and in the age range above 60 year, it was mostly late type (89.3%. A 68.5% of the patients suffering from the seizure had experienced ischemic stroke. However, the frequency of seizure occurrence in the patients with hemorrhagic stroke was statistically greater (p=0.003. Conclusion: This examination showed that occurrence of seizure attacks in the people with stroke is 14.5% and it is seen more in the hemorrhagic strokes than ischemic ones. The frontoparietal area is the most common location involved and tonic clonic was the most common seizure in the patients suffering from it who have experienced the stroke

  8. 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 inv...

  9. Dynamical systems V bifurcation theory and catastrophe theory

    CERN Document Server


    Bifurcation theory and catastrophe theory are two of the best known areas within the field of dynamical systems. Both are studies of smooth systems, focusing on properties that seem to be manifestly non-smooth. Bifurcation theory is concerned with the sudden changes that occur in a system when one or more parameters are varied. Examples of such are familiar to students of differential equations, from phase portraits. Moreover, understanding the bifurcations of the differential equations that describe real physical systems provides important information about the behavior of the systems. Catastrophe theory became quite famous during the 1970's, mostly because of the sensation caused by the usually less than rigorous applications of its principal ideas to "hot topics", such as the characterization of personalities and the difference between a "genius" and a "maniac". Catastrophe theory is accurately described as singularity theory and its (genuine) applications. The authors of this book, the first printing of w...

  10. Bilateral Paramedian Thalamic Infarction Initially Presenting as a Convulsive Seizure

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    Jianping Wang


    Full Text Available Bithalamic infarctions initially presenting as a convulsive seizure are rarely reported and, to our best knowledge, have never been reported in China. Here, we present a patient with convulsive seizure at the onset of bilateral paramedian thalamic infarction. The diffusion-weighted imaging revealed that the infarct area is supplied by Percheron artery. Associated with the relationship between seizure and centrencephalic system and reticular formation as previously reported, we suggest that seizure could be the onset symptom of paramedian thalamic infarction. Physicians should recognize this condition, because both seizure control and early ischemic stroke management are required.

  11. Pediatric intracerebral hemorrhage: acute symptomatic seizures and epilepsy. (United States)

    Beslow, Lauren A; Abend, Nicholas S; Gindville, Melissa C; Bastian, Rachel A; Licht, Daniel J; Smith, Sabrina E; Hillis, Argye E; Ichord, Rebecca N; Jordan, Lori C


    Seizures are believed to be common presenting symptoms in neonates and children with spontaneous intracerebral hemorrhage (ICH). However, few data are available on the epidemiology of acute symptomatic seizures or the risk for later epilepsy. To define the incidence of and explore risk factors for seizures and epilepsy in children with spontaneous ICH. Our a priori hypotheses were that younger age at presentation, cortical involvement of ICH, acute symptomatic seizures after presentation, ICH due to vascular malformation, and elevated intracranial pressure requiring urgent intervention would predict remote symptomatic seizures and epilepsy. Prospective cohort study conducted between March 1, 2007, and January 1, 2012. Three tertiary care pediatric hospitals. Seventy-three pediatric subjects with spontaneous ICH including 20 perinatal (≥37 weeks' gestation to 28 days) and 53 childhood subjects (>28 days to Acute symptomatic seizures (clinically evident and electrographic-only seizures within 7 days), remote symptomatic seizures, and epilepsy. Acute symptomatic seizures occurred in 35 subjects (48%). Acute symptomatic seizures as a presenting symptom of ICH occurred in 12 perinatal (60%) and 19 childhood (36%) subjects (P = .07). Acute symptomatic seizures after presentation occurred in 7 children. Electrographic-only seizures were present in 9 of 32 subjects (28%) with continuous electroencephalogram monitoring. One-year and 2-year remote symptomatic seizure-free survival rates were 82% (95% CI, 68-90) and 67% (95% CI, 46-82), respectively. One-year and 2-year epilepsy-free survival rates were 96% (95% CI, 83-99) and 87% (95% CI, 65-95), respectively. Elevated intracranial pressure requiring acute intervention was a risk factor for seizures after presentation (P = .01; Fisher exact test), remote symptomatic seizures, and epilepsy (P = .03, and P = .04, respectively; log-rank test). Presenting seizures are common in perinatal and childhood ICH. Continuous

  12. Socioeconomic inequality in catastrophic health expenditure in Brazil. (United States)

    Boing, Alexandra Crispim; Bertoldi, Andréa Dâmaso; Barros, Aluísio Jardim Dornellas de; Posenato, Leila Garcia; Peres, Karen Glazer


    To analyze the evolution of catastrophic health expenditure and the inequalities in such expenses, according to the socioeconomic characteristics of Brazilian families. Data from the National Household Budget 2002-2003 (48,470 households) and 2008-2009 (55,970 households) were analyzed. Catastrophic health expenditure was defined as excess expenditure, considering different methods of calculation: 10.0% and 20.0% of total consumption and 40.0% of the family's capacity to pay. The National Economic Indicator and schooling were considered as socioeconomic characteristics. Inequality measures utilized were the relative difference between rates, the rates ratio, and concentration index. The catastrophic health expenditure varied between 0.7% and 21.0%, depending on the calculation method. The lowest prevalences were noted in relation to the capacity to pay, while the highest, in relation to total consumption. The prevalence of catastrophic health expenditure increased by 25.0% from 2002-2003 to 2008-2009 when the cutoff point of 20.0% relating to the total consumption was considered and by 100% when 40.0% or more of the capacity to pay was applied as the cut-off point. Socioeconomic inequalities in the catastrophic health expenditure in Brazil between 2002-2003 and 2008-2009 increased significantly, becoming 5.20 times higher among the poorest and 4.17 times higher among the least educated. There was an increase in catastrophic health expenditure among Brazilian families, principally among the poorest and those headed by the least-educated individuals, contributing to an increase in social inequality.

  13. Porencephaly and cortical dysplasia as cause of seizures in a dog

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    Machado Gisele Fabrino


    Full Text Available Abstract Background Seizures are a common problem in small animal neurology and it may be related to underlying diseases. Porencephaly is an extremely rare disorder, and in Veterinary Medicine it affects more often ruminants, with only few reports in dogs. Case presentation A one-year-old intact male Shih-Tzu dog was referred to Veterinary University Hospital with history of abnormal gait and generalized tonic-clonic seizures. Signs included hypermetria, abnormal nystagmus and increased myotatic reflexes. At necropsy, during the brain analysis, a cleft was observed in the left parietal and occipital lobes, creating a communication between the subarachnoid space and the left lateral ventricle, consistent with porencephaly; and also a focal atrophy of the caudal paravermal and vermal portions of the cerebellum. Furthermore, the histological examination showed cortical and cerebellar neuronal dysplasia. Conclusions Reports of seizures due to porencephaly are rare in dogs. In this case, the dog presented a group of brain abnormalities which per se or in assemblage could result in seizure manifestation.

  14. Cannabidiol attenuates seizures and social deficits in a mouse model of Dravet syndrome. (United States)

    Kaplan, Joshua S; Stella, Nephi; Catterall, William A; Westenbroek, Ruth E


    Worldwide medicinal use of cannabis is rapidly escalating, despite limited evidence of its efficacy from preclinical and clinical studies. Here we show that cannabidiol (CBD) effectively reduced seizures and autistic-like social deficits in a well-validated mouse genetic model of Dravet syndrome (DS), a severe childhood epilepsy disorder caused by loss-of-function mutations in the brain voltage-gated sodium channel Na V 1.1. The duration and severity of thermally induced seizures and the frequency of spontaneous seizures were substantially decreased. Treatment with lower doses of CBD also improved autistic-like social interaction deficits in DS mice. Phenotypic rescue was associated with restoration of the excitability of inhibitory interneurons in the hippocampal dentate gyrus, an important area for seizure propagation. Reduced excitability of dentate granule neurons in response to strong depolarizing stimuli was also observed. The beneficial effects of CBD on inhibitory neurotransmission were mimicked and occluded by an antagonist of GPR55, suggesting that therapeutic effects of CBD are mediated through this lipid-activated G protein-coupled receptor. Our results provide critical preclinical evidence supporting treatment of epilepsy and autistic-like behaviors linked to DS with CBD. We also introduce antagonism of GPR55 as a potential therapeutic approach by illustrating its beneficial effects in DS mice. Our study provides essential preclinical evidence needed to build a sound scientific basis for increased medicinal use of CBD.

  15. SozRank: A new approach for localizing the epileptic seizure onset zone. (United States)

    Murin, Yonathan; Kim, Jeremy; Parvizi, Josef; Goldsmith, Andrea


    Epilepsy is one of the most common neurological disorders affecting about 1% of the world population. For patients with focal seizures that cannot be treated with antiepileptic drugs, the common treatment is a surgical procedure for removal of the seizure onset zone (SOZ). In this work we introduce an algorithm for automatic localization of the seizure onset zone (SOZ) in epileptic patients based on electrocorticography (ECoG) recordings. The proposed algorithm builds upon the hypothesis that the abnormal excessive (or synchronous) neuronal activity in the brain leading to seizures starts in the SOZ and then spreads to other areas in the brain. Thus, when this abnormal activity starts, signals recorded at electrodes close to the SOZ should have a relatively large causal influence on the rest of the recorded signals. The SOZ localization is executed in two steps. First, the algorithm represents the set of electrodes using a directed graph in which nodes correspond to recording electrodes and the edges' weights quantify the pair-wise causal influence between the recorded signals. Then, the algorithm infers the SOZ from the estimated graph using a variant of the PageRank algorithm followed by a novel post-processing phase. Inference results for 19 patients show a close match between the SOZ inferred by the proposed approach and the SOZ estimated by expert neurologists (success rate of 17 out of 19).

  16. SozRank: A new approach for localizing the epileptic seizure onset zone.

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    Yonathan Murin


    Full Text Available Epilepsy is one of the most common neurological disorders affecting about 1% of the world population. For patients with focal seizures that cannot be treated with antiepileptic drugs, the common treatment is a surgical procedure for removal of the seizure onset zone (SOZ. In this work we introduce an algorithm for automatic localization of the seizure onset zone (SOZ in epileptic patients based on electrocorticography (ECoG recordings. The proposed algorithm builds upon the hypothesis that the abnormal excessive (or synchronous neuronal activity in the brain leading to seizures starts in the SOZ and then spreads to other areas in the brain. Thus, when this abnormal activity starts, signals recorded at electrodes close to the SOZ should have a relatively large causal influence on the rest of the recorded signals. The SOZ localization is executed in two steps. First, the algorithm represents the set of electrodes using a directed graph in which nodes correspond to recording electrodes and the edges' weights quantify the pair-wise causal influence between the recorded signals. Then, the algorithm infers the SOZ from the estimated graph using a variant of the PageRank algorithm followed by a novel post-processing phase. Inference results for 19 patients show a close match between the SOZ inferred by the proposed approach and the SOZ estimated by expert neurologists (success rate of 17 out of 19.

  17. Seizure semiology of lesional frontal lobe epilepsies in children. (United States)

    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.

  18. Analyzing reliability of seizure diagnosis based on semiology. (United States)

    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.

  19. Catastrophic Senescence of the Pacific Salmon Without Mutation-Accumulation (United States)

    Meyer-Ortmanns, Hildegard

    We derive catastrophic senescence of the Pacific salmon from an aging model which was recently proposed by Stauffer. The model is based on the postulates of a minimum reproduction age and a maximal genetic lifespan. It allows for self-organization of a typical age of first reproduction and a typical age of death. Our Monte Carlo simulations of the population dynamics show that the model leads to catastrophic senescence for semelparous reproduction as it occurs in the case of salmon, to a more gradually increase of senescence for iteroparous reproduction.

  20. Jacksonian seizure as the relapse symptom of multiple sclerosis

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    Mohammad Reza Najafi


    Full Text Available Epilepsy is more common in patients with multiple sclerosis (MS than in the general population, occurring in 2-3% of patients. Convulsions may be either tonic-clonic in nature or partial complex. In these individuals, seizures most likely result from lesions present in the cerebral cortex and subcortical white matter. A Jacksonian seizure is a type of simple partial seizure characterized by abnormal movements that begin in one group of muscles and progress to adjacent groups of muscles. We describe a case of Jacksonian seizure as the relapse symptom of MS. Focal motor seizures of this patient have been observed before and presumably marking the clinical onset or during acute bouts of MS. In this case, Jacksonian seizures appear to be the sign of a flare of MS, while the majority of seizures had been reported occur unrelated to MS relapses.

  1. Epilepsy and Autism Spectrum Disorders


    小国, 美也子


    The relationship between epilepsy, autism spectrum disorders (ASD), and intellectual disability (ID) has received worldwide attention, in order to determine the mechanism of these disorders. Recently, in some papers have argued whether epilepsy causes ASD, and whether ASD worsens the seizures in epilepsy. Several causal relationships between the three disorders have been speculated. This paper reviewed and analyzed the studies that have evaluated the relationship between the disorders for de...

  2. Role of biomarkers in differentiating new-onset seizures from psychogenic nonepileptic seizures

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    Mahendra Javali


    Full Text Available Introduction: Review of literature revealed very limited studies considering a combination of serum prolactin (PRL and serum creatine kinase (CK as markers for differentiating epileptic and psychogenic nonepileptic seizures (PNES. Therefore, in the present study, we analyzed the role of serum PRL and serum CK, individually and in combination. Methodology: This prospective study was conducted in a tertiary care medical teaching hospital over a period of 18 months. Patients aged over 15 years suspected to have new-onset seizures presenting within 5 h of ictus were included in this study. CK, serum PRL was measured at 0–1, 1–3, and 3–5 h after seizures. Results: Hundred subjects were studied for the role of serum PRL and serum CK in differentiating epileptic and PNES. The mean age was 42.24 years with a male:female ratio of 1.27:1. All patients of generalized tonic–clonic seizures (GTCS, who presented within 1 h, had elevated PRL, whereas 75% of patients with partial seizures had elevated PRL within 1 h of presentation. Nearly 91.66% of patients with GTCS who presented within 1 h had elevated CPK, whereas 70% of patients with partial seizures had elevated CPK. None of the patients diagnosed with PNES showed rise in either of the markers. Conclusion: In the present study, none of the patients with PNES showed raise in either serum PRL or CK. However, there was no correlation between the types of seizure and PRL or serum CK levels.

  3. Declining incidence of catastrophic cervical spine injuries in French rugby: 1996-2006. (United States)

    Bohu, Yoann; Julia, Marc; Bagate, Christian; Peyrin, Jean-Claude; Colonna, Jean-Pierre; Thoreux, Patricia; Pascal-Moussellard, Hugues


    To investigate the incidence and the risk factors of catastrophic cervical spine injuries in French rugby. Descriptive epidemiology study. The patients included had cervical spine injuries causing neurological disorder classified from the ASIA scale, grade A to D. A retrospective review of all cases that occurred between the 1996-1997 and the 2005-2006 seasons was made. Circumstances of the injuries and of the clinical outcome were collected by interview. There were 37 cases of catastrophic cervical spine injuries in French rugby for the last 10 years. The incidence of the cervical spine injuries decreased during this period. The rates of injury were 2.1 per 100,000 players per year during the 1996-1997 season and 1.4 during the 2005-2006 season (P scrum was a major cause of injury, accounting for 51.3% (19/37). The forwards represented 89.2% (33/37) of the injured players. The hookers were involved in 37.8% (14/37) of the cases. The measures of prevention with the modification of the rules of scrum and the creation of a medical certificate required for players to play in the front row must have been successful. The incidence of disabling cervical spine injuries in French rugby has decreased for the last 10 years, which is linked to the decreasing incidence of injuries in the scrum. This epidemiological study shows the effectiveness of the preventive measures on cervical spine injuries in French rugby players. A national register of catastrophic cervical spine injuries extends our epidemiological observations.

  4. Pain catastrophizing predicts verbal expression among children with chronic pain and their mothers

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    Shelby L Langer


    Full Text Available This study examined intra- and inter-personal associations between pain catastrophizing and verbal expression in 70 children with recurrent abdominal pain and their mothers. Participants independently completed the Pain Catastrophizing Scale. Mothers and children then talked about the child’s pain. Speech was categorized using a linguistic analysis program. Catastrophizing was positively associated with the use of negative emotion words by both mothers and children. In addition, mothers’ catastrophizing was positively associated with both mothers’ and children’s anger word usage, whereas children’s catastrophizing was inversely associated with mothers’ anger word usage. Findings extend the literature on behavioral and interpersonal aspects of catastrophizing.

  5. Local cerebral metabolism during partial seizures

    Energy Technology Data Exchange (ETDEWEB)

    Engel, J. Jr.; Kuhl, D.E.; Phelps, M.E.; Rausch, R.; Nuwer, M.


    Interictal and ictal fluorodeoxyglucose scans were obtained with positron CT from four patients with spontaneous recurrent partial seizures, one with epilepsia partialis continua, and one with a single partial seizure induced by electrical stimulation of the hippocampus. Ictal metabolic patterns were different for each patient studied. Focal and generalized increased and decreased metabolism were observed. Ictal hypermetabolism may exceed six times the interictal rate and could represent activation of excitatory or inhibitory synapses in the epileptogenic region and its projection fields. Hypometabolism seen on ictal scans most likely reflects postictal depression and may indicate projection fields of inhibited neurons. No quantitative relationship between alterations in metabolism and EEG or behavioral measurements of ictal events could be demonstrated.

  6. The Presence of Consciousness in Absence Seizures (United States)

    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. PMID:21447898

  7. Seizure Following Topical Gammabenzene Hexachloride Therapy

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    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.

  8. Catastrophic Head Injuries in High School and Collegiate Sports. (United States)

    Mueller, Frederick O.


    Describes the incidence of catastrophic head injuries within high school and college sports. Data from a national surveillance system indicated that a football-related fatality occurred every year except one from 1945-99, mainly related to head injuries. From 1984-99, 69 football head-related injuries resulted in permanent disability. Deaths and…

  9. Three Solvable Matrix Models of a Quantum Catastrophe

    Czech Academy of Sciences Publication Activity Database

    Levai, G.; Růžička, František; Znojil, Miloslav


    Roč. 53, č. 9 (2014), s. 2875-2890 ISSN 0020-7748 Institutional support: RVO:61389005 Keywords : quantum theory * PT symmetry * Finite-dimensional non-Hermitian Hamiltonians * exceptional-point localization * quantum theory of catastrophes * methods of computer algebra Subject RIV: BE - Theoretical Physics Impact factor: 1.184, year: 2014

  10. Concrete ensemble Kalman filters with rigorous catastrophic filter divergence. (United States)

    Kelly, David; Majda, Andrew J; Tong, Xin T


    The ensemble Kalman filter and ensemble square root filters are data assimilation methods used to combine high-dimensional, nonlinear dynamical models with observed data. Ensemble methods are indispensable tools in science and engineering and have enjoyed great success in geophysical sciences, because they allow for computationally cheap low-ensemble-state approximation for extremely high-dimensional turbulent forecast models. From a theoretical perspective, the dynamical properties of these methods are poorly understood. One of the central mysteries is the numerical phenomenon known as catastrophic filter divergence, whereby ensemble-state estimates explode to machine infinity, despite the true state remaining in a bounded region. In this article we provide a breakthrough insight into the phenomenon, by introducing a simple and natural forecast model that transparently exhibits catastrophic filter divergence under all ensemble methods and a large set of initializations. For this model, catastrophic filter divergence is not an artifact of numerical instability, but rather a true dynamical property of the filter. The divergence is not only validated numerically but also proven rigorously. The model cleanly illustrates mechanisms that give rise to catastrophic divergence and confirms intuitive accounts of the phenomena given in past literature.

  11. Catastrophic ice lake collapse in Aram Chaos, Mars

    NARCIS (Netherlands)

    Roda, M.; Kleinhans, M.G.|info:eu-repo/dai/nl/217675123; Zegers, T.E.|info:eu-repo/dai/nl/155390562; Oosthoek, J.H.P.


    Hesperian chaotic terrains have been recognized as the source of outflow channels formed by catastrophic outflows. Four main scenarios have been proposed for the formation of chaotic terrains that involve different amounts of water and single or multiple outflow events. Here, we test these scenarios

  12. Vaginismus : Heightened Harm Avoidance and Pain Catastrophizing Cognitions

    NARCIS (Netherlands)

    Borg, Charmaine; Peters, Madelon L.; Schultz, Willibrord Weijmar; de Jong, Peter J.

    Introduction. Catastrophic appraisal of experienced pain may promote hypervigilance and intense pain, while the personality trait of harm avoidance (HA) might prevent the occurrence of correcting such experiences. Women inflicted with vaginismus may enter a self-perpetuating downward spiral of

  13. Laboratory tests of catastrophic disruption of rotating bodies (United States)

    Morris, A. J. W.; Burchell, M. J.


    The results of catastrophic disruption experiments on static and rotating targets are reported. The experiments used cement spheres of diameter 10 cm as the targets. Impacts were by mm sized stainless steel spheres at speeds of between 1 and 7.75 km s-1. Energy densities (Q) in the targets ranged from 7 to 2613 J kg-1. The experiments covered both the cratering and catastrophic disruption regimes. For static, i.e. non-rotating targets the critical energy density for disruption (Q*, the value of Q when the largest surviving target fragment has a mass equal to one half of the pre-impact target mass) was Q* = 1447 ± 90 J kg-1. For rotating targets (median rotation frequency of 3.44 Hz) we found Q* = 987 ± 349 J kg-1, a reduction of 32% in the mean value. This lower value of Q* for rotating targets was also accompanied by a larger scatter on the data, hence the greater uncertainty. We suggest that in some cases the rotating targets behaved as static targets, i.e. broke up with the same catastrophic disruption threshold, but in other cases the rotation helped the break up causing a lower catastrophic disruption threshold, hence both the lower value of Q* and the larger scatter on the data. The fragment mass distributions after impact were similar in both the static and rotating target experiments with similar slopes.

  14. Dissociation in patients with dissociative seizures: relationships with trauma and seizure symptoms. (United States)

    Pick, S; Mellers, J D C; Goldstein, L H


    This study aimed to extend the current understanding of dissociative symptoms experienced by patients with dissociative (psychogenic, non-epileptic) seizures (DS), including psychological and somatoform types of symptomatology. An additional aim was to assess possible relationships between dissociation, traumatic experiences, post-traumatic symptoms and seizure manifestations in this group. A total of 40 patients with DS were compared with a healthy control group (n = 43), matched on relevant demographic characteristics. Participants completed several self-report questionnaires, including the Multiscale Dissociation Inventory (MDI), Somatoform Dissociation Questionnaire-20, Traumatic Experiences Checklist and the Post-Traumatic Diagnostic Scale. Measures of seizure symptoms and current emotional distress (Hospital Anxiety and Depression Scale) were also administered. The clinical group reported significantly more psychological and somatoform dissociative symptoms, trauma, perceived impact of trauma, and post-traumatic symptoms than controls. Some dissociative symptoms (i.e. MDI disengagement, MDI depersonalization, MDI derealization, MDI memory disturbance, and somatoform dissociation scores) were elevated even after controlling for emotional distress; MDI depersonalization scores correlated positively with trauma scores while seizure symptoms correlated with MDI depersonalization, derealization and identity dissociation scores. Exploratory analyses indicated that somatoform dissociation specifically mediated the relationship between reported sexual abuse and DS diagnosis, along with depressive symptoms. A range of psychological and somatoform dissociative symptoms, traumatic experiences and post-traumatic symptoms are elevated in patients with DS relative to healthy controls, and seem related to seizure manifestations. Further studies are needed to explore peri-ictal dissociative experiences in more detail.


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    Full Text Available BACKGROUND AND OBJECTIVE: The study is aimed to reassess the role of CT in detecting various epileptogenic lesions with multi detector CT imaging, to know the value of CECT is evaluation of various lesions and to know the commonest CNS lesions ca using afebrile se i zures in Paediatric age group is the local population. METHODOLOGY: The study consists of 70 Pediatric patients suffering from afebrile seizures referred to Radio – diagnostic department S.V.R.R. Hospital at Tirupati for C.T. brain invest igation. EXCLUSION CRITERIA : A s our study is to evaluate epilepsy characterized by recurrent (more than two episodes seizures, with no immediate identifiable and avoidable cause (sleep deprivation, known metabolic disorders, alcohol withdrawal, pyrexia. Therefore we excluded patients below one month ago. Febrile convulsions, acute infections, toxic and known metabolic disorders Equipment used is Fourth generation Four slice CT with scan time 0.7 seconds Matrix size 640, gantry tilt 120, KV – 120 MAs – 100 to 200, Slice thickness 5mm and 2mm Auto power injector 3 to 3.5 ml per second. NECT : Continuous axial sections of brain, posterior fossa 3mm and rest of brain 5mm sections and 2mm sections were taken wherever necessary CECT is carried out logically in th ose cases which were inconclusive or ambiguous and NECT excluding more definite cases like congenital anomalies and calcified granulomas without peri lesion edema. IV CONTRAST : Non - ionic contrast medium at 1mg / kg body weight was used whenever indicated, n o adverse reactions were noted after injection of contrast medium and sedation was advised whenever the patient was un co - operative. RESULTS: In the present study we evaluated to cases of Pediatric Se i zures and observed and analyzed our findings with the available relevant clinical data and concluded that ; Out of 70 cases there are a Slight female Predilection 57%. And maximum incidence of Seizures was in the first 3 years, but

  16. Magnetic resonance imaging in complex partial seizures

    International Nuclear Information System (INIS)

    Furune, Sunao; Negoro, Tamiko; Maehara, Mitsuo; Nomura, Kazushi; Miura, Kiyokuni; Takahashi, Izumi; Watanabe, Kazuyoshi


    Magnetic resonance imaging (MRI) and computed tomography (CT) were performed on 45 patients with intractable complex partial seizures. MRI was performed with a superconducting whole-body scanner operating at 0.5 tesla (T) and 1.5 T. In patients with temporal lobe epilepsy, 8 of 24 patients had abnormal CT, but 16 or 24 patients showed abnormal MRI. 1.5 T MRI detected more abnormality than 0.5 T MRI when CT was normal. In patients with frontal lobe epilepsy, 5 of 7 patients had normal CT and MRI. In 2 other patients, MRI demonstrated an arachnoid cyst and increased signal intensity area on the T2-weighted images which were not detected by CT. In patients with occipital lobe epilepsy, 5 of 6 patients show abnormal CT and MRI. In patients with tuberous sclerosis, MRI revealed some increased signal intensity areas on the T2-weighted images in the occipital and temporal lobe, which were not detected by CT. Most surface EEG foci corresponded with the side of MRI abnormality. These data indicate that MRI is more informative than CT in complex partial seizures. MRI is the imaging technique of choice in the diagnosis of complex partial seizures. (author)

  17. Fluorocitrate-mediated astroglial dysfunction causes seizures. (United States)

    Willoughby, John O; Mackenzie, Lorraine; Broberg, Marita; Thoren, Anna E; Medvedev, Andrei; Sims, Neil R; Nilsson, Michael


    A role for astroglia in epileptogenesis has been hypothesised but is not established. Low doses of fluorocitrate specifically and reversibly disrupt astroglial metabolism by blocking aconitase, an enzyme integral to the tricarboxylic acid cycle. We used cerebral cortex injections of fluorocitrate, at a dose that we demonstrated to inhibit astroglial metabolism selectively, to determine whether astroglial disturbances lead to seizures. Rats were halothane-anesthetized, and 0.8 nmol of sodium fluorocitrate was injected into the cerebral cortex. Extradural electroencephalogram (EEG) electrodes were implanted, after which the anesthesia was ceased and the animals were observed. In all experiments, 14 of 15 fluorocitrate-treated animals exhibited epileptiform EEG discharges, with some animals exhibiting convulsive seizures. Discharges commenced as early as 30 min postfluorocitrate injection. Intraperitoneal octanol, but not halothane by inhalation, given to test the possible participation of gap junctions in EEG discharge generation, blocked or delayed the occurrence of discharges after fluorocitrate. These results indicate that focal cerebrocortical astroglial dysfunction leads to focal epileptiform discharges and sometimes to convulsive seizures and that the process possibly depends on effects mediated by gap junctions. Copyright 2003 Wiley-Liss, Inc.

  18. Characterization of early partial seizure onset: frequency, complexity and entropy. (United States)

    Jouny, Christophe C; Bergey, Gregory K


    A clear classification of partial seizures onset features is not yet established. Complexity and entropy have been very widely used to describe dynamical systems, but a systematic evaluation of these measures to characterize partial seizures has never been performed. Eighteen different measures including power in frequency bands up to 300 Hz, Gabor atom density (GAD), Higuchi fractal dimension (HFD), Lempel-Ziv complexity, Shannon entropy, sample entropy, and permutation entropy, were selected to test sensitivity to partial seizure onset. Intracranial recordings from 45 patients with mesial temporal, neocortical temporal and neocortical extratemporal seizure foci were included (331 partial seizures). GAD, Lempel-Ziv complexity, HFD, high frequency activity, and sample entropy were the most reliable measures to assess early seizure onset. Increases in complexity and occurrence of high-frequency components appear to be commonly associated with early stages of partial seizure evolution from all regions. The type of measure (frequency-based, complexity or entropy) does not predict the efficiency of the method to detect seizure onset. Differences between measures such as GAD and HFD highlight the multimodal nature of partial seizure onsets. Improved methods for early seizure detection may be achieved from a better understanding of these underlying dynamics. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  19. Hyperglycemia associated with seizure control in status epilepticus. (United States)

    Chiewthanakul, Piyawan; Noppaklao, Parinya; Sawanyawisuth, Kittisak; Tiamkao, Somsak


    Status epilepticus (SE) is a serious neurological condition and has a high mortality rate. Factors associated with seizure control measures in nonneurointensive care units (non-NICU) are limited. Adult patients diagnosed with SE at Khon Kaen hospital, Thailand from October 1st, 2010 to September 30th, 2012 were enrolled. Patients were categorized as having controlled seizures and having uncontrolled seizures. Controlled seizures were defined as seizures that were aborted without any recurrence, while uncontrolled seizures were defined as unstoppable or recurrent seizures. Clinical factors were analyzed to find factors associated with uncontrolled SE. During the study period, there were 211 patients diagnosed with SE. Of those, 57 patients (27.01%) were in the group with controlled SE. Plasma glucose and serum albumin were two significant factors with adjusted ORs (95% CI) of 1.008 (1.001, 1.027) and 0.166 (0.059, 0.466) that differentiated patients with controlled seizures from patients with uncontrolled seizures. Central nervous system infections and cardiac arrests were also completely associated with the uncontrolled SE in the multivariate logistic analysis. In the etiology of SE, high plasma glucose and low serum albumin levels were associated with uncontrolled seizures in patients with SE in the non-NICU setting. This article is part of a Special Issue entitled "Status Epilepticus". Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Epileptic seizures in patients with a posterior circulation infarct

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    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.

  1. A review of sleepwalking (somnambulism): the enigma of neurophysiology and polysomnography with differential diagnosis of complex partial seizures. (United States)

    Hughes, John R


    The goal of this report is to review all aspects of sleepwalking (SW), also known as somnambulism. Various factors seem to initiate SW, especially drugs, stress, and sleep deprivation. As an etiology, heredity is important, but other conditions include thyrotoxicosis, stress, and herpes simplex encephalitis. Psychological characteristics of sleepwalkers often include aggression, anxiety, panic disorder, and hysteria. Polysomnographic characteristics emphasize abnormal deep sleep associated with arousal and slow wave sleep fragmentation. In the differential diagnosis, the EEG is important to properly identify a seizure disorder, rather than SW. Associated disorders are Tourette's syndrome, sleep-disordered breathing, and migraine. Various kinds of treatment are discussed, as are legal considerations, especially murder during sleepwalking.

  2. P-gp Protein Expression and Transport Activity in Rodent Seizure Models and Human Epilepsy. (United States)

    Hartz, Anika M S; Pekcec, Anton; Soldner, Emma L B; Zhong, Yu; Schlichtiger, Juli; Bauer, Bjoern


    A cure for epilepsy is currently not available, and seizure genesis, seizure recurrence, and resistance to antiseizure drugs remain serious clinical problems. Studies show that the blood-brain barrier is altered in animal models of epilepsy and in epileptic patients. In this regard, seizures increase expression of blood-brain barrier efflux transporters such as P-glycoprotein (P-gp), which is thought to reduce brain uptake of antiseizure drugs, and thus, contribute to antiseizure drug resistance. The goal of the current study was to assess the viability of combining in vivo and ex vivo preparations of isolated brain capillaries from animal models of seizures and epilepsy as well as from patients with epilepsy to study P-gp at the blood-brain barrier. Exposing isolated rat brain capillaries to glutamate ex vivo upregulated P-gp expression to levels that were similar to those in capillaries isolated from rats that had status epilepticus or chronic epilepsy. Moreover, the fold-increase in P-gp protein expression seen in animal models is consistent with the fold-increase in P-gp observed in human brain capillaries isolated from patients with epilepsy compared to age-matched control individuals. Overall, the in vivo/ex vivo approach presented here allows detailed analysis of the mechanisms underlying seizure-induced changes of P-gp expression and transport activity at the blood-brain barrier. This approach can be extended to other blood-brain barrier proteins that might contribute to drug-resistant epilepsy or other CNS disorders as well.

  3. Ultra-low dose naltrexone potentiates the anticonvulsant effect of low dose morphine on clonic seizures. (United States)

    Honar, H; Riazi, K; Homayoun, H; Sadeghipour, H; Rashidi, N; Ebrahimkhani, M R; Mirazi, N; Dehpour, A R


    Significant potentiation of analgesic effects of opioids can be achieved through selective blockade of their stimulatory effects on intracellular signaling pathways by ultra-low doses of opioid receptor antagonists. However, the generality and specificity of this interaction is not well understood. The bimodal modulation of pentylenetetrazole-induced seizure threshold by opioids provide a model to assess the potential usefulness of this approach in seizure disorders and to examine the differential mechanisms involved in opioid anti- (morphine at 0.5-3 mg/kg) versus pro-convulsant (20-100 mg/kg) effects. Systemic administration of ultra-low doses of naltrexone (100 fg/kg-10 ng/kg) significantly potentiated the anticonvulsant effect of morphine at 0.5 mg/kg while higher degrees of opioid receptor antagonism blocked this effect. Moreover, inhibition of opioid-induced excitatory signaling by naltrexone (1 ng/kg) unmasked a strong anticonvulsant effect for very low doses of morphine (1 ng/kg-100 microg/kg), suggesting that a presumed inhibitory component of opioid receptor signaling can exert strong seizure-protective effects even at very low levels of opioid receptor activation. However, ultra-low dose naltrexone could not increase the maximal anticonvulsant effect of morphine (1-3 mg/kg), possibly due to a ceiling effect. The proconvulsant effects of morphine on seizure threshold were minimally altered by ultra-low doses of naltrexone while being completely blocked by a higher dose (1 mg/kg) of the antagonist. The present data suggest that ultra-low doses of opioid receptor antagonists may provide a potent strategy to modulate seizure susceptibility, especially in conjunction with very low doses of opioids.

  4. Enriched environment attenuates behavioral seizures and depression in chronic temporal lobe epilepsy. (United States)

    Vrinda, Marigowda; Sasidharan, Arun; Aparna, Sahajan; Srikumar, Bettadapura N; Kutty, Bindu M; Shankaranarayana Rao, Byrathnahalli S


    Temporal lobe epilepsy (TLE) is commonly associated with depression, anxiety, and cognitive impairment. Despite significant progress in our understanding of the pathophysiology of TLE, it remains the most common form of refractory epilepsy. Enriched environment (EE) has a beneficial effect in many neuropsychiatric disorders. However, the effect of EE on cognitive changes in chronic TLE has not been evaluated. Accordingly, the present study evaluated the effects of EE on chronic epilepsy-induced alterations in cognitive functions, electrophysiology, and cellular changes in the hippocampus. Status epilepticus (SE) was induced in 2-month-old male Wistar rats with lithium and pilocarpine. Six weeks' post SE, epileptic rats were either housed in their respective home cages or in an enrichment cage (6 h/day) for 14 days. Seizure behavior was video-monitored 2 weeks before and during exposure to EE. Depression-like behavior, anxiety-like behavior, and spatial learning and memory were assessed using the sucrose preference test (SPT), elevated plus maze (EPM), and Morris water maze (MWM), respectively. Delta and theta power in the CA1 region of hippocampus was assessed from recordings of local field potentials (LFPs). Cellular changes in hippocampus were assessed by histochemistry followed by unbiased stereologic analysis. EE significantly reduced seizure episodes and seizure duration in epileptic rats. In addition, EE alleviated depression and hyperactivity, and restored delta and theta power of LFP in the hippocampal CA1 region. However, EE neither ameliorated epilepsy-induced spatial learning and memory deficits nor restored cell density in hippocampus. This is the first study that evaluates the role of EE in a chronic TLE model, where rats were exposed to EE after occurrence of spontaneous recurrent seizures (SRS). Given that 30% of TLE patients are refractory to drug treatment, therapeutic strategies that utilize components of EE could be designed to alleviate

  5. Community resilience and decision theory challenges for catastrophic events. (United States)

    Cox, Louis Anthony


    Extreme and catastrophic events pose challenges for normative models of risk management decision making. They invite development of new methods and principles to complement existing normative decision and risk analysis. Because such events are rare, it is difficult to learn about them from experience. They can prompt both too little concern before the fact, and too much after. Emotionally charged and vivid outcomes promote probability neglect and distort risk perceptions. Aversion to acting on uncertain probabilities saps precautionary action; moral hazard distorts incentives to take care; imperfect learning and social adaptation (e.g., herd-following, group-think) complicate forecasting and coordination of individual behaviors and undermine prediction, preparation, and insurance of catastrophic events. Such difficulties raise substantial challenges for normative decision theories prescribing how catastrophe risks should be managed. This article summarizes challenges for catastrophic hazards with uncertain or unpredictable frequencies and severities, hard-to-envision and incompletely described decision alternatives and consequences, and individual responses that influence each other. Conceptual models and examples clarify where and why new methods are needed to complement traditional normative decision theories for individuals and groups. For example, prospective and retrospective preferences for risk management alternatives may conflict; procedures for combining individual beliefs or preferences can produce collective decisions that no one favors; and individual choices or behaviors in preparing for possible disasters may have no equilibrium. Recent ideas for building "disaster-resilient" communities can complement traditional normative decision theories, helping to meet the practical need for better ways to manage risks of extreme and catastrophic events. © 2012 Society for Risk Analysis.

  6. [A modified approach to the diagnosis and therapy of epileptic seizures in the third stage of life]. (United States)

    Gavranović, Muhamed; Delilović, Jasminka; Kurtović, Azra; Alibegović, Sakib; Rajić, Zeljka; Ajanović, Zakira


    Incidence of seizures in the elderly is nowadays greater than the one characteristic for children up to 10 years of age. Epileptic seizures are the third most common serious neurological disorder in this age group, after stroke and dementia. Optimal care for those patients, regarding to the seizures, demands some modification in diagnostic and treatment approach. Aim of this report was to point out problems in diagnostics, treatment and most common mistakes in practice. Fifty one patients were assessed, aged 65-83 years, (30 female and 21 male), with diagnosis of epilepsy and established antiepileptic treatment. All patients were re-examined, and following procedures were utilised: auto and heteroanamnesis (especially data provided by eyewitnesses), clinical examination, biochemical status, complete cardiological examination, EEG registration, serum concentrations of antiepileptic drugs, CT and MRI scan. Out of 51 patients 11 were misdiagnosed (syncope, provoked seizures, TIA). The most common form of seizures were partial seizures with or without secondary generalization (31 cases). Etiologic factors: stroke (25 cases), arteriosclerosis (7 cases), tumours (3 cases), trauma (2 cases), unknown (3 cases) cardiovascular diseases (29 casec) diabetes mellitus (20 cases), respiratory disturbance (12 cases) renal disturbances (8 cases). Only 30 patients had monotherapy from the beginning, with either carbamazepine or valproate. Rest were treated from the beginning with 2 antiepileptic drugs (phenobarbital + carbamazepine or pheytoin + phenobarbital). Adverse effects were recorded in 21 patients. I. It is crucial to distingiush unprovoked and provoked seizures during diagnostic procedures, as well as epileptic and non-epileptic attacks; 2. Principle of monotherapy is conditio sine qua non, and in treatment attention should be paid to co-morbidity, multitherapy, drug interactions, intoxication, diminished detoxication and elimination of drugs, as well as increased

  7. Study of the Determinant Factors in Seizure Following Gastroenteritis in Children Admitted in Tabriz Children's Hospital during 2001 to 2016

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    Iman Vafaei


    Full Text Available Background: One of the common side effects of gastroenteritis in children is seizure, which is one of the causes of fever, electrolyte disturbances, and meningitis. This study was aimed to investigate the determinant factors in seizure in children with gastroenteritis and seizure admitted in Tabriz Children's Hospital from 2001 to 2016. Materials and Methods: This is a descriptive study. The study population included all children admitted with diagnosis of gastroenteritis and seizure in Tabriz Children's Hospital during the years 2001 to 2016. The data of admitted patients including electrolyte disturbances, age, gender, blood-venous analysis, Blood urine nitrogen (BUN, and creatinine tests were extracted from hospital records by a resident and intern of this hospital using a questionnaire designed for this research. Results: A total of 84 patients were included in the study. The patients included 44 males (52.4% and 40 females (47.6%. The mean age of the patients was 9.31 ± 7.13 years. Forty-six (55.42% patients suffered from electrolyte impairment, 24 of which (52.2% were male and 22 (47.8% were female; and hyponatremia was the most common disorder (24.10%. Accordingly, only BUN of has proven to be a strong predictor of the likelihood of seizure; also despite of non-significant p-value of PH, it had a potentially strong association with seizure. Conclusion According to the results of this study, electrolyte impairment is fairly common in children with acute gastroenteritis. Education about the management of children with seizure to is an important factor in this regard.

  8. Pathways linking drug use and labour market trajectories: the role of catastrophic events. (United States)

    Richardson, Lindsey; Small, Will; Kerr, Thomas


    People affected by substance use disorders often experience sub-optimal employment outcomes. The role of drug use in processes that produce and entrench labour market precarity among people who inject drugs (PWID) have not, however, been fully described. We recruited 22 PWID from ongoing prospective cohort studies in Vancouver, Canada, with whom we conducted semi-structured retrospective interviews and then employed a thematic analysis that drew on concepts from life course theory to explore the mechanisms and pathways linking drug use and labour market trajectories. The participants' narratives identified processes corresponding to causation, whereby suboptimal employment outcomes led to harmful drug use; direct selection, where impairment, health complications or drug-seeking activities selected individuals out of employment; and indirect selection, where external factors, such as catastrophic events, marked the initiation or intensification of substance use concurrent with sudden changes in capacities for employment. Catastrophic events linking negative transitions in both drug use and labour market trajectories were of primary importance, demarcating critical initiation and transitional events in individual risk trajectories. These results challenge conventional assumptions about the primacy of drug use in determining employment outcomes among PWID and suggest the importance of multidimensional support to mitigate the initiation, accumulation and entrenchment of labour market and drug-related disadvantage. © 2015 Foundation for the Sociology of Health & Illness.

  9. Catastrophic antiphospholipid syndrome mimicking a malignant pancreatic tumour--a case report

    NARCIS (Netherlands)

    van Wissen, S.; Bastiaansen, B. A. J.; Stroobants, A. K.; van den Dool, E. J.; Idu, M. M.; Levi, M. [=Marcel M.; Stroes, E. S. G.


    The catastrophic antiphospholipid syndrome is characterised by rapid onset thromboses, often resistant to conventional anticoagulant treatment, and resulting in life threatening multiple organ dysfunction. The diagnosis of catastrophic antiphospholipid syndrome may be difficult, predominantly due to

  10. Catastrophic costs potentially averted by tuberculosis control in India and South Africa: a modelling study

    NARCIS (Netherlands)

    Verguet, Stéphane; Riumallo-Herl, Carlos; Gomez, Gabriela B.; Menzies, Nicolas A.; Houben, Rein M. G. J.; Sumner, Tom; Lalli, Marek; White, Richard G.; Salomon, Joshua A.; Cohen, Ted; Foster, Nicola; Chatterjee, Susmita; Sweeney, Sedona; Baena, Inés Garcia; Lönnroth, Knut; Weil, Diana E.; Vassall, Anna


    The economic burden on households affected by tuberculosis through costs to patients can be catastrophic. WHO's End TB Strategy recognises and aims to eliminate these potentially devastating economic effects. We assessed whether aggressive expansion of tuberculosis services might reduce catastrophic

  11. Subjective and objective characteristics of altered consciousness during epileptic seizures. (United States)

    Campora, Nuria; Kochen, Silvia


    Conscious states are inner states and processes of awareness. These states are by definition subjective. We analyzed subjective and objective characteristics of alteration of consciousness (AOC) during epileptic seizures, including its involvement in both the level of awareness and subjective content of consciousness. We evaluated AOC using the Consciousness Seizure Scale, the Ictal Consciousness Inventory, and a new structured survey developed by our group: the Seizure Perception Survey, which incorporates patients' subjective experiences before and after they watch a video-electroencephalographic recording of their own seizure. We included 35 patients (105 seizures) with drug-resistant epilepsy. Most seizures caused profound AOC. The content of consciousness was lower during temporal seizures with profound AOC. We uncovered a correlation between the subjective perception and objective duration of a seizure using the Seizure Perception Survey regarding memory; the patients had a better recall of ictal onset during wakefulness regardless of the epileptogenic zone, laterality, or magnitude of AOC. Nonetheless, the recovery of memory at the end of a seizure took more time in patients who showed greater AOC, less vivid content of consciousness, or a longer seizure. For 85% of the patients, this was the first time they were able to view their own seizures. The majority of the patients requested to view them again because this procedure allowed them to compare the recordings with their own memories and emotions during a seizure and to verify the real duration of the seizure. Alteration of consciousness is one of the most dramatic clinical manifestations of epilepsy. Usually, practitioners or relatives assume that the patients with AOC may not have any knowledge on their seizures. In this study, however, we found that most patients with AOC had a fairly accurate perception of the duration of a seizure and retained their memory of ictal onset. In contrast, for the

  12. Minimum Electric Field Exposure for Seizure Induction with Electroconvulsive Therapy and Magnetic Seizure Therapy. (United States)

    Lee, Won H; Lisanby, Sarah H; Laine, Andrew F; Peterchev, Angel V


    Lowering and individualizing the current amplitude in electroconvulsive therapy (ECT) has been proposed as a means to produce stimulation closer to the neural activation threshold and more focal seizure induction, which could potentially reduce cognitive side effects. However, the effect of current amplitude on the electric field (E-field) in the brain has not been previously linked to the current amplitude threshold for seizure induction. We coupled MRI-based E-field models with amplitude titrations of motor threshold (MT) and seizure threshold (ST) in four nonhuman primates (NHPs) to determine the strength, distribution, and focality of stimulation in the brain for four ECT electrode configurations (bilateral, bifrontal, right-unilateral, and frontomedial) and magnetic seizure therapy (MST) with cap coil on vertex. At the amplitude-titrated ST, the stimulated brain subvolume (23-63%) was significantly less than for conventional ECT with high, fixed current (94-99%). The focality of amplitude-titrated right-unilateral ECT (25%) was comparable to cap coil MST (23%), demonstrating that ECT with a low current amplitude and focal electrode placement can induce seizures with E-field as focal as MST, although these electrode and coil configurations affect differently specific brain regions. Individualizing the current amplitude reduced interindividual variation in the stimulation focality by 40-53% for ECT and 26% for MST, supporting amplitude individualization as a means of dosing especially for ECT. There was an overall significant correlation between the measured amplitude-titrated ST and the prediction of the E-field models, supporting a potential role of these models in dosing of ECT and MST. These findings may guide the development of seizure therapy dosing paradigms with improved risk/benefit ratio.

  13. Comparing maximum autonomic activity of psychogenic non-epileptic seizures and epileptic seizures using heart rate variability. (United States)

    Jeppesen, Jesper; Beniczky, Sándor; Johansen, Peter; Sidenius, Per; Fuglsang-Frederiksen, Anders


    The semiology of psychogenic non-epileptic seizures (PNES) can resemble epileptic seizures, and differentiation between epileptic seizures with no EEG-correlate and PNES can be challenging even for trained experts. Therefore, there has been a search for a quantitative measure, other than EEG and semiology that could distinguish PNES from epileptic seizures. We used ECG to measure heart rate variability (HRV) in order to compare maximum autonomic activity of epileptic seizures and PNES. These comparisons could potentially serve as biomarkers for distinguishing these types of clinical episodes. Forty-nine epileptic seizures from 17 patients and 24 PNES from 7 patients with analyzable ECG were recorded during long-term video-EEG monitoring. Moving windows of 100 R-R intervals throughout each seizure were used to find maximum values of Cardiac Sympathetic Index (CSI) (sympathetic tonus) and minimum values of Cardiac Vagal Index (CVI), Root-Mean-Square-of-Successive-Differences (RMSSD) and HF-power (parasympathetic tonus). In addition, non-seizure recordings of each patient were used to compare HRV-parameters between the groups. The maximum CSI for epilepsy seizures were higher than PNES (P=0.015). The minimum CVI, minimum RMSSD and HF-power did not show significant difference between epileptic seizures and PNES (P=0.762; P=0.152; P=0.818). There were no statistical difference of non-seizure HRV-parameters between the PNES and epilepsy patients. We found the maximum sympathetic activity accompanying the epileptic seizures to be higher, than that during the PNES. However, the great variation of autonomic response within both groups makes it difficult to use these HRV-measures as a sole measurement in distinguishing epileptic seizures from PNES. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  14. Neuroethological approach to frontolimbic epileptic seizures and parasomnias: The same central pattern generators for the same behaviours. (United States)

    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.

  15. Independent Neuronal Origin of Seizures and Behavioral Comorbidities in an Animal Model of a Severe Childhood Genetic Epileptic Encephalopathy.

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    Samuel K Asinof


    Full Text Available The childhood epileptic encephalopathies (EE's are seizure disorders that broadly impact development including cognitive, sensory and motor progress with severe consequences and comorbidities. Recently, mutations in DNM1 (dynamin 1 have been implicated in two EE syndromes, Lennox-Gastaut Syndrome and Infantile Spasms. Dnm1 encodes dynamin 1, a large multimeric GTPase necessary for activity-dependent membrane recycling in neurons, including synaptic vesicle endocytosis. Dnm1Ftfl or "fitful" mice carry a spontaneous mutation in the mouse ortholog of DNM1 and recapitulate many of the disease features associated with human DNM1 patients, providing a relevant disease model of human EE's. In order to examine the cellular etiology of seizures and behavioral and neurological comorbidities, we engineered a conditional Dnm1Ftfl mouse model of DNM1 EE. Observations of Dnm1Ftfl/flox mice in combination with various neuronal subpopulation specific cre strains demonstrate unique seizure phenotypes and clear separation of major neurobehavioral comorbidities from severe seizures associated with the germline model. This demonstration of pleiotropy suggests that treating seizures per se may not prevent severe comorbidity observed in EE associated with dynamin-1 mutations, and is likely to have implications for other genetic forms of EE.

  16. Pre and post craniotomy psychosis and seizure disorder in a ...

    African Journals Online (AJOL)

    The subject had a radiological Brain CT –Scan and Cranial MRI diagnosis of Temporo-parietal mass of Meningioma and based on clinical presentation of right sided weakness, 3 year history of deterioration of vision and brief awareness with altered behavior in the pre surgical period. He had a Simpson 11 Excision ...

  17. Designing Patient-Specific Optimal Neurostimulation Patterns for Seizure Suppression. (United States)

    Sandler, Roman A; Geng, Kunling; Song, Dong; Hampson, Robert E; Witcher, Mark R; Deadwyler, Sam A; Berger, Theodore W; Marmarelis, Vasilis Z


    Neurostimulation is a promising therapy for abating epileptic seizures. However, it is extremely difficult to identify optimal stimulation patterns experimentally. In this study, human recordings are used to develop a functional 24 neuron network statistical model of hippocampal connectivity and dynamics. Spontaneous seizure-like activity is induced in silico in this reconstructed neuronal network. The network is then used as a testbed to design and validate a wide range of neurostimulation patterns. Commonly used periodic trains were not able to permanently abate seizures at any frequency. A simulated annealing global optimization algorithm was then used to identify an optimal stimulation pattern, which successfully abated 92% of seizures. Finally, in a fully responsive, or closed-loop, neurostimulation paradigm, the optimal stimulation successfully prevented the network from entering the seizure state. We propose that the framework presented here for algorithmically identifying patient-specific neurostimulation patterns can greatly increase the efficacy of neurostimulation devices for seizures.

  18. Seizure semiology of anti-LGI1 antibody encephalitis. (United States)

    Beimer, Nicholas J; Selwa, Linda M


    Limbic encephalitis associated with anti-LGI1 antibody (LGI1 encephalitis) presents with a variety of features, the most prominent of which include seizures and progressive disturbance of memory and behaviour. Although varied in semiology, recognition of the pattern of seizures in LGI1 encephalitis is important, as early diagnosis and definitive treatment may prevent subsequent development of cognitive impairment. We present a patient with LGI1 encephalitis and "faciobrachial dystonic seizures-plus", which began as classic faciobrachial dystonic seizures and progressed to focal seizures with impaired awareness, dacrystic/gelastic-like outbursts, ictal speech, manual automatisms, and autonomic signs (tachycardia). Recognition of the broad range of seizure types associated with LGI1 encephalitis is crucial for early diagnosis and definitive treatment. [Published with video sequence on].

  19. Clinical characteristics and outcome of patients diagnosed with psychogenic nonepileptic seizures: a 5-year review.

    LENUS (Irish Health Repository)

    O'Sullivan, S S


    OBJECTIVE: The goal of this article was to describe the clinical characteristics and outcomes of patients diagnosed with psychogenic nonepileptic seizures (PNES). METHODS: We conducted a retrospective review of patients diagnosed with PNES in a 5-year period. RESULTS: Fifty patients with PNES were identified, giving an estimated incidence of 0.91\\/100,000 per annum. Thirty-eight were included for review, 15 of whom were male (39%). Eighteen patients had been diagnosed with epilepsy as well as PNES (47%). We demonstrated a gender difference in our patients, with males having higher seizure frequencies, more antiepileptic drug use, and a longer interval before diagnosis of PNES. Females were diagnosed with other conversion disorders more often than males. Impaired social function was observed in PNES, as was resistance to psychological interventions with a subsequent poor response to treatments. CONCLUSIONS: PNES remains a difficult condition to treat, and may affect males in proportions higher than those described in previous studies.

  20. Seizure and EEG patterns in Wolf-Hirschhorn (4p-) syndrome. (United States)

    Battaglia, Agatino; Carey, John C


    Wolf-Hirschhorn syndrome (WHS) is a well-characterized chromosomal disorder that occurs due to partial deletion of the short arm of chromosome 4 (4p-). Although, about 300 cases have been reported to date, limited data are available on electroclinical findings. Information given to parents at the time of diagnosis tends to be skewed to the extreme negative. To delineate the natural history of seizures and EEG patterns in WHS, and obtain better information on diagnosis or outcome in a clinical setting, we reviewed the available literature on electroclinical findings of WHS. 4p- syndrome is characterized by distinctive seizure and EEG patterns that facilitate the early diagnosis and management of such patients.

  1. Difference in anxiety symptoms between children and their parents facing a first seizure or epilepsy. (United States)

    Save-Pédebos, Jessica; Bellavoine, Vanina; Goujon, Estelle; Danse, Marion; Merdariu, Dana; Dournaud, Pascal; Auvin, Stéphane


    Many studies have shown that anxiety disorders are common in children with epilepsy. We explored symptoms of anxiety simultaneously in children and their parents. We conducted a cross-sectional study using the Revised Children's Manifest Anxiety Scale in children and the State-Trait Anxiety Inventory for Adult in parents. We included 118 parents and 67 children, who were divided into three groups: (1) first seizure, (2) epilepsy, and (3) nonepileptic paroxysmal event. We found that the level of anxiety in parents and children differed. We observed a significant increase in the anxiety level of parents whose children have had a first seizure, while we found a significant increase in the anxiety level of children and adolescents followed for epilepsy. These findings suggest that there is no direct relationship in the anxiety of the parents and their child. Further studies are needed to understand this variation over time. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Consciousness and epilepsy: why are complex-partial seizures complex? (United States)

    Englot, Dario J; Blumenfeld, Hal


    Why do complex-partial seizures in temporal lobe epilepsy (TLE) cause a loss of consciousness? Abnormal function of the medial temporal lobe is expected to cause memory loss, but it is unclear why profoundly impaired consciousness is so common in temporal lobe seizures. Recent exciting advances in behavioral, electrophysiological, and neuroimaging techniques spanning both human patients and animal models may allow new insights into this old question. While behavioral automatisms are often associated with diminished consciousness during temporal lobe seizures, impaired consciousness without ictal motor activity has also been described. Some have argued that electrographic lateralization of seizure activity to the left temporal lobe is most likely to cause impaired consciousness, but the evidence remains equivocal. Other data correlates ictal consciousness in TLE with bilateral temporal lobe involvement of seizure spiking. Nevertheless, it remains unclear why bilateral temporal seizures should impair responsiveness. Recent evidence has shown that impaired consciousness during temporal lobe seizures is correlated with large-amplitude slow EEG activity and neuroimaging signal decreases in the frontal and parietal association cortices. This abnormal decreased function in the neocortex contrasts with fast polyspike activity and elevated cerebral blood flow in limbic and other subcortical structures ictally. Our laboratory has thus proposed the "network inhibition hypothesis," in which seizure activity propagates to subcortical regions necessary for cortical activation, allowing the cortex to descend into an inhibited state of unconsciousness during complex-partial temporal lobe seizures. Supporting this hypothesis, recent rat studies during partial limbic seizures have shown that behavioral arrest is associated with frontal cortical slow waves, decreased neuronal firing, and hypometabolism. Animal studies further demonstrate that cortical deactivation and behavioral

  3. Sex-specific consequences of early life seizures. (United States)

    Akman, Ozlem; Moshé, Solomon L; Galanopoulou, Aristea S


    Seizures are very common in the early periods of life and are often associated with poor neurologic outcome in humans. Animal studies have provided evidence that early life seizures may disrupt neuronal differentiation and connectivity, signaling pathways, and the function of various neuronal networks. There is growing experimental evidence that many signaling pathways, like GABAA receptor signaling, the cellular physiology and differentiation, or the functional maturation of certain brain regions, including those involved in seizure control, mature differently in males and females. However, most experimental studies of early life seizures have not directly investigated the importance of sex on the consequences of early life seizures. The sexual dimorphism of the developing brain raises the question that early seizures could have distinct effects in immature females and males that are subjected to seizures. We will first discuss the evidence for sex-specific features of the developing brain that could be involved in modifying the susceptibility and consequences of early life seizures. We will then review how sex-related biological factors could modify the age-specific consequences of induced seizures in the immature animals. These include signaling pathways (e.g., GABAA receptors), steroid hormones, growth factors. Overall, there are very few studies that have specifically addressed seizure outcomes in developing animals as a function of sex. The available literature indicates that a variety of outcomes (histopathological, behavioral, molecular, epileptogenesis) may be affected in a sex-, age-, region-specific manner after seizures during development. Obtaining a better understanding for the gender-related mechanisms underlying epileptogenesis and seizure comorbidities will be necessary to develop better gender and age appropriate therapies. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Forecasting seizures in dogs with naturally occurring epilepsy.

    Directory of Open Access Journals (Sweden)

    J Jeffry Howbert

    Full Text Available Seizure forecasting has the potential to create new therapeutic strategies for epilepsy, such as providing patient warnings and delivering preemptive therapy. Progress on seizure forecasting, however, has been hindered by lack of sufficient data to rigorously evaluate the hypothesis that seizures are preceded by physiological changes, and are not simply random events. We investigated seizure forecasting in three dogs with naturally occurring focal epilepsy implanted with a device recording continuous intracranial EEG (iEEG. The iEEG spectral power in six frequency bands: delta (0.1-4 Hz, theta (4-8 Hz, alpha (8-12 Hz, beta (12-30 Hz, low-gamma (30-70 Hz, and high-gamma (70-180 Hz, were used as features. Logistic regression classifiers were trained to discriminate labeled pre-ictal and inter-ictal data segments using combinations of the band spectral power features. Performance was assessed on separate test data sets via 10-fold cross-validation. A total of 125 spontaneous seizures were detected in continuous iEEG recordings spanning 6.5 to 15 months from 3 dogs. When considering all seizures, the seizure forecasting algorithm performed significantly better than a Poisson-model chance predictor constrained to have the same time in warning for all 3 dogs over a range of total warning times. Seizure clusters were observed in all 3 dogs, and when the effect of seizure clusters was decreased by considering the subset of seizures separated by at least 4 hours, the forecasting performance remained better than chance for a subset of algorithm parameters. These results demonstrate that seizures in canine epilepsy are not randomly occurring events, and highlight the feasibility of long-term seizure forecasting using iEEG monitoring.

  5. Early Seizures After Stroke: Neurology Intensive Care Unit Experience


    Şadiye Gümüşyayla; Gönül Vural


    Objective: The aim of this study was to investigate the frequency of early seizures, the affecting factors, and the prognostic effect of seizures in patients with acute ischemic stroke (AIS), intracerebral hemorrhage (ICH), and sinus venous thrombosis (SVT) examined in the intensive care unit (ICU). Materials and Methods: In the neurology ICU, the records of patients followed up with AIS, ICH, and SVT within a defined time period were retrospectively examined. Results: Early seizures ...

  6. Surface acoustic wave probe implant for predicting epileptic seizures (United States)

    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.

  7. Seizures in JE Misra UK, Kalita J. JNS 2002;190:57

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Seizures in JE Misra UK, Kalita J. JNS 2002;190:57. During 1991-1999 ; out of 65 patients 30 (46%) had seizures, GTCS in 17, partial 13. Single seizures 11, 2 seizures in 8 and multiple in 11 pts. Status epilepticus in 2. Seizures easily controlled. Vietnamese JE ...

  8. 78 FR 24310 - Study and Report to Congress on Natural Catastrophes and Insurance (United States)


    ... market for natural catastrophe insurance in the United States.\\1\\ \\1\\ Public Law 112-141, Sec. 100247...) ``providing an assessment of the current state of the market for natural catastrophe insurance in the United... appropriate and available, regarding natural catastrophes and the current state of the market for insurance...

  9. Study on China’s Earthquake Prediction by Mathematical Analysis and its Application in Catastrophe Insurance (United States)

    Jianjun, X.; Bingjie, Y.; Rongji, W.


    The purpose of this paper was to improve catastrophe insurance level. Firstly, earthquake predictions were carried out using mathematical analysis method. Secondly, the foreign catastrophe insurances’ policies and models were compared. Thirdly, the suggestions on catastrophe insurances to China were discussed. The further study should be paid more attention on the earthquake prediction by introducing big data.

  10. Catastrophe risk data scoping for disaster risk finance in Asia (United States)

    Millinship, Ian; Revilla-Romero, Beatriz


    Developing countries across Latin America, Africa, and Asia are some of the most exposed to natural catastrophes in the world. Over the last 20 years, Asia has borne almost half the estimated global economic cost of natural disasters - around 53billion annually. Losses from natural disasters can damage growth and hamper economic development and unlike in developed countries where risk is reallocated through re/insurance, typically these countries rely on budget reallocations and donor assistance in order to attempt to meet financing needs. There is currently an active international dialogue on the need to increase access to disaster risk financing solutions in Asia. The World Bank-GFDRR Disaster Risk Financing and Insurance Program with financial support from the Rockefeller Foundation, is currently working to develop regional options for disaster risk financing for developing countries in Asia. The first stage of this process has been to evaluate available catastrophe data suitable to support the design and implementation of disaster risk financing mechanisms in selected Asian countries. This project was carried out by a consortium of JBA Risk Management, JBA Consulting, ImageCat and Cat Risk Intelligence. The project focuses on investigating potential data sources for fourteen selected countries in Asia, for flood, tropical cyclone, earthquake and drought perils. The project was carried out under four stages. The first phase focused to identify and catalogue live/dynamic hazard data sources such as hazard gauging networks, or earth observations datasets which could be used to inform a parametric trigger. Live data sources were identified that provide credibility, transparency, independence, frequent reporting, consistency and stability. Data were catalogued at regional level, and prioritised at local level for five countries: Bangladesh, Indonesia, Pakistan, Sri Lanka and Viet Nam. The second phase was to identify, catalogue and evaluate catastrophe risk models

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Comparison of precipitating factors for mania and partial seizures: Indicative of shared pathophysiology? (United States)

    Bostock, Emmanuelle C S; Kirkby, Kenneth C; Garry, Michael I; Taylor, Bruce V M


    Mania in bipolar disorder (BD) and partial (focal) seizures (PS) arising from the temporal lobes, have a number of similarities. Typically, a chronic course of the disorders is punctuated by acute illness episodes. Common features of episodes may include sensory, perceptual, cognitive and affective changes. Both respond to anticonvulsant treatment. Common mechanisms imputed include neurotransmitters and kindling processes. Further investigation may improve understanding of the occurrence of both mania and PS, casting light on the relevance of temporal lobe mediated processes and pathology. One avenue of investigation is to compare aetiological factors and determine the extent of overlap which may indicate shared brain localization or pathophysiology. Aetiology includes predisposing, precipitating or perpetuating factors. This paper examines the literature on precipitating factors of mania, first or subsequent episode, and of PS in diagnosed epilepsy, which is the second or subsequent seizure, to identify the extent and nature of their overlap. Narrative review based on a literature search of PubMed and Google Scholar. Precipitating factors for both mania and PS were stress, sleep deprivation, antidepressant medication and, tentatively, emotion. For mania alone, goal-attainment events, spring and summer season, postpartum, and drugs include steroids and stimulants. For PS alone, winter season, menstruation and specific triggers in complex reflex epilepsies. Those not substantiated include lunar phase and menopause. A wide range of chemicals may provoke isolated seizures but by definition epilepsy requires at least two seizures. The overlap of precipitating factors in mania and PS imply that common brain processes may contribute to both, consistent with findings from neuroscience research. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. AED discontinuation may be dangerous for seizure-free patients. (United States)

    Schmidt, Dieter


    Despite its benefits, stopping antiepileptic drugs (AEDs) in seizure-free patients is associated with several risks. AED discontinuation doubles the risk of seizure recurrence for up to 2 years compared with continued treatment. On average, one in three patients has a seizure recurrence, though the range can go up to 66% (34%, range 12-66%, 95% CI: 27-43). Furthermore, the outcome of treating a seizure recurrence in patients who have been seizure-free for years is surprisingly poor in some patients. Although the long-term prognosis is not worsened by drug discontinuation, one in five patients does not re-enter remission and for some patients, it may take several years to become seizure-free again. The risk of seizure recurrence is particularly high for those with juvenile myoclonic epilepsy and symptomatic focal epilepsy, the most frequent epilepsies in adults. Seizure-recurrence may have devastating, medical, psychological and social consequences for the individual, for example injury, loss of self-esteem, unemployment and losing a driver's license. Discontinuation should be avoided in patients with a high risk of seizure recurrence. Given these risks, patients will ultimately have to decide themselves whether they wish to discontinue drug treatment after full informed consent.

  14. Treatment Outcome Of Seizures Associated With Intracranial Cavernous Angiomas

    Directory of Open Access Journals (Sweden)

    Nievera Conrad C


    Full Text Available Seizures are among the typical presentations of intracranial cavernous angiomas (ICA. Twenty-one patients (age range: 2 to 53 years treated for seizures associated with ICA between 1983 and 1997 were restrospectively studied to evaluate their outcome following medical or surgical intervention. The mean interval between seizure onset and initial presentation at our institution was 7.6 years. Seizures were simple partial in 3 patients, complex partial in 15 and secondarily generalized tonic-clonic in 13. The commonest site of the lesion was the temporal lobe (52%. Multiple angiomas were observed in 5 (24% patients. Seven (32% patients were medically-managed with antiepileptic therapy and 14 (68% underwent either lesionectomy with resection of the epileptogenic zone (9 patients or temporal lobectomy (5 patients. Mean follow-up time was 4 years (range: 3 months to 14 years. Of the medically-managed patients, 3 (43% remained seizure-free whereas 4 (57% continued to have seizures with an average frequency of one per day. Of the surgically-managed patients, 12 (86% became seizure-free and 2 (14% had no more than two seizures per year. Surgery appears to be extremely effective in the management of seizures associated with ICA and should receive a strong and early consideration in patients who fail medical therapy.

  15. Disparity in regional cerebral blood flow during electrically induced seizure

    DEFF Research Database (Denmark)

    Sestoft, D; Meden, P; Hemmingsen, R


    This is a presentation of 2 cases in which the intraictal regional cerebral blood flow distribution was measured with the 99mTc-HMPAO single photon emission computerized tomography technique during an electrically induced seizure. Although the seizure was verified as generalized on electroencepha......This is a presentation of 2 cases in which the intraictal regional cerebral blood flow distribution was measured with the 99mTc-HMPAO single photon emission computerized tomography technique during an electrically induced seizure. Although the seizure was verified as generalized...

  16. Approach to seizures in the neonatal period: a European perspective

    DEFF Research Database (Denmark)

    Vento, M; de Vries, Lisbeth Elvira; Alberola, A


    In the neonatal period, seizures rank among the most common neurological symptoms, often indicating an underlying serious neurological condition. It is remarkable that although new tools have been incorporated into the diagnosis of neonatal seizures, there is no consensus about the therapeutic...... the treatment of seizures in the neonatal period in different European institutions. Conclusion: We conclude that phenobarbital is still the initial drug of choice followed by benzodiazepines, except in preterm infants with a birth weight below 1800 g. In refractory seizures, the use of continuous lidocaine...

  17. Early Seizures After Stroke: Neurology Intensive Care Unit Experience

    Directory of Open Access Journals (Sweden)

    Şadiye Gümüşyayla


    Full Text Available Objective: The aim of this study was to investigate the frequency of early seizures, the affecting factors, and the prognostic effect of seizures in patients with acute ischemic stroke (AIS, intracerebral hemorrhage (ICH, and sinus venous thrombosis (SVT examined in the intensive care unit (ICU. Materials and Methods: In the neurology ICU, the records of patients followed up with AIS, ICH, and SVT within a defined time period were retrospectively examined. Results: Early seizures occurred in 48 out of 199 patients who were followed up with AIS, ICH, and SVT in the neurology ICU within the specified time period. The frequency of having early seizures was found to be higher in patients with left hemisphere lesions, cortical lesions, and those with AIS with hemorrhagic transformation. Lesion volume was found to be higher in patients with AIS who had early seizures compared with those who had AIS without seizures. Early seizures were observed in all patients with SVT who were followed up in the ICU. Conclusion: Early seizures are a common complication in patients with stroke followed up in neurology ICUs. Determination of effective factors in early seizures is important for its early diagnosis and treatment

  18. [Sleep disorders and epilepsy]. (United States)

    Aoki, Ryo; Ito, Hiroshi


    It has been reported that patients with epilepsy often have insomnia and/or daytime sleepiness; the symptomatologic features differ in seizure types. Not only the administration of anti-epileptics, but also inappropriate sleep hygiene cause daytime sleepiness. In subjective assessment of sleepiness, we need to pay attention if it can correctly assess or not. The prevalence of obstructive sleep apnea in patients with epilepsy is approximately 10-30%. Sleep apnea deteriorates the seizure control because of worsen sleep condition by sleep apnea, especially in elderly patients. Some researchers report that continuous positive airway pressure was effective for seizure control. Patients with epilepsy occasionally have REM sleep behavior disorder as comorbidity. Examination using polysomnography is required for differential diagnosis.

  19. Cardiac Troponin I elevation after epileptic seizure

    Directory of Open Access Journals (Sweden)

    Sieweke Nicole


    Full Text Available Abstract Background Cardiac troponin-I (cTNI is highly specific biomarker to prove myocardial damage, e.g. in acute coronary syndrome (ACS. However, it occurs in other conditions as well. We therefore analysed cTNI increase in patients after generalized convulsive seizure. Methods Consecutive patients admitted with acute generalized convulsive seizure were included in case of cTNI measurement on admission. Among 898 selected cases, 53 patients were referred secondary to our department; in 845 cases cTNI measurements on admission were available. In case of multiple admissions (81 cases, only the first admission entered our analysis. In 17 patients elevated cTNI was determined due to ACS; in one patient a myocarditis was found. 5 patients suffered of relevant renal insufficiency. Finally 741 patients were included in the analysis. A cTNI cut-off level of ≥ 0.1 ng/ml was considered. Factors associated with a cTNI increase were analysed subsequently. Results The mean age of the study population (n = 741 was 47.8 years (SD ± 18.6, 40.9% were female. In 50 patients (6.7% a cTNI elevation of unknown origin was found; no obvious cardiac involvement could be detected in these patients who all remained asymptomatic. A vascular risk profile (including at least hypertension, hypercholesterolemia or diabetes (OR = 3.62; CI: 1.59 to 8.21; p = 0.001 and elevated creatine kinase on admission (OR = 2.36; CI: 1.26 to 4.39; p = 0.002 were independent factors associated with cTNI release. Conclusion cTNI release occurs in patients with generalized convulsive seizure with predominance in patients with vascular risk profile.

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

    Directory of Open Access Journals (Sweden)

    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.