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Sample records for partial epilepsy mechanisms

  1. Partial Epilepsy with Auditory Features

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    J Gordon Millichap

    2004-07-01

    Full Text Available The clinical characteristics of 53 sporadic (S cases of idiopathic partial epilepsy with auditory features (IPEAF were analyzed and compared to previously reported familial (F cases of autosomal dominant partial epilepsy with auditory features (ADPEAF in a study at the University of Bologna, Italy.

  2. Monotherapy for partial epilepsy: focus on levetiracetam

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    Antonio Gambardella

    2008-03-01

    Full Text Available Antonio Gambardella1,2, Angelo Labate1,2, Eleonora Colosimo1, Roberta Ambrosio1, Aldo Quattrone1,21Institute of Neurology, University Magna Græcia, Catanzaro, Italy; 2Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, ItalyAbstract: Levetiracetam (LEV, the S-enantiomer of alpha-ethyl-2-oxo-1-pyrollidine acetamide, is a recently licensed antiepileptic drug (AED for adjunctive therapy of partial seizures. Its mechanism of action is uncertain but it exhibits a unique profile of anticonvulsant activity in models of chronic epilepsy. Five randomized, double-blind, placebo-controlled trials enrolling adult or pediatric patients with refractory partial epilepsy have demonstrated the efficacy of LEV as adjunctive therapy, with a responder rate (≥50% reduction in seizure frequency of 28%–45%. Long-term efficacy studies suggest retention rates of 60% after one year, with 13% of patients seizure-free for 6 months of the study and 8% seizure-free for 1 year. More recent studies illustrated successful conversion to monotherapy in patients with refractory epilepsy, and its effectiveness as a single agent in partial epilepsy. LEV has also efficacy in generalized epilepsies. Adverse effects of LEV, including somnolence, lethargy, and dizziness, are generally mild and their occurrence rate seems to be not significantly different from that observed in placebo groups. LEV also has no clinically significant pharmacokinetic interactions with other AEDs, or with commonly prescribed medications. The combination of effective antiepileptic properties with a relatively mild adverse effect profile makes LEV an attractive therapy for partial seizures.Keywords: levetiracetam, partial epilepsy, antiepileptic drugs

  3. Serial SPECT in children with partial epilepsy

    International Nuclear Information System (INIS)

    Hosoya, Machiko; Ushiku, Hideo

    1995-01-01

    We performed serial single-photon emission CT (SPECT) with N-isopropyl-p-( 123 I)-Iodoamphetamine to measure the regional cerebral blood flow (rCBF) in 15 children with partial epilepsy. SPECT showed focal changes in 14 cases. Ten cases had abnormalities in the initial SPECT and another four cases in the second test. The cases with normal rCBF in initial SPECT had been tested in an early phase after the onset, and then decreased rCBF were observed in the second SPECT. The cases with both abnormal rCBF in the initial SPECT and improved rCBF in the second SPECT showed good prognosis in clinico-electrophysiological evolutions. In cases with abnormal changes of rCBF in the second SPECT, clinical prognosis was found to be not so good. These findings suggest that serial SPECT may be used to follow the course of epilepsy. (author)

  4. Genetics Home Reference: autosomal dominant partial epilepsy with auditory features

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    ... for This Condition ADLTE ADPEAF Autosomal dominant lateral temporal lobe epilepsy Epilepsy, partial, with auditory features ETL1 Related Information ... W, Nakken KO, Fischer C, Steinlein OK. Familial temporal lobe epilepsy with aphasic seizures and linkage to chromosome 10q22- ...

  5. Diffusion tensor imaging of partial intractable epilepsy

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    Dumas de la Roque, Anne; Oppenheim, Catherine; Rodrigo, Sebastian; Meder, Jean-Francois; Chassoux, Francine; Devaux, Bertrand; Beuvon, Frederic; Daumas-Duport, Catherine

    2005-01-01

    Our aim was to assess the value of diffusion tensor imaging (DTI) in patients with partial intractable epilepsy. We used DTI (25 non-collinear directions) in 15 patients with a cortical lesion on conventional MRI. Fractional anisotropy (FA) was measured in the internal capsule, and in the normal-appearing white matter (WM), adjacent tothe lesion, and away from the lesion, at a set distance of 2-3 cm. In each patient, increased or decreased FA measurements were those that varied from mirror values using an arbitrary 10% threshold. Over the whole population, ipsi- and contralateral FA measurements were also compared using a Wilcoxon test (p<0.05). Over the whole population, FA was significantly reduced in the WM adjacent to and away from the lesion, whilst being normal in the internal capsule. FA was reduced by more than 10% in the WM adjacent to and distant from the lesion in 13 and 12 patients respectively. For nine of the ten patients for whom the surgical resection encompassed the limits of the lesion on conventional MRI, histological data showed WM alterations (gliosis, axonal loss, abnormal cells). DTI often reveals WM abnormalities that are undetected on conventional MRI in patients with partial intractable epilepsy. (orig.)

  6. Ictal cerebral perfusion patterns in partial epilepsy: SPECT subtraction

    International Nuclear Information System (INIS)

    Lee, Hyang Woon; Hong, Seung Bong; Tae, Woo Suk; Kim, Sang Eun; Seo, Dae Won; Jeong, Seung Cheol; Yi, Ji Young; Hong, Seung Chyul

    2000-01-01

    To investigate the various ictal perfusion patterns and find the relationships between clinical factors and different perfusion patterns. Interictal and ictal SPECT and SPECT subtraction were performed in 61 patients with partial epilepsy. Both positive images showing ictal hyperperfusion and negative images revealing ictal hypoperfusion were obtained by SPECT subtraction. The ictal perfusion patterns of subtracted SPECT were classified into focal hyperperfusion, hyperperfusion-plus, combined hyperperfusion-hypoperfusion, and focal hypoperfusion only. The concordance rates with epileptic focus were 91.8% in combined analysis of ictal hyperperfusion and hypoperfusion images of subtracted SPECT, 85.2% in hyperperfusion images only of subtracted SPECT, and 68.9% in conventional ictal SPECT analysis. Ictal hypoperfusion occurred less frequently in temporal lobe epilepsy (TLE) than extratemporal lobe epilepsy. Mesial temporal hyperperfusion alone was seen only in mesial TLE while lateral temporal hyperperfusion alone was observed only in neocortical TLE. Hippocampal sclerosis had much lower incidence of ictal hypoperfusion than any other pathology. Some patients showed ictal hypoperfusion at epileptic focus with ictal hyperperfusion in the neighboring brain regions where ictal discharges propagated. Hypoperfusion as well as hyperperfusion in ictal SPECT should be considered for localizing epileptic focus. Although the mechanism of ictal hypoperfusion could be an intra-ictal early exhaustion of seizure focus or a steal phenomenon by the propagation of ictal discharges to adjacent brain areas, further study is needed to elucidate it.=20

  7. Ictal cerebral perfusion patterns in partial epilepsy: SPECT subtraction

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    Lee, Hyang Woon; Hong, Seung Bong; Tae, Woo Suk; Kim, Sang Eun; Seo, Dae Won; Jeong, Seung Cheol; Yi, Ji Young; Hong, Seung Chyul [Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of)

    2000-06-01

    To investigate the various ictal perfusion patterns and find the relationships between clinical factors and different perfusion patterns. Interictal and ictal SPECT and SPECT subtraction were performed in 61 patients with partial epilepsy. Both positive images showing ictal hyperperfusion and negative images revealing ictal hypoperfusion were obtained by SPECT subtraction. The ictal perfusion patterns of subtracted SPECT were classified into focal hyperperfusion, hyperperfusion-plus, combined hyperperfusion-hypoperfusion, and focal hypoperfusion only. The concordance rates with epileptic focus were 91.8% in combined analysis of ictal hyperperfusion and hypoperfusion images of subtracted SPECT, 85.2% in hyperperfusion images only of subtracted SPECT, and 68.9% in conventional ictal SPECT analysis. Ictal hypoperfusion occurred less frequently in temporal lobe epilepsy (TLE) than extratemporal lobe epilepsy. Mesial temporal hyperperfusion alone was seen only in mesial TLE while lateral temporal hyperperfusion alone was observed only in neocortical TLE. Hippocampal sclerosis had much lower incidence of ictal hypoperfusion than any other pathology. Some patients showed ictal hypoperfusion at epileptic focus with ictal hyperperfusion in the neighboring brain regions where ictal discharges propagated. Hypoperfusion as well as hyperperfusion in ictal SPECT should be considered for localizing epileptic focus. Although the mechanism of ictal hypoperfusion could be an intra-ictal early exhaustion of seizure focus or a steal phenomenon by the propagation of ictal discharges to adjacent brain areas, further study is needed to elucidate it.

  8. Prognosis of Partial Epilepsy Predicted by MRI and PET

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    J Gordon Millichap

    2007-03-01

    Full Text Available The evolution of cerebral glucose metabolism after partial seizure onset was studied in 38 children using PET scans over 3.0 +/- 1.3 years (and within a year after a third unprovoked partial seizure by researchers at the Clinical Epilepsy Section, NINDS, and Children’s National Medical Center, Washington, DC.

  9. The origin of the concept of partial epilepsy.

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    Eadie

    1999-03-01

    The International League Against Epilepsy has devised classifications which subdivide both epileptic seizures and the epilepsies and epileptic syndromes into two main types: generalized and partial. Epileptogenesis in the partial variety is believed to originate in a localized part of the cerebral cortex and results in clinical manifestations which appear to commence in only a restricted part of the sufferer's body. Use of the term 'partial' in relation to these entities has often been said to date back to James Cowles Prichard (1786-1849) who was the author of the second major work on epilepsy to be written in the UK. While Prichard certainly described 'partial epilepsy', he stated that he intended the words to refer to the fact that the disorder he described under that designation was only partly, and not fully, epileptic in nature. He did not refer to the fact that it affected only part of the body as his basis for using the term. In the absence of knowledge of localization of function in the cerebral cortex at Prichard's time of writing, he had no basis for deducing that the underlying epileptic process arose in only part of the brain. However, there is an earlier mention of the use of the word 'partial' in relation to epilepsy. This is to be found in the writings of the great Scottish physician William Cullen (1710-1790), and there is reason to believe that Prichard should have been aware of this. Cullen used 'partial' with an intention similar to the modern one, employing the word to refer to seizures which affected only part of the body. Credit for the origin of the idea of a 'partial' epilepsy should belong to Cullen; not only did he have priority over Prichard but his concept was closer to the modern one than was Prichard's. Copyright 1999 Harcourt Publishers Ltd.

  10. Positron emission tomography in presurgical diagnosis of partial epilepsies

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    Hajek, M.; Leenders, K.L.; Wieser, H.G.

    1992-01-01

    We present results of studies in which positron emission tomography was applied to the presurgical evaluation of epileptics. Emphasis is placed on results of PET studies with various tracers in partial epilepsies and on the use of PET in age-related epileptic syndromes in children. (orig.) [de

  11. Parahippocampal epilepsy with subtle dysplasia: A cause of "imaging negative" partial epilepsy.

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    Pillay, Neelan; Fabinyi, Gavin C A; Myles, Terry S; Fitt, Gregory J; Berkovic, Samuel F; Jackson, Graeme D

    2009-12-01

    Lesion-negative refractory partial epilepsy is a major challenge in the assessment of patients for potential surgery. Finding a potential epileptogenic lesion simplifies assessment and is associated with good outcome. Here we describe imaging features of subtle parahippocampal dysplasia in five cases that were initially assessed as having imaging-negative frontal or temporal lobe epilepsy. We analyzed the clinical and imaging features of five patients with seizures from the parahippocampal region. Five patients had subtle but distinctive magnetic resonance imaging (MRI) abnormalities in the parahippocampal gyrus. This was a unilateral signal abnormality in the parahippocampal white matter extending into gray matter on heavily T(1)- and T(2)-weighted images with relative preservation of the gray-white matter boundary on T(1)-weighted volume sequences. Only one of these patients had typical electroclinical unilateral temporal lobe epilepsy (TLE); one mimicked frontal lobe epilepsy, two showed bitemporal seizures, and one had unlocalized partial seizures. All have had surgery; four are seizure-free (one has occasional auras only, follow-up 6 months to 10 years), and one has a >50% seizure reduction. Histopathologic evaluation suggested dysplastic features in the surgical specimens in all. In patients with lesion-negative partial epilepsy with frontal or temporal semiology, or in cases with apparent bitemporal seizures, subtle parahippocampal abnormalities should be carefully excluded. Recognizing the MRI findings of an abnormal parahippocampal gyrus can lead to successful surgery without invasive monitoring, despite apparently incongruent electroclinical features.

  12. How do we make models that are useful in understanding partial epilepsies?

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    Prince, David A

    2014-01-01

    The goals of constructing epilepsy models are (1) to develop approaches to prophylaxis of epileptogenesis following cortical injury; (2) to devise selective treatments for established epilepsies based on underlying pathophysiological mechanisms; and (3) use of a disease (epilepsy) model to explore brain molecular, cellular and circuit properties. Modeling a particular epilepsy syndrome requires detailed knowledge of key clinical phenomenology and results of human experiments that can be addressed in critically designed laboratory protocols. Contributions to understanding mechanisms and treatment of neurological disorders has often come from research not focused on a specific disease-relevant issue. Much of the foundation for current research in epilepsy falls into this category. Too strict a definition of the relevance of an experimental model to progress in preventing or curing epilepsy may, in the long run, slow progress. Inadequate exploration of the experimental target and basic laboratory results in a given model can lead to a failed effort and false negative or positive results. Models should be chosen based on the specific issues to be addressed rather than on convenience of use. Multiple variables including maturational age, species and strain, lesion type, severity and location, latency from injury to experiment and genetic background will affect results. A number of key issues in clinical and basic research in partial epilepsies remain to be addressed including the mechanisms active during the latent period following injury, susceptibility factors that predispose to epileptogenesis, injury - induced adaptive versus maladaptive changes, mechanisms of pharmaco-resistance and strategies to deal with multiple pathophysiological processes occurring in parallel.

  13. Clinical usefulness of MRI and MRA in children with partial epilepsy

    International Nuclear Information System (INIS)

    Zajac, A.; Kacinski, M.; Kubik, A.; Kroczka, S.

    2006-01-01

    Partial epilepsy is a very important problem of epileptology in childhood including clinical and therapeutic aspect especially surgery treatment. The aim of this study is to assess clinical value of neuroimagine techniques (structural MRI, MRI angiography) in partial epilepsy diagnostics in children. The relation between results of examinations with these methods and congenital and acquired risk factors related to partial epilepsy, age of its onset and clinical assessment of patients was analyzed. The study group consisted of 140 children with partial epilepsy hospitalized between 1998 and 2004 in Department of Pediatric Neurology, Collegium Medicum Jagiellonian University, Krakow. The group included 70 girls and 70 boys, the age ranged from 2 months to 17 years. In study group statistical analysis included different factors as which can be related with results of neuroimaging as age, load of pregnancy and birth period, familiar epilepsy, patient's risk factors for appearance of epilepsy, acquired risk factors of epilepsy, results of neurological examination, type of epilepsy, status epilepticus, and signs according epileptic attacks which can be related with neuroimaging results. The primary method of neuroimagine in all patients was structural MRI, in 16 cases Magnetic Resonance Angiography (MRA). The parametric tests (t-student), nonparametric Mann-Whitney's test were used in statistical analysis. The bilateral Fisher test was used to check rate in groups. There was assessed sensitivity, specificity, positive predictive value, negative predictive value; the 95% confidence interval was calculated for these parameters. Abnormalities in neurological examination in children with partial epilepsy were strongly correlated with MRI findings. The structural changes in MRI were found in younger children, whose course of epilepsy was longer than children without MRI changes. Changes in hippocampus ere the most common in children with partial epilepsy with abnormalities in

  14. Long-term outcomes of epilepsy surgery in school-aged children with partial epilepsy.

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    Liang, Shuli; Wang, Shuai; Zhang, Junchen; Ding, Chengyun; Zhang, Zhiwen; Fu, Xiangping; Hu, Xiaohong; Meng, Xiaoluo; Jiang, Hong; Zhang, Shaohui

    2012-10-01

    The pediatric epileptic spectrum and seizure control in surgical patients have been defined in developed countries. However, corresponding data on school-aged children from developing countries are insufficient. We summarized epileptic surgical data from four centers in China, to compare surgical outcomes of school-aged children with intractable partial epilepsy from China and those from developed countries, and introduce surgical candidate criteria. Data from 206 children (aged 6-14 years) undergoing surgical resection for epilepsy between September 2001 and January 2007 were selected. Postoperative freedom from seizures was achieved in 173 cases (84.0%) at 1 year, 149 (72.3%) at 3 years, and 139 (67.5%) at 5 years. Patients with focal magnetic resonance imaging abnormalities and a short history of seizure were most likely to become seizure-free postoperatively. Those with preoperative low intelligence quotients who became seizure-free postoperatively achieved improvements in full memory quotients, intelligence quotients, and overall quality of life at 2 years. Significant differences were evident in mean changes of full intelligence quotient, full memory quotient, and overall quality of life between patients with preoperative low intelligence quotients who received corpus callosotomies and those with a normal preoperative intelligence quotient, and between seizure-free children and those with continual seizures. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Mechanisms of video-game epilepsy.

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    Fylan, F; Harding, G F; Edson, A S; Webb, R M

    1999-01-01

    We aimed to elucidate the mechanisms underlying video-game epilepsy by comparing the flicker- and spatial-frequency ranges over which photic and pattern stimulation elicited photoparoxysmal responses in two different populations: (a) 25 patients with a history of seizures experienced while playing video games; and (b) 25 age- and medication-matched controls with a history of photosensitive epilepsy, but no history of video-game seizures. Abnormality ranges were determined by measuring photoparoxysmal EEG abnormalities as a function of the flicker frequency of patterned and diffuse intermittent photic stimulation (IPS) and the spatial frequency of patterns on a raster display. There was no significant difference between the groups in respect of the abnormality ranges elicited by patterned or diffuse IPS or by spatial patterns. When the groups were compared at one specific IPS frequency (-50 Hz), however, the flicker frequency of European television displays, the video-game patients were significantly more likely to be sensitive. The results suggest that video-game seizures are a manifestation of photosensitive epilepsy. The increased sensitivity of video-game patients to IPS at 50 Hz indicates that display flicker may underlie video-game seizures. The similarity in photic- and pattern-stimulation ranges over which abnormalities are elicited in video-game patients and controls suggests that all patients with photosensitive epilepsy may be predisposed toward video-game-induced seizures. Photosensitivity screening should therefore include assessment by using both IPS at 50 Hz and patterns displayed on a television or monitor with a 50-Hz frame rate.

  16. Subjective sleep disturbances in children with partial epilepsy and their effects on quality of life

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    Gutter, Th; Brouwer, O. F.; de Weerd, A. W.

    Purpose: The purposes of this study were to explore the prevalence of sleep disturbances in a large cohort of school-aged children with partial epilepsy, to compare the findings with those in children without epilepsy of the same age and gender, and to evaluate the relationship between sleep

  17. Update on the role of eslicarbazepine acetate in the treatment of partial-onset epilepsy

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    Tambucci R

    2016-05-01

    Full Text Available Renato Tambucci,1 Claudia Basti,1 Maria Maresca,1 Giangennaro Coppola,2 Alberto Verrotti11Department of Pediatrics, University of L’Aquila, L’Aquila, Italy; 2Child and Adolescent Neuropsychiatry Unit, University of Salerno, Salerno, ItalyAbstract: Eslicarbazepine acetate (ESL is a once daily new third generation antiepileptic drug that shares the basic chemical structure of carbamazepine and oxcarbazepine – a dibenzazepine nucleus with the 5-carboxamide substituent, but is structurally different at the 10,11-position. ESL is a pro-drug metabolized to its major active metabolite eslicarbazepine. Despite the fact that the exact mechanism of action has not been fully elucidated, it is thought to involve inhibition of voltage-gated sodium channels (VGSC. ESL inhibits sodium currents in a voltage-dependent way by an interaction predominantly with the inactivated state of the VGSC, thus selectively reducing the activity of rapidly firing (epileptic neurons. ESL reduces VGSC availability through enhancement of slow inactivation. In Phase III studies, adjunctive therapy with ESL 800 or 1,200 mg/day leads to a significant decrease in the seizure frequency in adults with refractory partial onset epilepsy. Based on these results, ESL has been approved in Europe (by the European Medicines Agency and in the United States (by the US Food and Drug Administration as add-on therapy. Data on efficacy and safety have been confirmed by 1-year extension and real life observational studies. Recently, based on results from two randomized, double-blind, historical control Phase III trials, ESL received US Food and Drug Administration approval also as a monotherapy for patients with partial onset epilepsy. In the pediatric setting, encouraging results have been obtained suggesting its potential role in the management of epileptic children. Overall ESL was generally well tolerated. The most common adverse events were dizziness, somnolence, headache, nausea

  18. The characteristics of SPECT images in childhood benign partial epilepsy

    International Nuclear Information System (INIS)

    Jia Shaowei; Liao Jianxiang; Liu Xiaoyan; Zheng Xiyuan; Qin Jiong; Pan Zhongyun; Zuo Qihua

    1998-01-01

    Purpose: To investigate childhood benign partial epilepsy (BPE) with SPECT. Methods: Double SPECT imaging was performed on 21 cases of BPE at the stage of wake (interval spike discharge) and sleep (spike discharge), under EEG monitoring. The transverse images were reconstructed after digital image subtraction. The quantitative analysis was conducted with brain flow change rate (BFCR) % mathematical model. Results: EEG monitoring demonstrated approximately normal background of 21 cases of BPE during the stage of wake, and spike discharge frequency markedly increased during the stage of sleep, 117 foci were showed by SPeCT in cases of BPE, and the average was 5.6 +- 1.6 foci/case. The characteristics of SPECT transverse images were 1) multiple foci of mirror, 2) mostly seen in Rolandic region, 3) circular symbol, 4) the radioactivity in foci decreased during the stage of wake (interval spike discharge) and increased during the stage of sleep (spike discharge). The concordance of SPECT and EEG was 93.1% (109/117 foci). The BFCR% of all epileptogenic foci exceeded normal limit (99% confidence interval). There was no correlation between the spike discharge frequency and BFCR% (r = 0.45, P>0.05). Conclusions: Regional cerebral blood flow and function were abnormal during the epileptogenic foci were discharging abnormally in BPE

  19. Quality of life after surgery for intractable partial epilepsy in children: a cohort study with controls.

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    Mikati, Mohamad A; Ataya, Nour; Ferzli, Jessica; Kurdi, Rana; El-Banna, Diana; Rahi, Amal; Shamseddine, Alhan; Sinno, Durriyah; Comair, Youssef

    2010-08-01

    Investigate if quality of life (QOL) normalizes on long-term follow-up after surgery for partial epilepsy in children. This is a cohort study with controls in which a consecutive cohort of nineteen 2-14-year-old children who underwent focal resections for intractable partial seizures between 1996 and 2006, were matched with 19 non-surgery intractable partial epilepsy patients, and with 19 healthy subjects. The two epilepsy groups were matched for age, sex, socio-economic status (SES), cognitive level, seizure type, and seizure frequency. The healthy group was matched with the two epilepsy groups for age, sex, SES, and cognitive level. QOL was assessed using the QOLCE (Quality of Life in Childhood Epilepsy Questionnaire). In the surgery group (follow-up 3.84+/-2.26 years), 78.9% had Engel class-I versus 21.1% in non-surgery (p=0.01) (follow-up 3.44+/-2.95 years). Surgery patients were similar to healthy subjects in the social, emotional, cognitive, behavioral, and overall QOL (p>0.05) but had lower scores in the total QOL, physical, and health domains (p0.05, power>0.8). Our data indicate that epilepsy surgery for partial seizures in children is associated with better QOL as compared to children with intractable epilepsy who are not operated on, and suggest that in those who achieve seizure freedom normal QOL may at least potentially be possible.

  20. Common genetic variation and susceptibility to partial epilepsies: a genome-wide association study.

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    Kasperaviciūte, Dalia; Catarino, Claudia B; Heinzen, Erin L; Depondt, Chantal; Cavalleri, Gianpiero L; Caboclo, Luis O; Tate, Sarah K; Jamnadas-Khoda, Jenny; Chinthapalli, Krishna; Clayton, Lisa M S; Shianna, Kevin V; Radtke, Rodney A; Mikati, Mohamad A; Gallentine, William B; Husain, Aatif M; Alhusaini, Saud; Leppert, David; Middleton, Lefkos T; Gibson, Rachel A; Johnson, Michael R; Matthews, Paul M; Hosford, David; Heuser, Kjell; Amos, Leslie; Ortega, Marcos; Zumsteg, Dominik; Wieser, Heinz-Gregor; Steinhoff, Bernhard J; Krämer, Günter; Hansen, Jörg; Dorn, Thomas; Kantanen, Anne-Mari; Gjerstad, Leif; Peuralinna, Terhi; Hernandez, Dena G; Eriksson, Kai J; Kälviäinen, Reetta K; Doherty, Colin P; Wood, Nicholas W; Pandolfo, Massimo; Duncan, John S; Sander, Josemir W; Delanty, Norman; Goldstein, David B; Sisodiya, Sanjay M

    2010-07-01

    Partial epilepsies have a substantial heritability. However, the actual genetic causes are largely unknown. In contrast to many other common diseases for which genetic association-studies have successfully revealed common variants associated with disease risk, the role of common variation in partial epilepsies has not yet been explored in a well-powered study. We undertook a genome-wide association-study to identify common variants which influence risk for epilepsy shared amongst partial epilepsy syndromes, in 3445 patients and 6935 controls of European ancestry. We did not identify any genome-wide significant association. A few single nucleotide polymorphisms may warrant further investigation. We exclude common genetic variants with effect sizes above a modest 1.3 odds ratio for a single variant as contributors to genetic susceptibility shared across the partial epilepsies. We show that, at best, common genetic variation can only have a modest role in predisposition to the partial epilepsies when considered across syndromes in Europeans. The genetic architecture of the partial epilepsies is likely to be very complex, reflecting genotypic and phenotypic heterogeneity. Larger meta-analyses are required to identify variants of smaller effect sizes (odds ratio<1.3) or syndrome-specific variants. Further, our results suggest research efforts should also be directed towards identifying the multiple rare variants likely to account for at least part of the heritability of the partial epilepsies. Data emerging from genome-wide association-studies will be valuable during the next serious challenge of interpreting all the genetic variation emerging from whole-genome sequencing studies.

  1. Partial epilepsy and 47,XXX karyotype: report of four cases.

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    Roubertie, Agathe; Humbertclaude, Véronique; Leydet, Julie; Lefort, Geneviève; Echenne, Bernard

    2006-07-01

    Epilepsy is a common finding in chromosomal imbalances, but only a few chromosome abnormalities have a characteristic electro-clinical pattern. Trisomy X is one of the most common sex chromosome abnormalities in females, and is associated with considerable phenotypic variability. This report describes four 47,XXX females with mental deficiency and epilepsy. Although a specific electro-clinical pattern could not be defined, the epileptic phenotypes of these patients share many features; we suggest that the association 47,XXX/epilepsy/mental retardation may not be coincidental. This report also enlarges the clinical spectrum of the 47,XXX phenotype. Moreover, these observations highlight the critical role of chromosome X in epilepsy and mental retardation.

  2. Epilepsy

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    Wieser, H.G. [University Hospital, Dep. of Neurology, Zurich (Switzerland)

    1993-12-31

    PET has added valuable information to our knowledge of the human epilepsies. The most important observations have been the identification of localized regions of interictal cerebral dysfunction in patients with partial epilepsy, revealed with PET as local hypometabolism, hypoperfusion, or (in one study) enhanced {mu}opiate receptor binding. The following general conclusions about the anatomy of epilepsy can be drawn from interictal PET studies: (1) interictal neuronal dysfunction is not limited to the site of ictal onset, nor to brain areas immediately adjacent to structural damage, (2) temporal lobe dysfunction is most commonly encountered, usually in association with primary epileptogenic lesions in mesial temporal structures, but also on occasion with lateral temporal or extratemporal epileptogenic lesions which preferentially propagate to mesial temporal structures to give rise to complex partial seizures. It is now accepted that interictal {sup 18}F-FDG PET correctly lateralises the primarily epileptic temporal lobe in approximately 70% of patients. As a consequence of inclusion of PET into the UCLA presurgical evaluation protocol, Engel et al. were able to operate on 28% of the patients without using invasive methods, (3) local isolated neocortical dysfunction associated with simple partial seizures is only rarely revealed by PET, (4) remote interictal cerebral dysfunction associated with complex partial seizures is not necessarily limited to the involved TL, since contralateral temporal, extemporal neocortical and cerebral dysfunction may also be seen, (5) a variety of anatomical patterns of interictal cerebral dysfunction occur in secondary generalized epilepsies, which may be related to symptoms and signs, (6) no diffuse or localized interictal cerebral dysfunction has been identified by PET in patients with primary generalized childhood absence seizures. (author) 29 refs.

  3. Efficacy of low to moderate doses of oxcarbazepine in adult patients with newly diagnosed partial epilepsy.

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    Zou, Xue-Mei; Chen, Jia-Ni; An, Dong-Mei; Hao, Nan-Ya; Hong, Zhen; Hao, Xiao-Ting; Rao, Ping; Zhou, Dong

    2015-07-01

    The objective of this study was to explore the efficacy of low dose of oxcarbazepine (OXC) in adult patients with newly diagnosed partial epilepsy in an actual clinical setting. The associated factors influencing the poor control of seizures were also evaluated. The epilepsy database (2010-2014) from the Epilepsy Clinic of West China Hospital was retrospectively reviewed. A total of 102 adult patients with newly diagnosed, previously untreated partial epilepsy initially treated with OXC were included, and divided into good response group (64) and poor response group (38) according to whether they were seizure-free for at least 12 months. There were 27 (26.5%) patients becoming seizure-free with OXC 600 mg/day monotherapy. The remaining 75 patients had doses of either increasing OXC to 900 mg/day (n = 59) or the addition of another antiepileptic drug (AED) (n = 16), with another 20 (19.6%) and six (5.9%) patients becoming seizure-free, respectively (P = 0.788). In addition, two (2.0%) and nine (8.8%) patients became seizure-free with OXC > 900 mg/day monotherapy and OXC ≥ 900 mg/day combination therapy, respectively. Multivariate binary logistic regression analysis revealed that the time from onset of epilepsy to treatment initiation is significantly associated with seizure control (P = 0.02). Our results indicated that OXC at low to moderate doses is effective for the treatment of Chinese adult patients with newly diagnosed, previously untreated partial epilepsy, and a longer time interval from the onset of epilepsy to the start of treatment significantly predicts poor seizure control. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  4. Unfavorable surgical outcomes in partial epilepsy with secondary bilateral synchrony: Intracranial electroencephalography study.

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    Sunwoo, Jun-Sang; Byun, Jung-Ick; Moon, Jangsup; Lim, Jung-Ah; Kim, Tae-Joon; Lee, Soon-Tae; Jung, Keun-Hwa; Park, Kyung-Il; Chu, Kon; Kim, Manho; Chung, Chun-Kee; Jung, Ki-Young; Lee, Sang Kun

    2016-05-01

    Secondary bilateral synchrony (SBS) indicates bilaterally synchronous epileptiform discharges arising from a focal cortical origin. The present study aims to investigate SBS in partial epilepsy with regard to surgical outcomes and intracranial EEG findings. We retrospectively reviewed consecutive patients who underwent epilepsy surgery following extraoperative intracranial electroencephalography (EEG) study from 2008 to 2012. The presence of SBS was determined based upon the results of scalp EEG monitoring performed for presurgical evaluations. We reviewed scalp EEG, neuroimaging, intracranial EEG findings, and surgical outcomes in patients with SBS. We found 12 patients with SBS who were surgically treated for intractable partial epilepsy. Nine (75%) patients had lateralized ictal semiology and only two (16.6%) patients showed localized ictal onset in scalp EEG. Brain MRI showed epileptogenic lesion in three (25%) patients. Intracranial EEG demonstrated that ictal onset zone was widespread or non-localized in six (50%) patients. Low-voltage fast activity was the most common ictal onset EEG pattern. Rapid propagation of ictal onset was noted in 10 (83.3%) patients. Eleven patients underwent resective epilepsy surgery and only two patients (18.2%) achieved seizure-freedom (median follow-up 56 months). MRI-visible brain lesions were associated with favorable outcomes (p=0.024). Patients with SBS, compared to frontal lobe epilepsy without SBS, showed lesser localization in ictal onset EEG (p=0.029) and more rapid propagation during evolution of ictal rhythm (p=0.015). The present results suggested that resective surgery for partial epilepsy with SBS should be decided carefully, especially in case of nonlesional epilepsy. Poor localization and rapid spread of ictal onset were prominent in intracranial EEG, which might contribute to incomplete resection of the epileptogenic zone and poor surgical outcomes. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Epilepsy

    Science.gov (United States)

    ... Epilepsia What Is Epilepsy? Epilepsy comes from a Greek word meaning "to hold or seize," and people ... for epilepsy than somebody whose family has no history of seizures. How Can Doctors Help? If a ...

  6. Sleep-disordered breathing in epilepsy: epidemiology, mechanisms, and treatment.

    Science.gov (United States)

    Sivathamboo, Shobi; Perucca, Piero; Velakoulis, Dennis; Jones, Nigel C; Goldin, Jeremy; Kwan, Patrick; O'Brien, Terence J

    2018-04-01

    Epilepsy is a group of neurological conditions in which there is a pathological and enduring predisposition to generate recurrent seizures. Evidence over the last few decades suggests that epilepsy may be associated with increased sleep-disordered breathing, which may contribute towards sleep fragmentation, daytime somnolence, reduced seizure control, and cardiovascular-related morbidity and mortality. Chronic sleep-disordered breathing can result in loss of gray matter and cause deficits to memory and global cognitive function. Sleep-disordered breathing is a novel and independent predictor of sudden cardiac death and, as such, may be involved in the mechanisms leading to sudden unexpected death in epilepsy. Despite this, the long-term consequences of sleep-disordered breathing in epilepsy remain unknown, and there are no guidelines for screening or treating this population. There is currently insufficient evidence to indicate continuous positive airway pressure (CPAP) for the primary or secondary prevention of cardiovascular disease, and recent evidence has failed to show any reduction of fatal or nonfatal cardiovascular endpoints. Treatment of sleep-disordered breathing may potentially improve seizure control, daytime somnolence, and neurocognitive outcomes, but few studies have examined this relationship. In this review, we examine sleep-disordered breathing in epilepsy, and discuss the potential effect of epilepsy treatments. We consider the role of CPAP and other interventions for sleep-disordered breathing and discuss their implications for epilepsy management.

  7. WITHDRAWN: Oxcarbazepine add-on for drug-resistant partial epilepsy.

    Science.gov (United States)

    Castillo, Sergio M; Schmidt, Dieter B; White, Sarah; Shukralla, Arif

    2016-11-15

    Most people with epilepsy have a good prognosis and their seizures can be well controlled with the use of a single antiepileptic drug, but up to 30% develop refractory epilepsy, especially those with partial seizures. In this review we summarize the current evidence regarding oxcarbazepine when used as an add-on treatment for drug-resistant partial epilepsy. To evaluate the effects of oxcarbazepine when used as an add-on treatment for drug-resistant partial epilepsy. We searched the Cochrane Epilepsy Group's Specialized Register (28 March 2006), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2006), MEDLINE (1966 to March 2006). No language restrictions were imposed. We checked the reference lists of retrieved studies for additional reports of relevant studies. We also contacted Novartis (manufacturers of oxcarbazepine) and experts in the field. Randomized, placebo-controlled, double-blinded, add-on trials of oxcarbazepine in patients with drug-resistant partial epilepsy. Two review authors independently assessed trials for inclusion and extracted the relevant data. The following outcomes were assessed : (a) 50% or greater reduction in seizure frequency; (b) treatment withdrawal (any reason); (c) side effects. Primary analyses were intention-to-treat. Summary odds ratios were estimated for each outcome. Two trials were included representing 961 randomized patients.Overall Odds Ratio (OR) (95% Confidence Interval (CIs)) for 50% or greater reduction in seizure frequency compared to placebo 2.96 (2.20, 4.00).Treatment withdrawal OR (95% CIs) compared to placebo 2.17 (1.59, 2.97).Side effects: OR (99% CIs) compared to placebo, ataxia 2.93 (1.72, 4.99); dizziness 3.05 (1.99, 4.67); fatigue 1.80 (1.02, 3.19); nausea 2.88 (1.77, 4.69); somnolence 2.55 (1.84, 3.55); diplopia 4.32 (2.65, 7.04), were significantly associated with oxcarbazepine. Oxcarbazepine has efficacy as an add-on treatment in patients with drug

  8. Epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Fisher, R.S.; Frost, J.J. (Johns Hopkins Univ., Baltimore, MD (USA))

    1991-04-01

    As surgical treatments for adult and pediatric forms of epilepsy have become more refined, methods for noninvasive localization of epileptogenic foci have become increasingly important. Detection of focal brain metabolic or flow abnormalities is now well recognized as an essential step in the presurgical evaluation of many patients with epilepsy. Positron emission tomography (PET) scanning is most beneficial when used in the context of the total clinical evaluation of patients, including scalp EEG, invasive EEG, neuropsychologic testing, etc. Metabolic PET studies also give insight into pathophysiologic mechanisms of epilepsy. The dynamic nature of the interictal hypometabolism observed with 18(F)FDG in some patients suggests that excitatory or inhibitory neurotransmitters and their receptors may be involved. An exciting current application of PET scanning is the use of tracers for neurotransmitter receptors in the study of epilepsy patients. Mu and non-mu opiate receptors have been extensively studied and are beginning to give new insights into this disorder. Increased labeling of mu receptors in temporal neocortex using 11C-carfentanil has been demonstrated and, in some patients, supplements the clinical localization information from 18(F)FDG studies. Increased mu opiate receptor number or affinity is thought to play a role in anticonvulsant mechanisms. Specificity of increased mu receptors is supported by the absence of significant changes in non-mu opiate receptors. Other brain receptors are also of interest for future studies, particularly those for excitatory neurotransmitters. Combined studies of flow, metabolism, and neuroreceptors may elucidate the factors responsible for initiation and termination of seizures, thus improving patient treatment.95 references.

  9. Epilepsy

    International Nuclear Information System (INIS)

    Fisher, R.S.; Frost, J.J.

    1991-01-01

    As surgical treatments for adult and pediatric forms of epilepsy have become more refined, methods for noninvasive localization of epileptogenic foci have become increasingly important. Detection of focal brain metabolic or flow abnormalities is now well recognized as an essential step in the presurgical evaluation of many patients with epilepsy. Positron emission tomography (PET) scanning is most beneficial when used in the context of the total clinical evaluation of patients, including scalp EEG, invasive EEG, neuropsychologic testing, etc. Metabolic PET studies also give insight into pathophysiologic mechanisms of epilepsy. The dynamic nature of the interictal hypometabolism observed with 18[F]FDG in some patients suggests that excitatory or inhibitory neurotransmitters and their receptors may be involved. An exciting current application of PET scanning is the use of tracers for neurotransmitter receptors in the study of epilepsy patients. Mu and non-mu opiate receptors have been extensively studied and are beginning to give new insights into this disorder. Increased labeling of mu receptors in temporal neocortex using 11C-carfentanil has been demonstrated and, in some patients, supplements the clinical localization information from 18[F]FDG studies. Increased mu opiate receptor number or affinity is thought to play a role in anticonvulsant mechanisms. Specificity of increased mu receptors is supported by the absence of significant changes in non-mu opiate receptors. Other brain receptors are also of interest for future studies, particularly those for excitatory neurotransmitters. Combined studies of flow, metabolism, and neuroreceptors may elucidate the factors responsible for initiation and termination of seizures, thus improving patient treatment.95 references

  10. Genetic and epigenetic mechanisms of epilepsy: a review

    Directory of Open Access Journals (Sweden)

    Chen T

    2017-07-01

    Full Text Available Tian Chen,1,* Mohan Giri,2,* Zhenyi Xia,3 Yadu Nanda Subedi,2 Yan Li1 1Department of Health Management Center, Chongqing Three Gorges Central Hospital, Chongqing, People’s Republic of China; 2National Center for Rheumatic Diseases, Ratopul, Gaushala, Kathmandu, Nepal; 3Department of Thoracic Surgery, Chongqing Three Gorges Central Hospital, Chongqing, People’s Republic of China *These authors contributed equally to this work Abstract: Epilepsy is a common episodic neurological disorder or condition characterized by recurrent epileptic seizures, and genetics seems to play a key role in its etiology. Early linkage studies have localized multiple loci that may harbor susceptibility genes to epilepsy, and mutational analyses have detected a number of mutations involved in both ion channel and nonion channel genes in patients with idiopathic epilepsy. Genome-wide studies of epilepsy have found copy number variants at 2q24.2-q24.3, 7q11.22, 15q11.2-q13.3, and 16p13.11-p13.2, some of which disrupt multiple genes, such as NRXN1, AUTS2, NLGN1, CNTNAP2, GRIN2A, PRRT2, NIPA2, and BMP5, implicated for neurodevelopmental disorders, including intellectual disability and autism. Unfortunately, only a few common genetic variants have been associated with epilepsy. Recent exome-sequencing studies have found some genetic mutations, most of which are located in nonion channel genes such as the LGI1, PRRT2, EFHC1, PRICKLE, RBFOX1, and DEPDC5 and in probands with rare forms of familial epilepsy, and some of these genes are involved with the neurodevelopment. Since epigenetics plays a role in neuronal function from embryogenesis and early brain development to tissue-specific gene expression, epigenetic regulation may contribute to the genetic mechanism of neurodevelopment through which a gene and the environment interacting with each other affect the development of epilepsy. This review focused on the analytic tools used to identify epilepsy and then provided a

  11. Epilepsy

    Science.gov (United States)

    ... problems. Other Organizations Epilepsy Foundation National Institute of Neurological Disorders and Stroke Questions Questions to Ask Your Doctor What causes epilepsy? What are symptoms other than seizures? What should ...

  12. Epilepsy

    Science.gov (United States)

    Epilepsy is a brain disorder that causes people to have recurring seizures. The seizures happen when clusters ... may have violent muscle spasms or lose consciousness. Epilepsy has many possible causes, including illness, brain injury, ...

  13. Positron emission tomography in pre-surgical evaluation of partial epilepsy in adults

    International Nuclear Information System (INIS)

    Semah, F.; Dupont, S.

    1999-01-01

    Positron emission tomography (PET) may be used to map regional cerebral glucose metabolism using 18 F-deoxyglucose in patients with partial epilepsy. An area of reduced glucose metabolism, that is commonly more extensive than the underlying anatomical abnormality, is found in most of the patients with medically refractory partial epilepsy. These functional lesions are very useful in the delineation of the epileptogenic focus prior to surgery. PET may also be used to demonstrate abnormalities in the binding of specific ligands, such as 11 C-flumazenil, to the central benzodiazepine-GABA A receptor complex. Focal decreases in benzodiazepine receptor binding is commonly seen at an epileptic focus, in a more restricted distribution than the area of hypo-metabolism. (author)

  14. Epilepsy

    Science.gov (United States)

    ... eventually become less frequent or disappear altogether. What Causes Epilepsy? This's no clear-cut answer to why people ... epilepsy. Often doctors can't pinpoint the exact cause of a person's epilepsy. But scientists do know that some things can ...

  15. Features of the broader autism phenotype in people with epilepsy support shared mechanisms between epilepsy and autism spectrum disorder.

    Science.gov (United States)

    Richard, Annie E; Scheffer, Ingrid E; Wilson, Sarah J

    2017-04-01

    Richard, A.E., I.E. Scheffer and S.J. Wilson. Features of the broader autism phenotype in people with epilepsy support shared mechanisms between epilepsy and autism spectrum disorder. NEUROSCI BIOBEHAV REV 21(1) XXX-XXX, 2016. To inform on mechanisms underlying the comorbidity of epilepsy and autism spectrum disorder (ASD), we conducted meta-analyses to test whether impaired facial emotion recognition (FER) and theory of mind (ToM), key phenotypic traits of ASD, are more common in people with epilepsy (PWE) than controls. We contrasted these findings with those of relatives of individuals with ASD (ASD-relatives) compared to controls. Furthermore, we examined the relationship of demographic (age, IQ, sex) and epilepsy-related factors (epilepsy onset age, duration, seizure laterality and origin) to FER and ToM. Thirty-one eligible studies of PWE (including 1449 individuals: 77% with temporal lobe epilepsy), and 22 of ASD-relatives (N=1295) were identified by a systematic database search. Analyses revealed reduced FER and ToM in PWE compared to controls (p<0.001), but only reduced ToM in ASD-relatives (p<0.001). ToM was poorer in PWE than ASD-relatives. Only weak associations were found between FER and ToM and epilepsy-related factors. These findings suggest shared mechanisms between epilepsy and ASD, independent of intellectual disability. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. MRI-negative refractory partial epilepsy: role for diffusion tensor imaging in high field MRI.

    Science.gov (United States)

    Chen, Qin; Lui, Su; Li, Chun-Xiao; Jiang, Li-Jun; Ou-Yang, Luo; Tang, He-Han; Shang, Hui-Fang; Huang, Xiao-Qi; Gong, Qi-Yong; Zhou, Dong

    2008-07-01

    Our aim is to use the high field MR scanner (3T) to verify whether diffusion tensor imaging (DTI) could help in locating the epileptogenic zone in patients with MRI-negative refractory partial epilepsy. Fifteen patients with refractory partial epilepsy who had normal conventional MRI, and 40 healthy volunteers were recruited for the study. DTI was performed on a 3T MR scanner, individual maps of mean diffusivity (MD) and fractional anisotropy (FA) were calculated, and Voxel-Based Analysis (VBA) was performed for individual comparison between patients and controls. Voxel-based analysis revealed significant MD increase in variant regions in 13 patients. The electroclinical seizure localization was concurred to seven patients. No patient exhibited regions of significant decreased MD. Regions of significant reduced FA were observed in five patients, with two of these concurring with electroclinical seizure localization. Two patients had regions of significant increase in FA, which were distinct from electroclinical seizure localization. Our study's results revealed that DTI is a responsive neuroradiologic technique that provides information about the epileptogenic areas in patients with MRI-negative refractory partial epilepsy. This technique may also helpful in pre-surgical evaluation.

  17. Epilepsi

    DEFF Research Database (Denmark)

    Sabers, Anne; Kjær, Troels W

    2014-01-01

    Epilepsy affects around 33,000 people in Denmark. The classification of the epilepsies is currently under revision and the clinical course of the disease depends on the underlying aetiology. Diagnostic evaluation includes EEG and often long-term video-EEG monitoring to ensure the diagnosis and clas......-sification. More than two thirds of patients with epilepsy can obtain complete seizure control. The remainders, counting around 12.000 patients in Denmark, having medical refractory epilepsy should be considered for other treatment options; epilepsy surgery or other non-pharmacological treatment....

  18. Cognitive and psychosocial effects of oxcarbazepine monotherapy in newly diagnosed partial epilepsy.

    Science.gov (United States)

    Kim, Daeyoung; Seo, Ji-Hye; Joo, Eun Yeon; Lee, Hyang Woon; Shin, Won Chul; Hong, Seung Bong

    2014-01-01

    The aim of this study was to assess the effects of oxcarbazepine (OXC) on cognition and psychosocial difficulties in patients with new-onset partial epilepsy. Cognitive and psychosocial assessments were performed before and after 6 to 12 months of OXC monotherapy in 52 drug-naive patients (25 women; mean age, 31.1 years; SD, 12.1 years). Cognitive functions were evaluated with well-structured and validated tools. Mood, psychological distress, subjective handicap, and quality of life were also evaluated. Differences between baseline and after-treatment evaluation were compared and adjusted for possible confounders such as age, sex, seizure control, duration of epilepsy, assessment interval, and epileptogenic region. Mean assessment interval was 231.8 (range, 182-348) days, and mean (SD) OXC dose at retest was 693.8 (208.9) mg. The OXC was found to have no significant adverse effect on cognition. Furthermore, OXC monotherapy was not found to affect psychosocial difficulties, including psychological distress and subjective handicap. The results suggest that OXC monotherapy could be used to treat newly diagnosed partial epilepsy without adversely affecting cognitive and psychosocial functions.

  19. Mechanisms of prickle1a function in zebrafish epilepsy and retinal neurogenesis

    Directory of Open Access Journals (Sweden)

    Xue Mei

    2013-05-01

    Epilepsy is a complex neurological disorder characterized by unprovoked seizures. The etiology is heterogeneous with both genetic and environmental causes. Genes that regulate neurotransmitters and ion channels in the central nervous system have been associated with epilepsy. However, a recent screening in human epilepsy patients identified mutations in the PRICKLE1 (PK1 locus, highlighting a potentially novel mechanism underlying seizures. PK1 is a core component of the planar cell polarity network that regulates tissue polarity. Zebrafish studies have shown that Pk1 coordinates cell movement, neuronal migration and axonal outgrowth during embryonic development. Yet how dysfunction of Pk1 relates to epilepsy is unknown. To address the mechanism underlying epileptogenesis, we used zebrafish to characterize Pk1a function and epilepsy-related mutant forms. We show that knockdown of pk1a activity sensitizes zebrafish larva to a convulsant drug. To model defects in the central nervous system, we used the retina and found that pk1a knockdown induces neurite outgrowth defects; yet visual function is maintained. Furthermore, we characterized the functional and biochemical properties of the PK1 mutant forms identified in human patients. Functional analyses demonstrate that the wild-type Pk1a partially suppresses the gene knockdown retinal defects but not the mutant forms. Biochemical analysis reveals increased ubiquitylation of one mutant form and decreased translational efficiency of another mutant form compared with the wild-type Pk1a. Taken together, our results indicate that mutation of human PK1 could lead to defects in neurodevelopment and signal processing, providing insight into seizure predisposition in these patients.

  20. Epilepsi

    DEFF Research Database (Denmark)

    Sabers, Anne; Kjær, Troels W

    2014-01-01

    Epilepsy affects around 33,000 people in Denmark. The classification of the epilepsies is currently under revision and the clinical course of the disease depends on the underlying aetiology. Diagnostic evaluation includes EEG and often long-term video-EEG monitoring to ensure the diagnosis and cl...

  1. Partial epilepsy: A pictorial review of 3 TESLA magnetic resonance imaging features

    Directory of Open Access Journals (Sweden)

    Lucas Giansante Abud

    2015-09-01

    Full Text Available Epilepsy is a disease with serious consequences for patients and society. In many cases seizures are sufficiently disabling to justify surgical evaluation. In this context, Magnetic Resonance Imaging (MRI is one of the most valuable tools for the preoperative localization of epileptogenic foci. Because these lesions show a large variety of presentations (including subtle imaging characteristics, their analysis requires careful and systematic interpretation of MRI data. Several studies have shown that 3 Tesla (T MRI provides a better image quality than 1.5 T MRI regarding the detection and characterization of structural lesions, indicating that high-field-strength imaging should be considered for patients with intractable epilepsy who might benefit from surgery. Likewise, advanced MRI postprocessing and quantitative analysis techniques such as thickness and volume measurements of cortical gray matter have emerged and in the near future, these techniques will routinely enable more precise evaluations of such patients. Finally, the familiarity with radiologic findings of the potential epileptogenic substrates in association with combined use of higher field strengths (3 T, 7 T, and greater and new quantitative analytical post-processing techniques will lead to improvements regarding the clinical imaging of these patients. We present a pictorial review of the major pathologies related to partial epilepsy, highlighting the key findings of 3 T MRI.

  2. Ictal and interictal SPECT imaging of 8 patients with symptomatic partial epilepsy

    International Nuclear Information System (INIS)

    Motooka, Hiromichi

    1993-01-01

    Although epileptic discharges such as spike, spike and wave complex, sharp wave, and sharp and wave complex can be recorded by interictal scalp electroencephalography (EEG) in many patients with epilepsy, recent studies have demonstrated that no epileptic discharges can be recorded by interictal and ictal scalp EEGs in some patients who clinically exhibit epileptic seizures. Accordingly scalp EEG is not always helpful for diagnosing epilepsy or identifying the epileptic foci in the brain in these patients. Recently, studies using single photon emission computed tomography (SPECT) have been performed for patients with epilepsy and evidence that epileptic foci can be identified by changes in the regional cerebral blood flow (rCBF) seen on SPECT scanning have been accumulated. In the present study, therefore, 8 patients with medically intractable partial seizures were simultaneously or independently investigated by the recordings of scalp EEG and SPECT scanning during the interictal and ictal period. N-isopropyl-p[ 123 I]-iodoamphetamine ( 123 I-IMP) was used for SPECT scanning for 7 patients and 99m Tc-d,l-hexamethyl-propyleneamineoxime ( 99m Tc-HMPAO) for 1 patient. An increase in rCBF (hyperperfusion) or decrease in rCBF (hypoperfusion) were found in 4 patients by interictal SPECT imaging and in all patients by ictal SPECT imaging although epileptic discharges were observed in 3 patients by interictal scalp EEG and 5 patients by ictal scalp EEG. The findings of the present study indicate that ictal SPECT scanning is more useful for diagnosing epilepsy and identifying the epileptic foci in the brain than ictal scalp EEG. (author)

  3. Eslicarbazepine acetate add-on for drug-resistant partial epilepsy.

    Science.gov (United States)

    Chang, Xian-Chao; Yuan, Hai; Wang, Yi; Xu, Hui-Qin; Hong, Wen-Ke; Zheng, Rong-Yuan

    2017-10-25

    This is an updated version of the Cochrane Review published in the Cochrane Library 2011, Issue 12.The majority of people with epilepsy have a good prognosis, but up to 30% of people continue to have seizures despite several regimens of antiepileptic drugs. In this review, we summarized the current evidence regarding eslicarbazepine acetate (ESL) when used as an add-on treatment for drug-resistant partial epilepsy. To evaluate the efficacy and tolerability of ESL when used as an add-on treatment for people with drug-resistant partial epilepsy. The searches for the original review were run in November 2011. Subsequently, we searched the Cochrane Epilepsy Group Specialized Register (6 December 2016), the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 11) and MEDLINE (1946 to 6 December 2016). There were no language restrictions. We reviewed the reference lists of retrieved studies to search for additional reports of relevant studies. We also contacted the manufacturers of ESL and experts in the field for information about any unpublished or ongoing studies. Randomized placebo controlled double-blind add-on trials of ESL in people with drug-resistant partial epilepsy. Two review authors independently selected trials for inclusion and extracted data. Outcomes investigated included 50% or greater reduction in seizure frequency, seizure freedom, treatment withdrawal, adverse effects, and drug interactions. Primary analyses were by intention to treat (ITT). The dose-response relationship was evaluated in regression models. We included five trials (1799 participants) rated at low risk of bias; all studies were funded by BIAL. The overall risk ratio (RR) with 95% confidence interval (CI) for 50% or greater reduction in seizure frequency was 1.71 (95% CI 1.42 to 2.05). Dose regression analysis showed evidence that ESL reduced seizure frequency with an increase in efficacy with increasing doses of ESL. ESL was significantly associated with seizure freedom

  4. Epilepsy

    Science.gov (United States)

    ... a spectrum of brain disorders ranging from severe, life-threatening and disabling, to ones that are much more benign. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior or sometimes convulsions, muscle ...

  5. 99Tcm brain imaging for the assessment of patients with intractable partial epilepsy - our experience

    International Nuclear Information System (INIS)

    Schlicht, S.; Bruns, M.; Booth, R.; Octigan, K.; Karamoskos, P.; Cook, M.; O'Brien, T.

    2000-01-01

    Full text: 99 Tc m - Ethyl Cysteinate Diethylester (ECD) or Bicisate is a new radiopharmaceutical used for the assessment of cerebral perfusion. Unlike 99 Tc m Hexamethylpropylene Amine Oxime ( 99 Tc m - HMPAO) which is unstable and needs to be reconstituted immediately prior to injection, 99 Tc m -ECD is stable for up to eight hours following reconstitution. Therefore, 99 Tc m -ECD does not require mixing just prior to injection and is readily available on a daily inpatient basis to the epilepsy unit, facilitating earlier and faster injections, and the acquisition of true ictal studies. This is particularly important with patients who have extra temporal seizures which are typically brief in duration. 45 patients have undergone 99 Tc m -ECD studies for epilepsy in our department over a period of one year. Image acquisition routinely commences within two hours of injection, and consists of a 360 degree elliptical SPECT using an ADAC Dual Headed Gamma Camera. Patients undergo both ictal and inter ictal SPECT studies, and an MRI. Visual comparison of the ictal, inter ictal and MRI images is performed, as well as subtraction and co-registration. The SISCOM analysis technique is used which allows subtraction of the SPECTs and co registration with MRI. This has the advantage of improved specificity, sensitivity, and accurate anatomical localisation. The results of our experience with 99Tcm-ECD will be presented. In conclusion, we have found that 99 Tc m -ECD is ideally suited for peri-ictal SPECT studies as part of the pre-operative assessment of patients with intractable partial epilepsy. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  6. A study on epileptic negative myoclonus in atypical benign partial epilepsy of childhood.

    Science.gov (United States)

    Yang, Zhixian; Liu, Xiaoyan; Qin, Jiong; Zhang, Yuehua; Bao, Xinhua; Chang, Xingzhi; Wang, Shuang; Wu, Ye; Xiong, Hui

    2009-04-01

    To investigate the clinical and neurophysiological characteristics, particularly therapeutic considerations, of epileptic negative myoclonus (ENM) in atypical benign partial epilepsy (ABPE) of childhood. From 1998 to 2006, 14/242 patients with benign children epilepsy with centrotemporal spikes (BECTS) were diagnosed as having ABPE with ENM. In all 14 patients, we performed video-EEG monitoring along with tests with the patient's arms outstretched; 6/14 patients were also simultaneously underwent surface electromyogram (EMG). ENM manifestations, electrophysiological features, and responses to antiepileptic drugs were analyzed. In all cases, ENM developed after the onset of epilepsy and during antiepileptic drug therapy, and the appearance of ENM were corresponding to EEG findings of high-amplitude spikes followed by a slow wave in the contralateral motor areas with secondary generalization. This was further confirmed by time-locked silent EMG. During ENM occurrence or recurrence, habitual seizures and interictal discharges were exaggerated. In some patients, the changes in antiepileptic drug regimens in relation to ENM appearance included add-on therapy with carbamazepine, oxcarbazepine, and phenobarbital or withdrawal of valproate. ENM was controlled in most cases by administration of various combinations of valproate, clonazepam, and corticosteroids. The incidence of ENM or ABPE in our center was approximately 5.79%. A combination of video-EEG monitoring with the patient's arms outstretched and EMG is essential to identify ENM. The aggravation of habitual seizures and interictal discharges indicate ENM. Some antiepileptic drugs, such as carbamazepine, oxcarbazepine, and phenobarbital, may be related to ENM occurrence during spontaneous aggravation of ABPE. Various combinations of valproate, benzodiazepines, and corticosteroids are relatively effective for treating ENM that occurs in ABPE.

  7. Epilepsy.

    Science.gov (United States)

    Rotenberg, Alexander

    2013-01-01

    Noninvasive brain stimulation, particularly transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), are emerging as realistic tools for seizure control. Numerous open-label trials and a few recent randomized controlled trials suggest the capacity of both techniques to suppress seizures. Additionally, specialized TMS protocols aimed to map cortical function and to measure cortical excitability may have realistic roles as diagnostic tools in epilepsy. As the prevalence of drug-resistant epilepsy has not changed in recent years, TMS and tDCS offer noninvasive and nonpharmacological options to improve control of intractable seizures. © 2013 Elsevier B.V. All rights reserved.

  8. Epileptic negative drop attacks in atypical benign partial epilepsy: a neurophysiological study.

    Science.gov (United States)

    Hirano, Yoshiko; Oguni, Hirokazu; Osawa, Makiko

    2009-03-01

    We conducted a computer-assisted polygraphic analysis of drop attacks in a child with atypical benign partial epilepsy (ABPE) to investigate neurophysiological characteristics. The patient was a six-year two-month-old girl, who had started to have focal motor seizures, later combined with daily epileptic negative myoclonus (ENM) and drop attacks, causing multiple injuries. We studied episodes of ENM and drop attacks using video-polygraphic and computer-assisted back-averaging analysis. A total of 12 ENM episodes, seven involving the left arm (ENMlt) and five involving both arms (ENMbil), and five drop attacks were captured for analysis. All episodes were time-locked to spike-and-wave complexes (SWC) arising from both centro-temporo-parietal (CTP) areas. The latency between the onset of SWC and ENMlt, ENMbil, and drop attacks reached 68 ms, 42 ms, and 8 ms, respectively. The height of the spike as well as the slow-wave component of SWC for drop attacks were significantly larger than that for both ENMlt and ENMbil (p negative myoclonus involving not only upper proximal but also axial muscles, causing the body to fall. Thus, drop attacks in ABPE are considered to be epileptic negative drop attacks arising from bilateral CTP foci and differ from drop attacks of a generalized origin seen in Lennox-Gastaut syndrome and myoclonic-astatic epilepsy.

  9. [Utilization of carbamazepine and oxcarbazepine in pediatric patients with partial epilepsy in Spain. An observational study].

    Science.gov (United States)

    Rufo Campos, M; Carreño, M

    2009-01-01

    It is important to conduct studies on the utilization of new antiepileptic drugs in order to improve their use. Our objective is to describe the use patterns of carbamazepine and oxcarbazepine. Observational, cross-sectional, national study with 58 investigators that included 185 pediatric patients with partial epilepsy. We recorded prescription patterns, quality of life (QoL) using the QoL scale in childhood epilepsy (CAVE) and use of resources. 134 patients were under treatment with oxcarbazepine (72.4 %), with a mean dose of 22.3 mg/kg/day; standard deviation (SD): 8.04; 95 % confidence interval (CI): 20.9 to 23.7, and 51 (27.6%) with carbamazepine, mean dose of 14 mg/kg/day; SD: 6.2; 95 % CI: 12.3 to 15.8. A total of 19.4% and 21.6 %, respectively, followed multiple drug treatment. The mean scores on functional dimensions of CAVE were (out of 5): school attendance: 4.5; SD: 0.7; social relationships: 4.1; SD: 0.9, and autonomy: 3.9; SD: 1.9. Patients receiving multiple drug therapy had worse results in quality of life (p used in lower doses than recommended and the dosing is not adjusted for weight. Underdosing may lead to regimes of multiple drug therapy that should be reviewed individually.

  10. Value of 3.0 T MR imaging in refractory partial epilepsy and negative 1.5 T MRI.

    Science.gov (United States)

    Nguyen, Dang Khoa; Rochette, Emilie; Leroux, Jean-Maxime; Beaudoin, Gilles; Cossette, Patrick; Lassonde, Maryse; Guilbert, François

    2010-10-01

    High-field 3.0 T MR scanners provide an improved signal-to-noise ratio which can be translated in higher image resolution, possibly allowing critical detection of subtle epileptogenic lesions missed on standard-field 1.0-1.5 T MRIs. In this study, the authors explore the potential value of re-imaging at 3.0 T patients with refractory partial epilepsy and negative 1.5 T MRI. We retrospectively identified all patients with refractory partial epilepsy candidate for surgery who had undergone a 3.0 T MR study after a negative 1.5 T MR study. High-field 3.0 T MRIs were reviewed qualitatively by neuroradiologists experienced in interpreting epilepsy studies with access to clinical information. Relevance and impact on clinical management were assessed by an epileptologist. Between November 2006 and August 2009, 36 patients with refractory partial epilepsy candidate for surgery underwent 3.0 T MR study after a 1.5 T MR study failed to disclose a relevant epileptogenic lesion. A potential lesion was found only in two patients (5.6%, 95% CI: 1.5-18.1%). Both were found to have hippocampal atrophy congruent with other presurgical localization techniques which resulted in omission of an invasive EEG study and direct passage to surgery. The frequency of detection of a new lesion by re-imaging at 3.0 T patients with refractory partial epilepsy candidate for surgery was found to be low, but seems to offer the potential of a significant clinical impact for selected patients. This finding needs to be validated in a prospective controlled study. Copyright © 2010 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  11. Absence of association between major vault protein (MVP) gene polymorphisms and drug resistance in Chinese Han patients with partial epilepsy.

    Science.gov (United States)

    Zhou, Luo; Zhang, Mengqi; Long, Hongyu; Long, Lili; Xie, Yuanyuan; Liu, Zhaoqian; Kang, Jin; Chen, Qihua; Feng, Li; Xiao, Bo

    2015-11-15

    Drug resistance in epilepsy is common despite many antiepileptic drugs (AEDs) available for treatment. The development of drug resistant epilepsy may be a result of multiple factors. Several previous studies reported that the major vault protein (MVP) was significantly increased in epileptogenic brain tissues resected from patients with partial-onset seizures, indicating the possible involvement of MVP in drug resistance. In this article, we aimed to identify the association between single nucleotide polymorphisms (SNPs) of MVP gene and drug resistance of partial epilepsy in a Chinese Han population. A total of 510 patients with partial-onset seizures and 206 healthy controls were recruited. Among the patients, 222 were drug resistant and 288 were responsive. The selection of tagging SNPs was based on the Hapmap database and Haploview software and the genotyping was conducted on the Sequenom MassARRAY iPLEX platform. For the selected loci rs12149746, rs9938630 and rs4788186 in the MVP gene, there was no significant difference in allele or genotype distribution between the drug resistant and responsive groups, or between all of the patients and healthy controls. Linkage disequilibrium between any two loci was detected but there was no significant difference in haplotype frequency between the drug resistant and responsive groups. Our results suggest that MVP genetic polymorphisms and haplotypes may not be associated with drug resistance of partial epilepsy in the Chinese Han population. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Clinical usefulness of MRI and MRA in children with partial epilepsy; Ocena znaczenia klinicznego obrazowania MRI i MRA w padaczce czesciowej u dzieci

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    Zajac, A; Kacinski, M; Kubik, A; Kroczka, S [Klinika Neurologii Dzieciecej, Uniwersytet Jagiellonski, Collegium Medicum, Cracow (Poland)

    2006-07-01

    Partial epilepsy is a very important problem of epileptology in childhood including clinical and therapeutic aspect especially surgery treatment. The aim of this study is to assess clinical value of neuroimagine techniques (structural MRI, MRI angiography) in partial epilepsy diagnostics in children. The relation between results of examinations with these methods and congenital and acquired risk factors related to partial epilepsy, age of its onset and clinical assessment of patients was analyzed. The study group consisted of 140 children with partial epilepsy hospitalized between 1998 and 2004 in Department of Pediatric Neurology, Collegium Medicum Jagiellonian University, Krakow. The group included 70 girls and 70 boys, the age ranged from 2 months to 17 years. In study group statistical analysis included different factors as which can be related with results of neuroimaging as age, load of pregnancy and birth period, familiar epilepsy, patient's risk factors for appearance of epilepsy, acquired risk factors of epilepsy, results of neurological examination, type of epilepsy, status epilepticus, and signs according epileptic attacks which can be related with neuroimaging results. The primary method of neuroimagine in all patients was structural MRI, in 16 cases Magnetic Resonance Angiography (MRA). The parametric tests (t-student), nonparametric Mann-Whitney's test were used in statistical analysis. The bilateral Fisher test was used to check rate in groups. There was assessed sensitivity, specificity, positive predictive value, negative predictive value; the 95% confidence interval was calculated for these parameters. Abnormalities in neurological examination in children with partial epilepsy were strongly correlated with MRI findings. The structural changes in MRI were found in younger children, whose course of epilepsy was longer than children without MRI changes. Changes in hippocampus ere the most common in children with partial epilepsy with abnormalities in

  13. Pregabalin versus gabapentin in partial epilepsy: a meta-analysis of dose-response relationships

    Directory of Open Access Journals (Sweden)

    Thompson Sally

    2010-11-01

    Full Text Available Abstract Background To compare the efficacy of pregabalin and gabapentin at comparable effective dose levels in patients with refractory partial epilepsy. Methods Eight randomized placebo controlled trials investigating the efficacy of pregabalin (4 studies and gabapentin (4 studies over 12 weeks were identified with a systematic literature search. The endpoints of interest were "responder rate" (where response was defined as at least a 50% reduction from baseline in the number of seizures and "change from baseline in seizure-free days over the last 28 days (SFD". Results of all trials were analyzed using an indirect comparison approach with placebo as the common comparator. The base-case analysis used the intention-to-treat last observation carried forward method. Two sensitivity analyses were conducted among completer and responder populations. Results The base-case analysis revealed statistically significant differences in response rate in favor of pregabalin 300 mg versus gabapentin 1200 mg (odds ratio, 1.82; 95% confidence interval, 1.02, 3.25 and pregabalin 600 mg versus gabapentin 1800 mg (odds ratio, 2.52; 95% confidence interval, 1.21, 5.27. Both sensitivity analyses supported the findings of the base-case analysis, although statistical significance was not demonstrated. All dose levels of pregabalin (150 mg to 600 mg were more efficacious than corresponding dosages of gabapentin (900 mg to 2400 mg in terms of SFD over the last 28 days. Conclusion In patients with refractory partial epilepsy, pregabalin is likely to be more effective than gabapentin at comparable effective doses, based on clinical response and the number of SFD.

  14. A f-MRI study on memory function in normal subjects and patients with partial epilepsies

    International Nuclear Information System (INIS)

    Kamoda, Sachiko

    2004-01-01

    To investigate cerebral regions concerning a memory function and presence of memory lateralization, activated areas and the difference between the right and left hemisphere in functional magnetic resonance imaging (f-MRI) during verbal and visual memory tasks were examined in normal subjects and, as its clinical application, in patients with partial epilepsies. Subjects were 39 normal adult subjects and 10 adult patients. Of the 39 normal subjects, 30 were right-handed and 9 were left-handed. Further, of the 10 patients, 9 were right-handed and one was left-handed, and 7, 2 and 1 had temporal lobe, frontal lobe and undetermined partial epilepsies, respectively. Following the three type of memory task were designed; verbal memory tasks consisting of covert and overt recall tests of 10 words given auditory and visual memory task of covert recall tasks of 6 figures given visually. Activated cerebral areas were imaged with f-MRI using 1.5 tesla Magnetom Vision taken repeatedly during these tasks and neutral condition. Most of the 30 right-handed normal subjects showed activated areas over the left hemisphere specifically on the anterior cingulate, superior, middle and inferior frontal gyri during the verbal memory tasks of covert recall tests. Left hemisphere dominant activated areas in the precentral gyri were added during the verbal memory tasks of overt recall tests. On the other hand, 4 of the 9 left-handed normal subjects showed the left side-dominantly activated areas in the above-mentioned regions during the verbal memory tasks of covert and overt tests, in common with the right-handed subjects. However, 3 of the 9 left-handed normal subjects had right hemisphere dominant activation during the verbal memory tasks, while none of the 30 right-handed normal subjects showed such right side-dominancy. Further, the bilateral occipital lobes were activated during visual memory tasks. The reproducibility in this activation during these verbal and visual memory tasks

  15. Approach to resolving mechanism of epilepsy in autism spectrum disorders

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    Hashimoto, Toshiaki; Tsuda, Yoshimi [Naruto Univ. of Education, Naruto, Tokushima (Japan); Mori, Kenji; Fujii, Emiko; Fukumoto, Rei; Miyazaki, Masahito; Harada, Masashi [Tokushima Univ., Faculty of Medicine, Tokushima, Tokushima (Japan)

    2007-12-15

    Electroencephalography (EEG) abnormality is highly frequent in the autism spectrum disorders (ASD), where epilepsy is also highly complicated relative to general population. Authors have found that the abnormal EEG is evoked mainly from the forehead area. For the purpose to resolve the mechanism of epilepsy, the present study was performed on single photon emission computed tomography (SPECT) and {sup 1}H- MR spectroscopy (MRS) images in ASD patients. In the former, 167 MBq of {sup 123}I-iomazenil was intravenously injected to 24 patients (5-21 years old, M/F 21/3) and SPECT was done 3 hrs later, of which findings suggested the lowered activity of gamma aminobutyric acid (GABA) receptors in the frontal lobe. The latter {sup 1}H-MRS was performed in 44 patients (2-17 years old, M/F 36/8) and 10 controls of the same generation with GE Signa Vhi 3T with the region of interest (ROI) of the left frontal lobe. MEGA-PRESS and stimulated-echo acquisition mode (STEAM) methods were applied for GABA and N-acetylaspartate (NAA) measurements, respectively, with LC Model for their levels. The GABA level was found lower in the lobe than control. Results above suggested the presence of a certain functional abnormality in GABA system in ASD. (R.T.)

  16. Approach to resolving mechanism of epilepsy in autism spectrum disorders

    International Nuclear Information System (INIS)

    Hashimoto, Toshiaki; Tsuda, Yoshimi; Mori, Kenji; Fujii, Emiko; Fukumoto, Rei; Miyazaki, Masahito; Harada, Masashi

    2007-01-01

    Electroencephalography (EEG) abnormality is highly frequent in the autism spectrum disorders (ASD), where epilepsy is also highly complicated relative to general population. Authors have found that the abnormal EEG is evoked mainly from the forehead area. For the purpose to resolve the mechanism of epilepsy, the present study was performed on single photon emission computed tomography (SPECT) and 1 H- MR spectroscopy (MRS) images in ASD patients. In the former, 167 MBq of 123 I-iomazenil was intravenously injected to 24 patients (5-21 years old, M/F 21/3) and SPECT was done 3 hrs later, of which findings suggested the lowered activity of gamma aminobutyric acid (GABA) receptors in the frontal lobe. The latter 1 H-MRS was performed in 44 patients (2-17 years old, M/F 36/8) and 10 controls of the same generation with GE Signa Vhi 3T with the region of interest (ROI) of the left frontal lobe. MEGA-PRESS and stimulated-echo acquisition mode (STEAM) methods were applied for GABA and N-acetylaspartate (NAA) measurements, respectively, with LC Model for their levels. The GABA level was found lower in the lobe than control. Results above suggested the presence of a certain functional abnormality in GABA system in ASD. (R.T.)

  17. Vitamin D for the Treatment of Epilepsy: Basic Mechanisms, Animal Models and Clinical Trials

    Directory of Open Access Journals (Sweden)

    Kevin Pendo

    2016-12-01

    Full Text Available There is increasing evidence supporting dietary and alternative therapies for epilepsy, including the ketogenic diet, modified Atkins diet, and omega-3 fatty acids. Vitamin D is actively under investigation as a potential intervention for epilepsy. Vitamin D is fat soluble steroid which shows promise in animal models of epilepsy. Basic research has shed light on the possible mechanisms by which Vitamin D may reduce seizures, and animal data support the efficacy of Vitamin D in rat and mouse models of epilepsy. Very little clinical data exists to support the treatment of human epilepsy with Vitamin D, but positive findings from preliminary clinical trials warrant larger Phase I and II clinical trials in order to more rigorously determine the potential therapeutic value of Vitamin D as a treatment for human epilepsy.

  18. [Clinical and electrophysiologic studies on epileptic negative myoclonus in atypical benign partial epilepsy of childhood].

    Science.gov (United States)

    Yang, Zhi-xian; Liu, Xiao-yan; Qin, Jiong; Zhang, Yue-hua; Bao, Xin-hua; Chang, Xing-zhi; Wu, Ye; Xiong, Hui

    2008-12-01

    To investigate the clinical, neurophysiologic characteristics and therapeutic considerations of epileptic negative myoclonus (ENM) in atypical benign partial epilepsy of childhood (ABPE). Video-EEG monitoring with outstretched arm tests were carried out in 17 patients, and 9 of them were examined with simultaneous electromyography (EMG). The ENM manifestations, electrophysiologic features and responses to antiepileptic drugs (AED) were analyzed. Seventeen patients were diagnosed as having benign childhood epilepsy with centrotemporal spikes (BECT) during the early course of the disease and were treated with AED. During the course of the disease, hand trembling, objects dropping, head nodding and instability during standing might be clues for ENM occurrence. ENM had been confirmed in our patients by outstretched arm tests during video-EEG recording. The ictal EEG showed that high-amplitude spikes followed by a slow wave over the contralateral motor areas. This was further confirmed by time-locked silent EMG in 9 patients. During ENM occurrence or recurrence, the habitual seizures and interictal discharges were exaggerated. Atypical absence seizures also occurred in 6 patients. The alteration of therapeutic options of AED relating to ENM appearance in some patients included the add-on therapy with carbamazepine (CBZ), oxcarbazepine, phenobarbital, or withdrawal of valproate (VPA). ENM was controlled in most cases by using VPA, clonazepam (CZP) and corticosteroid with different combination. ENM could occur during the course of ABPE. Outstretching arm tests during video-EEG monitoring in combination with EMG was essential to confirm ENM. The ENM occurrence was always associated with the frequency increasing of habitual seizures and the aggravation of interictal discharges. Some AED such as CBZ might induce ENM. VPA, benzodiazepines and corticosteroid with different combination were relatively effective in treatment of ENM.

  19. Individual white matter fractional anisotropy analysis on patients with MRI negative partial epilepsy.

    Science.gov (United States)

    Duning, Thomas; Kellinghaus, Christoph; Mohammadi, Siawoosh; Schiffbauer, Hagen; Keller, Simon; Ringelstein, E Bernd; Knecht, Stefan; Deppe, Michael

    2010-02-01

    Conventional structural MRI fails to identify a cerebral lesion in 25% of patients with cryptogenic partial epilepsy (CPE). Diffusion tensor imaging is an MRI technique sensitive to microstructural abnormalities of cerebral white matter (WM) by quantification of fractional anisotropy (FA). The objectives of the present study were to identify focal FA abnormalities in patients with CPE who were deemed MRI negative during routine presurgical evaluation. Diffusion tensor imaging at 3 T was performed in 12 patients with CPE and normal conventional MRI and in 67 age matched healthy volunteers. WM integrity was compared between groups on the basis of automated voxel-wise statistics of FA maps using an analysis of covariance. Volumetric measurements from high resolution T1-weighted images were also performed. Significant FA reductions in WM regions encompassing diffuse areas of the brain were observed when all patients as a group were compared with controls. On an individual basis, voxel based analyses revealed widespread symmetrical FA reduction in CPE patients. Furthermore, asymmetrical temporal lobe FA reduction was consistently ipsilateral to the electroclinical focus. No significant correlations were found between FA alterations and clinical data. There were no differences in brain volumes of CPE patients compared with controls. Despite normal conventional MRI, WM integrity abnormalities in CPE patients extend far beyond the epileptogenic zone. Given that unilateral temporal lobe FA abnormalities were consistently observed ipsilateral to the seizure focus, analysis of temporal FA may provide an informative in vivo investigation into the localisation of the epileptogenic zone in MRI negative patients.

  20. Cerebral blood flow in temporal lobe epilepsy: a partial volume correction study

    International Nuclear Information System (INIS)

    Giovacchini, Giampiero; Bonwetsch, Robert; Theodore, William H.; Herscovitch, Peter; Carson, Richard E.

    2007-01-01

    Previous studies in temporal lobe epilepsy (TLE) have shown that, owing to brain atrophy, positron emission tomography (PET) can overestimate deficits in measures of cerebral function such as glucose metabolism (CMR glu ) and neuroreceptor binding. The magnitude of this effect on cerebral blood flow (CBF) is unexplored. The aim of this study was to assess CBF deficits in TLE before and after magnetic resonance imaging-based partial volume correction (PVC). Absolute values of CBF for 21 TLE patients and nine controls were computed before and after PVC. In TLE patients, quantitative CMR glu measurements also were obtained. Before PVC, regional values of CBF were significantly (p glu in middle and inferior temporal cortex, fusiform gyrus and hippocampus both before and after PVC. A significant positive relationship between disease duration and AIs for CMR glu , but not CBF, was detected in hippocampus and amygdala, before but not after PVC. PVC should be used for PET CBF measurements in patients with TLE. Reduced blood flow, in contrast to glucose metabolism, is mainly due to structural changes. (orig.)

  1. Role of I-123-iomazenil SPEDT imaging in drug resistant epilepsy with complex partial seizures

    Energy Technology Data Exchange (ETDEWEB)

    Sjoeholm, H.; Rosen, I.; Elmqvist, D. [Univ. Hospital, Dept. of Clinical Neurophysiology, Lund (Sweden)

    1995-07-01

    Fifteen patients with therapy resistant partial complex seizures with no structural lesions were examined interictally with 123-I-IOMAXENIL SPECT for measurement of benzodiazepine receptor distribution and with 99m-Tc-HMPAO SPEDT for measurement of cerebral blood flow distribution. Regional abnormalities were correlated with the seizure onset patterns in EEG later recorded with implanted subdural strips. SPECT scans were made immediately after and at 1 and 2 h after intravenous injection of 123-I-Iomaxenil. During that time there was a continuous change from an immediate flow-related distribution toward a more specific receptor distribution. The decay of radioactivity of I-123 in the brain was linear over time. Two patients on benzodiazepine treatment showed much faster elimination and showed no focal abnormalities. Eight patients with clear-cut unifocal seizure onset showed concordant focal benzodiazepine defects. These patients showed a progressive focus/homotopic non-focus enhancement over time much larger than the HMPAO scans in the same patients. Also the estimated focal area of abnormality was more restricted in the Iomazenil scans than in HMPAO scans. Five patients had more complex seizure onset patterns. In these patients a mismatch between the locations of abnormalities in Iomaxenil and HMPAO scans were often found but benzodiazepine receptor abnormalities were more circumscribed also in these patients. The results suggest that 123-I-Iomazenil SPECT is more useful than 99mTc-HMPAO SPECT when applied interictally in patients with partial complex epilepsy, since in addition to demonstrate the hemispheric laterality of the epileptogenic zone, 123-I-Iomazenil appears to indicate its anatomical location with higher confidence, which could be of practical value for positioning of intracranial EEG electrodes. (au) 36 refs.

  2. Genetics of Severe Early Onset Epilepsies

    Science.gov (United States)

    2017-08-24

    Epilepsy; Epileptic Encephalopathy; Ohtahara Syndrome; Infantile Spasms; Dravet Syndrome; Malignant Migrating Partial Epilepsy of Infancy; Early Myoclonic Epileptic Encephalopathy; PCDH19-related Epilepsy and Related Conditions

  3. High resolution magnetic resonance imaging in adults with partial or secondary generalised epilepsy attending a tertiary referral unit.

    Science.gov (United States)

    Li, L M; Fish, D R; Sisodiya, S M; Shorvon, S D; Alsanjari, N; Stevens, J M

    1995-10-01

    In the past the underlying structural abnormalities leading to the development of chronic seizure disorders have usually only been disclosed by histological examination of surgical or postmortem material, due to their often subtle nature that was beyond the resolution of CT or early MRI. The MRI findings in 341 patients with chronic, refractory epilepsy attending The National Hospital for Neurology and Neurosurgery and Chalfont Centre for Epilepsy are reported. Studies were performed on a 1.5 Tesla scanner with a specific volumetric protocol, allowing the reconstruction of 1.5 mm contiguous slices throughout the whole brain. Direct visual inspection of the two dimensional images without the use of additional quantitative measures showed that 254/341 (74%) were abnormal. Twenty four (7%) patients had more than one lesion. The principal MRI diagnoses were hippocampal asymmetry (32%), cortical dysgenesis (12%), tumour (12%), and vascular malformation (8%). Pathological confirmation was available from surgical specimens in 70 patients and showed a very high degree of sensitivity and specificity for the different entities. The advent of more widely available high resolution MRI should make it possible to identify the underlying pathological substrate in most patients with chronic partial epilepsy. This will allow a fundamental reclassification of the epilepsies for both medical and surgical management, with increasing precision as new methods (both of acquisition and postprocessing) are added to the neuroimaging battery used in clinical practice.

  4. Tantrums, Emotion Reactions and Their EEG Correlates in Childhood Benign Rolandic Epilepsy vs. Complex Partial Seizures: Exploratory Observations.

    Science.gov (United States)

    Potegal, Michael; Drewel, Elena H; MacDonald, John T

    2018-01-01

    We explored associations between EEG pathophysiology and emotional/behavioral (E/B) problems of children with two types of epilepsy using standard parent questionnaires and two new indicators: tantrums recorded by parents at home and brief, emotion-eliciting situations in the laboratory. Children with Benign Rolandic epilepsy (BRE, N = 6) reportedly had shorter, more angry tantrums from which they recovered quickly. Children with Complex Partial Seizures (CPS, N = 13) had longer, sadder tantrums often followed by bad moods. More generally, BRE correlated with anger and aggression; CPS with sadness and withdrawal. Scores of a composite group of siblings ( N = 11) were generally intermediate between the BRE and CPS groups. Across all children, high voltage theta and/or interictal epileptiform discharges (IEDs) correlated with negative emotional reactions. Such EEG abnormalities in left hemisphere correlated with greater social fear, right hemisphere EEG abnormalities with greater anger. Right hemisphere localization in CPS was also associated with parent-reported problems at home. If epilepsy alters neural circuitry thereby increasing negative emotions, additional assessment of anti-epileptic drug treatment of epilepsy-related E/B problems would be warranted.

  5. Tantrums, Emotion Reactions and Their EEG Correlates in Childhood Benign Rolandic Epilepsy vs. Complex Partial Seizures: Exploratory Observations

    Directory of Open Access Journals (Sweden)

    Michael Potegal

    2018-03-01

    Full Text Available We explored associations between EEG pathophysiology and emotional/behavioral (E/B problems of children with two types of epilepsy using standard parent questionnaires and two new indicators: tantrums recorded by parents at home and brief, emotion-eliciting situations in the laboratory. Children with Benign Rolandic epilepsy (BRE, N = 6 reportedly had shorter, more angry tantrums from which they recovered quickly. Children with Complex Partial Seizures (CPS, N = 13 had longer, sadder tantrums often followed by bad moods. More generally, BRE correlated with anger and aggression; CPS with sadness and withdrawal. Scores of a composite group of siblings (N = 11 were generally intermediate between the BRE and CPS groups. Across all children, high voltage theta and/or interictal epileptiform discharges (IEDs correlated with negative emotional reactions. Such EEG abnormalities in left hemisphere correlated with greater social fear, right hemisphere EEG abnormalities with greater anger. Right hemisphere localization in CPS was also associated with parent-reported problems at home. If epilepsy alters neural circuitry thereby increasing negative emotions, additional assessment of anti-epileptic drug treatment of epilepsy-related E/B problems would be warranted.

  6. Cerebral blood flow in temporal lobe epilepsy: a partial volume correction study

    Energy Technology Data Exchange (ETDEWEB)

    Giovacchini, Giampiero [University Milano-Bicocca, Milan (Italy); Bonwetsch, Robert; Theodore, William H. [National Institute of Neurological Diseases and Strokes, Clinical Epilepsy Section, Bethesda, MD (United States); Herscovitch, Peter [National Institutes of Health, PET Department, Clinical Center, Bethesda, MD (United States); Carson, Richard E. [Yale PET Center, New Haven, CT (United States)

    2007-12-15

    Previous studies in temporal lobe epilepsy (TLE) have shown that, owing to brain atrophy, positron emission tomography (PET) can overestimate deficits in measures of cerebral function such as glucose metabolism (CMR{sub glu}) and neuroreceptor binding. The magnitude of this effect on cerebral blood flow (CBF) is unexplored. The aim of this study was to assess CBF deficits in TLE before and after magnetic resonance imaging-based partial volume correction (PVC). Absolute values of CBF for 21 TLE patients and nine controls were computed before and after PVC. In TLE patients, quantitative CMR{sub glu} measurements also were obtained. Before PVC, regional values of CBF were significantly (p<0.05) lower in TLE patients than in controls in all regions, except the fusiform gyrus contralateral to the epileptic focus. After PVC, statistical significance was maintained in only four regions: ipsilateral inferior temporal cortex, bilateral insula and contralateral amygdala. There was no significant difference between patients and controls in CBF asymmetry indices (AIs) in any region before or after PVC. In TLE patients, AIs for CBF were significantly smaller than for CMR{sub glu} in middle and inferior temporal cortex, fusiform gyrus and hippocampus both before and after PVC. A significant positive relationship between disease duration and AIs for CMR{sub glu}, but not CBF, was detected in hippocampus and amygdala, before but not after PVC. PVC should be used for PET CBF measurements in patients with TLE. Reduced blood flow, in contrast to glucose metabolism, is mainly due to structural changes. (orig.)

  7. Preliminary experience of a three-dimensional, large-field-of-view PET scanner for the localization of partial epilepsy

    International Nuclear Information System (INIS)

    Binns, D.S.; O'Brien, T.J.; Murphy, M.; Cook, M.J.; Hicks, R.J.

    1999-01-01

    Full text: PET scanning is a useful ancillary technique in the localization of intractable partial epilepsy, but its widespread use has been limited by the high cost of traditional PET equipment and radioisotopes. The use of 3D-scanning mode with a large-field of-view PET scanner involves lower equipment costs and requires significantly lower doses of radioisotope. Our aim was to report our preliminary experience of the use of a 3-D, large-field-of-view scanner for FDG-PET studies in the localization of partial epilepsy. 31 patients (pts) with partial epilepsy were studied. The FDG-PET scans were reviewed blindly by a single reviewer without knowledge of seizure localization on structural imaging or ictal electroencephalographic (EEG) monitoring. The PET results were correlated with the localization by more traditional techniques and the results on surgery when available. A localized region of hypometabolism on FDG-PET scanning was reported in 26/31 (84%) patients (21 temporal, 5 extratemporal). This compared favourably with volumetric MRI on which 19/31 (61%) had a focal potentially epileptogenic abnormality, all of which were concordant with the PET localization. PET was concordant with ictal EEG onset in all 22 patients with localizing studies, including 5 pts with normal MRI. PET demonstrated localized hypometabolism in 4/5 pts with non-localizing ictal EEG and was concordant in both pts with abnormal MRI in this group. PET was considered normal in 4 pts, including 3 pts with normal MRI but localizing EEG and 1 pt without EEG or MRI abnormality. One pt with a localizing EEG and normal MRI was felt to have bitemporal hypometabolism. Five patients have subsequently had resective epilepsy surgery with 4 currently seizure-free and 1 significantly improved. Four patients are planned for surgery in the near future. In conclusion, FDG-PET using a 3-D, large-field-of view PET scanner provides sensitive and specific localization in partial epilepsy, and may provide a

  8. Similarities and differences in neuroplasticity mechanisms between brain gliomas and nonlesional epilepsy.

    Science.gov (United States)

    Bourdillon, Pierre; Apra, Caroline; Guénot, Marc; Duffau, Hugues

    2017-12-01

    To analyze the conceptual and practical implications of a hodotopic approach in neurosurgery, and to compare the similarities and the differences in neuroplasticity mechanisms between low-grade gliomas and nonlesional epilepsy. We review the recent data about the hodotopic organization of the brain connectome, alongside the organization of epileptic networks, and analyze how these two structures interact, suggesting therapeutic prospects. Then we focus on the mechanisms of neuroplasticity involved in glioma natural course and after glioma surgery. Comparing these mechanisms with those in action in an epileptic brain highlights their differences, but more importantly, gives an original perspective to the consequences of surgery on an epileptic brain and what could be expected after pathologic white matter removal. The organization of the brain connectome and the neuroplasticity is the same in all humans, but different pathologic mechanisms are involved, and specific therapeutic approaches have been developed in epilepsy and glioma surgery. We demonstrate that the "connectome" point of view can enrich epilepsy care. We also underscore how theoretical and practical tools commonly used in epilepsy investigations, such as invasive electroencephalography, can be of great help in awake surgery in general. Putting together advances in understanding of connectomics and neuroplasticity, leads to significant conceptual improvements in epilepsy surgery. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  9. Ion Channel Genes and Epilepsy: Functional Alteration, Pathogenic Potential, and Mechanism of Epilepsy.

    Science.gov (United States)

    Wei, Feng; Yan, Li-Min; Su, Tao; He, Na; Lin, Zhi-Jian; Wang, Jie; Shi, Yi-Wu; Yi, Yong-Hong; Liao, Wei-Ping

    2017-08-01

    Ion channels are crucial in the generation and modulation of excitability in the nervous system and have been implicated in human epilepsy. Forty-one epilepsy-associated ion channel genes and their mutations are systematically reviewed. In this paper, we analyzed the genotypes, functional alterations (funotypes), and phenotypes of these mutations. Eleven genes featured loss-of-function mutations and six had gain-of-function mutations. Nine genes displayed diversified funotypes, among which a distinct funotype-phenotype correlation was found in SCN1A. These data suggest that the funotype is an essential consideration in evaluating the pathogenicity of mutations and a distinct funotype or funotype-phenotype correlation helps to define the pathogenic potential of a gene.

  10. Hemispheric specialization in partial epilepsy role of dichotic listening cv task and central audiological evaluation in the neuropsychological assessment

    Directory of Open Access Journals (Sweden)

    Mauro Muszkat

    1991-12-01

    Full Text Available We studied 49 patients with partial epilepsy divided into lesional cases (i.e. with lesions on CT scan and non-lesional cases (i.e. without CT scan lesions, in relation to the Wechsler Intelligence Scale subtests (Coding, Digit span, dichotic listening CV task and Central Auditory Test (SSI, PSI. The aim of this paper was to study the hemispheric prevalence in dichotic listening task with regard to cognitive perforamance, as well as the presence or absence of central auditory dysfunction. Lesional cases presented a hemisphere prevalence in dichotic listening task with regard to cognitive performance, as well as the non-lesional cases tend to report the stimuli in the same side of EEC focus. Significant differences were found among the lesional and non lesional cases in relation to the digit span score and Coding subtest in right lesional cases versus right non-lesional cases. Both lesional and non-lesional group showed signs of central auditory dysfunction. We suggest that the dichotic listening and SSI and PSI test can be useful for a best comprehension of asymmetric neuropsychological performance in partial epilepsy.

  11. A Review of Eslicarbazepine Acetate for the Adjunctive Treatment of Partial-Onset Epilepsy

    Directory of Open Access Journals (Sweden)

    Rajinder P. Singh

    2011-01-01

    Full Text Available Eslicarbazepine acetate (ESL is a novel antiepileptic drug indicated for the treatment of partial-onset seizures. Structurally, it belongs to the dibenzazepine family and is closely related to carbamazepine and oxcarbazepine. Its main mechanism of action is by blocking the voltage-gated sodium channel. ESL is a pro-drug that is rapidly metabolized almost exclusively into S-licarbazepine, the biologically active drug. It has a favorable pharmacokinetic and drug-drug interaction profile. However, it may induce the metabolism of oral contraceptives and should be used with caution in females of child-bearing age. In the pre-marketing placebo-controlled clinical trials ESL has proven effective as adjunctive therapy in adult patients with refractory of partial-onset seizures. Best results were observed on a single daily dose between 800 and 1200 mg. In general, ESL was well tolerated, with most common dose-related side effects including dizziness, somnolence, headache, nausea and vomiting. Hyponatremia has been observed (0.6%-1.3%, but the incidence appears to be lower than with the use of oxcarbazepine. There is very limited information on the use of ESL in children or as monotherapy.

  12. Effect of partial volume correction on muscarinic cholinergic receptor imaging with single-photon emission tomography in patients with temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Weckesser, M.; Ziemons, K.; Griessmeier, M.; Sonnenberg, F.; Langen, K.J.; Mueller-Gaertner, H.W.; Hufnagel, A.; Elger, C.E.; Hacklaender, T.; Holschbach, M.

    1997-01-01

    Animal experiments and preliminary results in humans have indicated alterations of hippocampal muscarinic acetylcholine receptors (mAChR) in temporal lobe epilepsy. Patients with temporal lobe epilepsy often present with a reduction in hippocampal volume. The aim of this study was to investigate the influence of hippocampal atrophy on the quantification of mAChR with single photon emission tomography (SPET) in patients with temporal lobe epilepsy. Cerebral uptake of the muscarinic cholinergic antagonist [ 123 I]4-iododexetimide (IDex) was investigated by SPET in patients suffering from temporal lobe epilepsy of unilateral (n=6) or predominantly unilateral (n=1) onset. Regions of interest were drawn on co-registered magnetic resonance images. Hippocampal volume was determined in these regions and was used to correct the SPET results for partial volume effects. A ratio of hippocampal IDex binding on the affected side to that on the unaffected side was used to detect changes in muscarinic cholinergic receptor density. Before partial volume correction a decrease in hippocampal IDex binding on the focus side was found in each patient. After partial volume no convincing differences remained. Our results indicate that the reduction in hippocampal IDex binding in patients with epilepsy is due to a decrease in hippocampal volume rather than to a decrease in receptor concentration. (orig.). With 2 figs., 2 tabs

  13. Interictal SPECT of rCBF is of clinical utility in the preoperative evaluation of patients with partial epilepsy

    DEFF Research Database (Denmark)

    Andersen, A R; Hansen, B A; Høgenhaven, H

    1996-01-01

    Fifty-eight patients with drug-resistant partial epilepsy were studied preoperatively by interictal rCBF measurements using 99mTc-HMPAO and a dedicated brain SPECT camera (Tomomatic 64). Follow-up of seizure outcome, using the "Engel score", was at least 3 years. The data were analyzed in a blinded...... set-up, first visually and subsequently quantitatively by an automatic regional analysis. By visual analysis 95% of the patients were considered abnormal in one part of the brain, of whom 27% were abnormal on CT, 45% on MRI and 98% on scalp EEG. Using a quantitative regional analysis subdividing each...... patients ictal SPECT of rCBF was additionally performed. In 2 cases it added further information to the patient evaluation....

  14. Interictal SPECT of rCBF is of clinical utility in the preoperative evaluation of patients with partial epilepsy

    DEFF Research Database (Denmark)

    Andersen, A.R.; Hansen, B.A.; Hogenhaven, H

    1996-01-01

    Fifty-eight patients with drug-resistant partial epilepsy were studied preoperatively by interictal rCBF measurements using 99mTc-HMPAO and a dedicated brain SPECT camera (Tomomatic 64). Follow-up of seizure outcome, using the 'Engel score', was at least 3 years. The data were analyzed in a blinded...... set-up, first visually and subsequently quantitatively by an automatic regional analysis. By visual analysis 95% of the patients were considered abnormal in one part of the brain, of whom 27% were abnormal on CT, 45% on MRI and 98% on scalp EEG. Using a quantitative regional analysis subdividing each...... patients ictal SPECT of rCBF was additionally performed. In 2 cases it added further information to the patient evaluation...

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

    Directory of Open Access Journals (Sweden)

    Vuksanović Jasmina

    2008-01-01

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

  16. Integrated network analysis reveals potentially novel molecular mechanisms and therapeutic targets of refractory epilepsies.

    Directory of Open Access Journals (Sweden)

    Hongwei Chu

    Full Text Available Epilepsy is a complex neurological disorder and a significant health problem. The pathogenesis of epilepsy remains obscure in a significant number of patients and the current treatment options are not adequate in about a third of individuals which were known as refractory epilepsies (RE. Network medicine provides an effective approach for studying the molecular mechanisms underlying complex diseases. Here we integrated 1876 disease-gene associations of RE and located those genes to human protein-protein interaction (PPI network to obtain 42 significant RE-associated disease modules. The functional analysis of these disease modules showed novel molecular pathological mechanisms of RE, such as the novel enriched pathways (e.g., "presynaptic nicotinic acetylcholine receptors", "signaling by insulin receptor". Further analysis on the relationships between current drug targets and the RE-related disease genes showed the rational mechanisms of most antiepileptic drugs. In addition, we detected ten potential novel drug targets (e.g., KCNA1, KCNA4-6, KCNC3, KCND2, KCNMA1, CAMK2G, CACNB4 and GRM1 located in three RE related disease modules, which might provide novel insights into the new drug discovery for RE therapy.

  17. Focal cortical dysplasia of the temporal lobe with late-onset partial epilepsy: serial quantitative MRI

    Energy Technology Data Exchange (ETDEWEB)

    Rademacher, J.; Seitz, R.J. [Department of Neurology, Heinrich-Heine University Duesseldorf (Germany); Aulich, A. [Department of Radiology, Heinrich-Heine University, Duesseldorf (Germany); Reifenberger, G. [Department of Neuropathology, Heinrich-Heine University, Duesseldorf (Germany); Kiwit, J.C.W. [Department of Neurosurgery, Heinrich-Heine University, Duesseldorf (Germany); Langen, K.J.; Schmidt, D. [Institute of Medicine, Research Center Juelich, Heinrich-Heine University, Duesseldorf (Germany)

    2000-06-01

    We describe serial studies of focal cortical dysplasia causing temporal lobe seizures and progressive aphasia in a 54-year-old woman. Initially, MRI volumetry of the temporal lobes showed significant left cortical thickening corresponding to an elevated aminoacid uptake in the left temporoparietal and inferior frontal cortex on SPECT using 3-[{sup 123}I]iodo-{alpha}-methyl-l-tyrosine (IMT). After 1 year there was severe shrinkage of the left temporal lobe, possibly the result of recurrent complex partial seizures. (orig.)

  18. Focal cortical dysplasia of the temporal lobe with late-onset partial epilepsy: serial quantitative MRI

    International Nuclear Information System (INIS)

    Rademacher, J.; Seitz, R.J.; Aulich, A.; Reifenberger, G.; Kiwit, J.C.W.; Langen, K.J.; Schmidt, D.

    2000-01-01

    We describe serial studies of focal cortical dysplasia causing temporal lobe seizures and progressive aphasia in a 54-year-old woman. Initially, MRI volumetry of the temporal lobes showed significant left cortical thickening corresponding to an elevated aminoacid uptake in the left temporoparietal and inferior frontal cortex on SPECT using 3-[ 123 I]iodo-α-methyl-l-tyrosine (IMT). After 1 year there was severe shrinkage of the left temporal lobe, possibly the result of recurrent complex partial seizures. (orig.)

  19. Partial Linearization of Mechanical Systems with Application to Observer Design

    NARCIS (Netherlands)

    Sarras, Ioannis; Venkatraman, Aneesh; Ortega, Romeo; Schaft, Arjan van der

    2008-01-01

    We consider general mechanical systems and establish a necessary and sufficient condition for the existence of a suitable change in the generalized momentum coordinates such that the new dynamics become linear in the transformed momenta. The class of systems which can be (partially) linearized by

  20. Regional cerebral blood flow in diagnosis of childhood onset partial epilepsy

    International Nuclear Information System (INIS)

    Mitsuyoshi, Izuru; Tamaki, Kyoko; Mutoh, Kozo; Iwasaki, Yasushi; Konishi, Junji; Mikawa, Haruki; Okuno, Takehiko.

    1993-01-01

    We compared regional cerebral blood flow assessed by [ 123 I]N-isopropyl-p-iodoamphetamine (IMP) single-photon emission tomography (SPECT) with magnetic resonance imaging (MRI), computed tomography (CT) and interictal surface electroencephalography (EEG) to evaluate its diagnostic potential in 24 patients with partial seizures with onset in childhood. Focal low uptake areas were observed in SPECT scans of 18 patients and were presumed to represent epileptogenic areas in 17. MRI revealed an abnormality in 12 and CT in 6 patients, and all organic lesions showed SPECT abnormalities, too. Six patients without focal structural abnormalities showed regional perfusion deficit on SPECT. Routine scalp EEG revealed an epileptic focus in 17 patients and three of them showed discordant results between SPECT and EEG, which suggested more serious brain disorders. In two patients without EEG localization only SPECT showed focal abnormalities in the probable epileptic area. [ 123 I]IMP-SPECT was useful in locating the epileptic focus, particularly during the early period after the onset of partial seizures when the EEG gave inconclusive results. (author)

  1. Neurobiochemical mechanisms of a ketogenic diet in refractory epilepsy

    Directory of Open Access Journals (Sweden)

    Patricia Azevedo de Lima

    2014-12-01

    Full Text Available A ketogenic diet is an important therapy used in the control of drug-refractory seizures. Many studies have shown that children and adolescents following ketogenic diets exhibit an over 50% reduction in seizure frequency, which is considered to be clinically relevant. These benefits are based on a diet containing high fat (approximately 90% fat for 24 months. This dietary model was proposed in the 1920s and has produced variable clinical responses. Previous studies have shown that the mechanisms underlying seizure control involve ketone bodies, which are produced by fatty acid oxidation. Although the pathways involved in the ketogenic diet are not entirely clear, the main effects of the production of ketone bodies appear to be neurotransmitter modulation and antioxidant effects on the brain. This review highlights the impacts of the ketogenic diet on the modulation of neurotransmitters, levels of biogenic monoamines and protective antioxidant mechanisms of neurons. In addition, future perspectives are proposed.

  2. Long-term Effectiveness of Antiepileptic Drug Monotherapy in Partial Epileptic Patients: A 7-year Study in an Epilepsy Center in China

    Science.gov (United States)

    Zhu, Fei; Lang, Sen-Yang; Wang, Xiang-Qing; Shi, Xiao-Bing; Ma, Yun-Feng; Zhang, Xu; Chen, Ya-Nan; Zhang, Jia-Tang

    2015-01-01

    Background: It is important to choose an appropriate antiepileptic drug (AED) to manage partial epilepsy. Traditional AEDs, such as carbamazepine (CBZ) and valproate (VPA), have been proven to have good therapeutic effects. However, in recent years, a variety of new AEDs have increasingly been used as first-line treatments for partial epilepsy. As the studies regarding the effectiveness of new drugs and comparisons between new AEDs and traditional AEDs are few, it is determined that these are areas in need of further research. Accordingly, this study investigated the long-term effectiveness of six AEDs used as monotherapy in patients with partial epilepsy. Methods: This is a retrospective, long-term observational study. Patients with partial epilepsy who received monotherapy with one of six AEDs, namely, CBZ, VPA, topiramate (TPM), oxcarbazepine (OXC), lamotrigine (LTG), or levetiracetam (LEV), were identified and followed up from May 2007 to October 2014, and time to first seizure after treatment, 12-month remission rate, retention rate, reasons for treatment discontinuation, and adverse effects were evaluated. Results: A total of 789 patients were enrolled. The median time of follow-up was 56.95 months. CBZ exhibited the best time to first seizure, with a median time to first seizure of 36.06 months (95% confidential interval: 30.64–44.07). CBZ exhibited the highest 12-month remission rate (85.55%), which was significantly higher than those of TPM (69.38%, P = 0.006), LTG (70.79%, P = 0.001), LEV (72.54%, P = 0.005), and VPA (73.33%, P = 0.002). CBZ, OXC, and LEV had the best retention rate, followed by LTG, TPM, and VPA. Overall, adverse effects occurred in 45.87% of patients, and the most common adverse effects were memory problems (8.09%), rashes (7.76%), abnormal hepatic function (6.24%), and drowsiness (6.24%). Conclusion: This study demonstrated that CBZ, OXC, and LEV are relatively effective in managing focal epilepsy as measured by time to first seizure

  3. Long-term Effectiveness of Antiepileptic Drug Monotherapy in Partial Epileptic Patients: A 7-year Study in an Epilepsy Center in China

    Directory of Open Access Journals (Sweden)

    Fei Zhu

    2015-01-01

    Full Text Available Background: It is important to choose an appropriate antiepileptic drug (AED to manage partial epilepsy. Traditional AEDs, such as carbamazepine (CBZ and valproate (VPA, have been proven to have good therapeutic effects. However, in recent years, a variety of new AEDs have increasingly been used as first-line treatments for partial epilepsy. As the studies regarding the effectiveness of new drugs and comparisons between new AEDs and traditional AEDs are few, it is determined that these are areas in need of further research. Accordingly, this study investigated the long-term effectiveness of six AEDs used as monotherapy in patients with partial epilepsy. Methods: This is a retrospective, long-term observational study. Patients with partial epilepsy who received monotherapy with one of six AEDs, namely, CBZ, VPA, topiramate (TPM, oxcarbazepine (OXC, lamotrigine (LTG, or levetiracetam (LEV, were identified and followed up from May 2007 to October 2014, and time to first seizure after treatment, 12-month remission rate, retention rate, reasons for treatment discontinuation, and adverse effects were evaluated. Results: A total of 789 patients were enrolled. The median time of follow-up was 56.95 months. CBZ exhibited the best time to first seizure, with a median time to first seizure of 36.06 months (95% confidential interval: 30.64-44.07. CBZ exhibited the highest 12-month remission rate (85.55%, which was significantly higher than those of TPM (69.38%, P = 0.006, LTG (70.79%, P = 0.001, LEV (72.54%, P = 0.005, and VPA (73.33%, P = 0.002. CBZ, OXC, and LEV had the best retention rate, followed by LTG, TPM, and VPA. Overall, adverse effects occurred in 45.87% of patients, and the most common adverse effects were memory problems (8.09%, rashes (7.76%, abnormal hepatic function (6.24%, and drowsiness (6.24%. Conclusion: This study demonstrated that CBZ, OXC, and LEV are relatively effective in managing focal epilepsy as measured by time to first

  4. Combined study of 99mTc-HMPAO SPECT and computerized electroencephalographic topography (CET) in patients with medically refractory complex partial epilepsy

    International Nuclear Information System (INIS)

    Rodrigues, M.; Botelho, M.M.; Fonseca, A.T.; Peter, J.P.; Pimentel, T.; Vieira, M.R.

    1996-01-01

    For successful surgery for drug-resistant partial epilepsy the site of the seizure focus needs to be known exactly. The purpose of this study was to compare the evaluation of the regional cerebral blood flow (rCBF) (localization and degree of disturbances) by 99m Tc-hexamethylpropylene-amineoxime (HMPAO) single photon emission computed tomography (SPECT) with computerized electroencephalographic topography (CET) and transmission computed X-ray tomography (CT) in partial epilepsy. The study included 20 patients with medically refractory complex partial seizures. Of the 20 patients included, 15 were studied interictally, four ictally and one in both states, interictally and ictally. 99m Tc-HMPAO SPECT detected rCBF changes in 95% of the patients. Interictal studies demonstrated focal areas of hypoperfusion in 93% of the patients. Ictal studies demonstrated an area of hyperperfusion in all patients. Blood flow disturbances in deeper structures of the brain, such as basal ganglia, could be detected. The areas with abnormal 99m Tc-HMPAO uptake were concordant, in localization, with CET in 85% of the patients. Abnormal data with CT scans were found in only 45% of the patients. Focal lesions were found in 20% of the patients by CT scans. 99m Tc-HMPAO SPECT combined with CET may be a useful screening procedure prior to referral for invasive diagnostic procedures in future management of patients with medically refractory complex partial seizures. (author)

  5. Investigation into the mechanisms of vagus nerve stimulation for the treatment of intractable epilepsy, using {sup 99m}Tc-HMPAO SPET brain images

    Energy Technology Data Exchange (ETDEWEB)

    Barnes, Anna; Chisholm, Jennifer A.; Patterson, James; Wyper, David [Department of Clinical Physics, Institute of Neurological Sciences, Southern General Hospital, 1345 Govan Road, Glasgow G51 4TF (United Kingdom); Duncan, Roderick [Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow (United Kingdom); Lindsay, Kenneth [Department of Neurosurgery, Institute of Neurological Sciences, Southern General Hospital, Glasgow (United Kingdom)

    2003-02-01

    Vagus nerve stimulation (VNS) has gained recognition as a treatment for refractory epilepsies where surgical treatment is not possible. While it appears that this treatment is effective in some patients, the mechanism of action is not clearly understood. The purpose of this study was to clarify findings of other positron emission tomography and single-photon emission tomography (SPET) investigations by measuring the acute effect of VNS on patients who have normal cerebral anatomy on magnetic resonance imaging and who have not previously been exposed to VNS. We investigated six subjects (two males and four females, mean age 29.5 years, range 21-39 years) with intractable epilepsy. One patient had primary generalised epilepsy causing generalised tonic-clonic seizures; the remaining five patients had localisation-related epilepsy causing complex partial seizures. SPET imaging was performed using 250 MBq of {sup 99m}Tc-HMPAO and a four-scan paradigm - two with and two without stimulation. The stimulation began at VNS current levels of 0.25 mA and was increased according to the limit of patients' tolerance, usually defined by coughing or discomfort. The stimulating waveform was of continuous square wave pulses of 500 {mu}s duration at 30 Hz. Image analysis was by SPM99. Reduced perfusion during stimulation was observed in the ipsilateral brain stem, cingulate, amygdala and hippocampus and contralateral thalamus and cingulate. The study provides further evidence of the involvement of the limbic system in the action of vagal nerve stimulation. (orig.)

  6. The Epidemiology of Epilepsy and Traumatic Brain Injury: Severity, Mechanism, and Outcomes

    Science.gov (United States)

    2017-10-01

    SUBJECT TERMS Epilepsy, diagnoses, verification 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF...Veterans with epilepsy and controls on self -report measures (Aim 3)  Major Task 7: Conduct analyses comparing Veterans with epilepsy and controls on...epilepsy and controls on self -report measures (Aim 3) Work on this task will begin in late calendar year 2019 once the survey is fielded and a

  7. Partial discharge characteristics and mechanism in voids at impulse voltages

    International Nuclear Information System (INIS)

    Zhao, X F; Guo, Z F; Wang, Y Y; Li, J H; Li, Y M; Yao, X

    2011-01-01

    Partial discharge (PD) characteristics and mechanism in artificial cavities in an epoxy plate have been investigated for different void dimensions and impulse voltage waveforms. A differential measurement system was developed in order to detect PD current pulses effectively. Experimental results showed that the 50% probability PD inception voltage (PDIV 50 ) increases initially as the cavity diameter decreases at constant depth for double exponential impulses as well as oscillating impulses, but after aging, it becomes independent of the cavity diameter. Moreover, some distinctive characteristics of PD (e.g. main discharge and reverse discharge during the rise and fall phases of the applied voltage) were also investigated. The differences of the PD propagation and the mechanism between double exponential impulses and oscillating impulse were discussed

  8. Does mechanism of drug action matter to inform rational polytherapy in epilepsy?

    Science.gov (United States)

    Giussani, Giorgia; Beghi, Ettore

    2013-05-01

    When monotherapy for epilepsy fails, add-on therapy is an alternative option. There are several possible antiepileptic drug combinations based on their different and multiple mechanisms of action and pharmacokinetic interactions. However, only when benefits of drug combinations outweigh the harms, polytherapy can be defined as "rational". In the past 20 years, second generation AEDs have been marketed, some of which have better defined mechanisms of action and better pharmacokinetic profile. The mechanisms of action of AEDs involve, among others, blockade of voltage-gated sodium channels, blockade of voltage-gated calcium channel, activation of the ionotropic GABAA receptor and increase of GABA levels at the synaptic cleft, blockade of glutamate receptors, binding to synaptic vesicle protein 2A, and opening of KCNQ (Kv7) potassium channels. Aim of this review was to examine published reports on AEDs combinations in animal models and humans focusing on mechanisms of action and pharmacokinetic interactions. Studies in animals have shown that AED combinations are more effective when using drugs with different mechanisms of action. The most effective combination was found using a drug with a single mechanism of action and another with multiple mechanisms of action. In humans some combinations between a blocker of voltage-gated sodium channels and a drug with multiple mechanisms of action may be synergistic. Future studies are necessary to better define rational combinations and complementary mechanisms of action, considering also pharmacokinetic interactions and measures of toxicity and not only drug efficacy.

  9. Partial validation of a French version of the ADHD-rating scale IV on a French population of children with ADHD and epilepsy. Factorial structure, reliability, and responsiveness.

    Science.gov (United States)

    Mercier, Catherine; Roche, Sylvain; Gaillard, Ségolène; Kassai, Behrouz; Arzimanoglou, Alexis; Herbillon, Vania; Roy, Pascal; Rheims, Sylvain

    2016-05-01

    Attention deficit hyperactivity disorder (ADHD) is a well-known comorbidity in children with epilepsy. In English-speaking countries, the scores of the original ADHD-rating scale IV are currently used as main outcomes in various clinical trials in children with epilepsy. In French-speaking countries, several French versions are in use though none has been fully validated yet. We sought here for a partial validation of a French version of the ADHD-RS IV regarding construct validity, internal consistency (i.e., scale reliability), item reliability, and responsiveness in a group of French children with ADHD and epilepsy. The study involved 167 children aged 6-15years in 10 French neuropediatric units. The factorial structure and item reliability were assessed with a confirmatory factorial analysis for ordered categorical variables. The dimensions' internal consistency was assessed with Guttman's lambda 6 coefficient. The responsiveness was assessed by the change in score under methylphenidate and in comparison with a control group. The results confirmed the original two-dimensional factorial structure (inattention, hyperactivity/impulsivity) and showed a satisfactory reliability of most items, a good dimension internal consistency, and a good responsiveness of the total score and the two subscores. The studied French version of the ADHD-RS IV is thus validated regarding construct validity, reliability, and responsiveness. It can now be used in French-speaking countries in clinical trials of treatments involving children with ADHD and epilepsy. The full validation requires further investigations. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. GABAergic neuron deficit as an idiopathic generalized epilepsy mechanism: the role of BRD2 haploinsufficiency in juvenile myoclonic epilepsy.

    Directory of Open Access Journals (Sweden)

    Libor Velíšek

    Full Text Available Idiopathic generalized epilepsy (IGE syndromes represent about 30% of all epilepsies. They have strong, but elusive, genetic components and sex-specific seizure expression. Multiple linkage and population association studies have connected the bromodomain-containing gene BRD2 to forms of IGE. In mice, a null mutation at the homologous Brd2 locus results in embryonic lethality while heterozygous Brd2+/- mice are viable and overtly normal. However, using the flurothyl model, we now show, that compared to the Brd2+/+ littermates, Brd2+/- males have a decreased clonic, and females a decreased tonic-clonic, seizure threshold. Additionally, long-term EEG/video recordings captured spontaneous seizures in three out of five recorded Brd2+/- female mice. Anatomical analysis of specific regions of the brain further revealed significant differences in Brd2+/- vs +/+ mice. Specifically, there were decreases in the numbers of GABAergic (parvalbumin- or GAD67-immunopositive neurons along the basal ganglia pathway, i.e., in the neocortex and striatum of Brd2+/- mice, compared to Brd2+/+ mice. There were also fewer GABAergic neurons in the substantia nigra reticulata (SNR, yet there was a minor, possibly compensatory increase in the GABA producing enzyme GAD67 in these SNR cells. Further, GAD67 expression in the superior colliculus and ventral medial thalamic nucleus, the main SNR outputs, was significantly decreased in Brd2+/- mice, further supporting GABA downregulation. Our data show that the non-channel-encoding, developmentally critical Brd2 gene is associated with i sex-specific increases in seizure susceptibility, ii the development of spontaneous seizures, and iii seizure-related anatomical changes in the GABA system, supporting BRD2's involvement in human IGE.

  11. Are adverse effects of antiepileptic drugs different in symptomatic partial and idiopathic generalized epilepsies? The Portuguese-Brazilian validation of the Liverpool Adverse Events Profile.

    Science.gov (United States)

    Martins, H H; Alonso, N B; Vidal-Dourado, M; Carbonel, T D; de Araújo Filho, G M; Caboclo, L O; Yacubian, E M; Guilhoto, L M

    2011-11-01

    We report the results of administration of the Portuguese-Brazilian translation of the Liverpool Adverse Events Profile (LAEP) to 100 patients (mean age=34.5, SD=12.12; 56 females), 61 with symptomatic partial epilepsy (SPE) and 39 with idiopathic generalized epilepsy (IGE) (ILAE, 1989) who were on a stable antiepileptic drug (AED) regimen and being treated in a Brazilian tertiary epilepsy center. Carbamazepine was the most commonly used AED (43.0%), followed by valproic acid (32.0%). Two or more AEDs were used by 69.0% of patients. The mean LAEP score (19 questions) was 37.6 (SD=13.35). The most common adverse effects were sleepiness (35.0%), memory problems (35.0%), and difficulty in concentrating (25.0%). Higher LAEP scores were associated with polytherapy with three or more AEDs (P=0.005), female gender (P0.001) and Hospital Anxiety and Depression Scale (Depression: r=0.637, P<0.001; Anxiety: r=0.621, P<0.001) dimensions. LAEP overall scores were similar in people with SPE and IGE and were not helpful in differentiating adverse effects in these two groups. Clinical variables that influenced global LAEP were seizure frequency (P=0.050) and generalized tonic-clonic seizures in the last month (P=0.031) in the IGE group, and polytherapy with three or more AEDs (P=0.003 and P=0.003) in both IGE and SPE groups. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. About one case of mental anorexia associated with a right frontal partial epilepsy diagnosed in crisis by a PET with {sup 18}F.D.G; A propos d'un cas d'anorexie mentale associee a une epilepsie partielle frontale droite diagnostiquee en crise par une TEP au 18-FDG

    Energy Technology Data Exchange (ETDEWEB)

    Avet, J.; Decousus, M.; Dubois, F. [Service de medecine nucleaire, CHU de Saint-etienne, (France); Galusca, B. [service d' endocrinologie, CHU de Saint-etienne, (France); Convers, P. [service de neurologie, CHU de Saint-etienne, (France); Barral, F.G. [service de radiologie, CHU de Saint-etienne, (France)

    2009-05-15

    The physiology of mental anorexia is very controversial. In some cases, it was described an association with injuries close to the right frontal and temporal lobes. We report the case of an anorexia associated to a partial right frontal epilepsy, fortuitously diagnosed in crisis by a PET with {sup 18}F.D.G.. Conclusions: Because of its closely relationship with the limbic system, the abnormalities touching the right frontal area could contribute to the development of dietary behaviour troubles. This case illustrates this relationship and reports in addition a per-critic PET image of partial epilepsy, that is exceptional because of the tracer kinetics. (N.C.)

  13. Epilepsy and PET

    International Nuclear Information System (INIS)

    Shimizu, Hiroyuki; Ishijima, Buichi

    1984-01-01

    The glucose metabolism of interictal epileptic foci in human brains were analyzed by positron emission tomography. The seizure patterns of 29 epileptic patients were as follows; complex partial 13 cases, elementary partial 9 cases, and generalized 7 cases. 11 C was produced by a JSW medical cyclotron BC105 and was randomly tagged to glucose prepared by photosynthesis. Data sampling by PET was started 15 minutes after peroral administration of 11 C-glucose to the patients. Three slices with 1.75 cm distance were obtained by a single scanning. In temporal lobe epilepsy, three slices were selected as 2.0 cm, 3.75 cm and 5.5 cm above orbitomeatal line. The basal ganglia were scanned 4.5 -- 5.0 cm and the motor and sensory strips were 5.0 -- 9.0 cm above OML. The glucose metabolic rate was expressed with color scales and qualitatively estimated. The results disclosed an obvious hypometabolic zone around a focus area in 22 cases (76%) out of the 29 subjects. This hypometabolic zone was observed in 12 cases (92%) of 13 complex partial, 9 cases (78%) of 9 elementary partial, and 3 cases (43%) of 7 generalized seizure patterns. In temporal lobe epilepsy, the location of the hypometabolic zone was different according to the clinical symptoms. The patients with automatism, pseudoabsence, autonomic, and emotional symptoms had its foci in the mesial portion of the temporal lobe. On the other hand, the patients with psychical seizure revealed its low metabolic area in the lateral temporal cortex. In the elementary partial epilepsy, the hypoactive zones were observed in the motor, sensory, and visual cortical area in accordance with the clinical symptoms. Very interestingly, an explicit cortical focus was discovered in two cases of the generalized epilepsy. In these cases the mechanism of secondary generalization was supposed to proceed in the expression of their clinical symptoms. In one Lennox-Gastaut case, a unilateral temporal lobe was involved as the seizure focus. (J.P.N.)

  14. Imaging of the epilepsies

    Energy Technology Data Exchange (ETDEWEB)

    Urbach, H. [University of Bonn Medical Center, Department of Radiology/Neuroradiology, Bonn (Germany)

    2005-03-01

    Imaging of epilepsy patients is challenging, since epileptogenic lesions (defined as structural lesions causally related to the epilepsy syndrome) may be small and often do not change during life. Prior clinical information about the epilepsy syndrome and the semiology of the seizures is needed in order to plan the examination properly. The effort to detect an epileptogenic lesion is directed to partial (focal) epilepsy syndromes whereas - by definition - no lesion is identified in idiopathic epilepsies. Most patients with partial epilepsies suffer from mesial temporal lobe epilepsies. In these patients, 2- to 3-mm-thick T2-weighted and fluid-attenuated inversion-recovery (FLAIR) fast spin echo slices along or perpendicular to the temporal lobe length axis have the highest diagnostic efficacy. In contrast, in patients with extratemporal lobe epilepsies perpendicular FLAIR slices through the anatomic region, from which, due to clinical and EEG criteria, the seizures are likely to originate, are preferred. The imaging features of common epileptogenic lesions (hippocampal sclerosis, long-term epilepsy-associated tumours, focal cortical dysplasias, vascular malformations, encephalitis including limbic and Rasmussen's encephalitis, gyral scarring including ulegyria) are detailed in the second section of this paper. (orig.)

  15. Imaging of the epilepsies

    International Nuclear Information System (INIS)

    Urbach, H.

    2005-01-01

    Imaging of epilepsy patients is challenging, since epileptogenic lesions (defined as structural lesions causally related to the epilepsy syndrome) may be small and often do not change during life. Prior clinical information about the epilepsy syndrome and the semiology of the seizures is needed in order to plan the examination properly. The effort to detect an epileptogenic lesion is directed to partial (focal) epilepsy syndromes whereas - by definition - no lesion is identified in idiopathic epilepsies. Most patients with partial epilepsies suffer from mesial temporal lobe epilepsies. In these patients, 2- to 3-mm-thick T2-weighted and fluid-attenuated inversion-recovery (FLAIR) fast spin echo slices along or perpendicular to the temporal lobe length axis have the highest diagnostic efficacy. In contrast, in patients with extratemporal lobe epilepsies perpendicular FLAIR slices through the anatomic region, from which, due to clinical and EEG criteria, the seizures are likely to originate, are preferred. The imaging features of common epileptogenic lesions (hippocampal sclerosis, long-term epilepsy-associated tumours, focal cortical dysplasias, vascular malformations, encephalitis including limbic and Rasmussen's encephalitis, gyral scarring including ulegyria) are detailed in the second section of this paper. (orig.)

  16. Positron emission tomography in epilepsy

    International Nuclear Information System (INIS)

    Hosokawa, Shinichi; Kato, Motohiro; Otsuka, Makoto; Kuwabara, Yasuo; Ichiya, Yuichi; Goto, Ikuo

    1989-01-01

    Positron emission tomography (PET) was performed with the 18 F-fluoro-deoxy-glucose method on 29 patients with epilepsy (generalized epilepsy, 4; partial epilepsy, 24; undetermined type, 1). The subjects were restricted to patients with epilepsy without focal abnormality on X-CT. All the patients with generalized epilepsy showed a normal pattern on PET. Fourteen out of the 24 patients with partial epilepsy and the 1 with epilepsy of undermined type showed focal hypometabolism on PET. The hypometabolic zone was localized in areas including the temporal cortex in 11 patients, frontal in 2 and thalamus in 1. The location of hypometabolic zone and that of interictal paroxysmal activity on EEG were well correlated in most patients. The patients with poorly-controlled seizure showed a higher incidence of PET abnormality (12 out of 13) than those with well-controlled seizures (2 out of 11). The incidence of abnormality on PET and MRI and the location of both abnormality were not necessarily coincident. These results indicated that the PET examination in epilepsy provides valuable information about the location of epileptic focus, and that the findings on PET in patients with partial epilepsy may be one of the good indicators about the intractability of partial epilepsy, and that PET and MRI provide complementary information in the diagnosis of epilepsy. (author)

  17. Seizures triggered by food intake in antimuscarinic-treated fasted animals: evaluation of the experimental findings in terms of similarities to eating-triggered epilepsy.

    Science.gov (United States)

    Enginar, Nurhan; Nurten, Asiye

    2010-07-01

    Food intake triggers convulsions in fasted mice and rats treated with antimuscarinic drugs, scopolamine or atropine. Bearing some similarities in triggering factor and manifestations of the seizures in patients with eating-evoked epilepsy, seizures in fasted animals may provide insight into the mechanism(s) of this rare and partially controlled form of reflex epilepsy.

  18. Mechanisms of levetiracetam in the control of status epilepticus and epilepsy

    Directory of Open Access Journals (Sweden)

    Laxmikant S Deshpande

    2014-01-01

    Full Text Available Status epilepticus (SE is a major clinical emergency that is associated with high mortality and morbidity. SE causes significant neuronal injury and survivors are at a greater risk of developing acquired epilepsy and other neurological morbidities, including depression and cognitive deficits. Benzodiazepines and some anticonvulsant agents are drugs of choice for initial SE management. Despite their effectiveness, over 40% of SE cases are refractory to the initial treatment with two or more medications. Thus there is an unmet need of developing newer anti-SE drugs. Levetiracetam (LEV is a widely prescribed anti-epileptic drug that has been reported to be used in SE cases, especially in benzodiazepine-resistant SE or where phenytoin cannot be used due to allergic side-effects. Levetiracetam’s non-classical antiepileptic mechanisms of action, favorable pharmacokinetic profile, general lack of central depressant effects and lower incidence of drug interactions contributes to its use in SE management. This review will focus on LEV’s unique mechanism of action that makes it a viable candidate for SE treatment.

  19. Epilepsy and Mood Disorders

    Directory of Open Access Journals (Sweden)

    Sermin Kesebir

    2012-03-01

    Full Text Available Mood disorders are the most common psychiatric comorbid disorder that affects quality of life and prognosis in epilepsy. The relation between depression and epilepsy is bidirectional. Not only the risk of having a depression among epilepsy cases is more than the healthy control cases, but also the risk of having epilepsy among depressive cases is more than the healthy control cases. People diagnosed with epilepsy are five times more likely than their peers to commit suicide. Moreover it seems that some epilepsy types like temporal lobe epilepsy have a much higher risk (25 times for suicide. Risk of suicide in epilepsy, which is independent from depression, increases more with the presence of depression. The common pathway between epilepsy, depression and suicide is hypofrontality and irregularity of serotonin metabolism. Contrary to depression, data on relationship between bipolar disorder and epilepsy is limited. However, mood disorder, mixed episodes with irritable character and mania are more frequent than assumed. As a matter of fact, both disorders share some common features. Both are episodic and can become chronic. Kindling phenomenon, irregularities in neurotransmitters, irregularities in voltage gate ion channels and irregularities in secondary messenger systems are variables that are presented in the etiologies of both disorders. Anticonvulsant drugs with mood regulatory effects are the common points of treatment. Understanding their mechanisms of action will clarify the pathophysiological processes. In this article, the relationhip between epilepsy and mood disorders, comorbidity, secondary states and treatment options in both cases have been discussed.

  20. Partial Measurements and the Realization of Quantum-Mechanical Counterfactuals

    Science.gov (United States)

    Paraoanu, G. S.

    2011-07-01

    We propose partial measurements as a conceptual tool to understand how to operate with counterfactual claims in quantum physics. Indeed, unlike standard von Neumann measurements, partial measurements can be reversed probabilistically. We first analyze the consequences of this rather unusual feature for the principle of superposition, for the complementarity principle, and for the issue of hidden variables. Then we move on to exploring non-local contexts, by reformulating the EPR paradox, the quantum teleportation experiment, and the entanglement-swapping protocol for the situation in which one uses partial measurements followed by their stochastic reversal. This leads to a number of counter-intuitive results, which are shown to be resolved if we give up the idea of attributing reality to the wavefunction of a single quantum system.

  1. Book review: Partial Differential Equations and Fluid Mechanics

    NARCIS (Netherlands)

    Muntean, A.

    2011-01-01

    The baak is the result of the workshop Partial Differential Equations and Fluid Dynamics that look place at the Mathematics Institute of the University of Warwick. May 21st - 23rd, 2007. It contains ten review and research papers which provide an accessible summary of a wide range of active research

  2. Computer tomographic examinations in epilepsy

    International Nuclear Information System (INIS)

    De Villiers, J.F.K.

    1984-01-01

    Epileptic patients that was examined at the Universitas Hospital (Bloemfontein) by means of computerized tomography for the period July 1978 - December 1980, are divided into two groups: a) Patients with general epilepsy of convulsions - 507; b) Patients with vocal or partial epilepsy - 111. The method of examination and the results for both general and vocal epilepsy are discussed. A degenerative state was found in 35% of the positive computer tomographic examinations in general epilepsy and 22% of the positive examinations for vocal epilepsy. The purpose of the article was to explain the circumstances that can be expected when a epileptic patient is examined by means of computerized tomography

  3. Use of images of ictal-inter-ictal SPECT subtraction superimposed on MRI in pharmaco-resistant partial epilepsies in infants

    International Nuclear Information System (INIS)

    Vera, P.; Kaminska, A.; Cieuta, C.; Mangin, F.; Frouin, V.; Dulac, O.; Chiron, C.

    1997-01-01

    To study the significance of ictal SPECT in the pre-surgical examination of infant epilepsies we have explored 16 infants aged 3 months to 18 years presenting partial pharmaco-resistant epilepsy. All of them have had an ictal SPECT under EEG - video recording than, two days after, an inter-ictal SPECT coupled to a 3D cerebral MRI. The perfusion tracer, the 99m Tc - ECD, was injected in average at 15 seconds after the outset of crisis. The image processing implied a matching of the two SPECT examinations by a 3D rigid superposition method, a normalization and than a inter-ictal-ictal image subtraction. Finally, the subtraction was matched and superimposed on the MRI. The SPECT subtraction image showed one or several centres of ictal hyper-output in 15 patients, while the separated visual ictal and inter-ictal images were contributory in 8 cases only. The 16. infant presented very short crises (<10 sec). In the cases when the outset point of crises could be established clinically (12 cases) and/or on EEG (8 cases) a hyper-output of concordant localization was recorded. In 5 infants who have had an electrocorticography, a concordance was obtained in all the cases except in an infant having very short crises the subtraction image did not show hyper-output. These preliminary results show that the ictal - inter-ictal SPECT subtraction images, adjusted on MRI, appears to be reliable in detecting the outset point of crises in infants and at the same time useful in guiding the positioning of intra-cranial electrodes prior to surgery intervention

  4. The value of magnetoencephalography for seizure-onset zone localization in magnetic resonance imaging-negative partial epilepsy.

    Science.gov (United States)

    Jung, Julien; Bouet, Romain; Delpuech, Claude; Ryvlin, Philippe; Isnard, Jean; Guenot, Marc; Bertrand, Olivier; Hammers, Alexander; Mauguière, François

    2013-10-01

    Surgical treatment of epilepsy is a challenge for patients with non-contributive brain magnetic resonance imaging. However, surgery is feasible if the seizure-onset zone is precisely delineated through intracranial electroencephalography recording. We recently described a method, volumetric imaging of epileptic spikes, to delineate the spiking volume of patients with focal epilepsy using magnetoencephalography. We postulated that the extent of the spiking volume delineated with volumetric imaging of epileptic spikes could predict the localizability of the seizure-onset zone by intracranial electroencephalography investigation and outcome of surgical treatment. Twenty-one patients with non-contributive magnetic resonance imaging findings were included. All patients underwent intracerebral electroencephalography investigation through stereotactically implanted depth electrodes (stereo-electroencephalography) and magnetoencephalography with delineation of the spiking volume using volumetric imaging of epileptic spikes. We evaluated the spatial congruence between the spiking volume determined by magnetoencephalography and the localization of the seizure-onset zone determined by stereo-electroencephalography. We also evaluated the outcome of stereo-electroencephalography and surgical treatment according to the extent of the spiking volume (focal, lateralized but non-focal or non-lateralized). For all patients, we found a spatial overlap between the seizure-onset zone and the spiking volume. For patients with a focal spiking volume, the seizure-onset zone defined by stereo-electroencephalography was clearly localized in all cases and most patients (6/7, 86%) had a good surgical outcome. Conversely, stereo-electroencephalography failed to delineate a seizure-onset zone in 57% of patients with a lateralized spiking volume, and in the two patients with bilateral spiking volume. Four of the 12 patients with non-focal spiking volumes were operated upon, none became seizure

  5. Monoaminergic Mechanisms in Epilepsy May Offer Innovative Therapeutic Opportunity for Monoaminergic Multi-Target Drugs

    Directory of Open Access Journals (Sweden)

    Dubravka Svob Strac

    2016-11-01

    Full Text Available A large body of experimental and clinical evidence has strongly suggested that monoamines play an important role in regulating epileptogenesis, seizure susceptibility, convulsions and comorbid psychiatric disorders commonly seen in people with epilepsy. However, neither the relative significance of individual monoamines nor their interaction has yet been fully clarified due to the complexity of these neurotransmitter systems. In addition, epilepsy is diverse, with many different seizure types and epilepsy syndromes, and the role played by monoamines may vary from one condition to another. In this review, we will focus on the role of serotonin, dopamine, noradrenaline, histamine and melatonin in epilepsy. Recent experimental, clinical and genetic evidence, will be reviewed in consideration of the mutual relationship of monoamines with the other putative neurotransmitters. The complexity of epileptic pathogenesis may explain why the currently available drugs, developed according to the classic drug discovery paradigm of one-molecule-one-target, have turned out to be effective only in a percentage of people with epilepsy. Although no antiepileptic drugs currently target specifically monoaminergic systems, multi-target directed ligands acting on different monoaminergic proteins present on both neurons and glia cells may represent a new approach in the management of seizures and their generation as well as comorbid neuropsychiatric disorders.

  6. Nuclear imaging in epilepsy

    International Nuclear Information System (INIS)

    Chun, Kyung Ah

    2007-01-01

    Correct localization of epileptogenic zone is important for the successful epilepsy surgery. Both ictal perfusion single photon emission computed tomography (SPECT) and interictal F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) can provide useful information in the presurgical localization of intractable partial epilepsy. These imaging modalities have excellent diagnostic sensitivity in medial temporal lobe epilepsy and provide good presurgical information in neocortical epilepsy. Also provide functional information about cellular functions to better understand the neurobiology of epilepsy and to better define the ictal onset zone, symptomatogenic zone, propagation pathways, functional deficit zone and surround inhibition zones. Multimodality imaging and developments in analysis methods of ictal perfusion SPECT and new PET ligand other than FDG help to better define the localization

  7. Nuclear imaging in epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Chun, Kyung Ah [Yeungnam University Hospital, Daegu (Korea, Republic of)

    2007-04-15

    Correct localization of epileptogenic zone is important for the successful epilepsy surgery. Both ictal perfusion single photon emission computed tomography (SPECT) and interictal F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) can provide useful information in the presurgical localization of intractable partial epilepsy. These imaging modalities have excellent diagnostic sensitivity in medial temporal lobe epilepsy and provide good presurgical information in neocortical epilepsy. Also provide functional information about cellular functions to better understand the neurobiology of epilepsy and to better define the ictal onset zone, symptomatogenic zone, propagation pathways, functional deficit zone and surround inhibition zones. Multimodality imaging and developments in analysis methods of ictal perfusion SPECT and new PET ligand other than FDG help to better define the localization.

  8. Measurement of Local Partial Pressure of Oxygen in the Brain Tissue under Normoxia and Epilepsy with Phosphorescence Lifetime Microscopy

    Science.gov (United States)

    Zhang, Cong; Bélanger, Samuel; Pouliot, Philippe; Lesage, Frédéric

    2015-01-01

    In this work a method for measuring brain oxygen partial pressure with confocal phosphorescence lifetime microscopy system is reported. When used in conjunction with a dendritic phosphorescent probe, Oxyphor G4, this system enabled minimally invasive measurements of oxygen partial pressure (pO2) in cerebral tissue with high spatial and temporal resolution during 4-AP induced epileptic seizures. Investigating epileptic events, we characterized the spatio-temporal distribution of the "initial dip" in pO2 near the probe injection site and along nearby arterioles. Our results reveal a correlation between the percent change in the pO2 signal during the "initial dip" and the duration of seizure-like activity, which can help localize the epileptic focus and predict the length of seizure. PMID:26305777

  9. Measurement of Local Partial Pressure of Oxygen in the Brain Tissue under Normoxia and Epilepsy with Phosphorescence Lifetime Microscopy.

    Science.gov (United States)

    Zhang, Cong; Bélanger, Samuel; Pouliot, Philippe; Lesage, Frédéric

    2015-01-01

    In this work a method for measuring brain oxygen partial pressure with confocal phosphorescence lifetime microscopy system is reported. When used in conjunction with a dendritic phosphorescent probe, Oxyphor G4, this system enabled minimally invasive measurements of oxygen partial pressure (pO2) in cerebral tissue with high spatial and temporal resolution during 4-AP induced epileptic seizures. Investigating epileptic events, we characterized the spatio-temporal distribution of the "initial dip" in pO2 near the probe injection site and along nearby arterioles. Our results reveal a correlation between the percent change in the pO2 signal during the "initial dip" and the duration of seizure-like activity, which can help localize the epileptic focus and predict the length of seizure.

  10. Monoaminergic Mechanisms in Epilepsy May Offer Innovative Therapeutic Opportunity for Monoaminergic Multi-Target Drugs

    Science.gov (United States)

    Svob Strac, Dubravka; Pivac, Nela; Smolders, Ilse J.; Fogel, Wieslawa A.; De Deurwaerdere, Philippe; Di Giovanni, Giuseppe

    2016-01-01

    A large body of experimental and clinical evidence has strongly suggested that monoamines play an important role in regulating epileptogenesis, seizure susceptibility, convulsions, and comorbid psychiatric disorders commonly seen in people with epilepsy (PWE). However, neither the relative significance of individual monoamines nor their interaction has yet been fully clarified due to the complexity of these neurotransmitter systems. In addition, epilepsy is diverse, with many different seizure types and epilepsy syndromes, and the role played by monoamines may vary from one condition to another. In this review, we will focus on the role of serotonin, dopamine, noradrenaline, histamine, and melatonin in epilepsy. Recent experimental, clinical, and genetic evidence will be reviewed in consideration of the mutual relationship of monoamines with the other putative neurotransmitters. The complexity of epileptic pathogenesis may explain why the currently available drugs, developed according to the classic drug discovery paradigm of “one-molecule-one-target,” have turned out to be effective only in a percentage of PWE. Although, no antiepileptic drugs currently target specifically monoaminergic systems, multi-target directed ligands acting on different monoaminergic proteins, present on both neurons and glia cells, may represent a new approach in the management of seizures, and their generation as well as comorbid neuropsychiatric disorders. PMID:27891070

  11. Pharmacogenomics in epilepsy.

    Science.gov (United States)

    Balestrini, Simona; Sisodiya, Sanjay M

    2018-02-22

    There is high variability in the response to antiepileptic treatment across people with epilepsy. Genetic factors significantly contribute to such variability. Recent advances in the genetics and neurobiology of the epilepsies are establishing the basis for a new era in the treatment of epilepsy, focused on each individual and their specific epilepsy. Variation in response to antiepileptic drug treatment may arise from genetic variation in a range of gene categories, including genes affecting drug pharmacokinetics, and drug pharmacodynamics, but also genes held to actually cause the epilepsy itself. From a purely pharmacogenetic perspective, there are few robust genetic findings with established evidence in epilepsy. Many findings are still controversial with anecdotal or less secure evidence and need further validation, e.g. variation in genes for transporter systems and antiepileptic drug targets. The increasing use of genetic sequencing and the results of large-scale collaborative projects may soon expand the established evidence. Precision medicine treatments represent a growing area of interest, focussing on reversing or circumventing the pathophysiological effects of specific gene mutations. This could lead to a dramatic improvement of the effectiveness and safety of epilepsy treatments, by targeting the biological mechanisms responsible for epilepsy in each specific individual. Whilst much has been written about epilepsy pharmacogenetics, there does now seem to be building momentum that promises to deliver results of use in clinic. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  12. Versive seizures in occipital lobe epilepsy: lateralizing value and pathophysiology.

    Science.gov (United States)

    Usui, Naotaka; Mihara, Tadahiro; Baba, Koichi; Matsuda, Kazumi; Tottori, Takayasu; Umeoka, Shuichi; Kondo, Akihiko; Nakamura, Fumihiro; Terada, Kiyohito; Usui, Keiko; Inoue, Yushi

    2011-11-01

    To clarify the value of versive seizures in lateralizing and localizing the epileptogenic zone in patients with occipital lobe epilepsy, we studied 13 occipital lobe epilepsy patients with at least one versive seizure recorded during preoperative noninvasive video-EEG monitoring, who underwent occipital lobe resection, and were followed postoperatively for more than 2 years with Engel's class I outcome. The videotaped versive seizures were analyzed to compare the direction of version and the side of surgical resection in each patient. Moreover, we examined other motor symptoms (partial somatomotor manifestations such as tonic and/or clonic movements of face and/or limbs, automatisms, and eyelid blinking) associated with version. Forty-nine versive seizures were analyzed. The direction of version was always contralateral to the side of resection except in one patient. Among accompanying motor symptoms, partial somatomotor manifestations were observed in only five patients. In conclusion, versive seizure is a reliable lateralizing sign indicating contralateral epileptogenic zone in occipital lobe epilepsy. Since versive seizures were accompanied by partial somatomotor manifestations in less than half of the patients, it is suggested that the mechanism of version in occipital lobe epilepsy is different from that in frontal lobe epilepsy. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. Epilepsy treatment and creativity.

    Science.gov (United States)

    Zubkov, Sarah; Friedman, Daniel

    2016-04-01

    Creativity can be defined as the ability to understand, develop, and express, in a systematic fashion, novel orderly relationships. It is sometimes difficult to separate cognitive skills requisite for the creative process from the drive that generates unique new ideas and associations. Epilepsy itself may affect the creative process. The treatment of epilepsy and its comorbidities, by altering or disrupting the same neural networks through antiseizure drugs (ASDs), treatment of epilepsy comorbidities, ablative surgery, or neurostimulation may also affect creativity. In this review, we discuss the potential mechanisms by which treatment can influence the creative process and review the literature on the consequences of therapy on different aspects of creativity in people with epilepsy. This article is part of a Special Issue entitled "Epilepsy, Art, and Creativity". Copyright © 2016 Elsevier Inc. All rights reserved.

  14. High doses of carbamazepine for refractory partial epilepsy Altas doses de carbamazepina para epilepsia parcial refratária

    Directory of Open Access Journals (Sweden)

    Cristiana Borges Pereira

    1996-03-01

    Full Text Available Forty-eight patients with partial seizures were analysed during treatment with 1200 mg/d or more of carbamazepine (CBZ. Thirty-three were on monotherapy and fifteen on polytherapy. The other drugs were kept unchanged in the patients on polytherapy. The dose of CBZ was increased if no control was observed and the patient had no side effects. The doses used ranged between 1200 and 1900 mg/day (1200 mg/day, n=18; 1300mg/day, n=1; 1400 mg/day, n=7; 1600 mg/day, n=9; 1700 mg/day, n=4; 1800 mg/day, n=8; 1900 mg/day, n=1. Anticonvulsant plasma levels were taken to confirm patient compliance. The average plasma level was 9.6 ug/mL. The period of follow up varied from 3 to 96 months (M=25.6. Seizure's control was observed in 7 (14.48% patients taking 1200 mg/day and in 2 (4.16% patients taking 1400 mg/day of CBZ. Thirty-nine patients did not show any control (81.21%. Ten patients (20.81% had signs of intoxication. When patients have no improvement with 1400 mg/day, it is difficult to obtain any control despite the use of higher doses of CBZ, which frequently expose the patient to significant side effects.Foram analisados 48 pacientes epilépticos com crises parciais que faziam uso de carbamazepina (CBZ em doses iguais ou superiores a 1200 mg por dia. Trinta e três estavam em monoterapia e 15 em politerapia. As outras medicações foram mantidas constantes durante a manipulação da dose de CBZ nos pacientes em politerapia. O critério utilizado para o aumento da dose de CBZ foi a falta de controle clínico e a ausência de efeitos colaterais (independente da dosagem sérica. A dose máxima variou de 1200 a 1900 mg/dia (1200 mg, n=18; 1300 mg/dia, n=1; 1400 mg/dia, n=7; 1600 mg/dia, n=9; 1700 mg/dia, n=4; 1800 mg/dia, n=8 ; 1900 mg/dia, n=1. Dosagens séricas de anticonvulsivantes eram utilizadas no sentido de confirmar a aderência ao tratamento. A média das dosagens disponíveis foi de 9,6 ug/mL. O tempo de seguimento variou de 3 a 96 meses (M=25

  15. Clinical utility of flumazenil-PET versus [18F]fluorodeoxyglucose-PET and MRI in refractory partial epilepsy. A prospective study in 100 patients.

    Science.gov (United States)

    Ryvlin, P; Bouvard, S; Le Bars, D; De Lamérie, G; Grégoire, M C; Kahane, P; Froment, J C; Mauguière, F

    1998-11-01

    We assessed the clinical utility of [11C]flumazenil-PET (FMZ-PET) prospectively in 100 epileptic patients undergoing a pre-surgical evaluation, and defined the specific contribution of this neuro-imaging technique with respect to those of MRI and [18F]fluorodeoxyglucose-PET (FDG-PET). All patients benefited from a long term video-EEG monitoring, whereas an intracranial EEG investigation was performed in 40 cases. Most of our patients (73%) demonstrated a FMZ-PET abnormality; this hit rate was significantly higher in temporal lobe epilepsy (94%) than in other types of epilepsy (50%) (P lobe epilepsy associated with MRI signs of hippocampal sclerosis, FMZ-PET abnormalities delineated the site of seizure onset precisely, whenever they were coextensive with FDG-PET abnormalities; (ii) in bi-temporal epilepsy, FMZ-PET helped to confirm the bilateral origin of seizures by showing a specific pattern of decreased FMZ binding in both temporal lobes in 33% of cases; (iii) in patients with a unilateral cryptogenic frontal lobe epilepsy, FMZ-PET provided further evidence of the side and site of seizure onset in 55% of cases. Thus, FMZ-PET deserves to be included in the pre-surgical evaluation of these specific categories of epileptic patients, representing approximately half of the population considered for epilepsy surgery.

  16. Epilepsy - children

    Science.gov (United States)

    ... the one before it. Some children have a strange sensation before a seizure. Sensations may be tingling, ... Prognosis) Most children with epilepsy live a normal life. Certain types of childhood epilepsy go away or ...

  17. Infections, inflammation and epilepsy

    Science.gov (United States)

    Vezzani, Annamaria; Fujinami, Robert S.; White, H. Steve; Preux, Pierre-Marie; Blümcke, Ingmar; Sander, Josemir W.; Löscher, Wolfgang

    2016-01-01

    Epilepsy is the tendency to have unprovoked epileptic seizures. Anything causing structural or functional derangement of brain physiology may lead to seizures, and different conditions may express themselves solely by recurrent seizures and thus be labelled “epilepsy.” Worldwide, epilepsy is the most common serious neurological condition. The range of risk factors for the development of epilepsy varies with age and geographic location. Congenital, developmental and genetic conditions are mostly associated with the development of epilepsy in childhood, adolescence and early adulthood. Head trauma, infections of the central nervous system (CNS) and tumours may occur at any age and may lead to the development of epilepsy. Infections of the CNS are a major risk factor for epilepsy. The reported risk of unprovoked seizures in population-based cohorts of survivors of CNS infections from developed countries is between 6.8 and 8.3 %, and is much higher in resource-poor countries. In this review, the various viral, bacterial, fungal and parasitic infectious diseases of the CNS which result in seizures and epilepsy are discussed. The pathogenesis of epilepsy due to brain infections, as well as the role of experimental models to study mechanisms of epileptogenesis induced by infectious agents, is reviewed. The sterile (non-infectious) inflammatory response that occurs following brain insults is also discussed, as well as its overlap with inflammation due to infections, and the potential role in epileptogenesis. Furthermore, autoimmune encephalitis as a cause of seizures is reviewed. Potential strategies to prevent epilepsy resulting from brain infections and non-infectious inflammation are also considered. PMID:26423537

  18. SPECT and PET imaging in epilepsy

    International Nuclear Information System (INIS)

    Semah, F.

    2007-01-01

    Positron emission tomography (PET) and single photon emission computed tomography (SPECT) imaging are very useful for the management of patients with medically refractory partial epilepsy. Presurgical evaluation of patients with medically refractory partial epilepsy often included PET imaging using FDG. The use of SPECT in these patients adds some more information and gives the clinicians the possibility of having ictal imaging. Furthermore, PET and SPECT imaging are performed to better understand the pathophysiology of epilepsy. (authors)

  19. Photogenic partial seizures.

    Science.gov (United States)

    Hennessy, M J; Binnie, C D

    2000-01-01

    To establish the incidence and symptoms of partial seizures in a cohort of patients investigated on account of known sensitivity to intermittent photic stimulation and/or precipitation of seizures by environmental visual stimuli such as television (TV) screens or computer monitors. We report 43 consecutive patients with epilepsy, who had exhibited a significant EEG photoparoxysmal response or who had seizures precipitated by environmental visual stimuli and underwent detailed assessment of their photosensitivity in the EEG laboratory, during which all were questioned concerning their ictal symptoms. All patients were considered on clinical grounds to have an idiopathic epilepsy syndrome. Twenty-eight (65%) patients reported visually precipitated attacks occurring initially with maintained consciousness, in some instances evolving to a period of confusion or to a secondarily generalized seizure. Visual symptoms were most commonly reported and included positive symptoms such as coloured circles or spots, but also blindness and subjective symptoms such as "eyes going funny." Other symptoms described included nonspecific cephalic sensations, deja-vu, auditory hallucinations, nausea, and vomiting. No patient reported any clear spontaneous partial seizures, and there were no grounds for supposing that any had partial epilepsy excepting the ictal phenomenology of some or all of the visually induced attacks. These findings provide clinical support for the physiological studies that indicate that the trigger mechanism for human photosensitivity involves binocularly innervated cells located in the visual cortex. Thus the visual cortex is the seat of the primary epileptogenic process, and the photically triggered discharges and seizures may be regarded as partial with secondary generalization.

  20. Lateralização das funções musicais na epilepsia parcial Asymmetry of musical functions in partial epilepsy

    Directory of Open Access Journals (Sweden)

    CLÉO MONTEIRO FRANÇA CORREIA

    1998-12-01

    Full Text Available Foram avaliados 14 pacientes destros com idade mediana de 30 anos, portadores de epilepsia parcial (Grupo Epiléptico e divididos em dois Grupos (Direito e Esquerdo, segundo a lateralização da atividade paroxística no eletrencefalograma interictal. Dos 14 pacientes, 42,8% (6/14 dos casos apresentaram foco à direita, enquanto os 57,2% (8/14 restantes apresentaram foco à esquerda. O Grupo Controle foi formado por 31 indivíduos destros com idade mediana de 30 anos e sem história de doença neurológica ou antecedente de crises epilépticas. Os indivíduos estudados, sem conhecimento musical, realizaram Testes de Habilidades Musicais que envolveram Ritmo Espontâneo, Percepção dos Parâmetros Musicais (timbre, duração, altura, intensidade e ritmo e Testes Gnósico-Práxicos (reconhecimento e reprodução de parâmetros musicais e organização e reprodução de movimentos corporais rítmicos. Concluímos que a presença do foco no hemisfério cerebral direito afeta o desempenho de funções de reconhecimento melódico, enquanto que nos casos com foco no hemisfério cerebral esquerdo, a reprodução e organização rítmicas estão mais comprometidas quando comparados ao Grupo Controle.Fourteen right handed patients with partial epilepsy (Epileptic Group and with a median age of 31 years were divided into two groups (Right and Left, according the laterality of paroxystic activity in the eletroencaphalogram. Of the 14 patients, 42.8% (6/14 presented a focus at the right side while the others 57.2% (8/14 presented a focus at the left. The Control Group consisted of 31 right handed individuals with a median age of 30 years and with no previous history of neurological disease or epileptic seizures. All the individuals had no musical skills. They carried out Music Abilities Tests including Spontaneous Rhythm, Elemental Music Functions Perception (tone color, duration, pitch, intensity and rhythm and Complex Strutures Tests (recognition and

  1. Metabolic therapy for temporal lobe epilepsy in a dish: investigating mechanisms of ketogenic diet using electrophysiological recordings in hippocampal slices

    Directory of Open Access Journals (Sweden)

    Masahito Kawamura

    2016-11-01

    Full Text Available The hippocampus is prone to epileptic seizures and is a key brain region and experimental platform for investigating mechanisms associated with the abnormal neuronal excitability that characterizes a seizure. Accordingly, the hippocampal slice is a common in vitro model to study treatments that may prevent or reduce seizure activity. The ketogenic diet is a metabolic therapy used to treat epilepsy in adults and children for nearly 100 years; it can reduce or eliminate even severe or refractory seizures. New insights into its underlying mechanisms have been revealed by diverse types of electrophysiological recordings in hippocampal slices. Here we review these reports and their relevant mechanistic findings. We acknowledge that a major difficulty in using hippocampal slices is the inability to reproduce precisely the in vivo condition of ketogenic diet feeding in any in vitro preparation, and progress has been made in this in vivo/in vitro transition. Thus far at least three different approaches are reported to reproduce relevant diet effects in the hippocampal slices: (1 direct application of ketone bodies, (2 mimicking the ketogenic diet condition during a whole-cell patch-clamp technique, and (3 reduced glucose incubation of hippocampal slices from ketogenic diet–fed animals. Significant results have been found with each of these methods and provide options for further study into short- and long-term mechanisms including ATP-sensitive potassium channels, vesicular glutamate transporter, pannexin channels and adenosine receptors underlying ketogenic diet and other forms of metabolic therapy.

  2. Metabolic Therapy for Temporal Lobe Epilepsy in a Dish: Investigating Mechanisms of Ketogenic Diet using Electrophysiological Recordings in Hippocampal Slices

    Science.gov (United States)

    Kawamura, Masahito Jr.; Ruskin, David N.; Masino, Susan A.

    2016-01-01

    The hippocampus is prone to epileptic seizures and is a key brain region and experimental platform for investigating mechanisms associated with the abnormal neuronal excitability that characterizes a seizure. Accordingly, the hippocampal slice is a common in vitro model to study treatments that may prevent or reduce seizure activity. The ketogenic diet is a metabolic therapy used to treat epilepsy in adults and children for nearly 100 years; it can reduce or eliminate even severe or refractory seizures. New insights into its underlying mechanisms have been revealed by diverse types of electrophysiological recordings in hippocampal slices. Here we review these reports and their relevant mechanistic findings. We acknowledge that a major difficulty in using hippocampal slices is the inability to reproduce precisely the in vivo condition of ketogenic diet feeding in any in vitro preparation, and progress has been made in this in vivo/in vitro transition. Thus far at least three different approaches are reported to reproduce relevant diet effects in the hippocampal slices: (1) direct application of ketone bodies; (2) mimicking the ketogenic diet condition during a whole-cell patch-clamp technique; and (3) reduced glucose incubation of hippocampal slices from ketogenic diet–fed animals. Significant results have been found with each of these methods and provide options for further study into short- and long-term mechanisms including Adenosine triphosphate (ATP)-sensitive potassium (KATP) channels, vesicular glutamate transporter (VGLUT), pannexin channels and adenosine receptors underlying ketogenic diet and other forms of metabolic therapy. PMID:27847463

  3. Methods for improving mechanical properties of partially stabilized zirconia and the resulting product

    International Nuclear Information System (INIS)

    Aronov, V.A.

    1987-01-01

    A method for improving mechanical surface properties of a rigid body comprising partially stabilized zirconia as a constituent is described comprising the following steps: (i) providing a rigid body having an exposed surface and an interior volume; (ii) subjecting the exposed surface region of partially stabilized zirconia to external heating to heat the exposed surface region to 1100 0 C-1600 0 C without heating the interior volume above 500 0 C-800 0 C; and (iii) cooling the rigid body to a temperature of less than 500 0 C to cause a portion of the exposed surface region to transform from the tetragonal lattice modification to the monoclinic lattice modification, thereby creating a compressive stress field in the exposed surface region and improving the mechanical surface properties of the exposed surface region. In a ceramic body comprising a first exposed region of a partially stabilized zirconia, and a second region of a partially stabilized zirconia at an interior portion of the ceramic body, the improvement is described comprising the ceramic body having in the first, exposed region a greater percentage of the monoclinic lattice modification than in the second region; having in the first, exposed region 5 percent to 100 percent in the monoclinic lattice modification; and having a molded surface finish in the first, exposed region; the first, exposed region being subjected to a compressive field resulting from the greater percentage of the monoclinic lattice modification

  4. Targeting Epilepsy

    Science.gov (United States)

    ... abilities of people with epilepsy, fear seizures, or lack knowledge about seizure first aid or are not comfortable ... they help eliminate barriers to care, such as lack of transportation or ... both English- and Spanish-speaking adults with epilepsy. Researchers are ...

  5. Epilepsie aktuell

    DEFF Research Database (Denmark)

    Berendt, Mette; Hüelsmeyer, Velia-Isabel; Bhatti, Sofie F. M.

    2016-01-01

    of the consensus statements “IVETF consensus report on epilepsy definition, classification and terminology in companion animals” and “IVETF’s current understanding of idiopathic epilepsy of genetic or suspected genetic origin in purebred dogs” in German language to inform German veterinarians and professional...... circles about new knowledge and innovations in these fields. In the first part of the article, it is explained, why a new classification system of epilepsy and a common language to describe the disease is necessary. The proposals of the IVETF regarding the classification system and the terminology...... Richtlinien zur Klassifikation und Empfehlungen zu allen Aspekten der Epilepsie bei Hund und Katze in englischer Sprache publiziert (IVETF, 2015a, b). Im vorliegenden Artikel werden die Inhalte der Konsenspapiere „IVETF consensus report on epilepsy definition, classification and terminology in companion...

  6. Novel approaches to epilepsy treatment

    DEFF Research Database (Denmark)

    Sørensen, Andreas T; Kokaia, Merab

    2013-01-01

    The aim of epilepsy treatment is to achieve complete seizure freedom. Nonetheless, numerous side effects and seizure resistance to antiepileptic drugs (AEDs) affecting about 30-40% of all patients are main unmet needs in today's epileptology. For this reason, novel approaches to treat epilepsy......, and inhibitory neurotransmitters. We also address new molecular-genetic approaches utilizing optogenetic technology. The therapeutic strategies presented herein are predominately aimed toward treatment of partial/focal epilepsies, but could also be envisaged for targeting key seizure propagation areas...... are highly needed. Herein, we highlight recent progress in stem-cell-based and gene transfer-based therapies in epilepsy according to findings in animal models and address their potential clinical application. Multiple therapeutic targets are described, including neuropeptides, neurotrophic factors...

  7. Lateral buckling and mechanical stretchability of fractal interconnects partially bonded onto an elastomeric substrate

    International Nuclear Information System (INIS)

    Fu, Haoran; Xu, Sheng; Rogers, John A.; Xu, Renxiao; Huang, Yonggang; Jiang, Jianqun; Zhang, Yihui

    2015-01-01

    Fractal-inspired designs for interconnects that join rigid, functional devices can ensure mechanical integrity in stretchable electronic systems under extreme deformations. The bonding configuration of such interconnects with the elastomer substrate is crucial to the resulting deformation modes, and therefore the stretchability of the entire system. In this study, both theoretical and experimental analyses are performed for postbuckling of fractal serpentine interconnects partially bonded to the substrate. The deformation behaviors and the elastic stretchability of such systems are systematically explored, and compared to counterparts that are not bonded at all to the substrate

  8. Epilepsy - overview

    Science.gov (United States)

    ... or antiepileptic drugs), may reduce the number of future seizures: These drugs are taken by mouth. Which ... 23986299 . Wiebe S. The epilepsies. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: ...

  9. Sleep and Epilepsy: Strange Bedfellows No More.

    Science.gov (United States)

    St Louis, Erik K

    2011-09-01

    Ancient philosophers and theologians believed that altered consciousness freed the mind to prophesy the future, equating sleep with seizures. Only recently has the bidirectional influences of epilepsy and sleep upon one another received more substantive analysis. This article reviews the complex and increasingly recognized interrelationships between sleep and epilepsy. NREM sleep differentially activates interictal epileptiform discharges during slow wave (N3) sleep, while ictal seizure events occur more frequently during light NREM stages N1 and N2. The most commonly encountered types of sleep-related epilepsies (those with preferential occurrence during sleep or following arousal) include frontal and temporal lobe partial epilepsies in adults, and benign epilepsy of childhood with centrotemporal spikes (benign rolandic epilepsy) and juvenile myoclonic epilepsy in children and adolescents. Comorbid sleep disorders are frequent in patients with epilepsy, particularly obstructive sleep apnea in refractory epilepsy patients which may aggravate seizure burden, while treatment with nasal continuous positive airway pressure often improves seizure frequency. Distinguishing nocturnal events such as NREM parasomnias (confusional arousals, sleep walking, and night terrors), REM parasomnias including REM sleep behavior disorder, and nocturnal seizures if frequently difficult and benefits from careful history taking and video-EEG-polysomnography in selected cases. Differentiating nocturnal seizures from primary sleep disorders is essential for determining appropriate therapy, and recognizing co-existent sleep disorders in patients with epilepsy may improve their seizure burden and quality of life.

  10. Mechanical Properties Transformation On Zr54Al17Co29 Bulk Metallic Glass by Partial Crystallization

    Directory of Open Access Journals (Sweden)

    Yanuar Rohmat Aji Pradana

    2017-05-01

    Full Text Available Study on biomaterials is recently essential for rapid development of medical application and Zr54Al17Co29 BMGbecomes promising candidate due to the lack of toxic elements. Partial crystallization by isothermal annealing at SCL region was used to variate the crystallinities of BMG. The structural and thermal properties of as cast and partially crystallized samples were confirmed by XRD and DSC test, while microvickers and compression test were further utilized to investigate their mechanical properties. By the higher crystallinity, the hardness could be slightly increased in range 540 ± 5 to 575 ± 5 Hv. As-cast sample shows the yield strength and plastic strain of 2130 ± 75 MPa and 2.2 ± 1.6%. The yield strength is increased by the presence of 10% nanocrystal, afterwards, fall and raise phenomena are obtained with further crystallinity. However, with higher crystallinity, the plasticity is significantly degraded and no more plastic strain observed at sample with 50% of crystallinity. Both the presence of nanocrystalline phase and free volume annihilation are the reason of mechanical properties change on the Zr-based BMG.

  11. Epilepsy and radiological investigations

    International Nuclear Information System (INIS)

    Tomberg, T.

    2005-01-01

    Epilepsy is a heterogenous group of disorders with multiple causes. Clinical management of epilepsy patients requires knowledge of seizure syndromes, causes, and imaging features. The aim of radiological investigations is to recognize the underlying cause of epilepsy. The main indications for neuroimaging studies are partial and secondarily generalized seizures, patients with neurological signs and intractable seizures, and patients with focal signs on EEG. Partial seizures of any type are more likely to be associated with a focus that may be identified on neuroimaging. MRI is the method of choice for evaluating structural abnormalities of the brain. High resolution MRI and dedicated imaging technique are needed for detection of subtle pathological changes as cortical dysplasias and temporal medial sclerosis. Other lesions that may be detected include neoplasms, vascular malformations, destructive lesions following brain injury, stroke, infection, etc. CT continues to be the technique for the investigation of patients with seizures under certain conditions. New techniques such as functional MRI, MR spectroscopy, SPECT, receptor PET and magnetic source imaging are becoming clinical tools for improving diagnosis [et

  12. Psychosocial factors partially mediate the relationship between mechanical hyperalgesia and self-reported pain.

    Science.gov (United States)

    Mason, Kayleigh J; O'Neill, Terence W; Lunt, Mark; Jones, Anthony K P; McBeth, John

    2018-01-26

    helplessness) and illness perceptions (consequences and concern) were significant partial mediators of the association with global pain intensity when loaded on to a latent mediator for: tender point count [75% total effect; 95% confidence interval (CI) 22%, 100%]; MPS at the knee (49%; 12%, 86%); and DMA at the knee (63%; 5%, 100%). Latent psychosocial factors were also significant partial mediators of the association between pain intensity at the tested knee with MPS at the knee (30%; 2%, 58%), but not for DMA at the knee. Measures of mechanical hyperalgesia at the most painful knee and pain-free opposite forearm were associated with increased knee and global pain indicative of altered central processing. Psychosocial factors were significant partial mediators, highlighting the importance of the central integration of emotional processing in pain perception. Associations between mechanical hyperalgesia at the forearm and knee, psychosocial factors and increased levels of clinical global and knee pain intensity provide evidence of altered central processing as a key mechanism in knee pain, with psychological factors playing a key role in the expression of clinical pain.

  13. Solution of Fractional Partial Differential Equations in Fluid Mechanics by Extension of Some Iterative Method

    Directory of Open Access Journals (Sweden)

    A. A. Hemeda

    2013-01-01

    Full Text Available An extension of the so-called new iterative method (NIM has been used to handle linear and nonlinear fractional partial differential equations. The main property of the method lies in its flexibility and ability to solve nonlinear equations accurately and conveniently. Therefore, a general framework of the NIM is presented for analytical treatment of fractional partial differential equations in fluid mechanics. The fractional derivatives are described in the Caputo sense. Numerical illustrations that include the fractional wave equation, fractional Burgers equation, fractional KdV equation, fractional Klein-Gordon equation, and fractional Boussinesq-like equation are investigated to show the pertinent features of the technique. Comparison of the results obtained by the NIM with those obtained by both Adomian decomposition method (ADM and the variational iteration method (VIM reveals that the NIM is very effective and convenient. The basic idea described in this paper is expected to be further employed to solve other similar linear and nonlinear problems in fractional calculus.

  14. Antiphospholipid antibodies in children and adolescents with epilepsy

    African Journals Online (AJOL)

    Ehab

    the role of autoimmunity in the pathogenesis of epilepsy ... Background: Some immunologic mechanisms of epilepsy are cited in literature. ... Objective: This study investigates the prevalence of some antiphospholipid .... brain and in some cases magnetic resonance imaging .... DISCUSSION .... Rasmussen's encephalitis.

  15. Eslicarbazepine acetate in the treatment of adults with partial-onset epilepsy: an evidence-based review of efficacy, safety and place in therapy.

    Science.gov (United States)

    Lattanzi, Simona; Brigo, Francesco; Cagnetti, Claudia; Verrotti, Alberto; Zaccara, Gaetano; Silvestrini, Mauro

    2018-01-01

    Up to 30% of the patients diagnosed with epilepsy will continue suffering from seizures despite treatment with antiepileptic drugs, either in monotherapy or polytherapy. Hence, there remains the need to develop new effective and well-tolerated therapies. The objective of this article was to review the evidence for the efficacy and safety of eslicarbazepine acetate (ESL) as adjunctive treatment in adult patients with focal onset seizures. ESL is the newest, third-generation, single enantiomer member of the dibenzazepine family. Following oral administration, ESL is rapidly and extensively metabolized by hepatic first-pass hydrolysis to the active metabolite eslicarbazepine, which has linear, dose-proportional pharmacokinetics and low potential for drug-drug interactions. Eslicarbazepine works as a competitive blocker of the voltage gated sodium channels; unlike carbamazepine (CBZ) and oxcarbazepine (OXC), it has a lower affinity for the resting state of the channels, and reduces their availability by selectively enhancing slow inactivation. Efficacy and safety of ESL have been assessed in four randomized, Phase III clinical trials: the median relative reduction in standardized seizure frequency was 33.4% and 37.8% in the ESL 800 and 1,200 mg daily dose groups, and the responder rates were 33.8% and 43.1%, respectively. The incidence of treatment-emergent adverse events (TEAEs) increased with raising the dosage (ESL 400 mg: 63.8%, ESL 800 mg: 67.0%, ESL 1,200 mg: 73.1%). The TEAEs were generally mild to moderate in intensity, and the most common were dizziness, somnolence, headache and nausea. Open-label studies confirmed the findings from the pivotal trials and demonstrated sustained therapeutic effect of ESL over time and improvement of tolerability profile in patients switching from OXC/CBZ. No unexpected safety signals emerged over >5 years of follow-up. Once-daily adjunctive ESL at the doses of 800 and 1,200 mg was effective to reduce the seizure frequency and

  16. Analytical approach to linear fractional partial differential equations arising in fluid mechanics

    International Nuclear Information System (INIS)

    Momani, Shaher; Odibat, Zaid

    2006-01-01

    In this Letter, we implement relatively new analytical techniques, the variational iteration method and the Adomian decomposition method, for solving linear fractional partial differential equations arising in fluid mechanics. The fractional derivatives are described in the Caputo sense. The two methods in applied mathematics can be used as alternative methods for obtaining analytic and approximate solutions for different types of fractional differential equations. In these methods, the solution takes the form of a convergent series with easily computable components. The corresponding solutions of the integer order equations are found to follow as special cases of those of fractional order equations. Some numerical examples are presented to illustrate the efficiency and reliability of the two methods

  17. Identifying partial topology of complex dynamical networks via a pinning mechanism

    Science.gov (United States)

    Zhu, Shuaibing; Zhou, Jin; Lu, Jun-an

    2018-04-01

    In this paper, we study the problem of identifying the partial topology of complex dynamical networks via a pinning mechanism. By using the network synchronization theory and the adaptive feedback controlling method, we propose a method which can greatly reduce the number of nodes and observers in the response network. Particularly, this method can also identify the whole topology of complex networks. A theorem is established rigorously, from which some corollaries are also derived in order to make our method more cost-effective. Several numerical examples are provided to verify the effectiveness of the proposed method. In the simulation, an approach is also given to avoid possible identification failure caused by inner synchronization of the drive network.

  18. Mechanism of impaired regeneration of fatty liver in mouse partial hepatectomy model.

    Science.gov (United States)

    Murata, Hiroshi; Yagi, Takahito; Iwagaki, Hiromi; Ogino, Tetsuya; Sadamori, Hiroshi; Matsukawa, Hiroyoshi; Umeda, Yuzoh; Haga, Sanae; Takaka, Noriaki; Ozaki, Michitaka

    2007-12-01

    The mechanism of injury in steatotic liver under pathological conditions been extensively examined. However, the mechanism of an impaired regeneration is still not well understood. The aim of this study was to analyze the mechanism of impaired regeneration of steatotic liver after partial hepatectomy (PH). db/db fatty mice and lean littermates were used for the experiments. Following 70% PH, the survival rate and recovery of liver mass were examined. Liver tissue was histologically examined and analyzed by western blotting and RT-PCR. Of 35 db/db mice, 25 died within 48 h of PH, while all of the control mice survived. Liver regeneration of surviving db/db mice was largely impaired. In db/db mice, mitosis of hepatocytes after PH was disturbed, even though proliferating cell nuclear antigen (PCNA) expression (G1 to S phase marker) in hepatocytes was equally observed in both mice groups. Interestingly, phosphorylation of Cdc2 in db/db mice was suppressed by reduced expression of Wee1 and Myt1, which phosphorylate Cdc2 in S to G2 phase. In steatotic liver, cell-cycle-related proliferative disorders occurred at mid-S phase after PCNA expression. Reduced expression of Wee1 and Myt1 kinases may therefore maintain Cdc2 in an unphosphorylated state and block cell cycle progression in mid-S phase. These kinases may be critical factors involved in the impaired liver regeneration in fatty liver.

  19. [Modern aspects of epilepsy treatment].

    Science.gov (United States)

    Alajbegović, Azra; Kantardzić, Dzelaludin; Suljić, Enra; Alajbegović, Salem

    2003-01-01

    It is a general rule today, after a relevant diagnostics of an epilepsy, to start a monotherapy treatment, depending on a kind of a seizure, a life age and a general health condition. First line of monotherapy epilepsy drugs remain carbamazapine and sodium valproat. New drugs that are being introduced are: felbamat, gabapentin, lamotrigin, oxcarbazepin, tiagabin, topiramat, vigabatin and zanisamid. These are commonly used as add-on therapy, or as an addition for previously used antiepileptic. Their indicated areas are complex resistant partial seizures with or without generalization. Attention should be paid on proper dosage, interactions and toxicity. Regardless on the new epileptic era, according to reports of International League against epilepsy, most of the patients do not receive the drug that is the most appropriate for them concerning the price (cost-benefit). Neurosurgical methods in epilepsy treatment are: selective amygdalo-hyppocampotomy, temporal lobotomy, subpial resection, hemispherectomy, corpus callosotomy, removal of lesions like tumors or cysts provide encouraging results in reduction of epileptic seizures that can be followed by reduction of drug therapy. N. vagus stimulation is being wider introduced in resident epileptics. Treatment of epilepsy in women requires an approach to sexuality, conception, pregnancy, introduction of medicaments, antiepileptic terratogenity, contraception, motherhood and menopause. A special significance of modern approach to epilepsy is in treatment of elderly who have cerebrovascular and neurodegenerative disease as a cause of seizures. A complex treatment of epilepsy using pharmacological and neurosurgical approach requires supportive psychotherapy, socio-therapy, the work with a family, education about epilepsy and living a life with more quality having one.

  20. Anatomy-based reconstruction of FDG-PET images with implicit partial volume correction improves detection of hypometabolic regions in patients with epilepsy due to focal cortical dysplasia diagnosed on MRI

    International Nuclear Information System (INIS)

    Goffin, Karolien; Baete, Kristof; Nuyts, Johan; Laere, Koen van; Van Paesschen, Wim; Dupont, Patrick; Palmini, Andre

    2010-01-01

    Detection of hypometabolic areas on interictal FDG-PET images for assessing the epileptogenic zone is hampered by partial volume effects. We evaluated the performance of an anatomy-based maximum a-posteriori (A-MAP) reconstruction algorithm which combined noise suppression with correction for the partial volume effect in the detection of hypometabolic areas in patients with focal cortical dysplasia (FCD). FDG-PET images from 14 patients with refractory partial epilepsy were reconstructed using A-MAP and maximum likelihood (ML) reconstruction. In all patients, presurgical evaluation showed that FCD represented the epileptic lesion. Correspondence between the FCD location and regional metabolism on a predefined atlas was evaluated. An asymmetry index of FCD to normal cortex was calculated. Hypometabolism at the FCD location was detected in 9/14 patients (64%) using ML and in 10/14 patients (71%) using A-MAP reconstruction. Hypometabolic areas outside the FCD location were detected in 12/14 patients (86%) using ML and in 11/14 patients (79%) using A-MAP reconstruction. The asymmetry index was higher using A-MAP reconstruction (0.61, ML 0.49, p=0.03). The A-MAP reconstruction algorithm improved visual detection of epileptic FCD on brain FDG-PET images compared to ML reconstruction, due to higher contrast and better delineation of the lesion. This improvement failed to reach significance in our small sample. Hypometabolism outside the lesion is often present, consistent with the observation that the functional deficit zone tends to be larger than the epileptogenic zone. (orig.)

  1. Anatomy-based reconstruction of FDG-PET images with implicit partial volume correction improves detection of hypometabolic regions in patients with epilepsy due to focal cortical dysplasia diagnosed on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Goffin, Karolien; Baete, Kristof; Nuyts, Johan; Laere, Koen van [University Hospital Leuven, Division of Nuclear Medicine and Medical Imaging Center, Leuven (Belgium); Van Paesschen, Wim [University Hospital Leuven, Neurology Department, Leuven (Belgium); Dupont, Patrick [University Hospital Leuven, Division of Nuclear Medicine and Medical Imaging Center, Leuven (Belgium); University Hospital Leuven, Laboratory of Cognitive Neurology, Leuven (Belgium); Palmini, Andre [Pontificia Universidade Catolica do Rio Grande do Sul (PUCRS), Porto Alegre Epilepsy Surgery Program, Hospital Sao Lucas, Porto Alegre (Brazil)

    2010-06-15

    Detection of hypometabolic areas on interictal FDG-PET images for assessing the epileptogenic zone is hampered by partial volume effects. We evaluated the performance of an anatomy-based maximum a-posteriori (A-MAP) reconstruction algorithm which combined noise suppression with correction for the partial volume effect in the detection of hypometabolic areas in patients with focal cortical dysplasia (FCD). FDG-PET images from 14 patients with refractory partial epilepsy were reconstructed using A-MAP and maximum likelihood (ML) reconstruction. In all patients, presurgical evaluation showed that FCD represented the epileptic lesion. Correspondence between the FCD location and regional metabolism on a predefined atlas was evaluated. An asymmetry index of FCD to normal cortex was calculated. Hypometabolism at the FCD location was detected in 9/14 patients (64%) using ML and in 10/14 patients (71%) using A-MAP reconstruction. Hypometabolic areas outside the FCD location were detected in 12/14 patients (86%) using ML and in 11/14 patients (79%) using A-MAP reconstruction. The asymmetry index was higher using A-MAP reconstruction (0.61, ML 0.49, p=0.03). The A-MAP reconstruction algorithm improved visual detection of epileptic FCD on brain FDG-PET images compared to ML reconstruction, due to higher contrast and better delineation of the lesion. This improvement failed to reach significance in our small sample. Hypometabolism outside the lesion is often present, consistent with the observation that the functional deficit zone tends to be larger than the epileptogenic zone. (orig.)

  2. Ultrasonic and mechanical behavior of green and partially sintered alumina: Effects of slurry consolidation chemistry

    Energy Technology Data Exchange (ETDEWEB)

    Schilling, C.H.; Garcia, V.J.; Smith, R.M. [Ames Lab., IA (United States)]|[Iowa State Univ., Ames, IA (United States). Dept. of Materials Science and Engineering; Roberts, R.A. [Iowa State Univ., Ames, IA (United States)

    1998-10-01

    Green and partially sintered compacts of {alpha}-Al{sub 2}O{sub 3} powder were made by filtration of aqueous suspensions under three conditions: (i) electrostatic stabilization without any organic additive, (ii) strong flocculation near the isoelectric point without any organic additive, and (iii) weak flocculation by the use of maltodextrin or oxalic acid additives. The authors evaluated relationships between the macroscopic and interparticle mechanical behavior of these compacts using model correlations with measurements of diametral compression, ultrasonic velocity, and ultrasonic attenuation. Although type iii green specimens were less dense than type i, type iii exhibited significant increases in velocity, macroscopic Young`s modulus, interparticle-contact stiffness, and diametral compressive strength, suggesting that the mechanism of stiffening/strengthening entailed interparticle bridging of maltodextrin or oxalic acid. These properties were significantly reduced upon heating type iii specimens to 500 C, suggesting that pyrolysis of surface-adsorbed maltodextrin and oxalic acid may have reduced the interparticle stiffness and strength. In contrast, negligible changes in these properties occurred upon heating type i specimens to the same temperature. Despite small increases in packing density, significant decreases in attenuation and significant increases in velocity, interparticle-contact stiffness, and Young`s modulus occurred upon heating all specimens to {ge}700 C, suggesting the formation of interparticle necks by solid-state sintering.

  3. Managing Epilepsy

    Science.gov (United States)

    ... the person’s healthcare provider, and family and friends. What parents or caregivers can do Talk with your child’s heath care ... management resources for people with epilepsy and their caregivers. Learn more on our Find Support page . What can I do to keep my seizures in ...

  4. Vigabatrin in childhood epilepsy

    DEFF Research Database (Denmark)

    Uldall, P; Alving, J; Gram, L

    1995-01-01

    In an retrospective uncontrolled long-term study in 30 children with intractable epilepsy, it was found that treatment with vigabatrin resulted in a seizure reduction of more than 50% at 1-year follow-up in 40% of the children. The responders were all children with partial seizures. Side effects...... seizure-free patients were unsuccessful. No further side effects were observed. A study of evoked potentials in 12 children showed no alteration in latency and amplitudes of VEP following treatment with vigabatrin. Our results show that in children vigabatrin seems to have a stable effect even though...

  5. Partial monosomy Xq(Xq23 --> qter) and trisomy 4p(4p15.33 --> pter) in a woman with intractable focal epilepsy, borderline intellectual functioning, and dysmorphic features.

    Science.gov (United States)

    Bartocci, Arnaldo; Striano, Pasquale; Mancardi, Maria Margherita; Fichera, Marco; Castiglia, Lucia; Galesi, Ornella; Michelucci, Roberto; Elia, Maurizio

    2008-06-01

    Studies of epilepsy associated with chromosomal abnormalities may provide information about clinical and EEG phenotypes and possibly to identify new epilepsy genes. We describe a female patient with intractable focal epilepsy, borderline intellectual functioning, and facial dysmorphisms, in whom genetic study (i.e., karyotype and array-CGH analysis) revealed a distal trisomy 4p and distal monosomy Xq. Although any genetic hypothesis remains speculative, several genes are located in the 4p chromosome segment involved in the rearrangement, some of which may be related to epilepsy.

  6. American Epilepsy Society

    Science.gov (United States)

    ... for the AES Annual Meeting. More info here . Epilepsy Currents American Epilepsy Society Journal Impact Factor More ... P450 enzyme overexpression during spontaneous recurrent seizures More Epilepsy Professional News AES Status Epilepticus guideline for treatment ...

  7. Neuroreceptor imaging in epilepsy

    International Nuclear Information System (INIS)

    Frost, J.J.

    1991-01-01

    The neurochemical processes that mediate seizures in humans are not fully understood. PET has contributed to our understanding of the neurochemical abnormalities of epilepsy with studies of cerebral metabolism and, more recently, regional neuroreceptor binding. We have focused on inhibitory neurotransmitter receptors that may (1) be decreased, thus facilitating seizure initiation, or (2) increase in response to seizure activity. Opiate receptors are believed to mediate anticonvulsant effects of the endogenous opioids. Accordingly, [ 11 C]carfentanil, a ligand selective for the mu-opiate receptor, displays increased binding in temporal neocortex ipsilateral to seizure foci in complex partial epilepsy. This finding is consistent with activation of the endogenous opiate system in response to seizure activity. [ 11 C]diprenorphine, a ligand that labels mu-, delta- and kappa-opiate receptors with equal affinity, shows little or no change in temporal cortex. Together, these findings suggest a decrease in delta- or kappa-receptors. The development of delta- and kappa-selective receptor ligands will help to elucidate the involvement of these opiate receptors in human epilepsy. The benzodiazepine-GABA receptor complex is the most prevalent in mediating inhibitory brain processes. Use of the benzodiazepine (BZD) receptor ligand [ 11 C]RO 15-1788 has shown decreases in BZD receptors in human epilepsy in one study, but this has not been observed in a current study. Thus, the existence of reduced inhibitory processes that might enhance seizure initiation remains uncertain at present. Future studies of receptors for excitatory transmitters will provide additional insight into alternate factors potentially responsible for the initiation of seizures

  8. Anesthesia-induced epilepsy: causes and treatment.

    Science.gov (United States)

    Zhao, Xiaojuan; Wang, Xuefeng

    2014-09-01

    Epilepsy is a type of chronic brain disease that results from an abnormally high synchronization of neuronal discharge. The typical clinical features of epilepsy are paroxysms and transient and stereotyped brain dysfunction. Many cases of epileptic seizures occurring during anesthesia have been reportedx. Recently, risk assessment of epileptic seizures during surgery and anesthesia has gained increasing attention. In this review, we systematically summarize the influence of anesthesia on epileptic seizures; the types, durations and frequencies of seizures related to anesthesia; and the epidemiology, prevention, treatment and prognosis of epilepsy. We also explore the possible mechanism of epilepsy and provide guidance for anesthesia during surgeries.

  9. Statistical mechanics of normal grain growth in one dimension: A partial integro-differential equation model

    International Nuclear Information System (INIS)

    Ng, Felix S.L.

    2016-01-01

    We develop a statistical-mechanical model of one-dimensional normal grain growth that does not require any drift-velocity parameterization for grain size, such as used in the continuity equation of traditional mean-field theories. The model tracks the population by considering grain sizes in neighbour pairs; the probability of a pair having neighbours of certain sizes is determined by the size-frequency distribution of all pairs. Accordingly, the evolution obeys a partial integro-differential equation (PIDE) over ‘grain size versus neighbour grain size’ space, so that the grain-size distribution is a projection of the PIDE's solution. This model, which is applicable before as well as after statistically self-similar grain growth has been reached, shows that the traditional continuity equation is invalid outside this state. During statistically self-similar growth, the PIDE correctly predicts the coarsening rate, invariant grain-size distribution and spatial grain size correlations observed in direct simulations. The PIDE is then reducible to the standard continuity equation, and we derive an explicit expression for the drift velocity. It should be possible to formulate similar parameterization-free models of normal grain growth in two and three dimensions.

  10. Modelling the mechanics of partially mineralized collagen fibrils, fibres and tissue

    Science.gov (United States)

    Liu, Yanxin; Thomopoulos, Stavros; Chen, Changqing; Birman, Victor; Buehler, Markus J.; Genin, Guy M.

    2014-01-01

    Progressive stiffening of collagen tissue by bioapatite mineral is important physiologically, but the details of this stiffening are uncertain. Unresolved questions about the details of the accommodation of bioapatite within and upon collagen's hierarchical structure have posed a central hurdle, but recent microscopy data resolve several major questions. These data suggest how collagen accommodates bioapatite at the lowest relevant hierarchical level (collagen fibrils), and suggest several possibilities for the progressive accommodation of bioapatite at higher hierarchical length scales (fibres and tissue). We developed approximations for the stiffening of collagen across spatial hierarchies based upon these data, and connected models across hierarchies levels to estimate mineralization-dependent tissue-level mechanics. In the five possible sequences of mineralization studied, percolation of the bioapatite phase proved to be an important determinant of the degree of stiffening by bioapatite. The models were applied to study one important instance of partially mineralized tissue, which occurs at the attachment of tendon to bone. All sequences of mineralization considered reproduced experimental observations of a region of tissue between tendon and bone that is more compliant than either tendon or bone, but the size and nature of this region depended strongly upon the sequence of mineralization. These models and observations have implications for engineered tissue scaffolds at the attachment of tendon to bone, bone development and graded biomimetic attachment of dissimilar hierarchical materials in general. PMID:24352669

  11. PDGFB partial deletion: a new, rare mechanism causing brain calcification with leukoencephalopathy.

    Science.gov (United States)

    Nicolas, Gaël; Rovelet-Lecrux, Anne; Pottier, Cyril; Martinaud, Olivier; Wallon, David; Vernier, Louis; Landemore, Gérard; Chapon, Françoise; Prieto-Morin, Carol; Tournier-Lasserve, Elisabeth; Frébourg, Thierry; Campion, Dominique; Hannequin, Didier

    2014-06-01

    Idiopathic basal ganglia calcification (IBGC) is a progressive cerebral disorder with diverse motor, cognitive, and psychiatric expression. It is inherited as an autosomal dominant trait. Three IBGC-causing genes have been identified in the past 2 years: SLC20A2, PDGFRB, and PDGFB. Biological and genetic evidence showed that loss of function of either SLC20A2 or the PDGFB/PDGFRB pathway was the mechanism underlying calcification in patients with a mutation. Recently, in a study focusing on SLC20A2, a large deletion at this locus was reported. No study has systematically searched for copy number variants (CNV) involving these three genes. We designed a quantitative PCR assay of multiple short fluorescent fragments (QMPSF) to detect CNVs involving one of these three genes in a single assay. Among the 27 unrelated patients from our IBGC case series with no mutation in SLC20A2, PDGFRB, and PDGFB, we identified in one patient a heterozygous partial deletion involving exons 2 to 5 of PDGFB. This patient exhibited both strio-pallido-dentate calcification and white matter hyperintensity of presumed vascular origin, associated with mood disorder, subtle cognitive decline, and gait disorder. We confirmed by RT-PCR experiments that the allele carrying the deletion was transcribed. The resulting cDNA lacks sequence for several critical functional domains of the protein. Intragenic deletion of PDGFB is a new and rare mechanism causing IBGC. CNVs involving the three IBGC-causing genes should be investigated in patients with no point mutation.

  12. Abdominal epilepsy

    International Nuclear Information System (INIS)

    Hasan, N.; Razzaq, A.

    2004-01-01

    Abdominal epilepsy (AE) is a rather uncommon clinical entity in children that might create diagnostic confusion especially when it lacks the typical manifestations of an epileptic seizure. We report the case of a young boy having apparently unexplained episodes of paroxysmal abdominal symptoms with no other suggestion of an underlying epileptic disorder. The case also explains how the clinical presentation can be misleading unless a high index of suspicion is maintained to reach the ultimate diagnosis. (author)

  13. MR contribution in surgery of epilepsy

    International Nuclear Information System (INIS)

    Meiners, L.C.; Valk, J.; Jansen, G.H.; Veelen, C.W.M. van

    1999-01-01

    The contribution of MR imaging in patients with drug-resistant epilepsy considered for surgical therapy is discussed. In this review we focus on: (a) focal abnormalities (mesial temporal sclerosis, focal migration disorders, hamartomatous lesions and low-grade tumours, phakomatosis and vascular malformations) associated with therapy-resistant partial epilepsy, requiring resective surgery; (b) abnormalities leading to generalized seizures that require more drastic surgical procedures, such as callosotomy and functional hemispherectomy; and (c) localisation of implanted depth-electrodes. (orig.)

  14. Common comorbidity of epilepsy: a review of new progress

    Directory of Open Access Journals (Sweden)

    YANG Xue

    2012-10-01

    Full Text Available A range of medical and neurologic disorders occurs more frequently in people with epilepsy than in the general population and constitutes somatic comorbidity. Common examples include migraine, depression, schizophrenia, attention-deficit hyperactivity disorder (ADHD, sleep disorder, cognitive damage, developmental abnormality and so on. There are more interesting clinical features in some special types of patients with benign epilepsy of childhood with centrotemporal spikes (BECT, temporal epilepsy and mitochondrial encephalomyopathy. The association between epilepsy and other conditions can be due to a variety of interacting genetic, biologic structural, functional, pharmacological and environmental factors. Co-existence of other disorders in a person with epilepsy can complicate diagnosis, induce adverse prognostic implications and attenuate health?related quality of life. Therefore, recognition and management of comorbidity of epilepsy may facilitate the treatment of epilepsy. In this article, we review recent pathophysiologic and clinical studies to elucidate the etiology, mechanisms, clinical characteristics, differential diagnosis and treatment of common comorbidity of epilepsy.

  15. Hereditary epilepsy syndromes

    NARCIS (Netherlands)

    Callenbach, PMC; Brouwer, OF

    This paper reviews the present knowledge on the genetics of the epilepsies. Main clinical features, gene localization and pattern of inheritance of the idiopathic epilepsies, the progressive myoclonus epilepsies, and some other genetic disorders often associated with epilepsy, are described. (C)

  16. Dietary Therapies for Epilepsy

    Directory of Open Access Journals (Sweden)

    Eric H Kossoff

    2013-02-01

    Full Text Available Since their introduction in 1921, high-fat, low-carbohydrate "ketogenic" diets have been used worldwide for refractory childhood epilepsy. Approximately half of the children have at least half their seizures reduced, including 15% who are seizure free. The mechanisms of action of dietary therapies are under active investigation and appear to involve mitochondria. Once perceived as a last resort, modifications to initiation and maintenance, as well as the widespread use of pre-made ketogenic formulas have allowed dietary treatment to be used earlier in the course of epilepsy. For infantile spasms (West syndrome specifically, the ketogenic diet is successful about 50% of the time as a first-line treatment. New "alternative" diets such as the modified Atkins diet were created in 2003 and can be started more easily and are less restrictive. They may have particular value for countries in Asia. Side effects include constipation, dyslipidemia, growth slowing, acidosis, and kidney stones. Additionally, neurologists are studying ketogenic diets for conditions other than epilepsy, including Alzheimer's disease, autism, and brain tumors.

  17. Prevalence of Psychopathology in Childhood Epilepsy: Categorical and Dimensional Measures

    Science.gov (United States)

    Dunn, David W.; Austin, Joan K.; Perkins, Susan M.

    2009-01-01

    Few studies have utilized both categorical and dimensional measures of psychopathology in children with epilepsy. We evaluated 173 children (88 males, 85 females; mean age 11.7y [SD 1.8]; range 9-14y) who had epilepsy (generalized 36%, partial 61%) for at least 6 months. The primary caregiver completed a dimensional measure, the Child Behavior…

  18. The influence of partial oxidation mechanisms on tar destruction in TwoStage biomass gasification

    DEFF Research Database (Denmark)

    Ahrenfeldt, Jesper; Egsgaard, Helge; Stelte, Wolfgang

    2013-01-01

    adsorption and determined by stable isotope dilution analysis. The results have shown that partial oxidation reduces and converts primary tars into low molecular weight, polycyclic aromatic hydrocarbons (PAHs), primarily naphthalene. At temperatures above 950°C practically all phenol is converted...

  19. Hydrologic mechanisms governing fluid flow in partially saturated, fractured, porous tuff at Yucca Mountain

    International Nuclear Information System (INIS)

    Wang, J.S.Y.; Narasimhan, T.N.

    1984-10-01

    In contrast to the saturated zone where fluid moves rapidly along fractures, the fractures (with apertures large relative to the size of matrix pores) will desaturate first during drainage process and the bulk of fluid flow would be through interconnected pores in the matrix. Within a partially drained fracture, the presence of a relatively continuous air phase will produce practically an infinite resistance to liquid flow in the direction parallel to the fracture. The residual liquid will be held by capillary force in regions around fracture contact areas where the apertures are small. Normal to the fracture surfaces, the drained portion of the fractures will reduce the effective area for liquid flow from one matrix block to another matrix block. A general statistical theory is constructed for flow along the fracture and for flow between the matrix blocks to the fractures under partially saturated conditions. Results are obtained from an aperture distribution model for fracture saturation, hydraulic conductivity, and effective matrix-fracture flow areas as functions of pressure. Drainage from a fractured tuff column is simulated. The parameters for the simulations are deduced from fracture surface characteristics, spacings and orientations based on core analyses, and from matrix characteristics curve based on laboratory measurements. From the cases simulated for the fractured, porous column with discrete vertical and horizontal fractures and porous matrix blocks explicitly taken into account, it is observed that the highly transient changes from fully saturated conditions to partially saturated conditions are extremely sensitive to the fracture properties. However, the quasi-steady changes of the fluid flow of a partially saturated, fractured, porous system could be approximately simulated without taking the fractures into account. 22 references, 16 figures

  20. Vigabatrin in childhood epilepsy

    DEFF Research Database (Denmark)

    Uldall, P; Alving, J; Gram, L

    1995-01-01

    In an retrospective uncontrolled long-term study in 30 children with intractable epilepsy, it was found that treatment with vigabatrin resulted in a seizure reduction of more than 50% at 1-year follow-up in 40% of the children. The responders were all children with partial seizures. Side effects...... were mild and did not lead to discontinuation of the drug. Increased numbers of seizures were seen in three cases. A moderate weight increase was seen in 27% of the children. At 5-year follow-up 7 children (23%) still maintained a seizure reduction of more than 50%. Trials of monotherapy in three...... seizure-free patients were unsuccessful. No further side effects were observed. A study of evoked potentials in 12 children showed no alteration in latency and amplitudes of VEP following treatment with vigabatrin. Our results show that in children vigabatrin seems to have a stable effect even though...

  1. Cognition and dementia in older patients with epilepsy

    Science.gov (United States)

    Sen, Arjune; Capelli, Valentina

    2018-01-01

    Abstract With advances in healthcare and an ageing population, the number of older adults with epilepsy is set to rise substantially across the world. In developed countries the highest incidence of epilepsy is already in people over 65 and, as life expectancy increases, individuals who developed epilepsy at a young age are also living longer. Recent findings show that older persons with epilepsy are more likely to suffer from cognitive dysfunction and that there might be an important bidirectional relationship between epilepsy and dementia. Thus some people with epilepsy may be at a higher risk of developing dementia, while individuals with some forms of dementia, particularly Alzheimer’s disease and vascular dementia, are at significantly higher risk of developing epilepsy. Consistent with this emerging view, epidemiological findings reveal that people with epilepsy and individuals with Alzheimer’s disease share common risk factors. Recent studies in Alzheimer’s disease and late-onset epilepsy also suggest common pathological links mediated by underlying vascular changes and/or tau pathology. Meanwhile electrophysiological and neuroimaging investigations in epilepsy, Alzheimer’s disease, and vascular dementia have focused interest on network level dysfunction, which might be important in mediating cognitive dysfunction across all three of these conditions. In this review we consider whether seizures promote dementia, whether dementia causes seizures, or if common underlying pathophysiological mechanisms cause both. We examine the evidence that cognitive impairment is associated with epilepsy in older people (aged over 65) and the prognosis for patients with epilepsy developing dementia, with a specific emphasis on common mechanisms that might underlie the cognitive deficits observed in epilepsy and Alzheimer’s disease. Our analyses suggest that there is considerable intersection between epilepsy, Alzheimer’s disease and cerebrovascular disease raising

  2. The effect of various quantum mechanically derived partial atomic charges on the bulk properties of chloride-based ionic liquids

    Energy Technology Data Exchange (ETDEWEB)

    Zolghadr, Amin Reza, E-mail: arzolghadr@shirazu.ac.ir [Department of Chemistry, Shiraz University, Shiraz 71946-84795 (Iran, Islamic Republic of); Ghatee, Mohammad Hadi [Department of Chemistry, Shiraz University, Shiraz 71946-84795 (Iran, Islamic Republic of); Moosavi, Fatemeh [Department of Chemistry, Ferdowsi University of Mashhad, Mashhad 91779 (Iran, Islamic Republic of)

    2016-08-22

    Partial atomic charges using various quantum mechanical calculations for [C{sub n}mim]Cl (n = 1, 4) ionic liquids (ILs) are obtained and used for development of molecular dynamics simulation (MD) force fields. The isolated ion pairs are optimized using HF, B3LYP, and MP2 methods for electronic structure with 6-311++G(d,p) basis set. Partial atomic charges are assigned to the atomic center with CHELPG and NBO methods. The effect of these sets of partial charges on the static and dynamic properties of ILs is evaluated by performing a series of MD simulations and comparing the essential thermodynamic properties with the available experimental data and available molecular dynamics simulation results. In contrast to the general trends reported for ionic liquids with BF{sub 4}, PF{sub 6}, and iodide anions (in which restrained electrostatic potential (RESP) charges are preferred), partial charges derived by B3LYP-NBO method are relatively good in prediction of the structural, dynamical, and thermodynamic energetic properties of the chloride based ILs.

  3. The N Terminus of the Retinoblastoma Protein Inhibits DNA Replication via a Bipartite Mechanism Disrupted in Partially Penetrant Retinoblastomas

    Science.gov (United States)

    Borysov, Sergiy I.; Nepon-Sixt, Brook S.

    2015-01-01

    The N-terminal domain of the retinoblastoma (Rb) tumor suppressor protein (RbN) harbors in-frame exon deletions in partially penetrant hereditary retinoblastomas and is known to impair cell growth and tumorigenesis. However, how such RbN deletions contribute to Rb tumor- and growth-suppressive functions is unknown. Here we establish that RbN directly inhibits DNA replication initiation and elongation using a bipartite mechanism involving N-terminal exons lost in cancer. Specifically, Rb exon 7 is necessary and sufficient to target and inhibit the replicative CMG helicase, resulting in the accumulation of inactive CMGs on chromatin. An independent N-terminal loop domain, which forms a projection, specifically blocks DNA polymerase α (Pol-α) and Ctf4 recruitment without affecting DNA polymerases ε and δ or the CMG helicase. Individual disruption of exon 7 or the projection in RbN or Rb, as occurs in inherited cancers, partially impairs the ability of Rb/RbN to inhibit DNA replication and block G1-to-S cell cycle transit. However, their combined loss abolishes these functions of Rb. Thus, Rb growth-suppressive functions include its ability to block replicative complexes via bipartite, independent, and additive N-terminal domains. The partial loss of replication, CMG, or Pol-α control provides a potential molecular explanation for how N-terminal Rb loss-of-function deletions contribute to the etiology of partially penetrant retinoblastomas. PMID:26711265

  4. Listening to Epilepsy.

    Science.gov (United States)

    Brunquell, Phillip J.

    1994-01-01

    This paper discusses what epilepsy is and what it is not, defines types of epileptic seizures, identifies epilepsy syndromes, discusses antiepileptic drugs, describes seizure surgery, and examines issues of quality of life. (JDD)

  5. Multimodality Data Integration in Epilepsy

    Directory of Open Access Journals (Sweden)

    Otto Muzik

    2007-01-01

    Full Text Available An important goal of software development in the medical field is the design of methods which are able to integrate information obtained from various imaging and nonimaging modalities into a cohesive framework in order to understand the results of qualitatively different measurements in a larger context. Moreover, it is essential to assess the various features of the data quantitatively so that relationships in anatomical and functional domains between complementing modalities can be expressed mathematically. This paper presents a clinically feasible software environment for the quantitative assessment of the relationship among biochemical functions as assessed by PET imaging and electrophysiological parameters derived from intracranial EEG. Based on the developed software tools, quantitative results obtained from individual modalities can be merged into a data structure allowing a consistent framework for advanced data mining techniques and 3D visualization. Moreover, an effort was made to derive quantitative variables (such as the spatial proximity index, SPI characterizing the relationship between complementing modalities on a more generic level as a prerequisite for efficient data mining strategies. We describe the implementation of this software environment in twelve children (mean age 5.2±4.3 years with medically intractable partial epilepsy who underwent both high-resolution structural MR and functional PET imaging. Our experiments demonstrate that our approach will lead to a better understanding of the mechanisms of epileptogenesis and might ultimately have an impact on treatment. Moreover, our software environment holds promise to be useful in many other neurological disorders, where integration of multimodality data is crucial for a better understanding of the underlying disease mechanisms.

  6. Epilepsy and astrocyte energy metabolism.

    Science.gov (United States)

    Boison, Detlev; Steinhäuser, Christian

    2018-06-01

    Epilepsy is a complex neurological syndrome characterized by neuronal hyperexcitability and sudden, synchronized electrical discharges that can manifest as seizures. It is now increasingly recognized that impaired astrocyte function and energy homeostasis play key roles in the pathogenesis of epilepsy. Excessive neuronal discharges can only happen, if adequate energy sources are made available to neurons. Conversely, energy depletion during seizures is an endogenous mechanism of seizure termination. Astrocytes control neuronal energy homeostasis through neurometabolic coupling. In this review, we will discuss how astrocyte dysfunction in epilepsy leads to distortion of key metabolic and biochemical mechanisms. Dysfunctional glutamate metabolism in astrocytes can directly contribute to neuronal hyperexcitability. Closure of astrocyte intercellular gap junction coupling as observed early during epileptogenesis limits activity-dependent trafficking of energy metabolites, but also impairs clearance of the extracellular space from accumulation of K + and glutamate. Dysfunctional astrocytes also increase the metabolism of adenosine, a metabolic product of ATP degradation that broadly inhibits energy-consuming processes as an evolutionary adaptation to conserve energy. Due to the critical role of astroglial energy homeostasis in the control of neuronal excitability, metabolic therapeutic approaches that prevent the utilization of glucose might represent a potent antiepileptic strategy. In particular, high fat low carbohydrate "ketogenic diets" as well as inhibitors of glycolysis and lactate metabolism are of growing interest for the therapy of epilepsy. © 2017 Wiley Periodicals, Inc.

  7. Mechanical Properties of Portland Cement Concrete With Recycled Asphalt Pavement as Partial Replacement for Coarse Aggregate

    Science.gov (United States)

    2016-06-01

    Finding constructive uses for construction waste byproducts contributes to green engineering principles. One such plentiful material is recycled asphalt pavement (RAP). This report looks at the mechanical viability of including RAP in a high strength...

  8. Effect of polyester fiber reinforcement on the mechanical properties of interim fixed partial dentures

    Directory of Open Access Journals (Sweden)

    N. Gopichander

    2015-10-01

    Conclusion: Within the limitations of this study, polyester fiber reinforcements improved the mechanical properties of heat-polymerized PMMA, cold-polymerized PMMA, and bis-acrylic provisional FPD materials.

  9. International veterinary epilepsy task force consensus proposal

    DEFF Research Database (Denmark)

    Potschka, Heidrun; Fischer, Andrea; Löscher, Wolfgang

    2015-01-01

    Common criteria for the diagnosis of drug resistance and the assessment of outcome are needed urgently as a prerequisite for standardized evaluation and reporting of individual therapeutic responses in canine epilepsy. Thus, we provide a proposal for the definition of drug resistance and partial ...

  10. Acquired partial lipodystrophy and C3 glomerulopathy: Dysregulation of the complement system as a common mechanism

    Directory of Open Access Journals (Sweden)

    Fernando Corvillo

    2018-05-01

    Full Text Available The activation of the alternative pathway of the complement is involved in the development of several renal diseases, such as atypical haemolytic uraemic syndrome and C3 glomerulopathy. In C3 glomerulopathy, a high percentage of patients have circulating levels of the autoantibody called C3NeF, which causes systemic dysregulation of the complement system. In some cases, the presence of this antibody has been related with abnormalities of adipose tissue, causing acquired partial lipodystrophy (Barraquer–Simons syndrome. Acquired partial lipodystrophy is an extremely rare disorder affecting the distribution of subcutaneous adipose tissue and that mainly onsets during childhood. These patients, in addition to possibly presenting with all the metabolic disorders associated with the adipose tissue defect, present with C3 hypocomplementemia and C3NeF and 25% have developed C3 glomerulopathy. Although it has been known for some time how the dysregulation of the complement system affects the kidneys, it remains unknown how it exactly affects adipose tissue; nevertheless, the relationship is quite clear. In this paper, we describe the connection between the complement system with the biology of the adipose tissue and its pathogenesis reflected from acquired partial lipodystrophy. Resumen: La activación de la vía alternativa del complemento interviene en el desarrollo de varias enfermedades renales, como el síndrome hemolítico urémico atípico o la glomerulopatía C3. En esta última enfermedad un elevado porcentaje de los pacientes presentan niveles circulantes de un autoanticuerpo denominado C3NeF, causante de la desregulación del complemento a nivel sistémico. En ciertos casos, la presencia de este anticuerpo se asocia con alteraciones en el tejido adiposo, causando lipodistrofia parcial adquirida (síndrome de Barraquer-Simons, una enfermedad ultra-rara que afecta a la distribución del tejido adiposo subcutáneo y que comienza principalmente

  11. Compensatory Paracrine Mechanisms That Define The Urothelial Response to Injury in Partial Bladder Outlet Obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Bassuk, James; Lendvay, Thomas S.; Sweet, Robert; Han, Chang-Hee; Soygur, Tarkan; Cheng, Jan-Fang; Plaire, J. Chadwick; Charleston, Jay S.; Charleston, Lynne B.; Bagai, Shelly; Cochrane, Kimberly; Rubio, Eric; Bassuk, James A.; Fuchs, Elaine

    2007-06-21

    Diseases and conditions affecting the lower urinary tract are a leading cause of dysfunctional sexual health, incontinence, infection, and kidney failure. The growth, differentiation, and repair of the bladder's epithelial lining are regulated, in part, by fibroblast growth factor (FGF)-7 and -10 via a paracrine cascade originating in the mesenchyme (lamina propria) and targeting the receptor for FGF-7 and -10 within the transitional epithelium (urothelium). The FGF-7 gene is located at the 15q15-q21.1 locus on chromosome 15 and four exons generate a 3.852-kb mRNA. Five duplicated FGF-7 gene sequences that localized to chromosome 9 were predicted not to generate functional protein products, thus validating the use of FGF-7-null mice as an experimental model. Recombinant FGF-7 and -10 induced proliferation of human urothelial cells in vitro and transitional epithelium of wild-type and FGF-7-null mice in vivo.To determine the extent that induction of urothelial cell proliferation during the bladder response to injury is dependent on FGF-7, an animal model of partial bladder outlet obstruction was developed. Unbiased stereology was used to measure the percentage of proliferating urothelial cells between obstructed groups of wild-type and FGF-7-null mice. The stereological analysis indicated that a statistical significant difference did not exist between the two groups, suggesting that FGF-7 is not essential for urothelial cell proliferation in response to partial outlet obstruction. In contrast, a significant increase in FGF-10 expression was observed in the obstructed FGF-7-null group, indicating that the compensatory pathway that functions in this model results in urothelial repair.

  12. Memory Functioning in Children with Epilepsy: Frontal Lobe Epilepsy, Childhood Absence Epilepsy, and Benign Epilepsy with Centrotemporal Spikes

    OpenAIRE

    Lopes, Ana Filipa; Monteiro, José Paulo; Fonseca, Maria José; Robalo, Conceição; Simões, Mário Rodrigues

    2014-01-01

    Specific cognitive deficits have been identified in children with epilepsy irrespective of results on intelligence tests. Memory deficits are traditionally attributed to temporal lobe epilepsy, whereas the impact of frontal lobe epilepsy on memory functions has remained controversial. The aim of this study was the examination of memory abilities in other childhood common epilepsy syndromes (frontal lobe epilepsy (FLE), childhood absence epilepsy (CAE), and benign epilepsy with centrotemporal ...

  13. Neurostimulation as a promising epilepsy therapy.

    Science.gov (United States)

    Lin, Yicong; Wang, Yuping

    2017-12-01

    The revolution in theory, swift technological developments, and invention of new devices have driven tremendous progress in neurostimulation as a third-line treatment for epilepsy. Over the past decades, neurostimulation took its place in the field of epilepsy as an advanced treatment technique and opened up a new world. Numerous animal studies have proven the physical efficacy of stimulation of the brain and peripheral nerves. Based on this optimistic fundamental research, new advanced techniques are being explored in clinical practice. Over the past century, drawing on the benefits brought about by vagus nerve stimulation for the treatment of epilepsy, various new neurostimulation modalities have been developed to control seizures. Clinical studies including case reports, case series, and clinical trials have been booming in the past several years. This article gives a comprehensive review of most of these clinical studies. In addition to highlighting the advantages of neurostimulation for the treatment of epilepsy, concerns with this modality and future development directions are also discussed. The biggest advantage of neurostimulation over pharmacological treatments for epilepsy is the modulation of the epilepsy network by delivering stimuli at a specific target or the "hub." Conversely, however, a lack of knowledge of epilepsy networks and the mechanisms of neurostimulation may hinder further development. Therefore, theoretical research on the mechanism of epileptogenesis and epilepsy networks is needed in the future. Within the multiple modalities of neuromodulation, the final choice should be made after full discussion with a multidisciplinary team at a presurgical conference. Furthermore, the establishment of a neurostimulation system with standardized parameters and rigorous guidelines is another important issue. To achieve this goal, a worldwide collaboration of epilepsy centers is also suggested in the future.

  14. Analysis of clinical and imaging characters and prognosis in patients with epilepsy after stroke

    International Nuclear Information System (INIS)

    Huang Yongguang; Zeng Huiliang

    2003-01-01

    Objective: To evaluate the relationship between clinical, imaging characters and prognosis in patients with epilepsy after stroke. Methods: In total 78 cases of post-stroke epilepsy were studied retrospectively out of 840 cases. Results: The incidence of post-stroke epilepsy was 9.29%. The early-stage epilepsy (less than 2 weeks) accounted for 61.54%. The major type of seizure were partial seizure and general tonic-clonic seizure. The incidence was higher in patients with cerebral hemorrhage or with lesions involving the cortex. Symptomatolytic medication was effective. Compared with non-epilepsy group, the mortality of epilepsy was higher. Conclusion: Post-stroke epilepsy is usually accompanied with cortical focus, which is more often seen in patients with cerebral hemorrhage than in patients with cerebral infarction. Post-stroke epilepsy responses well to the medication but indicates a poor prognosis

  15. How predictive are photosensitive epilepsy models as proof of principle trials for epilepsy?

    Science.gov (United States)

    Yuen, Eunice S M; Sims, John R

    2014-06-01

    Human photosensitive epilepsy models have been used as proof of principle (POP) trials for epilepsy. Photosensitive patients are exposed to intermittent photic stimulation and the reduction in sensitivity to the number of standard visual stimulation frequencies is used as an endpoint. The aim of this research was to quantify the predictive capabilities of photosensitive POP trials, through a survey of current literature. A literature search was undertaken to identify articles describing photosensitive POP trials. Minimally efficacious doses (MEDs) in epilepsy were compared to doses in the POP trials that produced 50-100% response (ED50-100). Ratios of these doses were calculated and summarised statistically. The search identified ten articles describing a total of 17 anti-epileptic drugs. Of these, data for both MED and ED50-100 were available for 13 anti-epileptic drugs. The average ratio of MED to ED50-100 was 0.95 (95% CI 0.60-1.30). The difference in MED to ED50-100 ratios between partial epilepsy (0.82) was not significantly different from that of generalised epilepsy (1.08) (p=0.51). Photosensitive POP trials are a useful tool to quantitatively predict efficacy in epilepsy, and can be useful as early and informative indicators in anti-epileptic drug discovery and development. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  16. Persistent Interictal Musical Hallucination in a Patient With Mesial Temporal Sclerosis-Related Epilepsy: First Case Report and Etiopathological Hypothesis.

    Science.gov (United States)

    Borelli, Paolo; Vedovello, Marcella; Braga, Massimiliano; Pederzoli, Massimo; Beretta, Sandro

    2016-12-01

    Musical hallucination is a disorder of complex sound processing of instrumental music, songs, choirs, chants, etc. The underlying pathologies include moderate to severe acquired hearing loss (the auditory equivalent of Charles Bonnet syndrome), psychiatric illnesses (depression, schizophrenia), drug intoxication (benzodiazepines, salicylate, pentoxifylline, propranolol), traumatic lesions along the acoustic pathways, and epilepsy. The hallucinations are most likely to begin late in life; 70% of patients are women. Musical hallucination has no known specific therapy. Treating the underlying cause is the most effective approach; neuroleptic and antidepressant medications have only rarely succeeded.Musical hallucination in epilepsy typically presents as simple partial seizures originating in the lateral temporal cortex. To our knowledge, no formal report of musical hallucination in the interictal state has been published before. In contrast, other interictal psychotic features are a relatively common complication, especially in patients with long-standing drug-resistant epilepsy.We describe a 62-year-old woman with a long history of mesial temporal lobe epilepsy whose musical hallucination was solely interictal. We speculate on the possible link between temporal epilepsy and her hallucination. We hypothesize that, as a result of her epileptic activity-induced damage, an imbalance developed between the excitatory and inhibitory projections connecting the mesial temporal cortex to the other auditory structures. These structures may have generated hyperactivity in the lateral temporal cortex through a "release" mechanism that eventually resulted in musical hallucination.

  17. Plasma-assisted partial oxidation of methane at low temperatures: numerical analysis of gas-phase chemical mechanism

    Energy Technology Data Exchange (ETDEWEB)

    Goujard, Valentin; Nozaki, Tomohiro; Yuzawa, Shuhei; Okazaki, Ken [Department of Mechanical and Control Engineering, Tokyo Institute of Technology, 2-12-1 O-okayama, Meguro, 1528552, Tokyo (Japan); Agiral, Anil, E-mail: tnozaki@mech.titech.ac.jp [Mesoscale Chemical Systems, MESA Institute for Nanotechnology, Faculty of Science and Technology, University of Twente, PO Box 217, 7500 AE, Enschede (Netherlands)

    2011-07-13

    Methane partial oxidation was investigated using a plasma microreactor. The experiments were performed at 5 and 300 deg. C. Microreactor configuration allows an efficient evacuation of the heat generated by methane partial oxidation and dielectric barrier discharges, allowing at the same time a better temperature control. At 5 deg. C, liquid condensation of low vapour pressure compounds, such as formaldehyde and methanol, occurs. {sup 1}H-NMR analysis allowed us to demonstrate significant CH{sub 3}OOH formation during plasma-assisted partial oxidation of methane. Conversion and product selectivity were discussed for both temperatures. In the second part of this work, a numerical simulation was performed and a gas-phase chemical mechanism was proposed and discussed. From the comparison between the experimental results and the simulation it was found that CH{sub 3}OO{center_dot} formation has a determinant role in oxygenated compound production, since its fast formation disfavoured radical recombination. At 5 deg. C the oxidation leads mainly towards oxygenated compound formation, and plasma dissociation was the major phenomenon responsible for CH{sub 4} conversion. At 300 deg. C, higher CH{sub 4} conversion resulted from oxidative reactions induced by {center_dot}OH radicals with a chemistry predominantly oxidative, producing CO, H{sub 2}, CO{sub 2} and H{sub 2}O.

  18. Epilepsy, Cognition, and Behavior: The clinical picture

    Science.gov (United States)

    Berg, Anne T.

    2010-01-01

    Although epilepsy is defined by the occurrence of spontaneous epileptic seizures, a large body of evidence indicates that epilepsy is linked to a spectrum behavioral, psychiatric, and cognitive disorders as well as to sudden death. Explanations for these associations include: (1) The effects of structural lesions which may impair the functions subserved by the regions of the brain involved in the lesion. (2) The effects of seizure activity which may begin well before a clinical seizure occurs and may persist long after it is over raising questions about what truly constitutes “interictal.” In addition, encephalopathic effects of epilepsy in infancy during critical periods in development may be particularly severe and potentially irreversible. (3) Shared mechanisms underlying seizures as well as these other disorders in the absence of structural lesions or separate diseases of the CNS. Epidemiological and clinical studies demonstrate the elevated risk of cognitive, psychiatric, and behavioral disorders not just during but also prior to the onset of epilepsy (seizures) itself. These may outlast the active phase of epilepsy as well. The mounting evidence argues strongly for the recognition of epilepsy as part of a spectrum of disorders and against the notion that even uncomplicated epilepsy can a priori be considered benign. PMID:21214534

  19. Mechanical properties of partially pyrolysed composites with plain weave basalt fibre reinforcement

    Czech Academy of Sciences Publication Activity Database

    Černý, Martin; Halasová, Martina; Schweigstillová, Jana; Chlup, Zdeněk; Sucharda, Zbyněk; Glogar, Petr; Svítilová, Jaroslava; Strachota, Adam; Rýglová, Šárka

    2014-01-01

    Roč. 40, č. 5 (2014), s. 7507-7521 ISSN 0272-8842 R&D Projects: GA ČR GAP107/12/2445 Institutional support: RVO:67985891 ; RVO:68081723 ; RVO:61389013 Keywords : mechanical properties * ceramic-matrix composites * fracture toughness * heat treatment Subject RIV: JI - Composite Materials Impact factor: 2.605, year: 2014

  20. Application of the DC potential drop and the partial unloading methods to fracture mechanics tests

    International Nuclear Information System (INIS)

    Heerens, J.; Schwalbe, K.H.; Hellmann, D.; Knaack, J.; Mueller-Roos, J.

    1985-01-01

    The ability of the DC potential drop method and the partial unloading technique to measure crack growth and to detect initation of crack growth has been investigated using a number of steels and aluminium alloys. It was found that within the range of parameters investigated both of these methods can be recommended for the determination of the R-curve; however, since at small amounts of crack growth the DC potential drop method gave more consistent results it is therefore considered to be superior. The initation values J(0) of J determined by fractography were compared with J(Ic) as obtained by current practice. It was found that J(Ic) is poorly related to initation or to specific amount of crack growth. A modification of the J(Ic) procedure is proposed. Two contacting arrangements of the DC potential drop method were checked for initation detection: one indicates initation by a potential minimum (related to a J value J(min)), the other by the intersection of the R-curve with the blunting line (related to a J value J(int)). (orig.) [de

  1. Processes, mechanisms, parameters, and modeling approaches for partially saturated flow in soil and rock media

    International Nuclear Information System (INIS)

    Wang, J.S.Y.; Narasimhan, T.N.

    1993-06-01

    This report discusses conceptual models and mathematical equations, analyzes distributions and correlations among hydrological parameters of soils and tuff, introduces new path integration approaches, and outlines scaling procedures to model potential-driven fluid flow in heterogeneous media. To properly model the transition from fracture-dominated flow under saturated conditions to matrix-dominated flow under partially saturated conditions, characteristic curves and permeability functions for fractures and matrix need to be improved and validated. Couplings from two-phase flow, heat transfer, solute transport, and rock deformation to liquid flow are also important. For stochastic modeling of alternating units of welded and nonwelded tuff or formations bounded by fault zones, correlations and constraints on average values of saturated permeability and air entry scaling factor between different units need to be imposed to avoid unlikely combinations of parameters and predictions. Large-scale simulations require efficient and verifiable numerical algorithms. New path integration approaches based on postulates of minimum work and mass conservation to solve flow geometry and potential distribution simultaneously are introduced. This verifiable integral approach, together with fractal scaling procedures to generate statistical realizations with parameter distribution, correlation, and scaling taken into account, can be used to quantify uncertainties and generate the cumulative distribution function for groundwater travel times

  2. Ego functions in epilepsy

    DEFF Research Database (Denmark)

    Sørensen, A S; Hansen, H; Høgenhaven, H

    1988-01-01

    Two groups of epilepsy patients (28 patients with temporal lobe epilepsy and 15 patients with primary generalized epilepsy) entered a study of personality traits related to epilepsy, based on a modification of Bellak's semistructured interview for assessment of ego strength. Two groups of subjects...... than 15 years when the disease began. The number of anticonvulsants administered did not influence the results. No difference on adaptive level of ego functioning was found between the group with primary generalized epilepsy and the group with temporal lobe epilepsy. Similarly, the temporal lobe...... served as controls: 15 patients with a non-neurological but relapsing disorder, psoriasis, and 15 healthy volunteers. Compared with the group of healthy volunteers, a decreased adaptive level of ego functioning was found in the epilepsy groups, regardless of seizure types and EEG findings, and...

  3. Infective Causes of Epilepsy.

    Science.gov (United States)

    Bonello, M; Michael, B D; Solomon, T

    2015-06-01

    A wide range of infections of the central nervous system are responsible for both acute seizures and epilepsy. The pathogenesis and clinical semiology of the seizure disorders vary widely between the infective pathogens. The exact mechanisms underlying this are poorly understood, but appear, at least in part, to relate to the pathogen; the degree of cortical involvement; delays in treatment; and the host inflammatory response. The treatment of infective causes of seizures involves both symptomatic treatment with antiepileptic drugs and direct treatment of the underlying condition. In many cases, early treatment of the infection may affect the prognosis of the epilepsy syndrome. The greatest burden of acute and long-term infection-related seizures occurs in resource-poor settings, where both clinical and research facilities are often lacking to manage such patients adequately. Nevertheless, education programs may go a long way toward addressing the stigma, leading to improved diagnosis, management, and ultimately to better quality of life. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Interactions between hormones and epilepsy.

    Science.gov (United States)

    Taubøll, Erik; Sveberg, Line; Svalheim, Sigrid

    2015-05-01

    There is a complex, bidirectional interdependence between sex steroid hormones and epilepsy; hormones affect seizures, while seizures affect hormones thereby disturbing reproductive endocrine function. Both female and male sex steroid hormones influence brain excitability. For the female sex steroid hormones, progesterone and its metabolites are anticonvulsant, while estrogens are mainly proconvulsant. The monthly fluctuations in hormone levels of estrogen and progesterone are the basis for catamenial epilepsy described elsewhere in this issue. Androgens are mainly anticonvulsant, but the effects are more varied, probably because of its metabolism to, among others, estradiol. The mechanisms for the effects of sex steroid hormones on brain excitability are related to both classical, intracellularly mediated effects, and non-classical membrane effects due to binding to membrane receptors. The latter are considered the most important in relation to epilepsy. The different sex steroids can also be further metabolized within the brain to different neurosteroids, which are even more potent with regard to their effect on excitability. Estrogens potentiate glutamate responses, primarily by potentiating NMDA receptor activity, but also by affecting GABA-ergic mechanisms and altering brain morphology by increasing dendritic spine density. Progesterone and its main metabolite 5α-pregnan-3α-ol-20-one (3α-5α-THP) act mainly to enhance postsynaptic GABA-ergic activity, while androgens enhance GABA-activated currents. Seizures and epileptic discharges also affect sex steroid hormones. There are close anatomical connections between the temporolimbic system and the hypothalamus controlling the endocrine system. Several studies have shown that epileptic activity, especially mediated through the amygdala, alters reproductive function, including reduced ovarian cyclicity in females and altered sex steroid hormone levels in both genders. Furthermore, there is an asymmetric

  5. Mechanical properties of partially meltable superconducting YBa/sub 2/Cu/sub 3/O/sub 7-x/

    International Nuclear Information System (INIS)

    Selvamanickam, V.; Salama, K.

    1988-01-01

    Partial melting has been suggested as a method for the processing of the high temperatures superconducting YBa/sub 2/Cu/sub 3/O/sub 7-x/ to improve the current carrying capacity in this material. The authors have investigated the possibility of using this method for the improvement of bulk mechanical properties in addition to those related to superconductivity. Four parameters, namely, oxygen annealing temperature, melting temperature, melting time and cooling rate are identified and studied. Each parameter is varied individually and its effects on microstructure and mechanical and superconducting properties are examined. The results indicate that the properties of superconducting YBa/sub 2/Cu/sub 3/O/sub 7-x/ can be improved significantly using the proper melting temperature, melting time, cooling rate and oxygen annealing temperature

  6. A numerical toolkit to understand the mechanics of partially saturated granular materials

    OpenAIRE

    Roux , Jean-Noël

    2015-01-01

    ``Focus on Fluids'' section; International audience; The mechanisms by which a wetting, non-saturating liquid bestows macroscopic cohesion and strength to a granular material are usually not accessible to micromechanical investigations for saturations exceeding the pendular regime of isolated menisci, easily studied by discrete element models. The " JFM-Rapids " paper (vol. 762, R5, 2015) by Delenne, Richefeu and Radja¨ıRadja¨ı, exploiting a multiphase Lattice Boltzmann approach, pioneers the...

  7. Quantitative proteomics revealed partial fungistatic mechanism of ammonia against conidial germination of nematode-trapping fungus Arthrobotrys oligospora ATCC24927.

    Science.gov (United States)

    Liu, Tong; Tian, Dong-Wei; Zou, Li-Juan; Liu, Fang-Yu; Can, Qi-Yan; Yang, Jin-Kui; Xu, Jian-Ping; Huang, Xiao-Wei; Xi, Jia-Qin; Zhu, Ming-Liang; Mo, Ming-He; Zhang, Ke-Qin

    2018-05-01

    Ammonia is one of the fungistatic factors in soil that can suppress conidial germination, but the molecular mechanism underlying the suppression is unknown. In this study, the proteomes of fungistatic conidia, fresh conidia and germinated conidia of Arthrobotrys oligospora ATCC24927 were determined and quantified. The protein expression profile of fungistatic conidia was significantly different from those in the other two conditions. 281 proteins were down expressed in fungistatic conidia and characterized by GO annotation. Gene transcription analysis and inhibition of puromycin (a protein translation inhibitor) on conidial germination suggested that down expression of 33 protein translation related proteins might well result in repression of protein synthesis and inhibition of conidial germination. In addition, 16 down-expressed proteins were mapped to the Ras/mitogen-activated protein (Ras/MAP) regulatory networks which regulate conidial DNA synthesis. The conidial DNA synthesis was found to be definitely inhibited under by ammonia, and function studies of two Ras/MAP proteins by using knock-out strains provided partial evidence that Ras/MAP pathway regulate the conidial germination. These results suggested that down-expression of Ras/MAP related proteins might result in inhibition of DNA synthesis and finally result in inhibition conidial germination. This study revealed partial fungistatic mechanism of ammonia against conidial germination. Copyright © 2018 Elsevier Ltd. All rights reserved.

  8. Positive end-expiratory pressure improves gas exchange and pulmonary mechanics during partial liquid ventilation.

    Science.gov (United States)

    Kirmse, M; Fujino, Y; Hess, D; Kacmarek, R M

    1998-11-01

    Partial liquid ventilation (PLV) with perflubron (PFB) has been proposed as an adjunct to the current therapies for the acute respiratory distress syndrome (ARDS). Because PFB has been also referred to as "liquid PEEP," distributing to the most gravity-dependent regions of the lung, less attention has been paid to the amount of applied positive end-expiratory pressure (PEEP). We hypothesized that higher PEEP levels than currently applied are needed to optimize gas exchange, and that the lower inflection point (LIP) of the pressure-volume curve could be used to estimate the amount of PEEP needed when the lung is filled with PFB. Lung injury was induced in 23 sheep by repeated lung lavage with warmed saline until the PaO2/FIO2 ratio fell below 150. Five sheep were used to investigate the change of the LIP when the lung was filled with PFB in increments of 5 ml/kg/body weight to a total of 30 ml/kg/body weight. To evaluate the impact of PEEP set at LIP +1 cm H2O we randomized an additional 15 sheep to three groups with different doses (7.5 ml, 15 ml, 30 ml/kg/body weight) of PFB. In random order a PEEP of 5 cm H2O or PEEP at LIP +1 cm H2O was applied. The LIP decreased with incremental filling of PFB to a minimum at 10 ml (p PFB shifts the LIP to the left, and that setting PEEP at LIP +1 cm H2O improves gas exchange at moderate to high doses of PFB.

  9. Sudden cardiac arrest in people with epilepsy in the community

    Science.gov (United States)

    Lamberts, Robert J.; Blom, Marieke T.; Wassenaar, Merel; Bardai, Abdennasser; Leijten, Frans S.; de Haan, Gerrit-Jan; Sander, Josemir W.; Thijs, Roland D.

    2015-01-01

    Objective: To ascertain whether characteristics of ventricular tachycardia/fibrillation (VT/VF) differed between people with epilepsy and those without and which individuals with epilepsy were at highest risk. Methods: We ascertained 18 people with active epilepsy identified in a community-based registry of sudden cardiac arrest (SCA) with ECG-confirmed VT/VF (cases). We compared them with 470 individuals with VT/VF without epilepsy (VT/VF controls) and 54 individuals with epilepsy without VT/VF (epilepsy controls). Data on comorbidity, epilepsy severity, and medication use were collected and entered into (conditional) logistic regression models to identify determinants of VT/VF in epilepsy. Results: In most cases, there was an obvious (10/18) or presumed cardiovascular cause (5/18) in view of preexisting heart disease. In 2 of the 3 remaining events, near–sudden unexpected death in epilepsy (SUDEP) was established after successful resuscitation. Cases had a higher prevalence of congenital/inherited heart disease (17% vs 1%, p = 0.002), and experienced VT/VF at younger age (57 vs 64 years, p = 0.023) than VT/VF controls. VT/VF in cases occurred more frequently at/near home (89% vs 58%, p = 0.009), and was less frequently witnessed (72% vs 89%, p = 0.048) than in VT/VF controls. Cases more frequently had clinically relevant heart disease (50% vs 15%, p = 0.005) and intellectual disability (28% vs 1%, p epilepsy controls. Conclusion: Cardiovascular disease rather than epilepsy characteristics is the main determinant of VT/VF in people with epilepsy in the community. SCA and SUDEP are partially overlapping disease entities. PMID:26092917

  10. The causes of epilepsy: changing concepts of etiology of epilepsy over the past 150 years.

    Science.gov (United States)

    Shorvon, Simon D

    2011-06-01

    This paper provides a survey of the changing concepts of the etiology of epilepsy from 1860 to 2010, focusing on the first two 50-year periods and outlining more briefly major developments in the past 50 years. Among the concepts reviewed in the first 100 years are: the division between predisposing and exciting causes, idiopathic and genuine epilepsy, organic epilepsy, the concept of "cause" being equivalent to "causal mechanism," Russell Reynolds etiological classification, the neurological taint and theories of degeneration, the self-perpetuating nature of seizures, reflex theories of etiology, autointoxication, heredity and eugenics, epilepsy due to brain disorders, the role of EEG and of hippocampal sclerosis, psychological theories of causation, and the multifactorial view of epilepsy etiology. In the past 50 years, the major advances in studying causation in epilepsy have been: clinical biochemistry, neuroimaging, molecular genetics, studies of mechanisms of epilepsy, better statistical methodologies and classification. A number of general observations can be made: the identification of "cause" is not as simple as it might at first appear; progress in the study of causation has been often erratic and travelled up many cul-de-sacs; theories of causation are heavily influenced by societal influences and fashion, and is also heavily dependent on applied methodologies; the recently explored possibility that the underlying inherited mechanisms of epilepsy are shared with other neuropsychiatric conditions is in effect a reinvention of the concept of the neurological trait, and this has ethical and social implications. Considering and classifying cause in terms of causal mechanism, as was suggested by Hughlings Jackson, is an ultimate goal. Wiley Periodicals, Inc. © 2011 International League Against Epilepsy.

  11. Occipital lobe epilepsy secondary to posterior reversible encephalopathy syndrome (PRES) during a post-partum eclampsia in Mali (West Africa).

    Science.gov (United States)

    Youssoufa, Maïga; Callixte, Kuate Tegueu; Christian, Napon

    2013-08-13

    Eclampsia is known to cause posterior reversible encephalopathy syndrome (PRES) that is often associated with an extensive neurovascular damage affecting preferably posterior regions, often leading to reversible cortical blindness. In spite the magnitude of these lesions, post eclamptic symptomatic epilepsy is rare. We therefore report a case of symptomatic occipital lobe epilepsy secondary to PRES. A 39-year-old female right handed teacher who presented with headache of progressive onset, phosphenes, rapid decline of visual acuity to blindness, vomiting, repeated generalized tonic-clonic seizures followed by altered consciousness and very high blood pressure (HBP) of 240/120 mmHg, all of which started about 12 hours following a normal delivery. Nine months later, the patient presented with paroxysmal visual symptoms predominating in the right visual field followed by partial tonic clonic seizures with secondary generalization and recurrence of partial occipital lobe seizures. The pathophysiologic mechanism of irreversible tissue damage during PRES syndrome could result from a combination of events including the delay for early treatment, inadequate antihypertensive drugs that could worsen the brain damage by hypo perfusion, inadequate or delayed treatment for seizures or status epilepticus. Despite its high incidence in the third world, eclampsia is not a usual cause of epilepsy. Our case is the first description of post eclamptic occipital lobe epilepsy in Africa. With this report, we draw practitioners' attention on this rare complication.

  12. Longitudinal positron emission tomography imaging of glial cell activation in a mouse model of mesial temporal lobe epilepsy: Toward identification of optimal treatment windows.

    Science.gov (United States)

    Nguyen, Duc-Loc; Wimberley, Catriona; Truillet, Charles; Jego, Benoit; Caillé, Fabien; Pottier, Géraldine; Boisgard, Raphaël; Buvat, Irène; Bouilleret, Viviane

    2018-06-01

    Mesiotemporal lobe epilepsy is the most common type of drug-resistant partial epilepsy, with a specific history that often begins with status epilepticus due to various neurological insults followed by a silent period. During this period, before the first seizure occurs, a specific lesion develops, described as unilateral hippocampal sclerosis (HS). It is still challenging to determine which drugs, administered at which time point, will be most effective during the formation of this epileptic process. Neuroinflammation plays an important role in pathophysiological mechanisms in epilepsy, and therefore brain inflammation biomarkers such as translocator protein 18 kDa (TSPO) can be potent epilepsy biomarkers. TSPO is associated with reactive astrocytes and microglia. A unilateral intrahippocampal kainate injection mouse model can reproduce the defining features of human temporal lobe epilepsy with unilateral HS and the pattern of chronic pharmacoresistant temporal seizures. We hypothesized that longitudinal imaging using TSPO positron emission tomography (PET) with 18 F-DPA-714 could identify optimal treatment windows in a mouse model during the formation of HS. The model was induced into the right dorsal hippocampus of male C57/Bl6 mice. Micro-PET/computed tomographic scanning was performed before model induction and along the development of the HS at 7 days, 14 days, 1 month, and 6 months. In vitro autoradiography and immunohistofluorescence were performed on additional mice at each time point. TSPO PET uptake reached peak at 7 days and mostly related to microglial activation, whereas after 14 days, reactive astrocytes were shown to be the main cells expressing TSPO, reflected by a continuing increased PET uptake. TSPO-targeted PET is a highly potent longitudinal biomarker of epilepsy and could be of interest to determine the therapeutic windows in epilepsy and to monitor response to treatment. Wiley Periodicals, Inc. © 2018 International League Against Epilepsy.

  13. Dynamic observation by PET in epilepsy

    International Nuclear Information System (INIS)

    Shimizu, Hiroyuki; Ishijima, Buichi; Iio, Masaaki.

    1990-01-01

    Before the era when positron emission tomography (PET) has emerged, much controversy has existed concerning regional cerebral blood flow in partial epilepsy. In 1979, PET revealed that cerebral blood flow is decreased during the interictal period, but is remarkably increased in the intraictal phase. In this paper, historical process of dynamic observation in epilepsy is reviewed. Potential use and limitations of PET in the clinical setting are discussed in view of the scanning methods and the relationships between PET and electroencephalograms, magnetic resonance imaging, and surgical treatment. (N.K.) 106 refs

  14. Aging models of acute seizures and epilepsy.

    Science.gov (United States)

    Kelly, Kevin M

    2010-01-01

    Aged animals have been used by researchers to better understand the differences between the young and the aged brain and how these differences may provide insight into the mechanisms of acute seizures and epilepsy in the elderly. To date, there have been relatively few studies dedicated to the modeling of acute seizures and epilepsy in aged, healthy animals. Inherent challenges to this area of research include the costs associated with the purchase and maintenance of older animals and, at times, the unexpected and potentially confounding comorbidities associated with aging. However, recent studies using a variety of in vivo and in vitro models of acute seizures and epilepsy in mice and rats have built upon early investigations in the field, all of which has provided an expanded vision of seizure generation and epileptogenesis in the aged brain. Results of these studies could potentially translate to new and tailored interventional approaches that limit or prevent the development of epilepsy in the elderly.

  15. Epilepsy: Is there hope?

    Directory of Open Access Journals (Sweden)

    Carlos A. M. Guerreiro

    2016-01-01

    Full Text Available Epilepsy is a highly prevalent chronic neurologic disorder and leads to social, behavioural, health and economic consequences. 'Treatment gap' varies from 10 per cent in developed countries to 75 per cent in low-income countries. Stigma and discrimination related to epilepsy are prevalent worldwide. Electroencephalography (EEG is considered the most important tool for evaluating the patient with epilepsy. Video-EEG monitoring is an important tool for confirming the seizure type and estimating the epileptogenic zone in the brain. Neuroimaging evaluation is important to determine the aetiology of the epilepsies. Genetic testing has increased the probability of identifying the causes of some types of epilepsies. Epilepsy can be treated in an affordable way with low-cost medications. Refractory epilepsies occur in approximately one-third of recently diagnosed patients with epilepsy. For this group of patients, there are options of surgical treatment, diets and neurostimulation to improve seizure control and quality of life. In poorly organized societies, there is a lack of prioritization of epilepsy in national health policies, limited resources for trained personnel and a shortage of basic antiepileptic medications. There is evidence of improvement in the understanding of epilepsy and a clear progress in the management of epileptic seizures in recent times.

  16. [Current management of epilepsy].

    Science.gov (United States)

    Mizobuchi, Masahiro

    2013-09-01

    Epilepsy is one of the most common neurological disorders. Global neurological knowledge is essential for differential diagnosis of epileptic syndromes due to the diversity of ictal semiology, causes and syndromes. Neurologists play an important role in planning the medical care for patients with epilepsy, as medication is the most fundamental therapeutic strategy. Some patients with early-onset epilepsy require joint care by pediatric neurologists, those with intractable epilepsy by neurosurgeons, and those with psychological comorbidity by psychiatrists, and neurologists should play a coordinating role. While there is a great need for neurologists to participate in epilepsy care, neurologists in Japan currently do not participate substantially in the epilepsy management system. It is necessary to train more neurologists who can provide epilepsy care and conduct basic and clinical research on epilepsy by providing continuous education on epilepsy for general neurologists as well as pre- and post-graduate medical students. Most of the patients who require long-term treatment experience many medical problems and social handicaps, such as adverse effects of medication, social stigma, educational disadvantages and difficulties in obtaining driver's license. To improve the quality of life of patients with epilepsy, it is desirable to build broad medical-social networks participated by patients, doctors, neurological nurses, psychologists, social workers, school teachers, managers of employment support facilities and care givers.

  17. Thyroid hormones: Possible roles in epilepsy pathology.

    Science.gov (United States)

    Tamijani, Seyedeh Masoumeh Seyedhoseini; Karimi, Benyamin; Amini, Elham; Golpich, Mojtaba; Dargahi, Leila; Ali, Raymond Azman; Ibrahim, Norlinah Mohamed; Mohamed, Zahurin; Ghasemi, Rasoul; Ahmadiani, Abolhassan

    2015-09-01

    Thyroid hormones (THs) L-thyroxine and L-triiodothyronine, primarily known as metabolism regulators, are tyrosine-derived hormones produced by the thyroid gland. They play an essential role in normal central nervous system development and physiological function. By binding to nuclear receptors and modulating gene expression, THs influence neuronal migration, differentiation, myelination, synaptogenesis and neurogenesis in developing and adult brains. Any uncorrected THs supply deficiency in early life may result in irreversible neurological and motor deficits. The development and function of GABAergic neurons as well as glutamatergic transmission are also affected by THs. Though the underlying molecular mechanisms still remain unknown, the effects of THs on inhibitory and excitatory neurons may affect brain seizure activity. The enduring predisposition of the brain to generate epileptic seizures leads to a complex chronic brain disorder known as epilepsy. Pathologically, epilepsy may be accompanied by mitochondrial dysfunction, oxidative stress and eventually dysregulation of excitatory glutamatergic and inhibitory GABAergic neurotransmission. Based on the latest evidence on the association between THs and epilepsy, we hypothesize that THs abnormalities may contribute to the pathogenesis of epilepsy. We also review gender differences and the presumed underlying mechanisms through which TH abnormalities may affect epilepsy here. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  18. SPECT and MRI in the diagnosis of epilepsy

    International Nuclear Information System (INIS)

    Gruenwald, F.; Biersack, H.J.; Bockisch, A.; Elger, C.E.; Durwen, H.F.; Penin, H.

    1989-01-01

    This study presents the results obtained using SPECT and MRI in epilepsy - mainly based on presurgical investigation in therapy-resistant cases of temporal lobe epilepsy. MRI was positive in 61% of 102 examined patients, SPECT was positive in 84%. In 46 patients with temporal lobe epilepsy subjected to partial temporal lobectomy was performed later on there was agreement of the results obtained with regard to the lateralisation in 74%. Although MRI, due to its sensitivity is superior to CT in diagnosis of epilepsy, CT should be performed in any case because some morphological changes - especially small arteriovenous malformations - are only seen in CT. MRI and SPECT should be considered as two complementary methods in epilepsy diagnosis, serving to evaluate morphology and function. A definite statement as to the predictive value of both methods remains to be made depending on a comparison of the results with the postoperative outcome referring to seizure frequency and cognitive function. (orig.) [de

  19. Epilepsy in Adults with TSC

    Science.gov (United States)

    ... Privacy Policy Sitemap Learn Engage Donate About TSC Epilepsy in Adults with TSC Individuals with tuberous sclerosis ... being well controlled for long periods of time. Epilepsy and Seizures Epilepsy is any brain disorder that ...

  20. Epilepsy in patients with autism: links, risks and treatment challenges

    Directory of Open Access Journals (Sweden)

    Besag FMC

    2017-12-01

    Full Text Available Frank MC Besag Neurodevelopmental Team, East London Foundation NHS Trust, Family Consultation Clinic, Bedford, UK Abstract: Autism is more common in people with epilepsy, approximately 20%, and epilepsy is more common in people with autism with reported rates of approximately 20%. However, these figures are likely to be affected by the current broader criteria for autism spectrum disorder (ASD, which have contributed to an increased prevalence of autism, with the result that the rate for ASD in epilepsy is likely to be higher and the figure for epilepsy in ASD is likely to be lower. Some evidence suggests that there are two peaks of epilepsy onset in autism, in infancy and adolescence. The rate of autism in epilepsy is much higher in those with intellectual disability. In conditions such as the Landau–Kleffner syndrome and nonconvulsive status epilepticus, the epilepsy itself may present with autistic features. There is no plausible mechanism for autism causing epilepsy, however. The co-occurrence of autism and epilepsy is almost certainly the result of underlying factors predisposing to both conditions, including both genetic and environmental factors. Conditions such as attention deficit hyperactivity disorder, anxiety and sleep disorders are common in both epilepsy and autism. Epilepsy is generally not a contraindication to treating these conditions with suitable medication, but it is important to take account of relevant drug interactions. One of the greatest challenges in autism is to determine why early childhood regression occurs in perhaps 25%. Further research should focus on finding the cause for such regression. Whether epilepsy plays a role in the regression of a subgroup of children with autism who lose skills remains to be determined. Keywords: epilepsy, autism, regression, genetics, environment, Landau-Kleffner, CSWS 

  1. Mechanical spectroscopy studies of partially amorphous Nd60Fe30Al10 alloys

    International Nuclear Information System (INIS)

    Tarnowski, German C.; Salva, Horacio; Ghilarducci, Ada A.; Urreta, Silvia E.; Billoni, Orlando V.; Fabietti, Luis M.

    2004-01-01

    The hard magnetic properties of melt spun Nd 60 Fe 30 Al 10 alloys are attributed to a major matrix nominally amorphous for X-ray diffraction, composed by two metastable nanosized (∼5 nm) phases with different intrinsic magnetic properties. This composite system is investigated for the first time by mechanical spectroscopy techniques in the temperature range between 50 K and 450 K (1 kHz) where large annealing effects and two damping phenomena are detected. The as-cast microstructure irreversibly changes during annealing above 330 K, leading to a large modulus recovery accompanied by a reduction in the internal friction level. A relatively large relaxation effect is observed about 290 K, evidenced by a narrow internal friction peak with the corresponding step in the elastic modulus; this peak remains stable under thermal cycling between 200 K and 300 K but is affected by aging at 330 K and practically vanishes after heating to 450 K. Another internal friction peak is observed at about 250 K which has associated an anomalous modulus effect; in this temperature range, the internal friction and the elastic modulus exhibit heating/cooling hysteresis, which strongly depends on the extreme temperatures of the thermal cycle, a behavior frequently associated to first-order phase transformations

  2. Ketone bodies in epilepsy.

    Science.gov (United States)

    McNally, Melanie A; Hartman, Adam L

    2012-04-01

    Seizures that are resistant to standard medications remain a major clinical problem. One underutilized option for patients with medication-resistant seizures is the high-fat, low-carbohydrate ketogenic diet. The diet received its name based on the observation that patients consuming this diet produce ketone bodies (e.g., acetoacetate, β-hydroxybutyrate, and acetone). Although the exact mechanisms of the diet are unknown, ketone bodies have been hypothesized to contribute to the anticonvulsant and antiepileptic effects. In this review, anticonvulsant properties of ketone bodies and the ketogenic diet are discussed (including GABAergic and glutamatergic effects). Because of the importance of ketone body metabolism in the early stages of life, the effects of ketone bodies on developing neurons in vitro also are discussed. Understanding how ketone bodies exert their effects will help optimize their use in treating epilepsy and other neurological disorders. © 2012 The Authors. Journal of Neurochemistry © 2012 International Society for Neurochemistry.

  3. Effect of partially hydrolyzed guar gum on pasting, thermo-mechanical and rheological properties of wheat dough.

    Science.gov (United States)

    Mudgil, Deepak; Barak, Sheweta; Khatkar, B S

    2016-12-01

    Partially hydrolyzed guar gum was prepared using enzymatic hydrolysis of native guar gum that can be utilized as soluble fiber source. The effect of partially hydrolyzed guar gum (PHGG) on pasting, thermo-mechanical and rheological properties of wheat flour was investigated using rapid visco-analyzer, Mixolab and Microdoughlab. Wheat flour was replaced with 1-5g PHGG per 100g of wheat flour on weight basis. PHGG addition decreased the peak, trough, breakdown, setback and final viscosity of wheat flour. Water absorption and amylase activity of wheat dough were increased whereas starch gelatinization and protein weakening of wheat dough were reduced as a result of PHGG addition to wheat flour. PHGG addition also increased the peak dough height, arrival time, dough development time, dough stability and peak energy of wheat dough system. However, dough softening was decreased after PHGG addition to wheat flour dough. Overall, it can be assumed that PHGG has influenced the properties of wheat flour dough system by decreasing the RVA viscosities and increasing the water absorption and starch gelatinization of wheat dough system. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Christianity and epilepsy.

    Science.gov (United States)

    Owczarek, K; Jędrzejczak, J

    2013-01-01

    Epileptic seizures have been known from time immemorial. Throughout the ages, however, ideas concerning the aetiology and treatment of epilepsy have changed considerably. Epilepsy is mentioned many times in the Pentateuch, where it is portrayed as a mysterious condition, whose symptoms, course and contingencies evade rational laws and explanations. In the Middle Ages, the accepted view which prevailed in social consciousness was that patients with epilepsy were possessed by Satan and other impure spirits. One common method of treatment of epileptic seizures was to submit the patient to cruel exorcisms. Patients were frequently injured in the process and some of them even died. Our understanding of epilepsy and its social consequences has improved considerably within the last century. The most significant progress as far as diagnosis and treatment of epilepsy is concerned took place in the last four decades of the twentieth century. Although we now know much more about epilepsy than we used to, this knowledge is still insufficiently popularized.

  5. Photoacoustic Imaging of Epilepsy

    Science.gov (United States)

    2014-04-01

    using simulation and phantom experiments; (4) To test and validate the PAT system using a well established animal model of temporal lobe epilepsy ...and evaluation (3) Software Development (4) Animal experiments (5) Rat Model of Temporal Lobe Epilepsy (6) Analysis of the images from the in vivo...details please see the progress report of the third year of the project. 5. Rat Model of Temporal Lobe Epilepsy (Task 6) During months 37-48 of this

  6. Use and impact of positron computed tomography scanning in epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Mazziotta, J.C.; Engel, J. Jr.

    1984-01-01

    Through the effective combination of instrumentation, tracer kinetic principles, and radiopharmaceuticals, positron computed tomography (PET) allows for the analytic, noninvasive measurement of local tissue physiology in humans. A large number of studies have already been performed in patients with epilepsy using 18F-fluorodeoxyglucose (FDG) to measure local cerebral glucose utilization. In patients with complex partial epilepsy who are candidates for surgery, hypometabolic zones have been seen consistently (70%) in the interictal state. The complex anatomical and pathophysiological investigation of these hypometabolic zones is discussed. Ictal studies of patients with partial seizures have demonstrated a much more variable metabolic pattern which usually consists of hypermetabolism relative to baseline or interictal studies. Generalized epilepsy produced by electroconvulsive shock and petit mal epilepsy have been studied using FDG to estimate glucose metabolism.

  7. The importance of computer tomography in the diagnosis of epilepsy

    International Nuclear Information System (INIS)

    Ladurner, G.; Sager, W.D.; Dusik, B.; Lechner, H.; Graz Univ.

    1979-01-01

    208 patients with epilepsy were investigated by computertomography (Emil Scanner CT 1010 and CT 5005). In 173 patients with generalised epilepsy 87 had a normal scan, 51 revealed a definitive diagnosis and 37 showed generalised atrophy. Of the 35 patients with partial seizures a definitive diagnosis was possible in 22; representing a higher proportion than the group with generalised seizures. A definitive diagnosis from the CT Scan was significantly more common in both patients with generalised and partial seizures when pathological neurological findings were also present. Symptomatic epilepsy was only significantly commoner in Dementia patients with generalised seizures. A significantly higher proportion of patients over 30 years old demonstrated a symptomatic epilepsy than those under 30 yaers of age. (orig.) [de

  8. RBFOX1 and RBFOX3 mutations in rolandic epilepsy

    DEFF Research Database (Denmark)

    Lal, Dennis; Reinthaler, Eva M; Altmüller, Janine

    2013-01-01

    Partial deletions of the gene encoding the neuronal splicing regulator RBFOX1 have been reported in a range of neurodevelopmental diseases, including idiopathic generalized epilepsy. The RBFOX1 protein and its homologues (RBFOX2 and RBFOX3) regulate alternative splicing of many neuronal transcripts...... involved in the homeostatic control of neuronal excitability. In this study, we explored if structural microdeletions and exonic sequence variations in RBFOX1, RBFOX2, RBFOX3 confer susceptibility to rolandic epilepsy (RE), a common idiopathic focal childhood epilepsy. By high-density SNP array screening...... that exon deletions and truncating mutations of RBFOX1 and RBFOX3 contribute to the genetic variance of partial and generalized idiopathic epilepsy syndromes....

  9. Juvenile myoclonic epilepsy as a spectrum disorder: A focused review.

    Science.gov (United States)

    Baykan, Betül; Wolf, Peter

    2017-07-01

    In consequence of newer research juvenile myoclonic epilepsy (JME) is no longer seen as a homogeneous disease. The causes of the existing variance are only partially known yet. We discuss to what extent the phenotypical spectrum of this polygenetically determined disorder expresses genetically defined endophenotypes, or is due to mere quantitative differences in the expression of the core phenotype. Of the three common seizure types of JME, myoclonic, generalized tonic-clonic and absences, absences also occur independently and are strong candidates for an endophenotype. Focal features may in some patients be seen in clinical seizures or the EEG but rarely in both. They have no morphological correlates. In a system epilepsy, local manifestations are possible, and some are due to reflex mechanisms. Of the four reflex epileptic traits common in JME, photosensitivity and praxis induction appear related to basic mechanisms of the core syndrome, whereas language-induced orofacial reflex myocloni and eye closure sensitivity are also seen in other clinical contexts and therefore seem to represent endophenotypes. Cognitive abnormalities indicating slight frontal lobe dysfunction seem to be ubiquitous in JME and are also seen in unaffected siblings of patients. Cluster B personality disorder is found in 1/3 of patients, representing a more severe expression of the underlying pathology. Treatment response and prognosis seem to be affected by an interplay of the described factors producing the severest end of the JME spectrum. The spectrum appears to be due to an interaction of stronger or weaker expression of the core phenotype with various endophenotypes. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  10. Epilepsy: Indian perspective

    Directory of Open Access Journals (Sweden)

    Nandanavana Subbareddy Santhosh

    2014-01-01

    Full Text Available There are 50 million people living with epilepsy worldwide, and most of them reside in developing countries. About 10 million persons with epilepsy are there in India. Many people with active epilepsy do not receive appropriate treatment for their condition, leading to large treatment gap. The lack of knowledge of antiepileptic drugs, poverty, cultural beliefs, stigma, poor health infrastructure, and shortage of trained professionals contribute for the treatment gap. Infectious diseases play an important role in seizures and long-term burden causing both new-onset epilepsy and status epilepticus. Proper education and appropriate health care services can make tremendous change in a country like India. There have been many original researches in various aspects of epilepsy across India. Some of the geographically specific epilepsies occur only in certain regions of our country which have been highlighted by authors. Even the pre-surgical evaluation and epilepsy surgery in patients with drug-resistant epilepsy is available in many centers in our country. This article attempts to provide a complete preview of epilepsy in India.

  11. Personality characteristics and epilepsy

    DEFF Research Database (Denmark)

    Sørensen, A S; Hansen, H; Andersen, R

    1989-01-01

    as controls. Four clinical meaningful dimensions of included personality traits were identified: ixoide, ideational, obsessive-compulsive and affective features. Analyses based on the Rasch model approved of all dimensions except for affective features. The epilepsy group obtained the highest scores on all 3......Patients with a long history of temporal lobe epilepsy or primary generalized epilepsy entered a questionnaire study of personality characteristics, based on a modification of the Bear-Fedio inventory for temporal lobe behavioural syndrome. Psoriasis patients and healthy volunteers served...... dysfunction in the epilepsy group, the mere presence of a chronic disorder with potential social stigmatization influences personality....

  12. Stigma of epilepsy.

    Science.gov (United States)

    Bandstra, Nancy F; Camfield, Carol S; Camfield, Peter R

    2008-09-01

    Epilepsy directly affects 50 million people worldwide. Most can achieve excellent seizure control; however, people living with epilepsy continue to suffer from enacted or perceived stigma that is based on myths, misconceptions and misunderstandings that have persisted for thousands of years. This paper reviews the frequency and nature of stigma toward epilepsy. Significant negative attitudes prevail in the adolescent and adult public worldwide leading to loneliness and social avoidance both in school and in the workplace. People with epilepsy are often wrongly viewed as having mental health and antisocial issues and as being potentially violent toward others. Twenty-five percent of adults having epilepsy describe social stigma as a result of their epilepsy. They fear rejection and often feel shame or loneliness from this diagnosis. The psychosocial and social impact of epilepsy is significant. Yet few specific interventions have been demonstrated to alter this perception. The effect on public education is primarily short-term, while change over the long-term in attitudes and inaccurate beliefs have not presently been proven effective. School education programming demonstrates improved knowledge and attitude a month after a classroom intervention, but persisting change over a longer period of time has not been evaluated. In-depth adult psycho-educational programs for adults with epilepsy improves knowledge, coping skills and level of felt stigma. However these gains have not demonstrated persistence over time. Myths, misconceptions and misunderstandings about epilepsy continue and programs aimed at increasing knowledge and reducing negative public attitudes should be enhanced.

  13. [Sleep disorders in epilepsy].

    Science.gov (United States)

    Kotova, O V; Akarachkova, E S

    2014-01-01

    The review of the literature on sleep disorders in epilepsy over the last two decades is presented. Paroxysmal phenomena of epileptic origin, nonepileptic paroxysms, antiepileptic drugs, polypragmasia and comorbid depression may affect sleep in epilepsy.Shortening of sleep time may cause seizures, hallucinations and depression because sleep plays an important role in the regulation of excitatory and inhibitory processes in the brain both in healthy people and in patients with epilepsy. According to the literature data, drugs (short treatment courses of hypnotics) or nonpharmacological methods should be used for treatment insomnia inpatients with epilepsy.

  14. Approaches to refractory epilepsy

    Directory of Open Access Journals (Sweden)

    Jerome Engel

    2014-01-01

    Full Text Available Epilepsy is one of the most common serious neurological conditions, and 30 to 40% of people with epilepsy have seizures that are not controlled by medication. Patients are considered to have refractory epilepsy if disabling seizures continue despite appropriate trials of two antiseizure drugs, either alone or in combination. At this point, patients should be referred to multidisciplinary epilepsy centers that perform specialized diagnostic testing to first determine whether they are, in fact, pharmacoresistant, and then, if so, offer alternative treatments. Apparent pharmacoresistance can result from a variety of situations, including noncompliance, seizures that are not epileptic, misdiagnosis of the seizure type or epilepsy syndrome, inappropriate use of medication, and lifestyle issues. For patients who are pharmacoresistant, surgical treatment offers the best opportunity for complete freedom from seizures. Surgically remediable epilepsy syndromes have been identified, but patients with more complicated epilepsy can also benefit from surgical treatment and require more specialized evaluation, including intracranial EEG monitoring. For patients who are not surgical candidates, or who are unwilling to consider surgery, a variety of other alternative treatments can be considered, including peripheral or central neurostimulation, ketogenic diet, and complementary and alternative approaches. When such alternative treatments are not appropriate or effective, quality of life can still be greatly improved by the psychological and social support services offered by multidisciplinary epilepsy centers. A major obstacle remains the fact that only a small proportion of patients with refractory epilepsy are referred for expert evaluation and treatment.

  15. Increasing Utilization Of Pediatric Epilepsy Surgery In The United States Between 1997 and 2009

    Science.gov (United States)

    Pestana Knight, Elia M.; Schiltz, Nicholas K.; Bakaki, Paul M.; Koroukian, Siran M.; Lhatoo, Samden D.; Kaiboriboon, Kitti

    2014-01-01

    SUMMARY OBJECTIVE To examine national trends of pediatric epilepsy surgery usage in the United States between 1997 and 2009. METHODS We performed a serial cross-sectional study of pediatric epilepsy surgery using triennial data from the Kids’ Inpatient Database from 1997 to 2009. The rates of epilepsy surgery for lobectomies, partial lobectomies, and hemispherectomies in each study year were calculated based on the number of prevalent epilepsy cases in the corresponding year. The age-race-sex adjusted rates of surgeries were also estimated. Mann-Kendall trend test was used to test for changes in the rates of surgeries over time. Multivariable regression analysis was also performed to estimate the effect of time, age, race, and sex on the annual incidence of epilepsy surgery. RESULTS The rates of pediatric epilepsy surgery significantly increased from 0.85 epilepsy surgeries per 1,000 children with epilepsy in 1997 to 1.44 epilepsy surgeries per 1,000 children with epilepsy in 2009. An increment in the rates of epilepsy surgeries was noted across all age groups, in boys and girls, all races, and all payer types. The rate of increase was lowest in blacks and in children with public insurance. The overall number of surgical cases for each study year was lower than 35% of children who were expected to have surgery, based on the estimates from the Connecticut Study of Epilepsy. SIGNIFICANCE In contrast to adults, pediatric epilepsy surgery numbers have increased significantly in the past decade. However, epilepsy surgery remains an underutilized treatment for children with epilepsy. In addition, black children and those with public insurance continue to face disparities in the receipt of epilepsy surgery. PMID:25630252

  16. A young infant with musicogenic epilepsy.

    Science.gov (United States)

    Lin, Kuang-Lin; Wang, Huei-Shyong; Kao, Pan-Fu

    2003-05-01

    Musicogenic epilepsy is a relatively rare form of epilepsy. In its pure form, it is characterized by epileptic seizures that are provoked exclusively by listening to music. The usual type of seizure is partial complex or generalized tonic-clonic. Precipitating factors are quite specific, such as listening to only one composition or the actual playing of music on an instrument. However, simple sound also can be a trigger. We report a 6-month-old infant with musicogenic epilepsy. She manifested right-sided focal seizures with occasional generalization. The seizures were frequently triggered by loud music, especially that by the Beatles. The interictal electroencephalography results were normal. Ictal spikes were present throughout the left temporal area during continuous electroencephalograpic monitoring. Brain magnetic resonance imaging results were normal, whereas single-photon emission computed tomography of the brain revealed hypoperfusion of the left temporal area. The young age and epileptogenic left temporal lobe lesion in this patient with musicogenic epilepsy were unusual characteristics. Theoretically, three levels of integration are involved in music processing in the brain. The involved integration of this infant's brain may be the sensory level rather than the emotional level. Nevertheless, the personal musicality and musical style of the Beatles might play an important role in this patient's epilepsy.

  17. Eating epilepsy: clinical and neuro image aspects - case report

    International Nuclear Information System (INIS)

    Buchpiguel, Carlos A.; Yacubian, Elza Marcia T.; Fiore, Lia Arno; Jorge, Carmen Lisa; Yamaga, Liliam I.; Watanabe, Tomoco; Bacheschi, Luis A.; Scaff, Milberto; Magalhaes, Alvaro E.A.

    1994-01-01

    Eating epilepsy is an uncommon form of reflex epilepsy. The authors present a case report of a patient with clinical diagnosis of eating epilepsy who was submitted to clinical tests, neuroimaging studies (MRI and SPECT) and surface EEG. Multiple intercritical EEGs showed sharp discharges in the posterior left temporal area. The MRI did not show any abnormality. The intercritical brain SPECT showed clear hypoperfusion in the posterior left temporal area; so confirming the epileptogenic focus in producing the partial complex seizures triggered by eating. (author)

  18. Focal epilepsy with ictal abdominal pain: a case report

    OpenAIRE

    Cerminara, Caterina; El Malhany, Nadia; Roberto, Denis; Curatolo, Paolo

    2013-01-01

    Focal epilepsy with ictal abdominal pain is an unusual partial epilepsy characterized by paroxysmal episodes of abdominal or visceral pain, disturbance of awareness and electroencephalographic abnormalities. We describe a new case of ictal abdominal pain in which gastrointestinal complaints were the only manifestation of seizures and review the previously described pediatric patients. In our patient clinical findings, ictal EEG abnormalities, and a good response to antiepileptic drugs allowed...

  19. Epilepsy: Asia versus Africa.

    Science.gov (United States)

    Bhalla, Devender; Tchalla, Achille Edem; Marin, Benoît; Ngoungou, Edgard Brice; Tan, Chong Tin; Preux, Pierre-Marie

    2014-09-01

    Is epilepsy truly an "African ailment"? We aimed to determine this, since international health agencies often refer to epilepsy as an African disease and the scientific literature has spoken the same tone. Various published materials, mainly reports, articles, were used to gather Asian and African evidence on various aspects of epilepsy and many of its risk and associated factors. Our results suggest that in no way can epilepsy be considered as an African ailment and such characterization is most likely based on popular beliefs rather than scientific evidence. In comparison to Africa, Asia has a 5.0% greater burden from all diseases, and is 17.0% more affected from neuropsychiatric disorders (that include epilepsy). Given that more countries in Asia are transitioning, there may be large demographic and lifestyle changes in the near future. However these changes are nowhere close to those expected in Africa. Moreover, 23 million Asians have epilepsy in comparison to 3.3 million Africans and 1.2 million sub-Saharan Africans. In comparison to Africa, Asia has more untreated patients, 55.0% more additional epilepsy cases every year, because of its larger population, with greater treatment cost and possibly higher premature mortality. Of several associated factors discussed herein, many have more importance for Asia than Africa. The current state of epilepsy in Asia is far less than ideal and there is an urgent need to recognize and accept the importance of epilepsy in Asia. In no way can epilepsy be considered as an African ailment. This is most likely based on popular beliefs rather than scientific evidence. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

  20. Genetic Forms of Epilepsies and other Paroxysmal Disorders

    Science.gov (United States)

    Olson, Heather E.; Poduri, Annapurna; Pearl, Phillip L.

    2016-01-01

    Genetic mechanisms explain the pathophysiology of many forms of epilepsy and other paroxysmal disorders such as alternating hemiplegia of childhood, familial hemiplegic migraine, and paroxysmal dyskinesias. Epilepsy is a key feature of well-defined genetic syndromes including Tuberous Sclerosis Complex, Rett syndrome, Angelman syndrome, and others. There is an increasing number of singe gene causes or susceptibility factors associated with several epilepsy syndromes, including the early onset epileptic encephalopathies, benign neonatal/infantile seizures, progressive myoclonus epilepsies, genetic generalized and benign focal epilepsies, epileptic aphasias, and familial focal epilepsies. Molecular mechanisms are diverse, and a single gene can be associated with a broad range of phenotypes. Additional features, such as dysmorphisms, head size, movement disorders, and family history may provide clues to a genetic diagnosis. Genetic testing can impact medical care and counseling. We discuss genetic mechanisms of epilepsy and other paroxysmal disorders, tools and indications for genetic testing, known genotype-phenotype associations, the importance of genetic counseling, and a look towards the future of epilepsy genetics. PMID:25192505

  1. Elucidating mechanisms for insect body size: partial support for the oxygen-dependent induction of moulting hypothesis.

    Science.gov (United States)

    Kivelä, Sami M; Viinamäki, Sonja; Keret, Netta; Gotthard, Karl; Hohtola, Esa; Välimäki, Panu

    2018-01-25

    Body size is a key life history trait, and knowledge of its mechanistic basis is crucial in life history biology. Such knowledge is accumulating for holometabolous insects, whose growth is characterised and body size affected by moulting. According to the oxygen-dependent induction of moulting (ODIM) hypothesis, moult is induced at a critical mass at which oxygen demand of growing tissues overrides the supply from the tracheal respiratory system, which principally grows only at moults. Support for the ODIM hypothesis is controversial, partly because of a lack of proper data to explicitly test the hypothesis. The ODIM hypothesis predicts that the critical mass is positively correlated with oxygen partial pressure ( P O 2 ) and negatively with temperature. To resolve the controversy that surrounds the ODIM hypothesis, we rigorously test these predictions by exposing penultimate-instar Orthosia gothica (Lepidoptera: Noctuidae) larvae to temperature and moderate P O 2  manipulations in a factorial experiment. The relative mass increment in the focal instar increased along with increasing P O 2 , as predicted, but there was only weak suggestive evidence of the temperature effect. Probably owing to a high measurement error in the trait, the effect of P O 2  on the critical mass was sex specific; high P O 2  had a positive effect only in females, whereas low P O 2  had a negative effect only in males. Critical mass was independent of temperature. Support for the ODIM hypothesis is partial because of only suggestive evidence of a temperature effect on moulting, but the role of oxygen in moult induction seems unambiguous. The ODIM mechanism thus seems worth considering in body size analyses. © 2018. Published by The Company of Biologists Ltd.

  2. Mortality in epilepsy.

    Science.gov (United States)

    Hitiris, Nikolas; Mohanraj, Rajiv; Norrie, John; Brodie, Martin J

    2007-05-01

    All studies report an increased mortality risk for people with epilepsy compared with the general population. Population-based studies have demonstrated that the increased mortality is often related to the cause of the epilepsy. Common etiologies include neoplasia, cerebrovascular disease, and pneumonia. Deaths in selected cohorts, such as sudden unexpected death in epilepsy (SUDEP), status epilepticus (SE), suicides, and accidents are more frequently epilepsy-related. SUDEP is a particular cause for concern in younger people, and whether and when SUDEP should be discussed with patients with epilepsy remain problematic issues. Risk factors for SUDEP include generalized tonic-clonic seizures, increased seizure frequency, concomitant learning disability, and antiepileptic drug polypharmacy. The overall incidence of SE may be increasing, although case fatality rates remain constant. Mortality is frequently secondary to acute symptomatic disorders. Poor compliance with treatment in patients with epilepsy accounts for a small proportion of deaths from SE. The incidence of suicide is increased, particularly for individuals with epilepsy and comorbid psychiatric conditions. Late mortality figures in patients undergoing epilepsy surgery vary and are likely to reflect differences in case selection. Future studies of mortality should be prospective and follow agreed guidelines to better quantify risk and causation in individual populations.

  3. Epilepsy and driving

    Directory of Open Access Journals (Sweden)

    Matej Mavrič

    2015-05-01

    Full Text Available Epilepsy poses a risk for all participants in road traffic; therefore people with epilepsy do not meet the criteria for an unlimited driving license. Their driving is affected not only by epileptic seizures causing impaired consciousness and involuntary movements, but also by antiepileptic drugs with their many unwanted affects. The experts have not yet agreed on whether people with epilepsy have an increased risk of experiencing a road traffic accident. However, recent data suggests that the overall risk is lower compared to other medical conditions. Scientific evidence forms the basis of legislation, which by limiting people with epilepsy, enables all participants in road traffic to drive in the safest possible environment. The legislation that governs epilepsy and driving in Slovenia has been recently thoroughly reformed and thus allows a less discriminatory management of people with epilepsy. Although people with epilepsy experience many issues in their daily life, including their personal relationships and employment, they often list the need for driving as a top concern in surveys. General physicians play an important role in managing the issues of people with epilepsy.

  4. Epilepsi og orale manifestationer

    DEFF Research Database (Denmark)

    Jacobsen, Pernille Endrup; Haubek, Dorte; Østergaard, John Rosendahl

    2016-01-01

    Risiko for sygdom I mundhulen hos patienter med epilepsy Epilepsi er en kronisk neurologisk lidelse, der ofte vil kræve medicinsk behandling for at holde patienterne fri for anfald. Lidelsen kan have betydning for patientens psykosociale og kognitive udvikling, der indirekte kan have betydning...

  5. Psychiatric Comorbidity in Epilepsy

    NARCIS (Netherlands)

    Swinkels, Wilhelmina Adriana Maria

    2006-01-01

    Het proefschrift beschrijft de relatie tussen epilepsie en psychiatrische stoornissen. Voor het onderzoek werden zowel klinische als poliklinische patiënten met epilepsie onderzocht op het voorkomen van DSM as I klinische stoornissen en as II persoonlijkheidsstoornissen. De resultaten werden

  6. Personality characteristics and epilepsy

    DEFF Research Database (Denmark)

    Sørensen, A S; Hansen, H; Andersen, R

    1989-01-01

    Patients with a long history of temporal lobe epilepsy or primary generalized epilepsy entered a questionnaire study of personality characteristics, based on a modification of the Bear-Fedio inventory for temporal lobe behavioural syndrome. Psoriasis patients and healthy volunteers served...

  7. Behandling af rolandisk epilepsi

    DEFF Research Database (Denmark)

    Miranda, Maria Jose; Ahmad, Banoo Bakir

    2017-01-01

    Recent literature indicates, that rolandic epilepsy/epilepsy of childhood with centrotemporal spikes may not be as benign as previously assumed. This study investigates the existing evidence, which describes the treatment effects on seizure frequency as well as improvement of cognition in childre...

  8. Stress and childhood epilepsy

    NARCIS (Netherlands)

    Campen, J.S. van

    2015-01-01

    Epilepsy is one of the most common chronic diseases in childhood, characterized by the enduring predisposition to generate epileptic seizures. Children with epilepsy and their parents often report seizures precipitated by stress. In order to increase our understanding of the pathophysiological

  9. Behavior Disorders and Epilepsy

    OpenAIRE

    J Gordon Millichap

    1993-01-01

    A longitudinal study of 127 children with epilepsy aged 8-12 years and their mothers, designed to identify factors contributing to behavior problems, is reported from the Indiana University School of Nursing, Indianapolis; the Minnesota Comprehensive Epilepsy Program, Minneapolis; and the Harvard School of Public Health, Boston.

  10. Patterns of language and auditory dysfunction in 6-year-old children with epilepsy.

    Science.gov (United States)

    Selassie, Gunilla Rejnö-Habte; Olsson, Ingrid; Jennische, Margareta

    2009-01-01

    In a previous study we reported difficulty with expressive language and visuoperceptual ability in preschool children with epilepsy and otherwise normal development. The present study analysed speech and language dysfunction for each individual in relation to epilepsy variables, ear preference, and intelligence in these children and described their auditory function. Twenty 6-year-old children with epilepsy (14 females, 6 males; mean age 6:5 y, range 6 y-6 y 11 mo) and 30 reference children without epilepsy (18 females, 12 males; mean age 6:5 y, range 6 y-6 y 11 mo) were assessed for language and auditory ability. Low scores for the children with epilepsy were analysed with respect to speech-language domains, type of epilepsy, site of epileptiform activity, intelligence, and language laterality. Auditory attention, perception, discrimination, and ear preference were measured with a dichotic listening test, and group comparisons were performed. Children with left-sided partial epilepsy had extensive language dysfunction. Most children with partial epilepsy had phonological dysfunction. Language dysfunction was also found in children with generalized and unclassified epilepsies. The children with epilepsy performed significantly worse than the reference children in auditory attention, perception of vowels and discrimination of consonants for the right ear and had more left ear advantage for vowels, indicating undeveloped language laterality.

  11. Managing Epilepsy in Pregnancy

    LENUS (Irish Health Repository)

    O Dwyer, V

    2017-02-01

    Epilepsy is one of the commonest medical conditions affecting women of childbearing age1. In the most recent triennial report into maternal deaths in Ireland and the UK, two thirds of women who died had a medical condition. In this report, 14 maternal deaths during pregnancy and up to 42 days postpartum were attributable to epilepsy or seizures; a rate of 0.4 per 100,000 maternities. In 12 of these women’ the cause was sudden unexplained death in epilepsy. Thus, epilepsy remains a high-risk condition in pregnancy. The gold standard of care is a multidisciplinary approach involving obstetricians, a neurologist and an epilepsy nurse specialist2. Like other units in Ireland this multidisciplinary service is currently provided in the National Maternity Hospital’s maternal medicine clinic, in conjunction with neurology services in Beaumont Hospital.

  12. Rational management of epilepsy.

    Science.gov (United States)

    Viswanathan, Venkataraman

    2014-09-01

    Management of epilepsies in children has improved considerably over the last decade, all over the world due to the advances seen in the understanding of the patho-physiology of epileptogenesis, availability of both structural and functional imaging studies along with better quality EEG/video-EEG recordings and the availability of a plethora of newer anti-epileptic drugs which are tailormade to act on specific pathways. In spite of this, there is still a long way to go before one is able to be absolutely rational about which drug to use for which type of epilepsy. There have been a lot of advances in the area of epilepsy surgery and is certainly gaining ground for specific cases. Better understanding of the genetic basis of epilepsies will hopefully lead to a more rational treatment plan in the future. Also, a lot of work needs to be done to dispel various misunderstandings and myths about epilepsy which still exists in our country.

  13. ADHD in idiopathic epilepsy

    Directory of Open Access Journals (Sweden)

    Marcos H. C. Duran

    2014-01-01

    Full Text Available Our aim was to clarify the correlation of attention deficit hyperactivity disorder (ADHD with epilepsy and behavior problems. This was a cross-sectional study. Sixty children with idiopathic epilepsy were interviewed using the MTA-SNAP IV Teacher and Parent Rating Scale, Vineland Adaptive Behavior Scales and Conners’ Rating Scales. We used the chi-square test to analyze the correlation of epilepsy variables in patients with and without ADHD with a significance level of 0.05. Eight patients had ADHD symptoms (13%, seven had the inattentive ADHD subtype and only three had behavioral problems. When epileptic patients with and without ADHD symptoms were compared we found no significant difference in regard to epilepsy variables. All patients were controlled and 43% were either without AED or undergoing withdrawal. Our study revealed a low comorbidity of ADHD symptoms and epilepsy due to low interference of seizures and drug treatment on the comorbid condition.

  14. Epilepsy and Mitochondrial Dysfunction

    Directory of Open Access Journals (Sweden)

    Russell P. Saneto DO, PhD

    2017-10-01

    Full Text Available Epilepsy is a common manifestation of mitochondrial disease. In a large cohort of children and adolescents with mitochondrial disease (n = 180, over 48% of patients developed seizures. The majority (68% of patients were younger than 3 years and medically intractable (90%. The electroencephalographic pattern of multiregional epileptiform discharges over the left and right hemisphere with background slowing occurred in 62%. The epilepsy syndrome, infantile spasms, was seen in 17%. Polymerase γ mutations were the most common genetic etiology of seizures, representing Alpers-Huttenlocher syndrome (14%. The severity of disease in those patients with epilepsy was significant, as 13% of patients experienced early death. Simply the loss of energy production cannot explain the development of seizures or all patients with mitochondrial dysfunction would have epilepsy. Until the various aspects of mitochondrial physiology that are involved in proper brain development are understood, epilepsy and its treatment will remain unsatisfactory.

  15. Epilepsy after stroke

    DEFF Research Database (Denmark)

    Olsen, T S; Høgenhaven, H; Thage, O

    1987-01-01

    Development of epilepsy was studied prospectively in a group of 77 consecutive stroke patients. Included were stroke patients less than 75 years old admitted within the first 3 days after the stroke. Excluded were patients with subarachnoid hemorrhage, vertebrobasilar stroke, and patients...... with other severe diseases. Cerebral angiography, CT, and EEG were performed in all patients. The patients were followed clinically for 2 to 4 years. Seven patients (9%) developed epilepsy. Of 23 patients with lesions involving the cortex, 6 (26%) developed epilepsy. Of 54 patients in whom the cortex...... was not involved, only 1 (2%) developed epilepsy. Patients with persisting paresis and cortical involvement seem to be at particularly high risk of developing epilepsy, as 50% of such patients (6 of 12) developed the disease....

  16. 77 FR 59197 - Epilepsy Program

    Science.gov (United States)

    2012-09-26

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Epilepsy... Program Expansion Supplement Award to the Epilepsy Foundation of America. SUMMARY: The Health Resources... Child Health Bureau's Epilepsy Program to the Epilepsy Foundation of America (U23MC19824) to support...

  17. Understanding Neuronal Mechanisms of Epilepsy ...

    Indian Academy of Sciences (India)

    Admin

    α subunit of Rat Brain type IIA Voltage Gated Sodium Channel and geneticin selection ..... scaling the mother wavelet. Scale = 1/ .... through dynamic clamp. Dynamic Clamp ... It has been shown that like in vivo neurons, cortical networks in.

  18. [Epilepsy: incidens, prevalens and causes].

    Science.gov (United States)

    Forsgren, Lars; Sundelin, Heléne; Sveinsson, Olafur

    2018-05-21

    Epilepsy affects people in all ages with the highest incidence in small children, particularly before age one year, and in elderly aged 65 years and older. In Sweden, between 4500-5000 persons develop epilepsy annually. Based on studies from North America and Europe, including the Nordic countries, the number of people with active epilepsy in Sweden is between 60000-70000. The lifetime risk for epilepsy up to age 85 years is 4-5 %, i.e. approximately every 25th person. The new epilepsy classification divides etiology into the following groups: structural, genetic, infectious, metabolic, immune and unknown. The majority (70%) of people with epilepsy eventually become seizure free. Epilepsy increases the risk of psychosocial problems and accidents. People with epilepsy have up to a 3-fold increase in mortality, mainly due to the underlying causes and epilepsy related deaths, e.g. status epilepticus, SUDEP and accidents. Somatic, psychiatric and neuropsychiatric comorbidities are common in epilepsy.

  19. Genetic determinants of common epilepsies

    DEFF Research Database (Denmark)

    2014-01-01

    and insufficient power. We aimed to identify risk loci through meta-analyses of genome-wide association studies for all epilepsy and the two largest clinical subtypes (genetic generalised epilepsy and focal epilepsy). METHODS: We combined genome-wide association data from 12 cohorts of individuals with epilepsy...... not previously implicated in epilepsy and provides further evidence about the genetic architecture of these disorders, with the ultimate aim of assisting in disease classification and prognosis. The data suggest that specific loci can act pleiotropically raising risk for epilepsy broadly, or can have effects...... and controls from population-based datasets. Controls were ethnically matched with cases. We phenotyped individuals with epilepsy into categories of genetic generalised epilepsy, focal epilepsy, or unclassified epilepsy. After standardised filtering for quality control and imputation to account for different...

  20. Safety and efficacy of levetiracetam for the treatment of partial onset seizures in children from one month of age

    Directory of Open Access Journals (Sweden)

    Cormier J

    2013-02-01

    Full Text Available Justine Cormier, Catherine J ChuMassachusetts General Hospital, Department of Neurology, Programs in Child Neurology and Neurophysiology, Boston, MA, USAAbstract: Epilepsy is a common neurological disorder in the pediatric population, affecting up to one percent of children, and for which the mainstay of treatment is anticonvulsant medication. Despite the frequent use of anticonvulsant drugs, remarkably little is known about the safety and efficacy of most of these medications in the pediatric epilepsy population. Of 34 anticonvulsants currently approved for use by the US Food and Drug Administration (FDA, only 13 have been approved for use in children. Although infants and young children are disproportionately affected by epilepsy, there are currently only three anticonvulsant medications that have been specifically evaluated and approved for use in children younger than 2 years of age. In 2012, the FDA approved levetiracetam as an adjunctive treatment for partial onset seizures in infants and children from one month of age. Here we review the available data on levetiracetam in the pediatric epilepsy population. We first discuss the pharmacological profile of levetiracetam, including its mechanism of action, formulations and dosing, and pharmacokinetics in children. We then review the available efficacy, safety, and tolerability data in children from one month of age with partial onset seizures. We conclude that the current data leading to the approval of levetiracetam for use in infants and children with partial onset seizures is encouraging, although more work needs to be done before definitive conclusions can be drawn about the efficacy of levetiracetam across different pediatric age groups.Keywords: levetiracetam, anticonvulsant drug, partial seizures, pediatric epilepsy

  1. Can Neurochemical Changes of Mood Disorders Explain the Increase Risk of Epilepsy or its Worse Seizure Control?

    Science.gov (United States)

    Kanner, Andres M

    2017-07-01

    The existence of a bidirectional relation between mood disorders and epilepsy has been suggested by six population-based studies. Furthermore, three studies have associated a higher risk of treatment-resistant epilepsy with a history of depression preceding the onset of epilepsy. Common pathogenic mechanisms operant in depression and epilepsy may provide a possible explanation of these observations. This article reviews some of the leading pathogenic mechanisms of depression with respect to potential proconvulsant properties that may provide explanations for these phenomena.

  2. Excessive masturbation after epilepsy surgery.

    Science.gov (United States)

    Ozmen, Mine; Erdogan, Ayten; Duvenci, Sirin; Ozyurt, Emin; Ozkara, Cigdem

    2004-02-01

    Sexual behavior changes as well as depression, anxiety, and organic mood/personality disorders have been reported in temporal lobe epilepsy (TLE) patients before and after epilepsy surgery. The authors describe a 14-year-old girl with symptoms of excessive masturbation in inappropriate places, social withdrawal, irritability, aggressive behavior, and crying spells after selective amygdalohippocampectomy for medically intractable TLE with hippocampal sclerosis. Since the family members felt extremely embarrassed, they were upset and angry with the patient which, in turn, increased her depressive symptoms. Both her excessive masturbation behavior and depressive symptoms remitted within 2 months of psychoeducative intervention and treatment with citalopram 20mg/day. Excessive masturbation is proposed to be related to the psychosocial changes due to seizure-free status after surgery as well as other possible mechanisms such as Kluver-Bucy syndrome features and neurophysiologic changes associated with the cessation of epileptic discharges. This case demonstrates that psychiatric problems and sexual changes encountered after epilepsy surgery are possibly multifactorial and in adolescence hypersexuality may be manifested as excessive masturbation behavior.

  3. Improvement of Physico-mechanical Properties of Partially Amorphous Acetaminophen Developed from Hydroalcoholic Solution Using Spray Drying Technique

    Science.gov (United States)

    Sadeghi, Fatemeh; Torab, Mansour; Khattab, Mostafa; Homayouni, Alireza; Afrasiabi Garekani, Hadi

    2013-01-01

    Objective(s): This study was performed aiming to investigate the effect of particle engineering via spray drying of hydroalcoholic solution on solid states and physico-mechanical properties of acetaminophen. Materials and Methods: Spray drying of hydroalcoholic solution (25% v/v ethanol/water) of acetaminophen (5% w/v) in the presence of small amounts of polyninylpyrrolidone K30 (PVP) (0, 1.25, 2.5 and 5% w/w based on acetaminophen weight) was carried out. The properties of spray dried particles namely morphology, surface characteristics, particle size, crystallinity, dissolution rate and compactibility were evaluated. Results: Spray drying process significantly changed the morphology of acetaminophen crystals from acicular (rod shape) to spherical microparticle. Differential scanning calorimetery (DSC) and x-ray powder diffraction (XRPD) studies ruled out any polymorphism in spray dried samples, however, a major reduction in crystallinity up to 65%, especially for those containing 5% w/w PVP was observed. Spray dried acetaminophen particles especially those obtained in the presence of PVP exhibited an obvious improvement of the dissolution and compaction properties. Tablets produced from spray dried samples exhibited excellent crushing strengths and no tendency to cap. Conclusions: The findings of this study revealed that spray drying of acetaminophen from hydroalcoholic solution in the presence of small amount of PVP produced partially amorphous particles with improved dissolution and excellent compaction properties. PMID:24379968

  4. Knee Extensor Rate of Torque Development Before and After Arthroscopic Partial Meniscectomy, With Analysis of Neuromuscular Mechanisms.

    Science.gov (United States)

    Cobian, Daniel G; Koch, Cameron M; Amendola, Annunziato; Williams, Glenn N

    2017-12-01

    Study Design Descriptive, prospective single-cohort longitudinal study. Background Though rapid torque development is essential in activities of daily living and sports, it hasn't been specifically tested by most physical therapists or incorporated into rehabilitation programs until late in the treatment process. Little evidence is available on quadriceps torque development capacity before and after arthroscopic knee surgery. Objectives To study knee extensor rate of torque development, contributing mechanisms, and associations with strength and patient-reported outcomes before and during the first 6 weeks after arthroscopic partial meniscectomy. Methods Twenty subjects (mean ± SD age, 42.3 ± 13.7 years; body mass index, 26.6 ± 3.1 kg/m 2 ) were tested before surgery, and at 2 and 5 weeks after surgery. Quadriceps muscle volume, strength, activation, rate of torque development, and patient-reported outcomes were evaluated across the study period. Results Significant side-to-side differences in quadriceps strength and voluntary rate of torque development were observed at each time point (Ptorque development capacity. Side-to-side rate of torque development deficits after surgery were associated with lower patient-reported outcomes scores. Conclusion Diminished rapid torque development capacity is common in arthroscopic meniscal debridement patients. This reduced capacity is associated with an inability to quickly recruit and drive the quadriceps muscles (neural mechanisms) and not muscle atrophy or other peripheral factors tested. Patient-reported outcomes are associated with quadriceps rate of torque development, but not strength or muscle size. Rapid torque development warrants greater attention in rehabilitation. J Orthop Sports Phys Ther 2017;47(12):945-956. Epub 9 Oct 2017. doi:10.2519/jospt.2017.7310.

  5. Familial risk of epilepsy: a population-based study

    Science.gov (United States)

    Peljto, Anna L.; Barker-Cummings, Christie; Vasoli, Vincent M.; Leibson, Cynthia L.; Hauser, W. Allen; Buchhalter, Jeffrey R.

    2014-01-01

    probands with focal epilepsy, standardized incidence ratios were 1.0 (95% confidence interval 0.00–2.19) for generalized epilepsy and 2.6 (95% confidence interval 1.19–4.26) for focal epilepsy. Epilepsy incidence was greater in offspring of female probands than in offspring of male probands, and this maternal effect was restricted to offspring of probands with focal epilepsy. The results suggest that risks for epilepsies of unknown and prenatal/developmental cause may be influenced by shared genetic mechanisms. They also suggest that some of the genetic influences on generalized and focal epilepsies are distinct. However, the similar increase in risk for focal epilepsy among relatives of probands with either generalized (2.5-fold) or focal epilepsy (2.6-fold) may reflect some coexisting shared genetic influences. PMID:24468822

  6. Toxoplasma gondii and Epilepsy.

    Science.gov (United States)

    Ayaz, Erol; Türkoğlu, Şule Aydın; Orallar, Hayriye

    2016-06-01

    Toxoplasma gondii is a zoonotic parasite can be seen in all the vital organ; in the acute phase, it can be found in the blood, cerebrospinal fluid, semen, tears, saliva, urine, and in almost all body fluids. Transplasental infection can lead to fetal damage and miscarriage. Its last hosts are felines and intermediate hosts are all mammals, including humans. People infected by the ingestion of meat containing cysts in undercooked or raw, are thrown oocysts with cat felines By taking in water and food, from mother to fetus transplacental way, the infected organ transplantation, blood transfusion, laboratory accidents and kaprofaj transmitted by mechanical vectors of the invertebrates. Suppression of the immune system is being transformed to the shape and texture of the cysts with bradyzoite. The parasite settles in the cells of the tissue cysts and causes change in the cellular mechanisms, such as cytokinin task. Depending on changes and type of neurotransmitter (GABA, glutamate, serotonin, dopamine) levels in CSF in ions (Ca, K, Cl, Mg), it is believed that there is a change in their concentration. In this review, literature about the relationship between T. gondii and epilepsy and epileptiform activity the importance of parasites, which settle in the brain, will be highlighted.

  7. Art and epilepsy surgery.

    Science.gov (United States)

    Ladino, Lady Diana; Hunter, Gary; Téllez-Zenteno, José Francisco

    2013-10-01

    The impact of health and disease has led many artists to depict these themes for thousands of years. Specifically, epilepsy has been the subject of many famous works, likely because of the dramatic and misunderstood nature of the clinical presentation. It often evokes religious and even mythical processes. Epilepsy surgical treatment has revolutionized the care of selected patients and is a relatively recent advance. Epilepsy surgery has been depicted in very few artistic works. The first portrait showing a potential surgical treatment for patients with epilepsy was painted in the 12th century. During the Renaissance, Bosch famously provided artistic commentary on traditional beliefs in "The stone of madness". Several of these works demonstrate a surgeon extracting a stone from a patient's head, at one time believed to be the source of all "folly", including epileptic seizures, psychosis, intellectual disability, depression, and a variety of other illnesses. There are some contemporary art pieces including themes around epilepsy surgery, all of them depicting ancient Inca Empire procedures such as trepanning. This article reviews the most relevant artistic works related with epilepsy surgery and also its historical context at the time the work was produced. We also present a painting from the Mexican artist Eduardo Urbano Merino that represents the patient's journey through refractory epilepsy, investigations, and ultimately recovery. Through this work, the artist intends to communicate hope and reassurance to patients going through this difficult process. © 2013.

  8. Epilepsy is Dancing.

    Science.gov (United States)

    Tuft, Mia; Gjelsvik, Bergljot; Nakken, Karl O

    2015-10-01

    In "Epilepsy is Dancing", in Antony and the Johnsons' album "The Crying Light"(2009), the lyrics and accompanying music video depicts an epileptic seizure in which the person is transferred to another beautiful and magical world. This may be called "enchanted epilepsy"; i.e., the experience of epilepsy as deeply nourishing and (positively) transforming, is conveyed not only in the lyrics but also the visual and auditory qualities of the video. The seizure in the video gives associations to Shakespeare's "A Midsummer Night's dream". If epilepsy appears in music lyrics, the focus is mostly on negative aspects of the illness, such as horror, fear and repulsive sexuality associated with the fits [1,2]. Contradictory to these lyrics, Anthony and the Johnsons' song is an example of a positive portrayal of epilepsy. It is open to a multitude of meanings, emotional valence and appraisal of epilepsy. By widening the experiential range associated with epileptic seizures, these lyrics highlight the inherently construed nature of epileptic experience. The song stands out in several ways. First, it describes epilepsy in positive terms, prioritising the euphoric, ecstatic, potentially empowering and enhancing aspects of epileptic seizures. Second, the lyrics and accompanying video point to divine experiences associated with epileptic seizures. Through the lyrics and the music video we are, as an audience, able to sense a snicket of an epileptic seizure, but also the universal experience of loosing control. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. [Tropical causes of epilepsy].

    Science.gov (United States)

    Carod-Artal, F J

    Eighty-five percent of all epileptics live in tropical regions. Prenatal risk factors, traumatic brain injuries and different parasitic infestations of the central nervous system (CNS) are the reasons behind the high prevalence of epilepsy. This work reviews the main parasitic infestations causing epilepsy in the tropics. Neurocysticercosis is the main cause of focal epilepsy in early adulthood in endemic areas (30-50%). All the phases of cysticerci (viable, transitional and calcified) are associated with epileptic seizures. Anti-cysticercus treatment helps get rid of cysticerci faster and reduces the risk of recurrence of seizures in patients with viable cysts. Symptomatic epilepsy can be the first manifestation of neuroschistosomiasis in patients without any systemic symptoms. The pseudotumoral form can trigger seizures secondary to the presence of granulomas and oedemas in the cerebral cortex. The eggs of Schistosoma japonicum are smaller, reach the CNS more easily and trigger epileptic seizures more frequently. Toxocariasis and sparganosis are other parasitic infestations that can give rise to symptomatic seizures. The risk factors for suffering chronic epilepsy after cerebral malaria are a positive familial history of epilepsy and a history of episodes of fever and cerebral malaria that began with coma or which progressed with multiple, prolonged epileptic seizures. About 20% of patients with cerebral infarction secondary to Chagas disease present late vascular epilepsy as a complication. Very few studies have been conducted to examine the prognosis, risk of recurrence and modification of the natural course of seizures associated with tropical parasitic infestations, except for the case of neurocysticercosis.

  10. Epilepsy after Febrile Seizures

    DEFF Research Database (Denmark)

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

    2016-01-01

    to evaluate genetic associations of different febrile seizure subtypes. Results Histories of febrile seizures were validated in 1051 twins in 900 pairs. The febrile seizure type was classified as simple, complex, or febrile status epilepticus. There were 61% simple, 12% complex, and 7% febrile status...... 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...

  11. Role of Neuroinflammation in Evolution of Childhood Epilepsy.

    Science.gov (United States)

    Koh, Sookyong

    2018-01-01

    Until a decade ago, epilepsy research had focused mainly on alterations of neuronal activities and excitability. Such neurocentric emphasis has neglected the role of glia and involvement of inflammation in the pathogenesis of epilepsy. It is becoming clear that immune and inflammatory reactions do occur in the brain despite the brain's lack of conventional lymphatic drainage and graft acceptance and the presence of vascular brain barrier that tightly regulates infiltration of blood monocytes and lymphocytes. The critical roles of brain-resident immune mediators and of brain-infiltrating peripheral leukocytes are increasingly recognized. Inflammatory processes, including activation of microglia and astrocytes and production of proinflammatory cytokines and related molecules, occur in human epilepsy as well as in experimental models of epilepsy. Immune mechanism that underlies evolution of drug-resistant epilepsy and epileptic encephalopathy represents a new target and will aid in development of novel immunotherapeutic drugs and therapies against the key constituents in immune pathways.

  12. Functional brain networks and prediction models in childhood epilepsy

    NARCIS (Netherlands)

    Diessen, E.G.A.L. van

    2015-01-01

    Modern network science revolutionized the field of neuroscience and revealed significant insights into the organization of the brain. Throughout this thesis we applied a network analytical approach to improve our understanding of the pathological mechanisms underlying focal epilepsy. The presented

  13. Intrathecal immunoglobulin synthesis in patients with symptomatic epilepsy and epilepsy of unknown etiology ('cryptogenic').

    Science.gov (United States)

    Fauser, S; Soellner, C; Bien, C G; Tumani, H

    2017-09-01

    To compare the frequency of intrathecal immunoglobulin (Ig) synthesis in patients with symptomatic epilepsy and epilepsy of unknown etiology ('cryptogenic'). Patients with epileptic (n = 301) and non-epileptic (n = 10) seizures were retrospectively screened for autochthonous intrathecal Ig synthesis and oligoclonal bands (OCBs) in the cerebrospinal fluid. Intrathecal IgG/OCBs were detected in 8% of patients with epilepsies of unknown etiology, 5% of patients with first seizures of unknown cause and 0-4% of patients with epilepsy due to brain tumors, cerebrovascular disease or other etiologies. Intrathecal IgG/OCBs were not seen in patients with psychogenic seizures. Identical OCBs in serum and cerebrospinal fluid were more common in all patient groups (10-40% depending on underlying etiology). Intrathecal IgG synthesis/OCBs were observed slightly more frequently in patients with 'cryptogenic' epilepsy and with first seizures of unknown etiology than in other patient groups. However, this remained an infrequent finding and thus we could not confirm humoral immunity as a leading disease mechanism in patients with epilepsy in general or with unknown etiology in particular. © 2017 EAN.

  14. Memory Functioning in Children with Epilepsy: Frontal Lobe Epilepsy, Childhood Absence Epilepsy, and Benign Epilepsy with Centrotemporal Spikes

    Directory of Open Access Journals (Sweden)

    Ana Filipa Lopes

    2014-01-01

    Full Text Available Specific cognitive deficits have been identified in children with epilepsy irrespective of results on intelligence tests. Memory deficits are traditionally attributed to temporal lobe epilepsy, whereas the impact of frontal lobe epilepsy on memory functions has remained controversial. The aim of this study was the examination of memory abilities in other childhood common epilepsy syndromes (frontal lobe epilepsy (FLE, childhood absence epilepsy (CAE, and benign epilepsy with centrotemporal spikes (BECTS and the influence of epilepsy-related variables. Memory was examined in 90 children with epilepsy (each epilepsy group consisted of 30 children, aged 6–15, and compared with 30 control children. Children with FLE showed significant deficits in verbal and visual memory. In addition, type of epilepsy, earlier age at epilepsy onset, and longer active duration of epilepsy were associated with memory problems. Seizure frequency and treatment, however, did not influence memory performance. This study indicates that children with FLE show greater risk of developing memory deficits than children with CAE or BECTS, thus highlighting the importance of assessing also memory functions in frontal lobe epilepsy.

  15. The analysis of the mechanical properties of F75 Co-Cr alloy for use in selective laser melting (SLM manufacturing of removable partial dentures (RPD

    Directory of Open Access Journals (Sweden)

    D. Jevremovic

    2012-04-01

    Full Text Available The presented work discusses the applicability of the selective laser melting technique (SLM in manufacture of removable partial denture (RPD frameworks with the emphasis on material properties. The paper presents initial results of a conducted test of the mechanical properties of the F75 Co-Cr dental alloy used with selective laser melting.

  16. Professional activity of people with epilepsy

    Directory of Open Access Journals (Sweden)

    Anna Staniszewska

    2015-07-01

    Full Text Available Background: The aim of the study was to determine the occupational activity of epileptic patients. Particular attention was paid to employment of people with epilepsy, the way the workplace is informed about the disease, impact of education on employment opportunities and the relationship between clinical type of epilepsy and professional activity. Material and Methods: Patients were recruited from the neurological outpatient clinic in Warszawa and asked to fill in a customized questionnaire, containing questions on their socio-demographic, clinical and employment status. Results: The study included 197 adult patients with epilepsy (64 professionally active and 133 inactive. As many as 47.7% of respondents declared that the disease impeded their employment, and 77.2% admitted that the occurrence of seizure at work had negatively affected their comfort. As many as 42.2% professionally active respondents had revealed the disease at work. There was a statistically significant difference between individuals with primarily generalized seizures and those with partial and secondarily generalized seizures (30.61% vs. 2.63%, p 0.05. Neither current work status had impact on opinions about difficulties in finding a job (p > 0.05. Conclusions: Epilepsy is a great obstacle to finding and maintaining employment. Less than 1/2 of patients inform the workplace about their illness, mainly due to previous negative experiences. Since education significantly enables the employment, programs aimed at promoting vocational activation of patients should facilitate access to learning. Med Pr 2015;66(3:343–350

  17. Mechanism of Protein Denaturation: Partial Unfolding of the P22 Coat Protein I-Domain by Urea Binding

    Science.gov (United States)

    Newcomer, Rebecca L.; Fraser, LaTasha C.R.; Teschke, Carolyn M.; Alexandrescu, Andrei T.

    2015-01-01

    The I-domain is an insertion domain of the bacteriophage P22 coat protein that drives rapid folding and accounts for over half of the stability of the full-length protein. We sought to determine the role of hydrogen bonds (H-bonds) in the unfolding of the I-domain by examining 3JNC’ couplings transmitted through H-bonds, the temperature and urea-concentration dependence of 1HN and 15N chemical shifts, and native-state hydrogen exchange at urea concentrations where the domain is predominantly folded. The native-state hydrogen-exchange data suggest that the six-stranded β-barrel core of the I-domain is more stable against unfolding than a smaller subdomain comprised of a short α-helix and three-stranded β-sheet. H-bonds, separately determined from solvent protection and 3JNC’ H-bond couplings, are identified with an accuracy of 90% by 1HN temperature coefficients. The accuracy is improved to 95% when 15N temperature coefficients are also included. In contrast, the urea dependence of 1HN and 15N chemical shifts is unrelated to H-bonding. The protein segments with the largest chemical-shift changes in the presence of urea show curved or sigmoidal titration curves suggestive of direct urea binding. Nuclear Overhauser effects to urea for these segments are also consistent with specific urea-binding sites in the I-domain. Taken together, the results support a mechanism of urea unfolding in which denaturant binds to distinct sites in the I-domain. Disordered segments bind urea more readily than regions in stable secondary structure. The locations of the putative urea-binding sites correlate with the lower stability of the structure against solvent exchange, suggesting that partial unfolding of the structure is related to urea accessibility. PMID:26682823

  18. Surgical management of epilepsy

    African Journals Online (AJOL)

    in epilepsy surgery and working in conjunction with an experienced epileptologist ... memory and the psychological impairment, and prepare the family ... ning that allows visualisation of abnormal activity or active lesions in cases of multiple ...

  19. Epilepsy or seizures - discharge

    Science.gov (United States)

    ... and the people you work with about your seizure disorder. Driving your own car is generally safe and ... References Abou-Khalil BW, Gallagher MJ, Macdonald RL. Epilepsies. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy ...

  20. Relationship between social competence and neurocognitive performance in children with epilepsy.

    Science.gov (United States)

    Raud, Triin; Kaldoja, Mari-Liis; Kolk, Anneli

    2015-11-01

    Epilepsy may affect a child's social skills and social cognition. The purpose of the study was to examine associations between sociocognitive skills and neurocognitive performance in children with epilepsy. Thirty-five children with epilepsy between the ages of 7 and 12 years (25 with partial and 10 with generalized epilepsy) and 30 controls participated. Theory of Mind (ToM) tasks, Social Cognition Questionnaire proposed by Saltzman-Benaiah and Lalonde (2007), and Social Skills Rating System were used to assess social competence and sociocognitive skills. Neurocognitive performance was assessed using the NEPSY battery. Children with epilepsy demonstrated more difficulties in understanding false belief (pChildren with epilepsy performed significantly worse in attention, executive, verbal, and fine motor tasks (pChildren with generalized epilepsy had more problems in memory tasks (pchildren with partial epilepsy. An age of onset over 9.1 years was positively associated with ToM skills (r=.42, pchildren with better executive functions, and language and visuospatial skills was revealed. The type of epilepsy and age of onset significantly affected ToM skills. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Multiplex families with epilepsy

    Science.gov (United States)

    Afawi, Zaid; Oliver, Karen L.; Kivity, Sara; Mazarib, Aziz; Blatt, Ilan; Neufeld, Miriam Y.; Helbig, Katherine L.; Goldberg-Stern, Hadassa; Misk, Adel J.; Straussberg, Rachel; Walid, Simri; Mahajnah, Muhammad; Lerman-Sagie, Tally; Ben-Zeev, Bruria; Kahana, Esther; Masalha, Rafik; Kramer, Uri; Ekstein, Dana; Shorer, Zamir; Wallace, Robyn H.; Mangelsdorf, Marie; MacPherson, James N.; Carvill, Gemma L.; Mefford, Heather C.; Jackson, Graeme D.; Scheffer, Ingrid E.; Bahlo, Melanie; Gecz, Jozef; Heron, Sarah E.; Corbett, Mark; Mulley, John C.; Dibbens, Leanne M.; Korczyn, Amos D.

    2016-01-01

    Objective: To analyze the clinical syndromes and inheritance patterns of multiplex families with epilepsy toward the ultimate aim of uncovering the underlying molecular genetic basis. Methods: Following the referral of families with 2 or more relatives with epilepsy, individuals were classified into epilepsy syndromes. Families were classified into syndromes where at least 2 family members had a specific diagnosis. Pedigrees were analyzed and molecular genetic studies were performed as appropriate. Results: A total of 211 families were ascertained over an 11-year period in Israel. A total of 169 were classified into broad familial epilepsy syndrome groups: 61 generalized, 22 focal, 24 febrile seizure syndromes, 33 special syndromes, and 29 mixed. A total of 42 families remained unclassified. Pathogenic variants were identified in 49/211 families (23%). The majority were found in established epilepsy genes (e.g., SCN1A, KCNQ2, CSTB), but in 11 families, this cohort contributed to the initial discovery (e.g., KCNT1, PCDH19, TBC1D24). We expand the phenotypic spectrum of established epilepsy genes by reporting a familial LAMC3 homozygous variant, where the predominant phenotype was epilepsy with myoclonic-atonic seizures, and a pathogenic SCN1A variant in a family where in 5 siblings the phenotype was broadly consistent with Dravet syndrome, a disorder that usually occurs sporadically. Conclusion: A total of 80% of families were successfully classified, with pathogenic variants identified in 23%. The successful characterization of familial electroclinical and inheritance patterns has highlighted the value of studying multiplex families and their contribution towards uncovering the genetic basis of the epilepsies. PMID:26802095

  2. Pediatric epilepsy: The Indian experience.

    Science.gov (United States)

    Gadgil, Pradnya; Udani, Vrajesh

    2011-10-01

    Epilepsy is a common clinical entity in neurology clinics. The understanding of the genetics of epilepsy has undergone a sea change prompting re-classification by the International league against epilepsy recently. The prevalence rates of epilepsy in India are similar to those of developed nations. However, the large treatment gap is a major challenge to our public health system. Perinatal injuries are a major causative factor in pediatric group. We have discussed a few common etiologies such as neurocysticercosis and newer genetic epilepsy syndromes. We have also briefly touched upon the Indian experience in pediatric epilepsy surgery.

  3. [Economic aspects of epilepsy].

    Science.gov (United States)

    Argumosa, A; Herranz, J L

    2000-06-01

    The economic magnitude of epilepsy is determined by its effect on the employment status of the patients, the cost of drug treatment for them and the healthcare system and the repercussion worldwide. Studies of the cost of the disease show that it has economic importance due to the sum of the direct and indirect costs caused by it. In the case of epilepsy, the results of studies in various countries led to the creation of a Commission on Economic Aspects of Epilepsy. The lack of epidemiological studies regarding epilepsy in Spain may explain the lack of publications on this subject in our country. The percentage of the total cost due to antiepileptic drugs is considerable and will probably increase in the future. The pharmaco-economic evaluation made by cost-benefit, cost-effectiveness, cost-usefulness analysis and studies to minimize costs should serve to use healthcare resources in the most effective manner and justify the rational use of the new antiepileptic drugs. The economic impact of epilepsy is added to the repercussion of the disease itself on the patient and his family. The different distribution of costs in children and adults with epilepsy suggest the need for intervention at an early age to try to reduce the long term economic and personal repercussions. The pharmaco-economic evaluation of the new antiepileptic drugs will make it clear whether their considerable cost is worth paying for their greater effectivity.

  4. Coeliac disease and epilepsy.

    LENUS (Irish Health Repository)

    Cronin, C C

    2012-02-03

    Whether there is an association between coeliac disease and epilepsy is uncertain. Recently, a syndrome of coeliac disease, occipital lobe epilepsy and cerebral calcification has been described, mostly in Italy. We measured the prevalence of coeliac disease in patients attending a seizure clinic, and investigated whether cerebral calcification occurred in patients with both coeliac disease and epilepsy. Screening for coeliac disease was by IgA endomysial antibody, measured by indirect immunofluorescence using sections of human umbilical cord. Of 177 patients screened, four patients were positive. All had small-bowel histology typical of coeliac disease. The overall frequency of coeliac disease in this mixed patient sample was 1 in 44. In a control group of 488 pregnant patients, two serum samples were positive (1 in 244). Sixteen patients with both coeliac disease and epilepsy, who had previously attended this hospital, were identified. No patient had cerebral calcification on CT scanning. Coeliac disease appears to occur with increased frequency in patients with epilepsy, and a high index of suspicion should be maintained. Cerebral calcification is not a feature of our patients with epilepsy and coeliac disease, and may be an ethnically-or geographically-restricted finding.

  5. Incidence of epilepsy among patients with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Pertin Sianturi

    2006-08-01

    Full Text Available Epilepsy is a chronic condition due to cerebral function disorders. Epilepsy occurs as a common complication of many neurological disorders such as cerebral palsy (CP that can affect further brain damage especially if they are with prolonged seizure. The incidence of epilepsy among patients with CP varies between 25-35%. The high incidence of epilepsy among patients with CP suggests that this disorder has common or related origins. We carried out the retrospective study to determine incidence of epilepsy among patients with CP registered within July 1988 to June 1998 in YPAC Medan and to determine whether the incidence of epilepsy differed according to type of CP. Data were compiled from medical records, including name, sex, parity, mothers age, prenatal, perinatal, and postnatal history, and EEG results. Data were analyzed using statistical computer program and its significance was evaluated by chi square test at p < 0,05. There were 67 cases with CP, 53 cases spastic CP, 13 cases mixed CP and one case dyskinetic CP. Of the 67 cases CP, 47,8% male, 52,2% female and mean age 50,3 (SD 36,9 months. There were 25 (37,3% patients CP associated with epilepsy, 72% general seizures, 20% partial seizures, and 8% infantile spasms. The incidence of epilepsy was significant different among patients with CP associated with type of CP and gestasional age, p < 0,05. We concluded that incidence of epilepsy among patients with CP in YPAC Medan was 37,3% and significantly different among patients with CP according to type CP and gestasional age.

  6. Relationship between child epilepsy and MRI findings in von Recklinghausen Neurofibromatosis (NF 1)

    International Nuclear Information System (INIS)

    Yasujima, Hidehiro; Komatsu, Mikio; Sakurai, Takashi; Kodama, Soichi

    1994-01-01

    Fourteen children meeting the NIH consensus diagnostic criteria for NF 1 were evaluated at the Department of Pediatrics, Himeji Red Cross Hospital. MRI and EEG were examined in all patients, respectively. Four of 14 patients had a history of epilepsy, two had suffered West syndrome, one had complex partial seizures and one had secondary generalized partial epilepsy. Seven (50%) of 14 patients showed abnormal MRI; three (75%) of 4 patients with epilepsy and four (40%) of 10 patients with epilepsy showed low intensity on T 1 -weighted images and hyperintensity on T 2 -weighted images in the globus pallidus and brain stem. These results suggest that children with NF 1 have a spectrum of MRI abnormalities, irrespective of existence of epilepsy. (author)

  7. High temperature mechanisms and kinetics of SiC oxidation under low partial pressures of oxygen: application to the fuel cladding of gas fast reactors

    International Nuclear Information System (INIS)

    Hun, N.

    2011-01-01

    Gas Fast Reactor (GFR) is one of the different Generation IV concepts under investigation for energy production. SiC/SiC composites are candidates of primary interest for a GFR fuel cladding use, thanks to good corrosion resistance among other properties. The mechanisms and kinetics of SiC oxidation under operating conditions have to be identified and quantified as the corrosion can decrease the mechanical properties of the composite. An experimental device has been developed to study the oxidation of silicon carbide under high temperature and low oxygen partial pressure. The results pointed out that not only parabolic oxidation, but also interfacial reactions and volatilization occur under such conditions. After determining the kinetics of each mechanism, as functions of oxygen partial pressure and temperature, the data are used for the modeling of the composites oxidation. The model will be used to predict the lifetime of the composite in operating conditions. (author) [fr

  8. The effect of epilepsy on autistic symptom severity assessed by the social responsiveness scale in children with autism spectrum disorder.

    Science.gov (United States)

    Ko, Chanyoung; Kim, Namwook; Kim, Eunjoo; Song, Dong Ho; Cheon, Keun-Ah

    2016-06-27

    As the prevalence of autism spectrum disorders in people with epilepsy ranges from 15 to 47 % (Clarke et al. in Epilepsia 46:1970-1977, 2005), it is speculated that there is a special relationship between the two disorders, yet there has been a lack of systematic studies comparing the behavioral phenotype between autistic individuals and autistic individuals with epilepsy. This study aims to investigate how the co-occurrence of epilepsy and Autism Spectrum Disorder (ASD) affects autistic characteristics assessed by the Social Responsiveness Scale (SRS), which has been used as a measure of autism symptoms in previous studies. In this research we referred to all individuals with Autism or Autistic Disorder as individuals with ASD. We reviewed the complete medical records of 182 participants who presented to a single tertiary care referral center from January 1, 2013 to July 28, 2015, and subsequently received complete child and adolescent psychiatric assessments. Of the 182 participants, 22 were diagnosed with Autism Spectrum Disorder and epilepsy. Types of epilepsy observed in these individuals included complex partial seizure, generalized tonic-clonic seizure, or infantile spasm. Using 'Propensity Score Matching' we selected 44 children, diagnosed with only Autism Spectrum Disorder, whose age, gender, and intelligence quotient (IQ) were closely matched with the 22 children diagnosed with Autism Spectrum Disorder and epilepsy. Social functioning of participants was assessed by the social responsiveness scale, which consists of five categories: social awareness, social cognition, social communication, social motivation, and autistic mannerisms. Bivariate analyses were conducted to compare the ASD participants with epilepsy group with the ASD-only group on demographic and clinical characteristics. Chi square and t test p values were calculated when appropriate. There was no significant difference in age (p = 0.172), gender (p > 0.999), IQ (FSIQ, p = 0.139; VIQ

  9. Dielectric strength behaviour and mechanical properties of transparent insulation materials suitable to optical monitoring of partial discharges

    International Nuclear Information System (INIS)

    Lothongkam, Chaiyaporn

    2014-01-01

    A novel optical detection method for partial discharge in HV/EHV cable terminations has been proposed. Optical sensor fibres integrated into the HV equipment provide high sensitivity as well as immunity to electromagnetic interference and enable therefore on-line monitoring in electromagnetically noisy environment. The availability of optically transparent silicone rubbers that meet strict dielectric and mechanical criteria is a crucial prerequisite for the implementation of this method. The optically transparent silicone rubbers can be applied for the fabrication of a modern rubber stress cone as well as for the development of a new optical sensing element sensitive to PD activities. In this thesis, AC dielectric strength behaviour and mechanical properties of three types of commercially available silicone rubbers were investigated. One of the characterized silicone rubbers was a translucent type whereas the two others were optically transparent types, however with different chemical curing reactions. The measurements of tensile strength and elongation at break were carried out according to the ISO 37 standard. For investigation of the dielectric strength E b behaviour of the virgin and modified silicone rubbers, a new methodology was developed. It is, at the same time, highly reliable and efficient, saves time and reduces material consumption in comparison to previously reported methodologies. The key component of this methodology is a specifically developed test facility. Furthermore, the methodology comprises determinations for easy preparation and handling of high-quality test specimens. This test method provides various advantages over other methods that have previously been used for measurement of the fundamental quantity E b value of silicone rubbers. Both technical and economic demands are satisfied. The new facility also enables cost-effective routine tests in material research laboratories. The high quality of the obtained test results was verified by

  10. The borderland of migraine and epilepsy in children.

    Science.gov (United States)

    Rajapakse, Thilinie; Buchhalter, Jeffrey

    2016-06-01

    To provide a review on the spectrum of migraine-epilepsy disorders in children. The migraine-epilepsy continuum covers a fascinating array of disorders that share many clinical similarities but also differ fundamentally in pathophysiology. In the pediatric population, its study can be complicated by the young age of those affected and the lack of clear understanding of the neurobiology of these disorders within the developing brain. This review serves to discuss the borderland of migraine and epilepsy in children. It will focus on epidemiology and comorbidity of the two disorders, possible mechanisms for shared pathophysiology informed by basic and translational science, and an overview of clinical similarities and differences. It will also discuss differentiation of migraine aura from childhood occipital epilepsies. Finally, the review concludes with a discussion of current classification methods for capturing cases on the migraine-epilepsy spectrum and a call for a united approach towards a better definition of this spectrum of disorders. Recent advances examining the migraine-epilepsy spectrum show clinicopathological similarities between the two disorders in children. Epidemiology demonstrates reciprocally increased incidences of epilepsy in migraineurs and of migraines in children with epilepsy, however, prospective longitudinal in children are currently lacking. Clinically, the two disorders show similarity in preictal, ictal, and postictal phenomena, with close temporal association of the two conditions described by the controversial term of "migralepsy." Basic science research has contributed significant improvements in understanding the generation of both of these episodic neurological conditions, with common links seen at a cellular level involving synaptic glutamate release and the provocation of varying propagation methods including cortical spreading depression in migraine and the paroxysmal depolarizing shift in epilepsy. Despite these significant

  11. Epilepsy and homicide

    Directory of Open Access Journals (Sweden)

    Pandya NS

    2013-05-01

    Full Text Available Neil S Pandya,1 Mirna Vrbancic,2 Lady Diana Ladino,3,4 José F Téllez-Zenteno31Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; 2Department of Clinical Health Psychology, Royal University Hospital, Saskatoon, Saskatchewan, Canada; 3Division of Neurology, Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; 4Department of Neurology, College of Medicine, University of Antioquia, Medellin, ColombiaPurpose: We report the rare case of a patient with intractable epilepsy and escalating aggression, resulting in murder, who had complete resolution of her seizures and explosive behavior following a right temporal lobectomy.Patients and methods: We searched the available literature from 1880 to 2013 for cases of epilepsy being used as a court defense for murder and collected information regarding the final sentencing outcomes. We selected 15 papers with a total of 50 homicides.Results: We describe the case of a 47-year-old woman with drug-resistant right temporal epilepsy who developed increasing emotional lability, outbursts of anger and escalating violent behavior culminating in a violent murder. The patient was imprisoned while awaiting trial. In the interim, she underwent a successful temporal lobectomy with full resolution of seizures, interictal rage and aggressive behaviors. After the surgery, her charges were downgraded and she was transferred to a psychiatric facility.Conclusion: The aggressive behavior associated with epilepsy has been described in the literature for over a century. A link between epilepsy and aggression has been disproportionally emphasized. These patients share some common characteristics: they are usually young men with a long history of epilepsy and lower than average intelligence. The violent act is postictal, sudden-onset, more likely to occur after a cluster of seizures and is usually related with alcohol abuse.Keywords: aggression, crime, epilepsy

  12. Clinical characteristics and treatment responses in new-onset epilepsy in the elderly.

    Science.gov (United States)

    Tanaka, Akihiro; Akamatsu, Naoki; Shouzaki, Taisaku; Toyota, Tomoko; Yamano, Mitsuhiko; Nakagawa, Masanori; Tsuji, Sadatoshi

    2013-11-01

    Epidemiologic studies have shown that the incidence of epilepsy is the highest in the elderly population. Because the elderly constitutes the most rapidly growing population, epilepsy in this group is an important health issue worldwide. To identify the characteristics of epilepsy in the elderly, we reviewed our experience at a tertiary referral center in Japan. We searched all electronic medical records of the past 6 years at the epilepsy clinic of the hospital affiliated to our University-affiliated hospital. We defined an elderly person as an individual aged 65 years and above. All patients underwent history and physical examinations, 3T magnetic resonance imaging and/or computer tomography, and electroencephalogram (EEG). The diagnosis of epilepsy, age of onset, etiology, and antiepileptic medication were recorded. We identified 70 patients who developed epilepsy after the age of 65 years. The mean age of seizure onset was 73.1 years and 52.9% patients were males. Complex partial seizures (CPS) without secondarily generalization (n=33, 47.1%) were most frequent. The most frequent diagnosis was temporal lobe epilepsy (n=50, 71.4%). Etiological diagnosis was possible in nearly 50% patients, including those with cerebrovascular disease. A clear cause of epilepsy was not found (i.e., non-lesional epilepsy) in 52.8% patients. Interictal EEG revealed focal epileptiform discharges in 72.9% (n=51) patients. Of the 54 patients who were followed more than 1 year, 42 patients (77.8%) were on antiepileptic monotherapy and 52 patients (96.3%) had been seizure-free for more than 1 year. The most frequent diagnosis in our cohort of elderly persons with new-onset epilepsy was temporal lobe epilepsy. Non-lesional temporal lobe epilepsy was not uncommon. Epileptogenecity was relatively low in elderly patients and they responded well to antiepileptic medication. Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  13. Controlling mechanisms of surface partial pressure of CO2 in Jiaozhou Bay during summer and the influence of heavy rain

    Science.gov (United States)

    Li, Yunxiao; Yang, Xufeng; Han, Ping; Xue, Liang; Zhang, Longjun

    2017-09-01

    Due to the combined effects of natural processes and human activities, carbon source/sink processes and mechanisms in the coastal ocean are becoming more and more important in current ocean carbon cycle research. Based on differences in the ratio of total alkalinity (TA) to dissolved inorganic carbon (DIC) associated with terrestrial input, biological process (production and respiration), calcium carbonate (CaCO3) process (precipitation and dissolution) and CO2 evasion/invasion, we discuss the mechanisms controlling the surface partial pressure of CO2 (pCO2) in Jiaozhou Bay (JZB) during summer and the influence of heavy rain, via three cruises performed in mid-June, early July and late July of 2014. In mid-June and in early July, without heavy rain or obvious river input, sea surface pCO2 ranged from 521 to 1080 μatm and from 547 to 998 μatm, respectively. The direct input of DIC from sewage and the intense respiration produced large DIC additions and the highest pCO2 values in the northeast of the bay near the downtown of Qingdao. However, in the west of the bay, significant CaCO3 precipitation led to DIC removal but no obvious increase in pCO2, which was just close to that in the central area. Due to the shallow depth and longer water residence time in this region, this pattern may be related to the sustained release of CO2 into the atmosphere. In late July, heavy rain promoted river input in the western and eastern portions of JZB. Strong primary production led to a significant decrease in pCO2 in the western area, with the lowest pCO2 value of 252 μatm. However, in the northeastern area, the intense respiration remained, and the highest pCO2 value was 1149 μatm. The average air-sea CO2 flux in mid-June and early July was 20.23 mmol m- 2 d- 1 and 23.56 mmol m- 2 d- 1, respectively. In contrast, in late July, sources became sinks for atmospheric CO2 in the western and central areas of the bay, halving the average air-sea CO2 flux to a value of 10.58 mmol m- 2

  14. Effects of a ketogenic diet on brain metabolism in epilepsy

    DEFF Research Database (Denmark)

    Korsholm, Kirsten; Law, Ian

    2013-01-01

    For a subpopulation of drug-resistant epilepsies, a ketogenic diet constitutes the treatment of choice. A ketogenic diet is a high-fat, low-protein, and low-carbohydrate diet, which induces ketosis. Despite the use in treatment of epilepsy since 1924, the clinical efficacy was not demonstrated...... in a controlled, randomized trial until 2008, showing its capability of reducing seizure frequency with more than 50%. However, the exact mechanism of this form of treatment is still unknown. We report here a patient with drug-resistant epilepsy on a ketogenic diet, where a brain 18F-FDG PET examination...

  15. Temporal lobe epilepsy: etiology, fisiopathogeny and magnetic resonance imaging

    International Nuclear Information System (INIS)

    Michaux, Ruben P.

    2003-01-01

    The seizures constitute one of the first causes of consultation in neurology and medical emergencies in all etary groups. The partial seizures are the most frequent form of clinical presentation specially those originated in the temporal lobes. In this revision article the author offers an update of the fisiopathogeny, the etiology and MRI findings in temporal epilepsy, and actualizes concepts derived from basic sciences. Selected cases of frequent pathologic causes contribute to illustrate this paper. In the physiopathology of the generalized seizures, alterations of the nets or thalamus cortical neuronal circuits and anomaly in the ionic canals functions have been demonstrated; in the partial seizures, particularly in the Mesial Temporal Sclerosis, alterations in the conformation of excitatory neo circuits have been verified. There are evidences of specific genetic seizures that express or appear sometime after birth, and others acquired, in which there is a variable time lapse between the action of a determined noxa and the installation of the clinical status, which suggest the existence of an epileptogenic mechanism as a gradual process in its development, and open a promissory field of investigation in search of preventive therapies. In many cases of acquired lesions seizures are related to the excitotoxicity mediated by glutamate as a possible trigger of the process. Besides, neuronal division has been demonstrated in the hippocampus, which could explain a neurogenic mechanism in the development of the seizures. The pathologic molecular findings in cortical malformations and the function of the glial cells in the neuronal homeostasis, contribute with data that sustain the neuro genesis of the seizures. The MRI provides a valuable information in Mesial Temporal Sclerosis, CNS tumoral lesions, neuronal migration disorders, vascular malformation, trauma and infections. Conclusion. The knowledge derived from areas as molecular biology, genetic and

  16. Structural, mechanical, electrical and wetting properties of ZrNx films deposited by Ar/N2 vacuum arc discharge: Effect of nitrogen partial pressure

    Science.gov (United States)

    Abdallah, B.; Naddaf, M.; A-Kharroub, M.

    2013-03-01

    Non-stiochiometric zirconium nitride (ZrNx) thin films have been deposited on silicon substrates by vacuum arc discharge of (N2 + Ar) gas mixtures at different N2 partial pressure ratio. The microstructure, mechanical, electrical and wetting properties of these films are studied by means of X-ray diffraction (XRD), micro-Raman spectroscopy, Rutherford back scattering (RBS) technique, conventional micro-hardness testing, electrical resistivity, atomic force microscopy (AFM) and contact angle (CA) measurements. RBS results and analysis show that the (N/Zr) ratio in the film increases with increasing the N2 partial pressure. A ZrNx film with (Zr/N) ratio in the vicinity of stoichiometric ZrN is obtained at N2 partial pressure of 10%. XRD and Raman results indicate that all deposited films have strained cubic crystal phase of ZrN, regardless of the N2 partial pressure. On increasing the N2 partial pressure, the relative intensity of (1 1 1) orientation with respect to (2 0 0) orientation is seen to decrease. The effect of N2 partial pressure on micro-hardness and the resistivity of the deposited film is revealed and correlated to the alteration of grain size, crystallographic texture, stoichiometry and residual stress developed in the film. In particular, it is found that residual stress and nitrogen incorporation in the film play crucial role in the alteration of micro-hardness and resistivity respectively. In addition, CA and AFM results demonstrate that as N2 partial pressure increases, both the surface hydrophobicity and roughness of the deposited film increase, leading to a significant decrease in the film surface free energy (SFE).

  17. Alteration of consciousness in focal epilepsy: the global workspace alteration theory.

    Science.gov (United States)

    Bartolomei, Fabrice; McGonigal, Aileen; Naccache, Lionel

    2014-01-01

    Alteration of consciousness (AOC) is an important clinical manifestation of partial seizures that greatly impacts the quality of life of patients with epilepsy. Several theories have been proposed in the last fifty years. An emerging concept in neurology is the global workspace (GW) theory that postulates that access to consciousness (from several sensorial modalities) requires transient coordinated activity from associative cortices, in particular the prefrontal cortex and the posterior parietal associative cortex. Several lines of evidence support the view that partial seizures alter consciousness through disturbance of the GW. In particular, a nonlinear relation has been shown between excess of synchronization in the GW regions and the degree of AOC. Changes in thalamocortical synchrony occurring during the spreading of the ictal activity seem particularly involved in the mechanism of altered consciousness. This link between abnormal synchrony and AOC offers new perspectives in the treatment of the AOC since means of decreasing consciousness alteration in seizures could improve patients' quality of life. © 2013.

  18. Febrile Infection-Related Epilepsy Syndrome (FIRES): An Overview of Treatment and Recent Patents.

    Science.gov (United States)

    Hon, Kam Lun E Lun; Leung, Alexander K C; Torres, Alcy R

    2018-05-08

    New-onset refractory status epilepticus (NORSE) refers to a clinical presentation in a patient without active epilepsy or other existing relevant neurological disorder, with new onset of refractory status epilepticus in the absence of a clear acute or active structural, metabolic, or toxic cause. Febrile infection-related epilepsy syndrome (FIRES) is a subset of NORSE that requires a febrile infection between 24 hours and 2 weeks prior to the onset of refractory status epilepticus, with or without fever at the onset of status epilepticus, and with no restriction to the age of the patient. The literature on FIRES is scarce. This article reviews the pathophysiology, clinical features, and various treatment modalities in the treatment of FIRES. A Medline/Pubmed search was conducted using Clinical Queries with the key terms "febrile infection-related epilepsy syndrome", "FIRES", "new-onset refractory status epilepticus" and "NORSE". The search strategy included meta-analyses, randomized controlled trials, clinical trials, reviews and pertinent references. Patents were searched using the key term "FIRES", "NORSE" and "febrile epilepsy syndrome" from www.google.com/patents, www.uspto.gov, and www.freepatentsonline.com. FIRES almost invariably begins with a mild nonspecific febrile illness in an otherwise healthy individual. Twenty four hours to two weeks later, seizures begin and quickly become very frequent and worsen, becoming status epilepticus. Seizures can be simple motor, complex partial or secondary generalized. The exact etiology is no known. It is possible that the syndrome is caused by an inflammatory or autoimmune mechanism. Seizures in FIRES are notoriously very difficult to treat. Treatment modalities include, among others, various antiepileptic drugs, ketogenic diet, intravenous corticosteroids, intravenous immunoglobulin, and burst-suppression coma. Outcome is poor; most children are left with significant cognitive disability and refractory epilepsy

  19. Epilepsy in Dostoevsky.

    Science.gov (United States)

    Iniesta, Ivan

    2013-01-01

    Fyodor M. Dostoevsky (Moscow, 1821-Saint Petersburg, 1881) suffered epilepsy throughout his whole literary career. The aim here is to understand his condition in light of his novels, correspondence, and his contemporaries' accounts as well as through the eyes of later generations of neurologists. From Murin (The landlady, 1847) to Smerdyakov (The brothers Karamazov, 1880), Dostoevsky portrayed up to six characters with epilepsy in his literature. The first symptoms of the disease presented in early adulthood, but he was only diagnosed with epilepsy a decade later. In 1863 he went abroad seeking expert advice from the famous neurologists Romberg and Trousseau. Dostoevsky made an intelligent use of epilepsy in his literature (of his experiential auras or dreamy states particularly) and through it found a way to freedom from perpetual military servitude. His case offers an insight into the natural history of epilepsy (a cryptogenic localization related one of either fronto-medial or temporal lobe origin using contemporary medical terms), thus inspiring later generations of writers and neurologists. Furthermore, it illustrates the good use of an ordinary neurological disorder by an extraordinary writer who transformed adversity into opportunity. © 2013 Elsevier B.V. All rights reserved.

  20. Scott Fitzgerald: famous writer, alcoholism and probable epilepsy

    Directory of Open Access Journals (Sweden)

    Mariana M. Wolski

    Full Text Available ABSTRACT Scott Fitzgerald, a world-renowned American writer, suffered from various health problems, particularly alcohol dependence, and died suddenly at the age of 44. According to descriptions in A Moveable Feast, by Ernest Hemingway, Fitzgerald had episodes resembling complex partial seizures, raising the possibility of temporal lobe epilepsy.

  1. The Pharmacological Basis of Cannabis Therapy for Epilepsy.

    Science.gov (United States)

    Reddy, Doodipala Samba; Golub, Victoria M

    2016-04-01

    Recently, cannabis has been suggested as a potential alternative therapy for refractory epilepsy, which affects 30% of epilepsy, both adults and children, who do not respond to current medications. There is a large unmet medical need for new antiepileptics that would not interfere with normal function in patients with refractory epilepsy and conditions associated with refractory seizures. The two chief cannabinoids are Δ-9-tetrahyrdrocannabinol, the major psychoactive component of marijuana, and cannabidiol (CBD), the major nonpsychoactive component of marijuana. Claims of clinical efficacy in epilepsy of CBD-predominant cannabis or medical marijuana come mostly from limited studies, surveys, or case reports. However, the mechanisms underlying the antiepileptic efficacy of cannabis remain unclear. This article highlights the pharmacological basis of cannabis therapy, with an emphasis on the endocannabinoid mechanisms underlying the emerging neurotherapeutics of CBD in epilepsy. CBD is anticonvulsant, but it has a low affinity for the cannabinoid receptors CB1 and CB2; therefore the exact mechanism by which it affects seizures remains poorly understood. A rigorous clinical evaluation of pharmaceutical CBD products is needed to establish the safety and efficacy of their use in the treatment of epilepsy. Identification of mechanisms underlying the anticonvulsant efficacy of CBD is also critical for identifying other potential treatment options. Copyright © 2016 by The American Society for Pharmacology and Experimental Therapeutics.

  2. Association between administered oxygen, arterial partial oxygen pressure and mortality in mechanically ventilated intensive care unit patients

    NARCIS (Netherlands)

    de Jonge, Evert; Peelen, Linda; Keijzers, Peter J.; Joore, Hans; de Lange, Dylan; van der Voort, Peter Hj; Bosman, Robert J.; de Waal, Ruud Al; Wesselink, Ronald; de Keizer, Nicolette F.

    2008-01-01

    Introduction The aim of this study was to investigate whether in-hospital mortality was associated with the administered fraction of oxygen in inspired air (FiO(2)) and achieved arterial partial pressure of oxygen (PaO2). Methods This was a retrospective, observational study on data from the first

  3. Association between administered oxygen, arterial partial oxygen pressure and mortality in mechanically ventilated intensive care unit patients

    NARCIS (Netherlands)

    de Jonge, Evert; Peelen, Linda; Keijzers, Peter J.; Joore, Hans; de Lange, Dylan; van der Voort, Peter H. J.; Bosman, Robert J.; de Waal, Ruud A. L.; Wesselink, Ronald; de Keizer, Nicolette F.

    2008-01-01

    Introduction The aim of this study was to investigate whether in-hospital mortality was associated with the administered fraction of oxygen in inspired air (FiO(2)) and achieved arterial partial pressure of oxygen (PaO(2)). Methods This was a retrospective, observational study on data from the first

  4. A Comparison of Item Selection Techniques and Exposure Control Mechanisms in CATs Using the Generalized Partial Credit Model.

    Science.gov (United States)

    Pastor, Dena A.; Dodd, Barbara G.; Chang, Hua-Hua

    2002-01-01

    Studied the impact of using five different exposure control algorithms in two sizes of item pool calibrated using the generalized partial credit model. Simulation results show that the a-stratified design, in comparison to a no-exposure control condition, could be used to reduce item exposure and overlap and increase pool use, while degrading…

  5. Preferences of Patients for Discussing Sudden Unexpected Death in Epilepsy

    Directory of Open Access Journals (Sweden)

    Sūna Normunds

    2017-08-01

    Full Text Available People with epilepsy have increased mortality rates, which is partially attributed to sudden unexpected death in epilepsy syndrome (SUDEP. Poor seizure control appears to be the strongest SUDEP risk factor. Management of epilepsy and adherence to therapy is critical to seizure control. The belief by caregivers of negative influence caused by being informed about the syndrome is the main reason SUDEP is not disclosed. There are no clear recommendations when to disclose the risk of SUDEP and how much information should be provided. We addressed the preferences of Latvian epilepsy patients for discussing SUDEP as well as awareness of the syndrome. Our study involved 55 epilepsy patients. We found that, as in other studies, our patients were relatively well informed about SUDEP. We found that a considerable proportion of patients preferred to receive information about SUDEP from a general practitioner. We note the belief of patients that the disclosure of SUDEP would either improve or have no effect on the quality of life. We were able to identify groups of patients with a self-reported belief of more frequent expected anxiety and poor adherence to medical treatment. Our data improves the understanding of preferences of patient for discussing the negative aspects of epilepsy.

  6. [Sleep disorders and epilepsy].

    Science.gov (United States)

    Aoki, Ryo; Ito, Hiroshi

    2014-05-01

    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.

  7. Epilepsy surgery in a liver-transplanted girl with temporal lobe epilepsy and hippocampal sclerosis following PRES with status epilepticus.

    Science.gov (United States)

    Dilena, Robertino; Nebbia, Gabriella; Fiorica, Lorenzo; Farallo, Marcello; Degrassi, Irene; Gozzo, Francesca; Pelliccia, Veronica; Barbieri, Sergio; Cossu, Massimo; Tassi, Laura

    2016-07-01

    Posterior reversible encephalopathy syndrome (PRES) with status epilepticus may occur after liver transplant. This may rarely lead to refractory epilepsy and hippocampal sclerosis (HS). We report the first case of epilepsy surgery in a liver-transplanted patient with refractory temporal lobe epilepsy. A 3-year-old girl underwent liver transplant for congenital biliary atresia. Four days after transplant she manifested PRES with status epilepticus, but she recovered within a couple of weeks. At the age of 5 years she started presenting complex partial seizures, that became refractory to antiepileptic drugs (AED), worsening psychosocial performances. The pre-surgical work-up identified a left HS and temporal pole alterations. A left antero-mesial temporal lobectomy was performed, leading to epilepsy remission and allowing AED withdrawal. Drug-resistant temporal lobe epilepsy and HS may occur as sequelae of PRES with status epilepticus related to liver transplant and cyclosporine use. In this setting early epilepsy surgery may reduce the time of chronic exposure to AED and severe illness due to repeated seizures. This option might have additional advantages in the subgroup of epileptic patients with liver transplant, preserving the liver from the potential damage due to multiple AED trials and their interaction with commonly used immunosuppressant drugs. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  8. Effect of surfactant and partial liquid ventilation treatment on gas exchange and lung mechanics in immature lambs: influence of gestational age.

    Science.gov (United States)

    Rey-Santano, Carmen; Mielgo, Victoria; Gastiasoro, Elena; Valls-i-Soler, Adolfo; Murgia, Xabier

    2013-01-01

    Surfactant (SF) and partial liquid ventilation (PLV) improve gas exchange and lung mechanics in neonatal RDS. However, variations in the effects of SF and PLV with degree of lung immaturity have not been thoroughly explored. Experimental Neonatal Respiratory Physiology Research Unit, Cruces University Hospital. Prospective, randomized study using sealed envelopes. 36 preterm lambs were exposed (at 125 or 133-days of gestational age) by laparotomy and intubated. Catheters were placed in the jugular vein and carotid artery. All the lambs were assigned to one of three subgroups given: 20 mL/Kg perfluorocarbon and managed with partial liquid ventilation (PLV), surfactant (Curosurf®, 200 mg/kg) or (3) no pulmonary treatment (Controls) for 3 h. Cardiovascular parameters, blood gases and pulmonary mechanics were measured. In 125-day gestation lambs, SF treatment partially improved gas exchange and lung mechanics, while PLV produced significant rapid improvements in these parameters. In 133-day lambs, treatments with SF or PLV achieved similarly good responses. Neither surfactant nor PLV significantly affected the cardiovascular parameters. SF therapy response was more effective in the older gestational age group whereas the effectiveness of PLV therapy was not gestational age dependent.

  9. Forced Normalization: Antagonism Between Epilepsy and Psychosis.

    Science.gov (United States)

    Kawakami, Yasuhiko; Itoh, Yasuhiko

    2017-05-01

    The antagonism between epilepsy and psychosis has been discussed for a long time. Landolt coined the term "forced normalization" in the 1950s to describe psychotic episodes associated with the remission of seizures and disappearance of epileptiform activity on electroencephalograms in individuals with epilepsy. Since then, neurologists and psychiatrists have been intrigued by this phenomenon. However, although collaborative clinical studies and basic experimental researches have been performed, the mechanism of forced normalization remains unknown. In this review article, we present a historical overview of the concept of forced normalization, and discuss potential pathogenic mechanisms and clinical diagnosis. We also discuss the role of dopamine, which appears to be a key factor in the mechanism of forced normalization. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Revealing vilazodone's binding mechanism underlying its partial agonism to the 5-HT1A receptor in the treatment of major depressive disorder.

    Science.gov (United States)

    Zheng, Guoxun; Xue, Weiwei; Yang, Fengyuan; Zhang, Yang; Chen, Yuzong; Yao, Xiaojun; Zhu, Feng

    2017-11-01

    It has been estimated that major depressive disorder (MDD) will become the second largest global burden among all diseases by 2030. Various types of drugs, including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and serotonin receptor partial agonist/reuptake inhibitors (SPARIs), have been approved and become the primary or first-line medications prescribed for MDD. SPARI was expected to demonstrate more enhanced drug efficacy and a rapid onset of action as compared to SSRI and SNRI. As one of the most famous SPARIs, vilazodone was approved by the FDA for the treatment of MDD. Because of the great clinical importance of vilazodone, its binding mechanism underlying its partial agonism to the 5-HT 1A receptor (5-HT 1A R) could provide valuable information to SPARIs' drug-like properties. However, this mechanism has not been reported to date; consequently, the rational design of new efficacious SPARI-based MDD drugs is severely hampered. To explore the molecular mechanism of vilazodone, an integrated computational strategy was adopted in this study to reveal its binding mechanism and prospective structural feature at the agonist binding site of 5-HT 1A R. As a result, 22 residues of this receptor were identified as hotspots, consistently favoring the binding of vilazodone and its analogues, and a common binding mechanism underlying their partial agonism to 5-HT 1A R was, therefore, discovered. Moreover, three main interaction features between vilazodone and 5-HT 1A R have been revealed and schematically summarized. In summary, this newly identified binding mechanism will provide valuable information for medicinal chemists working in the field of rational design of novel SPARIs for MDD treatment.

  11. Cognitive impairments in epilepsy

    Directory of Open Access Journals (Sweden)

    Aleksandr Anatolyevich Kostylev

    2013-01-01

    Full Text Available Cognitive impairments in epilepsy are a current problem in neurology. The basis of the idea on the pathogenesis of higher nervous system dysfunctions is the interaction of a few factors that include the form and duration of the disease, gender differences, and the impact of antiepileptic therapy. The role of interattack epileptiform changes in the development of cognitive deficit in adults and epileptic encephalopathies in children is discussed. Up-to-date neurophysiological and neuroimaging diagnostic methods allow the detection of new features in the course and progression of higher nervous system dysfunctions in epilepsy.

  12. Epilepsy: A Spectrum Disorder

    Science.gov (United States)

    Sirven, Joseph I.

    2015-01-01

    Epilepsy, a disorder of unprovoked seizures is a multifaceted disease affecting individuals of all ages with a particular predilection for the very young and old. In addition to seizures, many patients often report cognitive and psychiatric problems associated with both the seizures themselves and its therapy. Epilepsy has numerous etiologies both idiopathic and acquired with a wide range of therapeutic responses. Despite numerous treatments available to control repetitive seizures including medications, diets, immunotherapy, surgery, and neuromodulatory devices, a large percentage of patients continue to suffer the consequences of uncontrolled seizures, which include psychosocial stigma and death. PMID:26328931

  13. Recent advances in epilepsy genetics.

    Science.gov (United States)

    Orsini, Alessandro; Zara, Federico; Striano, Pasquale

    2018-02-22

    In last few years there has been rapid increase in the knowledge of epilepsy genetics. Nowadays, it is estimated that genetic epilepsies include over than 30% of all epilepsy syndromes. Several genetic tests are now available for diagnostic purposes in clinical practice. In particular, next-generation sequencing has proven to be effective in revealing gene mutations causing epilepsies in up to a third of the patients. This has lead also to functional studies that have given insight into disease pathophysiology and consequently to the identification of potential therapeutic targets opening the way of precision medicine for epilepsy patients. This minireview is focused on the most recent advances in genetics of epilepsies. We will also overview the modern genomic technologies and illustrate the diagnostic pathways in patients with genetic epilepsies. Finally, the potential implications for a personalized treatment (precision medicine) are also discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. The influnece of the partial single reduction on mechanical properties wires made from trip steel with 0,43 % C

    Directory of Open Access Journals (Sweden)

    S. Wiewiórowska

    2015-01-01

    Full Text Available Large strain inhomogeneity is caused by the shape of deformation zone of die and by the friction between tool and deformed wire for multistage wire drawing processes. The influence on the value of the redundant strain by the use of different partial single reductions during all wire drawing process was observed. This problem is particularly important for TRIP steel wires drawing processes because the strain intensity influences on the speed of retained austenite transformation into martensite.

  15. Benign childhood epilepsy with occipital paroxysms: neuropsychological findings.

    Science.gov (United States)

    Germanò, Eva; Gagliano, Antonella; Magazù, Angela; Sferro, Caterina; Calarese, Tiziana; Mannarino, Erminia; Calamoneri, Filippo

    2005-05-01

    Benign childhood epilepsy with occipital paroxysms is classified among childhood benign partial epilepsies. The absence of neurological and neuropsychological deficits has long been considered as a prerequisite for a diagnosis of benign childhood partial epilepsy. Much evidence has been reported in literature in the latest years suggesting a neuropsychological impairment in this type of epilepsy, particularly in the type with Rolandic paroxysms. The present work examines the neuropsychological profiles of a sample of subjects affected by the early-onset benign childhood occipital seizures (EBOS) described by Panayotopulos. The patient group included 22 children (14 males and 8 females; mean age 10.1+/-3.3 years) diagnosed as having EBOS. The patients were examined with a set of tests investigating neuropsychological functions: memory, attention, perceptive, motor, linguistic and academic (reading, writing, arithmetic) abilities. The same instruments have been given to a homogeneous control group as regards sex, age, level of education and socio-economic background. None of the subjects affected by EBOS showed intellectual deficit (mean IQ in Wechsler Full Scale 91.7; S.D. 8.9). Results show a widespread cognitive dysfunction in the context of a focal epileptogenic process in EBOS. In particular, children with EBOS show a significant occurrence of specific learning disabilities (SLD) and other subtle neuropsychological deficits. We found selective dysfunctions relating to perceptive-visual attentional ability (pmemory abilities (psupports the hypothesis that epilepsy itself plays a role in the development of neuropsychological impairment. Supported by other studies that have documented subtle neuropsychological deficits in benign partial epilepsy, we stress the importance of reconsidering its supposed "cognitive benignity", particularly in occipital types.

  16. Analytic information processing style in epilepsy patients.

    Science.gov (United States)

    Buonfiglio, Marzia; Di Sabato, Francesco; Mandillo, Silvia; Albini, Mariarita; Di Bonaventura, Carlo; Giallonardo, Annateresa; Avanzini, Giuliano

    2017-08-01

    Relevant to the study of epileptogenesis is learning processing, given the pivotal role that neuroplasticity assumes in both mechanisms. Recently, evoked potential analyses showed a link between analytic cognitive style and altered neural excitability in both migraine and healthy subjects, regardless of cognitive impairment or psychological disorders. In this study we evaluated analytic/global and visual/auditory perceptual dimensions of cognitive style in patients with epilepsy. Twenty-five cryptogenic temporal lobe epilepsy (TLE) patients matched with 25 idiopathic generalized epilepsy (IGE) sufferers and 25 healthy volunteers were recruited and participated in three cognitive style tests: "Sternberg-Wagner Self-Assessment Inventory", the C. Cornoldi test series called AMOS, and the Mariani Learning style Questionnaire. Our results demonstrate a significant association between analytic cognitive style and both IGE and TLE and respectively a predominant auditory and visual analytic style (ANOVA: p values <0,0001). These findings should encourage further research to investigate information processing style and its neurophysiological correlates in epilepsy. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. A finite element evaluation of mechanical function for 3 distal extension partial dental prosthesis designs with a 3-dimensional nonlinear method for modeling soft tissue.

    Science.gov (United States)

    Nakamura, Yoshinori; Kanbara, Ryo; Ochiai, Kent T; Tanaka, Yoshinobu

    2014-10-01

    The mechanical evaluation of the function of partial removable dental prostheses with 3-dimensional finite element modeling requires the accurate assessment and incorporation of soft tissue behavior. The differential behaviors of the residual ridge mucosa and periodontal ligament tissues have been shown to exhibit nonlinear displacement. The mathematic incorporation of known values simulating nonlinear soft tissue behavior has not been investigated previously via 3-dimensional finite element modeling evaluation to demonstrate the effect of prosthesis design on the supporting tissues. The purpose of this comparative study was to evaluate the functional differences of 3 different partial removable dental prosthesis designs with 3-dimensional finite element analysis modeling and a simulated patient model incorporating known viscoelastic, nonlinear soft tissue properties. Three different designs of distal extension removable partial dental prostheses were analyzed. The stress distributions to the supporting abutments and soft tissue displacements of the designs tested were calculated and mechanically compared. Among the 3 dental designs evaluated, the RPI prosthesis demonstrated the lowest stress concentrations on the tissue supporting the tooth abutment and also provided wide mucosa-borne areas of support, thereby demonstrating a mechanical advantage and efficacy over the other designs evaluated. The data and results obtained from this study confirmed that the functional behavior of partial dental prostheses with supporting abutments and soft tissues are consistent with the conventional theories of design and clinical experience. The validity and usefulness of this testing method for future applications and testing protocols are shown. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  18. WONOEP appraisal: Biomarkers of epilepsy-associated comorbidities.

    Science.gov (United States)

    Ravizza, Teresa; Onat, Filiz Y; Brooks-Kayal, Amy R; Depaulis, Antoine; Galanopoulou, Aristea S; Mazarati, Andrey; Numis, Adam L; Sankar, Raman; Friedman, Alon

    2017-03-01

    Neurologic and psychiatric comorbidities are common in patients with epilepsy. Diagnostic, predictive, and pharmacodynamic biomarkers of such comorbidities do not exist. They may share pathogenetic mechanisms with epileptogenesis/ictogenesis, and as such are an unmet clinical need. The objectives of the subgroup on biomarkers of comorbidities at the XIII Workshop on the Neurobiology of Epilepsy (WONOEP) were to present the state-of-the-art recent research findings in the field that highlighting potential biomarkers for comorbidities in epilepsy. We review recent progress in the field, including molecular, imaging, and genetic biomarkers of comorbidities as discussed during the WONOEP meeting on August 31-September 4, 2015, in Heybeliada Island (Istanbul, Turkey). We further highlight new directions and concepts from studies on comorbidities and potential new biomarkers for the prediction, diagnosis, and treatment of epilepsy-associated comorbidities. The activation of various molecular signaling pathways such as the "Janus Kinase/Signal Transducer and Activator of Transcription," "mammalian Target of Rapamycin," and oxidative stress have been shown to correlate with the presence and severity of subsequent cognitive abnormalities. Furthermore, dysfunction in serotonergic transmission, hyperactivity of the hypothalamic-pituitary-adrenocortical axis, the role of the inflammatory cytokines, and the contributions of genetic factors have all recently been regarded as relevant for understanding epilepsy-associated depression and cognitive deficits. Recent evidence supports the utility of imaging studies as potential biomarkers. The role of such biomarker may be far beyond the diagnosis of comorbidities, as accumulating clinical data indicate that comorbidities can predict epilepsy outcomes. Future research is required to reveal whether molecular changes in specific signaling pathways or advanced imaging techniques could be detected in the clinical settings and correlate

  19. Déjà Experiences in Temporal Lobe Epilepsy

    OpenAIRE

    Illman, Nathan A.; Butler, Chris R.; Souchay, Celine; Moulin, Chris J. A.

    2012-01-01

    Historically, déjà vu has been linked to seizure activity in temporal lobe epilepsy, and clinical reports suggest that many patients experience the phenomenon as a manifestation of simple partial seizures. We review studies on déjà vu in epilepsy with reference to recent advances in the understanding of déjà vu from a cognitive and neuropsychological standpoint. We propose a decoupled familiarity hypothesis, whereby déjà vu is produced by an erroneous feeling of familiarity which is not in ...

  20. Marijuana for epilepsy?

    OpenAIRE

    Di Giovanni, Giuseppe

    2016-01-01

    Marijuana has been used for centuries for medical reasons. In the early 20th century it was first linked to treatment for epilepsy. Over the last few decades researchers have been unravelling the truth behind the drug. Prof. Giuseppe Di Giovanni tells us more about using marijuana for medical research and his own research on this controversial drug.

  1. Mobile EEG in epilepsy

    NARCIS (Netherlands)

    Askamp, Jessica; van Putten, Michel Johannes Antonius Maria

    2014-01-01

    The sensitivity of routine EEG recordings for interictal epileptiform discharges in epilepsy is limited. In some patients, inpatient video-EEG may be performed to increase the likelihood of finding abnormalities. Although many agree that home EEG recordings may provide a cost-effective alternative

  2. Global Health: Epilepsy.

    Science.gov (United States)

    Ali, Amza

    2018-04-01

    Epilepsy is a frequently misunderstood and highly stigmatized condition. Major treatment gaps exist across the world, most so in areas of financial constraint. Classification permits the best approaches to treatment and to ascertaining prognosis. The International League Against Epilepsy's new classification system emphasizes clinical aspects and utilizes all available resources to determine whether it is a focal or generalized epilepsy. The most important tools are a careful history, clinical examination, electroencephalography, and appropriate neuroimaging. Inadequate, delayed, and incomplete evaluation may lead to misdiagnosis and costly mismanagement. Treatment is generally pharmacological, with approximately 20 to 30% of patients eventually proving refractory to medications and thus becoming potential surgical candidates. The type of epilepsy, age, gender, comorbidities, drug interactions, and drug cost are important factors in choosing an antiepileptic drug (AED). The teratogenic potential of some AEDs, weight gain, and menstrual hormone-related issues are important considerations in women. The impact of AEDs on bone health is critical in all age groups, particularly in the elderly. Psychiatric problems, mostly depression and anxiety, can have a great impact on seizure control and overall quality of life. Finally, effective partnerships and collaborations can bring resources, both human and financial, to regions that would otherwise find it impossible to effect change on their own. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  3. Hormones and absence epilepsy

    NARCIS (Netherlands)

    Luijtelaar, E.L.J.M. van; Tolmacheva, E.A.; Budziszewska, B.; Stein, J.

    2017-01-01

    Hormones have an extremely large impact on seizures and epilepsy. Stress and stress hormones are known to reinforce seizure expression, and gonadal hormones affect the number of seizures and even the seizure type. Moreover, hormonal concentrations change drastically over an individual's lifetime,

  4. Epilepsy in the Elderly

    Directory of Open Access Journals (Sweden)

    Lu-An Chen

    2012-06-01

    Full Text Available Elderly people are the largest and continuously fastest growing population among patients with epilepsy. Elderly patients with epilepsy are very different from other age groups in many respects and clinicians shouldn’t treat them in the same way as younger adults. Accurate diagnosis of epilepsy in the elderly is much more difficult and atypical manifestations and misdiagnoses are certainly not the exception. Syncope is probably the most important differential diagnosis. High clinical suspicion and proper investigation are the best tools for prompt diagnosis. Etiologies of late-onset epilepsy are mainly symptomatic and cerebrovascular diseases are the most common causes in this age group, followed by degenerative diseases such as Alzheimer’s disease. It is appropriate to consider starting antiepileptic drug (AED treatment at the first-ever seizure in elderly patients who have remote symptomatic causes such as stroke and dementia. According to the high recurrence rate of seizure and the good response to AEDs in elderly patients, the proper choice from various AEDs for seizure control is very important. Decision-making for AED choice depends on many different factors, including pharmacological properties, efficacy, tolerability from side effects, drug interactions, and medical comorbidities. The newer AEDs with lesser adverse effects and fewer drug interactions appear to be reasonable treatment options for elderly patients. However, more evidence from clinical trials in this specific age group is warranted.

  5. Mitochondrial dysfunction in epilepsy

    Czech Academy of Sciences Publication Activity Database

    Folbergrová, Jaroslava; Kunz, W.S.

    2012-01-01

    Roč. 12, č. 1 (2012), s. 35-40 ISSN 1567-7249 R&D Projects: GA ČR(CZ) GA309/05/2015; GA ČR GA309/08/0292 Institutional research plan: CEZ:AV0Z50110509 Keywords : epilepsy * mitochondrial dysfunction * neurodegeneration Subject RIV: FH - Neurology Impact factor: 4.025, year: 2012

  6. Epilepsy and brain tumors

    Science.gov (United States)

    ENGLOT, DARIO J.; CHANG, EDWARD F.; VECHT, CHARLES J.

    2016-01-01

    Seizures are common in patients with brain tumors, and epilepsy can significantly impact patient quality of life. Therefore, a thorough understanding of rates and predictors of seizures, and the likelihood of seizure freedom after resection, is critical in the treatment of brain tumors. Among all tumor types, seizures are most common with glioneuronal tumors (70–80%), particularly in patients with frontotemporal or insular lesions. Seizures are also common in individuals with glioma, with the highest rates of epilepsy (60–75%) observed in patients with low-grade gliomas located in superficial cortical or insular regions. Approximately 20–50% of patients with meningioma and 20–35% of those with brain metastases also suffer from seizures. After tumor resection, approximately 60–90% are rendered seizure-free, with most favorable seizure outcomes seen in individuals with glioneuronal tumors. Gross total resection, earlier surgical therapy, and a lack of generalized seizures are common predictors of a favorable seizure outcome. With regard to anticonvulsant medication selection, evidence-based guidelines for the treatment of focal epilepsy should be followed, and individual patient factors should also be considered, including patient age, sex, organ dysfunction, comorbidity, or cotherapy. As concomitant chemotherapy commonly forms an essential part of glioma treatment, enzyme-inducing anticonvulsants should be avoided when possible. Seizure freedom is the ultimate goal in the treatment of brain tumor patients with epilepsy, given the adverse effects of seizures on quality of life. PMID:26948360

  7. exercise and epilepsy

    OpenAIRE

    UK, Epilepsy Society

    2018-01-01

    Exercise improves fitness, energy and mood and relieves stress. Improving overall health and wellbeing in this way can help reduce seizures and the impact of epilepsy for some people. It can also help people feel more in control of their health.

  8. Microstructure Evolution and Mechanical Behavior of a CMnSiAl TRIP Steel Subjected to Partial Austenitization Along with Quenching and Partitioning Treatment

    Science.gov (United States)

    Kong, H.; Chao, Q.; Cai, M. H.; Pavlina, E. J.; Rolfe, B.; Hodgson, P. D.; Beladi, H.

    2018-02-01

    The present study investigated the microstructure evolution and mechanical behavior in a low carbon CMnSiAl transformation-induced plasticity (TRIP) steel, which was subjected to a partial austenitization at 1183 K (910 °C) followed by one-step quenching and partitioning (Q&P) treatment at different isothermal holding temperatures of [533 K to 593 K (260 °C to 320 °C)]. This thermal treatment led to the formation of a multi-phase microstructure consisting of ferrite, tempered martensite, bainitic ferrite, fresh martensite, and retained austenite, offering a superior work-hardening behavior compared with the dual-phase microstructure (i.e., ferrite and martensite) formed after partial austenitization followed by water quenching. The carbon enrichment in retained austenite was related to not only the carbon partitioning during the isothermal holding process, but also the carbon enrichment during the partial austenitization and rapid cooling processes, which has broadened our knowledge of carbon partitioning mechanism in conventional Q&P process.

  9. Issues related to symptomatic and disease-modifying treatments affecting cognitive and neuropsychiatric comorbidities of epilepsy

    Science.gov (United States)

    Brooks-Kayal, Amy R.; Bath, Kevin G.; Berg, Anne T.; Galanopoulou, Aristea S.; Holmes, Gregory L.; Jensen, Frances E.; Kanner, Andres M.; O’Brien, Terence J.; Whittemore, Vicky H.; Winawer, Melodie R.; Patel, Manisha; Scharfman, Helen E.

    2014-01-01

    Summary Many symptoms of neurologic or psychiatric illness—such as cognitive impairment, depression, anxiety, attention deficits, and migraine—occur more frequently in people with epilepsy than in the general population. These diverse comorbidities present an underappreciated problem for people with epilepsy and their caregivers because they decrease quality of life, complicate treatment, and increase mortality. In fact, it has been suggested that comorbidities can have a greater effect on quality of life in people with epilepsy than the seizures themselves. There is increasing recognition of the frequency and impact of cognitive and behavioral comorbidities of epilepsy, highlighted in the 2012 Institute of Medicine report on epilepsy. Comorbidities have also been acknowledged, as a National Institutes of Health (NIH) Benchmark area for research in epilepsy. However, relatively little progress has been made in developing new therapies directed specifically at comorbidities. On the other hand, there have been many advances in understanding underlying mechanisms. These advances have made it possible to identify novel targets for therapy and prevention. As part of the International League Against Epilepsy/American Epilepsy Society workshop on preclinical therapy development for epilepsy, our working group considered the current state of understanding related to terminology, models, and strategies for therapy development for the comorbidities of epilepsy. Herein we summarize our findings and suggest ways to accelerate development of new therapies. We also consider important issues to improve research including those related to methodology, nonpharmacologic therapies, biomarkers, and infrastructure. PMID:23909853

  10. Sex and Hormonal influences on Seizures and Epilepsy

    Science.gov (United States)

    Velíšková, Jana; DeSantis, Kara A.

    2012-01-01

    Epilepsy is the third most common chronic neurological disorder. Clinical and experimental evidence supports the role of sex and influence of sex hormones on seizures and epilepsy as well as alterations of the endocrine system and levels of sex hormones by epileptiform activity. Conversely, seizures are sensitive to changes in sex hormone levels, which in turn may affect the seizure-induced neuronal damage. The effects of reproductive hormones on neuronal excitability and seizure-induced damage are complex to contradictory and depend on different mechanisms, which have to be accounted for in data interpretation. Both estradiol and progesterone/allopregnanolone may have beneficial effects for patients with epilepsy. Individualized hormonal therapy should be considered as adjunctive treatment in patients with epilepsy to improve seizure control as well as quality of life. PMID:22504305

  11. Rock-Mechanics Research. A Survey of United States Research to 1965, with a Partial Survey of Canadian Universities.

    Science.gov (United States)

    National Academy of Sciences - National Research Council, Washington, DC.

    The results of a survey, conducted by the Committee on Rock Mechanics, to determine the status of training and research in rock mechanics in presented in this publication. In 1964 and 1965 information was gathered by questionnaires sent to industries, selected federal agencies, and universities in both the United States and Canada. Results are…

  12. Angels and demons: neurotrophic factors and epilepsy.

    Science.gov (United States)

    Simonato, Michele; Tongiorgi, Enrico; Kokaia, Merab

    2006-12-01

    Several lines of evidence indicate that neurotrophic factors (NTFs) could be key causal mediators in the development of acquired epileptic syndromes. Yet the trophic properties of NTFs indicate that they might be used to treat epilepsy-associated damage. Accordingly, different NTFs, or even the same NTF, could produce functionally contrasting effects in the context of epilepsy. Recent experimental evidence begins to shed light on the mechanisms underlying these contrasting effects. Understanding these mechanisms will be instrumental for the development of effective therapies, which must be based on a careful consideration of the biological properties of NTFs. Here, we critically evaluate new information emerging in this area and discuss its implications for clinical treatment.

  13. Genetics Home Reference: pyridoxine-dependent epilepsy

    Science.gov (United States)

    ... Home Health Conditions Pyridoxine-dependent epilepsy Pyridoxine-dependent epilepsy Printable PDF Open All Close All Enable Javascript ... view the expand/collapse boxes. Description Pyridoxine-dependent epilepsy is a condition that involves seizures beginning in ...

  14. Epilepsy Surgery for Individuals with TSC

    Science.gov (United States)

    ... Privacy Policy Sitemap Learn Engage Donate About TSC Epilepsy Surgery for Individuals with TSC In this video ... Aria Fallah, MD, discusses the surgical treatment of epilepsy in children with tuberous sclerosis complex. Epilepsy is ...

  15. Epilepsy and the Wnt Signaling Pathway

    Science.gov (United States)

    2015-06-01

    forebrain development. The primary target is Wnt 8b, which is elevated in this period 4. Fox G1 is also genetically associated with infantile spasms 8...the Warburg effect’s role in non- cancerous tissues is largely unexplored. Second, in other diseases such as diabetes , Wnt signaling has emerged as...epilepsy and infantile spasms, we found that both mechanisms appeared to contribute. Two of the three genes came from our observation that several genes

  16. Seizure-related factors and non-verbal intelligence in children with epilepsy. A population-based study from Western Norway.

    Science.gov (United States)

    Høie, B; Mykletun, A; Sommerfelt, K; Bjørnaes, H; Skeidsvoll, H; Waaler, P E

    2005-06-01

    To study the relationship between seizure-related factors, non-verbal intelligence, and socio-economic status (SES) in a population-based sample of children with epilepsy. The latest ILAE International classifications of epileptic seizures and syndromes were used to classify seizure types and epileptic syndromes in all 6-12 year old children (N=198) with epilepsy in Hordaland County, Norway. The children had neuropediatric and EEG examinations. Of the 198 patients, demographic characteristics were collected on 183 who participated in psychological studies including Raven matrices. 126 healthy controls underwent the same testing. Severe non-verbal problems (SNVP) were defined as a Raven score at or Raven percentile group, whereas controls were highly over-represented in the higher percentile groups. SNVP were present in 43% of children with epilepsy and 3% of controls. These problems were especially common in children with remote symptomatic epilepsy aetiology, undetermined epilepsy syndromes, myoclonic seizures, early seizure debut, high seizure frequency and in children with polytherapy. Seizure-related characteristics that were not usually associated with SNVP were idiopathic epilepsies, localization related (LR) cryptogenic epilepsies, absence and simple partial seizures, and a late debut of epilepsy. Adjusting for socio-economic status factors did not significantly change results. In childhood epilepsy various seizure-related factors, but not SES factors, were associated with the presence or absence of SNVP. Such deficits may be especially common in children with remote symptomatic epilepsy aetiology and in complex and therapy resistant epilepsies. Low frequencies of SNVP may be found in children with idiopathic and LR cryptogenic epilepsy syndromes, simple partial or absence seizures and a late epilepsy debut. Our study contributes to an overall picture of cognitive function and its relation to central seizure characteristics in a childhood epilepsy population

  17. Confronting the stigma of epilepsy

    Directory of Open Access Journals (Sweden)

    Sanjeev V Thomas

    2011-01-01

    Full Text Available Stigma and resultant psychosocial issues are major hurdles that people with epilepsy confront in their daily life. People with epilepsy, particularly women, living in economically weak countries are often ill equipped to handle the stigma that they experience at multiple levels. This paper offers a systematic review of the research on stigma from sociology and social psychology and details how stigma linked to epilepsy or similar conditions can result in stereotyping, prejudice and discrimination. We also briefly discuss the strategies that are most commonly utilized to mitigate stigma. Neurologists and other health care providers, social workers, support groups and policy makers working with epilepsy need to have a deep understanding of the social and cultural perceptions of epilepsy and the related stigma. It is necessary that societies establish unique determinants of stigma and set up appropriate strategies to mitigate stigma and facilitate the complete inclusion of people with epilepsy as well as mitigating any existing discrimination.

  18. Familial benign nonprogressive myoclonic epilepsies.

    Science.gov (United States)

    Striano, Pasquale; de Falco, Fabrizio A; Minetti, Carlo; Zara, Federico

    2009-05-01

    Work on the classification of epileptic syndromes is ongoing, and many syndromes are still under discussion. In particular, special difficulty still persists in correctly classifying epilepsies with myoclonic seizures. The existence of special familial epileptic syndromes primarily showing myoclonic features has been recently suggested on the basis of a clear pattern of inheritance or on the identification of new chromosomal genetic loci linked to the disease. These forms in development include familial infantile myoclonic epilepsy (FIME), benign adult familial myoclonic epilepsy (BAFME), or autosomal dominant cortical myoclonus and epilepsy (ADCME), and, maybe, adult-onset myoclonic epilepsy (AME). In the future, the identification of responsible genes and the protein products will contribute to our understanding of the molecular pathways of epileptogenesis and provide neurobiologic criteria for the classification of epilepsies, beyond the different phenotypic expression.

  19. Management of epilepsy in elderly

    Directory of Open Access Journals (Sweden)

    Harsono Harsono

    2003-03-01

    Full Text Available Management of epilepsy in elderly requires understanding the unique biochemical and pharmacological characteristics of these patients. Management decisions must be based on accurate classification of seizures or epilepsy syndromes, a thorough neurological assessment to define etiology, and a comprehensive assessment of the patient’s health and living situation. Concomitant illnesses such as neurological, psychiatric, metabolic, or cardiac disorders will require individualization of plans and instructions. Specific problems of treatment of epilepsy in the elderly compared to childhood patients are as follows: distinctive range of causes of epilepsy, distinctive differential diagnosis, concurrent pathologies unrelated to epilepsy, pharmacokinetic and pharmacodynamic differences, and distinctive psychosocial effects. (Med J Indones 2003; 12: 40-7 Keywords:  epilepsy, elderly, management, concomitant illness, pharmacokinetic

  20. Diagnostic imaging in focal epilepsy

    International Nuclear Information System (INIS)

    Zlatareva, D.

    2013-01-01

    Focal epilepsies account for 60% of all seizure disorders worldwide. In this review the classic and new classification system of epileptic seizures and syndromes as well as genetic forms are discussed. Magnetic resonance (MR) is the technique of choice for diagnostic imaging in focal epilepsy because of its sensitivity and high tissue contrast. The review is focused on the lack of consensus of imaging protocols and reported findings in refractory epilepsy. The most frequently encountered MRI findings in epilepsy are reported and their imaging characteristics are depicted. Diagnosis of hippocampal sclerosis and malformations of cortical development as two major causes of refractory focal epilepsy is described in details. Some promising new techniques as positron emission tomography computed tomography (PET/CT) and MR and PET/CT fusion are briefly discussed. Also the relevance of adequate imaging in focal epilepsy, some practical points in imaging interpretation and differential diagnosis are highlighted. (author)

  1. Partial (focal) seizure

    Science.gov (United States)

    ... Patient Instructions Epilepsy - what to ask your doctor - adult Epilepsy - what to ask your doctor - child Images Central nervous system and peripheral nervous system References Abou-Khalil BW, ...

  2. Profile of Epilepsy in a Regional Hospital in Al Qassim, Saudi Arabia

    Science.gov (United States)

    Hamdy, Nermin A; Alamgir, Mohammad Jawad; Mohammad, El Gamri E; Khedr, Mahmoud H; Fazili, Shafat

    2014-01-01

    Introduction Epilepsy is a diverse set of chronic neurological disorders characterized by seizures. It is one of the most common of the serious neurological disorders. About 3% of people will be diagnosed with epilepsy at some time in their lives. Objectives We aimed to address the commonest types of seizures, their aetiologies, EEG and neuroimaging results and prognosis of patients presented to neurology services of the King Fahad Specialist Hospital- AlQassim (KFSH). Methodology In this retrospective epidemiological study we investigated the medical records of patients with epilepsy, who attended the neurology services of KFSH, during the study period (26/10/2011–26/4/2012). Results The study included 341 patients; 189 (55.4%) males and 152 (44.6%) females. Their ages ranged between 12 and 85 years (mean ± SD = 31±16.9). The majority of patients had Generalised Tonic Clonic Seizures (76.2%), followed by Complex Partial Seizures (7.6%). 73% of our patients had idiopathic epilepsy. The commonest causes for symptomatic epilepsy were Cerebro Vascular Accidents and Head trauma. Hemiplegia, mental retardation and psychiatric illness were the commonest comorbidity. 69.3% of patients had controlled seizures. Patients with idiopathic epilepsy were significantly controlled than patients with symptomatic epilepsy (P=0.01), and those using one Anti Epileptic Drug were significantly controlled compared to patients using polytherapy (P=0.0001) there was no significant relation between controlled seizure and duration of illness or hospitalization or EEG changes. Conclusion Seizure types, aetiology, drug therapy, Comorbidities and outcome in a tertiary care hospital in Saudi Arabia are similar to previous local and international studies. 35.3% of patients were hospitalized, higher rates than previous studies. Seizure control was better in generalized seizures and idiopathic epilepsy compared to complex partial seizures or partial seizures with secondary generalization and

  3. Psychiatric Aspects of Childhood Epilepsy

    OpenAIRE

    Raman Deep PATTANAYAK; Rajesh SAGAR

    2012-01-01

    How to Cite this Article: Pattanayak RD, Sagar R. Psychiatric Aspects of Childhood Epilepsy. Iran J Child Neurol 2012;6(2):9-18.Childhood epilepsy is a chronic, recurrent disorder of unprovoked seizures. Theonset of epilepsy in childhood has significant implications for brain growth anddevelopment. Seizures may impair the ongoing neurodevelopmental processes and compromise the child’s intellectual and cognitive functioning, leading totremendous cognitive, behavioral and psychosocial consequen...

  4. Idiopathic focal epilepsies: the "lost tribe".

    Science.gov (United States)

    Pal, Deb K; Ferrie, Colin; Addis, Laura; Akiyama, Tomoyuki; Capovilla, Giuseppe; Caraballo, Roberto; de Saint-Martin, Anne; Fejerman, Natalio; Guerrini, Renzo; Hamandi, Khalid; Helbig, Ingo; Ioannides, Andreas A; Kobayashi, Katsuhiro; Lal, Dennis; Lesca, Gaetan; Muhle, Hiltrud; Neubauer, Bernd A; Pisano, Tiziana; Rudolf, Gabrielle; Seegmuller, Caroline; Shibata, Takashi; Smith, Anna; Striano, Pasquale; Strug, Lisa J; Szepetowski, Pierre; Valeta, Thalia; Yoshinaga, Harumi; Koutroumanidis, Michalis

    2016-09-01

    The term idiopathic focal epilepsies of childhood (IFE) is not formally recognised by the ILAE in its 2010 revision (Berg et al., 2010), nor are its members and boundaries precisely delineated. The IFEs are amongst the most commonly encountered epilepsy syndromes affecting children. They are fascinating disorders that hold many "treats" for both clinicians and researchers. For example, the IFEs pose many of the most interesting questions central to epileptology: how are functional brain networks involved in the manifestation of epilepsy? What are the shared mechanisms of comorbidity between epilepsy and neurodevelopmental disorders? How do focal EEG discharges impact cognitive functioning? What explains the age-related expression of these syndromes? Why are EEG discharges and seizures so tightly locked to slow-wave sleep? In the last few decades, the clinical symptomatology and the respective courses of many IFEs have been described, although they are still not widely appreciated beyond the specialist community. Most neurologists would recognise the core syndromes of IFE to comprise: benign epilepsy of childhood with centro-temporal spikes or Rolandic epilepsy (BECTS/RE); Panayiotopoulos syndrome; and the idiopathic occipital epilepsies (Gastaut and photosensitive types). The Landau-Kleffner syndrome and the related (idiopathic) epilepsy with continuous spikes and waves in sleep (CSWS or ESES) are also often included, both as a consequence of the shared morphology of the interictal discharges and their potential evolution from core syndromes, for example, CSWS from BECTS. Atypical benign focal epilepsy of childhood also has shared electro-clinical features warranting inclusion. In addition, a number of less well-defined syndromes of IFE have been proposed, including benign childhood seizures with affective symptoms, benign childhood epilepsy with parietal spikes, benign childhood seizures with frontal or midline spikes, and benign focal seizures of adolescence. The

  5. The long-term outcomes of epilepsy surgery

    Science.gov (United States)

    Keller, Simon; Nicolson, Andrew; Biswas, Shubhabrata; Smith, David; Osman Farah, Jibril; Eldridge, Paul; Wieshmann, Udo

    2018-01-01

    Objective Despite modern anti-epileptic drug treatment, approximately 30% of epilepsies remain medically refractory and for these patients, epilepsy surgery may be a treatment option. There have been numerous studies demonstrating good outcome of epilepsy surgery in the short to median term however, there are a limited number of studies looking at the long-term outcomes. The aim of this study was to ascertain the long-term outcome of resective epilepsy surgery in a large neurosurgery hospital in the U.K. Methods This a retrospective analysis of prospectively collected data. We used the 2001 International League Against Epilepsy (ILAE) classification system to classify seizure freedom and Kaplan-Meier survival analysis to estimate the probability of seizure freedom. Results We included 284 patients who underwent epilepsy surgery (178 anterior temporal lobe resections, 37 selective amygdalohippocampectomies, 33 temporal lesionectomies, 36 extratemporal lesionectomies), and had a prospective median follow-up of 5 years (range 1–27). Kaplan-Meier estimates showed that 47% (95% CI 40–58) remained seizure free (apart from simple partial seizures) at 5 years and 38% (95% CI 31–45) at 10 years after surgery. 74% (95% CI 69–80) had a greater than 50% seizure reduction at 5 years and 70% (95% CI 64–77) at 10 years. Patients who had an amygdalohippocampectomy were more likely to have seizure recurrence than patients who had an anterior temporal lobe resection (p = 0.006) and temporal lesionectomy (p = 0.029). There was no significant difference between extra temporal and temporal lesionectomies. Hippocampal sclerosis was associated with a good outcome but declined in relative frequency over the years. Conclusion The vast majority of patients who were not seizure free experienced at least a substantial and long-lasting reduction in seizure frequency. A positive long-term outcome after epilepsy surgery is possible for many patients and especially those with

  6. A Population-Based Study of Long-term Outcomes of Cryptogenic Focal Epilepsy in Childhood: Cryptogenic Epilepsy is NOT Probably Symptomatic Epilepsy

    Science.gov (United States)

    Wirrell, Elaine C; Grossardt, Brandon R; So, Elson L; Nickels, Katherine C

    2011-01-01

    Purpose To compare long-term outcome in a population-based group of children with cryptogenic vs symptomatic focal epilepsy diagnosed from 1980–2004 and to define the course of epilepsy in the cryptogenic group. Methods We identified all children residing in Olmsted County, MN, 1 month through 17 years with newly diagnosed, non-idiopathic focal epilepsy from 1980–2004. Children with idiopathic partial epilepsy syndromes were excluded. Medical records were reviewed to determine etiology, results of imaging and EEG studies, treatments used, and long-term outcome. Children were defined as having symptomatic epilepsy if they had a known genetic or structural/metabolic etiology, and as cryptogenic if they did not. Key Findings Of 359 children with newly-diagnosed epilepsy, 215 (60%) had non-idiopathic focal epilepsy. Of these, 206 (96%) were followed for more than 12 months. Ninety five children (46%) were classified as symptomatic. Median follow-up from diagnosis was similar in both groups, being 157 months (25%ile, 75%ile 89, 233) in the cryptogenic group vs 134 months (25%ile, 75%ile 78, 220) in the symptomatic group (p=0.26). Of 111 cryptogenic cases, 66% had normal cognition. Long-term outcome was significantly better in those with cryptogenic vs symptomatic etiology (intractable epilepsy at last follow-up, 7% vs 40%, p<0.001; seizure-freedom at last follow-up, 81% vs 55%, p<0.001). Of those who achieved seizure-freedom at final follow-up, 68% of the cryptogenic group versus only 46% of the symptomatic group were off antiepileptic medications (p=0.01). One third of the cryptogenic group had a remarkably benign disorder, with no seizures seen after initiation of medication, or in those who were untreated, after the second afebrile seizure. A further 5% had seizures within the first year but remained seizure-free thereafter. With the exception of perinatal complications, which predicted against seizure remission, no other factors were found to significantly

  7. Epilepsy and vaccinations: Italian guidelines.

    Science.gov (United States)

    Pruna, Dario; Balestri, Paolo; Zamponi, Nelia; Grosso, Salvatore; Gobbi, Giuseppe; Romeo, Antonino; Franzoni, Emilio; Osti, Maria; Capovilla, Giuseppe; Longhi, Riccardo; Verrotti, Alberto

    2013-10-01

    Reports of childhood epilepsies in temporal association with vaccination have had a great impact on the acceptance of vaccination programs by health care providers, but little is known about this possible temporal association and about the types of seizures following vaccinations. For these reasons the Italian League Against Epilepsy (LICE), in collaboration with other Italian scientific societies, has decided to generate Guidelines on Vaccinations and Epilepsy. The aim of Guidelines on Vaccinations and Epilepsy is to present recent unequivocal evidence from published reports on the possible relationship between vaccines and epilepsy in order to provide information about contraindications and risks of vaccinations in patients with epilepsy. The following main issues have been addressed: (1) whether contraindications to vaccinations exist in patients with febrile convulsions, epilepsy, and/or epileptic encephalopathies; and (2) whether any vaccinations can cause febrile seizures, epilepsy, and/or epileptic encephalopathies. Diphtheria-tetanus-pertussis (DTP) vaccination and measles, mumps, and rubella vaccination (MMR) increase significantly the risk of febrile seizures. Recent observations and data about the relationships between vaccination and epileptic encephalopathy show that some cases of apparent vaccine-induced encephalopathy could in fact be caused by an inherent genetic defect with no causal relationship with vaccination. Wiley Periodicals, Inc. © 2013 International League Against Epilepsy.

  8. Prevalence and risk factors of seizure clusters in adult patients with epilepsy.

    Science.gov (United States)

    Chen, Baibing; Choi, Hyunmi; Hirsch, Lawrence J; Katz, Austen; Legge, Alexander; Wong, Rebecca A; Jiang, Alfred; Kato, Kenneth; Buchsbaum, Richard; Detyniecki, Kamil

    2017-07-01

    In the current study, we explored the prevalence of physician-confirmed seizure clusters. We also investigated potential clinical factors associated with the occurrence of seizure clusters overall and by epilepsy type. We reviewed medical records of 4116 adult (≥16years old) outpatients with epilepsy at our centers for documentation of seizure clusters. Variables including patient demographics, epilepsy details, medical and psychiatric history, AED history, and epilepsy risk factors were then tested against history of seizure clusters. Patients were then divided into focal epilepsy, idiopathic generalized epilepsy (IGE), or symptomatic generalized epilepsy (SGE), and the same analysis was run. Overall, seizure clusters were independently associated with earlier age of seizure onset, symptomatic generalized epilepsy (SGE), central nervous system (CNS) infection, cortical dysplasia, status epilepticus, absence of 1-year seizure freedom, and having failed 2 or more AEDs (Pepilepsy (16.3%) and IGE (7.4%; all Pepilepsy type showed that absence of 1-year seizure freedom since starting treatment at one of our centers was associated with seizure clustering in patients across all 3 epilepsy types. In patients with SGE, clusters were associated with perinatal/congenital brain injury. In patients with focal epilepsy, clusters were associated with younger age of seizure onset, complex partial seizures, cortical dysplasia, status epilepticus, CNS infection, and having failed 2 or more AEDs. In patients with IGE, clusters were associated with presence of an aura. Only 43.5% of patients with seizure clusters were prescribed rescue medications. Patients with intractable epilepsy are at a higher risk of developing seizure clusters. Factors such as having SGE, CNS infection, cortical dysplasia, status epilepticus or an early seizure onset, can also independently increase one's chance of having seizure clusters. Copyright © 2017. Published by Elsevier B.V.

  9. Positron emission tomography in presurgical evaluation of epilepsy

    International Nuclear Information System (INIS)

    Willoch, F.; Arnold, S.; Noachtar, S.; Bartenstein, P.

    1997-01-01

    In a considerable proportion of patients with medically intractable partial epilepsies who are considered for surgery, the detection of a lesion with MRI or CT is not possible. Functional imaging methods can provide clinically useful information in these cases, being methods which enable localisation of functional abnormalities independent from EEG. There is an extensive knowledge about interictal PET-investigations with F-18 FDG. Many centers dealing with preoperative evaluation of epilepsy use this method as part of their diagnostic routine. Most studies report a decrease of glucose metabolism in topographic correlation to the EEG defined seizure origin in temporal lobe epilepsy in 70%-85% of the patients. The sensitivity reported for the detection of extratemporal foci is markedly lower. The mapping of neuronal structures with specific ligands, i.e. benzodiazepine receptor ligands has advantages compared to the detection of changes in flow and metabolism. It enables the differentiation of abnormalities in the neuronal texture of the brain from deactivated cortical areas. This is especially important when surgical procedures other than standard resection techniques are considered. The clinical importance of the functional imaging methods is that they help to decrease the amount of invasive EEG recordings in temporal lobe epilepsy. Furthermore, in extratemporal epilepsies functional imaging techniques facilitate the placement of the electrodes for invasive EEG recording. (orig.) [de

  10. Linkage and association analysis of CACNG3 in childhood absence epilepsy

    DEFF Research Database (Denmark)

    Everett, Kate V; Chioza, Barry; Aicardi, Jean

    2007-01-01

    Childhood absence epilepsy (CAE) is an idiopathic generalised epilepsy characterised by absence seizures manifested by transitory loss of awareness with 2.5-4 Hz spike-wave complexes on ictal EEG. A genetic component to aetiology is established but the mechanism of inheritance and the genes...

  11. Causes and consequences of pathogenic processes in evolution: Implications from experimental epilepsy in animals

    NARCIS (Netherlands)

    Godlevsky, L.S.; Luijtelaar, E.L.J.M. van; Shandra, A.A.; Coenen, A.M.L.

    2002-01-01

    Examples from experimental epilepsy in animals are used to illustrate the view that a crucial role of the transfer of mechanisms from compensatory into pathogenic (e.g. lethal ones in the course of a disease), is played by the power of pathologic stimuli. In the genesis of epilepsy it is suggested

  12. Rolandic epilepsy and dyslexia

    Directory of Open Access Journals (Sweden)

    Ecila P. Oliveira

    2014-11-01

    Full Text Available Objective Although benign epilepsy with centrotemporal spikes (BECTS is an idiopathic, age-related epilepsy syndrome with favorable outcome, recent studies have shown impairment in specific neuropsychological tests. The objective of this study was to analyze the comorbidity between dyslexia and BECTS. Method Thirty-one patients with clinical and electroencephalographic diagnosis of BECTS (group A and 31 paired children (group B underwent a language and neuropsychological assessment performed with several standardized protocols. Our findings were categorized as: a dyslexia; b other difficulties; c without difficulties. Our results were compared and statistically analyzed. Results Our data showed that dyslexia occurred in 19.4% and other difficulties in 74.2% of our patients. This was highly significant when compared with the control group (p<0.001. Phonological awareness, writing, reading, arithmetic, and memory tests showed a statistically significant difference when comparing both groups. Conclusion Our findings show significant evidence of the occurrence of dyslexia in patients with BECTS.

  13. Epilepsy and videogames.

    Science.gov (United States)

    Bureau, Michelle; Hirsch, Edouard; Vigevano, Federico

    2004-01-01

    Since the first case of videogame (VG) epilepsy was reported in 1981, many cases of seizures triggered by VGs were reported, not only in photosensitive, but also in non-photosensitive children and adolescents with epilepsy. We provide an overview of the literature with overall conclusions and recommendations regarding VG playing. Specific preventive measures concerning the physical characteristics of images included in commercially available VGs (flash rate, choice of colors, patterns, and contrast) can lead in the future to a clear decrease of this problem. In addition to the positive effect of such measures, the collaborative studies performed in France and in the rest of Europe have stressed the importance of a safe distance to the screen of > or = 2 m, and the less provocative role of 100-Hz screens.

  14. Imaging in epilepsy

    International Nuclear Information System (INIS)

    Gupta, Arun Kumar; Sharma, Raju; Sarma, Dipanka

    2000-01-01

    Epilepsy is a common problem in the paediatric age group. Imaging plays a vital role in identifying the seizure focus. Cross-sectional imaging modalities like CT and MRI have had a major impact on the management of seizure disorders. MRI, because of its high contrast resolution and multiplanar capability is the ideal imaging modality but its use is restricted due to high cost. Computed tomography is cheaper and is the first, and often, the only modality used, especially in the under privileged areas of the world. In the tropical countries inflammatory granuloma are a common cause of epilepsy and CT is adequate to detect these lesions. Other causes include congenital abnormalities, neoplastic and vascular causes. (author)

  15. Chronic Posttraumatic Epilepsy following Neocortical Undercut Lesion in Mice.

    Directory of Open Access Journals (Sweden)

    Xingjie Ping

    Full Text Available Posttraumatic epilepsy (PTE usually develops in a small percentage of patients of traumatic brain injury after a varying latent period. Modeling this chronic neurological condition in rodents is time consuming and inefficient, which constitutes a significant obstacle in studying its mechanism and discovering novel therapeutics for its prevention and treatment. Partially isolated neocortex, or undercut, is known to induce cortical hyperexcitability and epileptiform activity in vitro, and has been used extensively for studying the neurophysiological mechanism of posttraumatic epileptogenesis. However, whether the undercut lesion in rodents causes chronic epileptic seizures has not been systematically characterized. Here we used a miniature telemetry system to continuously monitor electroencephalography (EEG in adult C57BL mice for up to 3 months after undercut surgery. We found that 50% of animals developed spontaneous seizures between 16-50 days after injury. The mean seizure duration was 8.9±3.6 seconds, and the average seizure frequency was 0.17±0.17 times per day. There was no progression in seizure frequency and duration over the recording period. Video monitoring revealed behavioral arrests and clonic limb movement during seizure attacks. A pentylenetetrazol (PTZ test further showed increased seizure susceptibility in the undercut mice. We conclude that undercut lesion in mice is a model of chronic PTE that involves spontaneous epileptic seizures.

  16. Prevalence of epilepsy in children from a Brazilian area of high deprivation.

    Science.gov (United States)

    Sampaio, Letícia P B; Caboclo, Luis Otávio S F; Kuramoto, Karina; Reche, Angela; Yacubian, Elza Márcia T; Manreza, Maria Luiza G

    2010-02-01

    This study assessed the prevalence rate of epilepsy and its causes in children and adolescents in one area of high deprivation in São Paulo, São Paulo, in Southeast Brazil. Between July 2005 and June 2006, 4947 families from a population of 22,013 inhabitants (including 10,405 children and adolescents between the ages of 0 and 16 years) living in the shantytown of Paraisópolis, were interviewed. In the first phase, a validated questionnaire was administered, to identify the occurrence of seizures. In the second phase, clinical history, neurologic examination, electroencephalography, and structural neuroimaging were performed. The diagnosis of epilepsy, including etiology, seizure types, and epileptic syndrome classification, was according to criteria of the International League Against Epilepsy. The screening phase identified 353 presumptive cases. In the second phase, 101 of these cases (33.8%) received the diagnosis of epilepsy. Crude prevalence of epilepsy was 9.7/1000 and prevalence of active epilepsy was 8.7/1000. Partial seizures were the most frequent seizure type (62/101). Symptomatic focal epilepsy was the most common form, and hypoxic-ischemic encephalopathy the most common etiology, reflecting the socioeconomic conditions of this specific population. Adequate public policies regarding perinatal assistance could help reduce the prevalence of epilepsy.

  17. Astroglial networks and implications for therapeutic neuromodulation of epilepsy

    Directory of Open Access Journals (Sweden)

    Mark R Witcher

    2012-08-01

    Full Text Available Epilepsy is a common chronic neurologic disorder affecting approximately 1 percent of the world population. More than one-third of all epilepsy patients have incompletely controlled seizures or debilitating medication side effects in spite of optimal medical management. Medically refractory epilepsy is associated with excess injury and mortality, psychosocial dysfunction, and significant cognitive impairment. Effective treatment options for these patients can be limited. The cellular mechanisms underlying seizure activity are incompletely understood, though we here describe multiple lines of evidence supporting the likely contribution of astroglia to epilepsy, with focus on individual astrocytes and their network functions. Of the emerging therapeutic modalities for epilepsy, one of the most intriguing is the field of neuromodulation. Neuromodulatory treatment, which consists of administering electrical pulses to neural tissue to modulate its activity leading to a beneficial effect, may be an option for these patients. Current modalities consist of vagal nerve stimulation, open and closed loop stimulation, and transcranial magnetic stimulation. Due to their unique properties, we here present astrocytes as likely important targets for the developing field of neuromodulation in the treatment of epilepsy.

  18. Astroglial networks and implications for therapeutic neuromodulation of epilepsy.

    Science.gov (United States)

    Witcher, Mark R; Ellis, Thomas L

    2012-01-01

    Epilepsy is a common chronic neurologic disorder affecting approximately 1% of the world population. More than one-third of all epilepsy patients have incompletely controlled seizures or debilitating medication side effects in spite of optimal medical management. Medically refractory epilepsy is associated with excess injury and mortality, psychosocial dysfunction, and significant cognitive impairment. Effective treatment options for these patients can be limited. The cellular mechanisms underlying seizure activity are incompletely understood, though we here describe multiple lines of evidence supporting the likely contribution of astroglia to epilepsy, with focus on individual astrocytes and their network functions. Of the emerging therapeutic modalities for epilepsy, one of the most intriguing is the field of neuromodulation. Neuromodulatory treatment, which consists of administering electrical pulses to neural tissue to modulate its activity leading to a beneficial effect, may be an option for these patients. Current modalities consist of vagal nerve stimulation, open and closed-loop stimulation, and transcranial magnetic stimulation. Due to their unique properties, we here present astrocytes as likely important targets for the developing field of neuromodulation in the treatment of epilepsy.

  19. Neuropharmacological imaging in epilepsy with PET and SPECT

    International Nuclear Information System (INIS)

    Henry, T.R.; Pennell, P.B.

    1998-01-01

    Functional neuroimaging with positron and single photon emitter-labeling has added considerably to the understanding of epileptic seizure activity and of the postictal and interictal cerebral dysfunctions that accompany many epilepsies. Some of these functional alterations cannot be studied in humans by any other technique, and in other instances the information is complementary to that provided by other techniques, some of which are invasive or even require tissue destruction. Available radiotracer imaging techniques have yet to be fully applied to several important epileptic syndromes (including the Lennox-Gastaut syndrome and other secondary generalized epilepsies), to physiological aspects of the natural history of temporal lobe epilepsy or any other commonly occurring epilepsy, and to the assessment of mechanism of action and adverse effects of antiepileptic drugs and other epilepsy therapies. New radiotracers should be developed to permit study of specific excitatory amino acid receptors and other receptor sites that are known to be relevant to the development of epilepsy, to the onset of individual seizures, and to interical dysfunctions

  20. [Epilepsy and pregnancy].

    Science.gov (United States)

    Delmis, J; Drazancić, A; Tkalcević, T; Ivanisević, M

    1991-01-01

    A total of 132 women with epilepsy were confined in the period from 1978-1989. Their pregnancies and outcomes were analysed. The special aim was to find out if the anticonvulsive therapy has any correlation with the occurrence of fetal malformations in the studied group of women. In 43.9% of pregnant women with epilepsy, methyl-phenobarbitone as an anticonvulsive drug was administered, while carbamazepine was applied in 13.6% cases. A combination of phenytoin and phenobarbitone was prescribed in 18.9% of cases. Primidone was the drug of choice in 8% cases and 5.3% of patients were treated with various combinations of anticonvulsive drugs. Hyperemesis, threatened spontaneous abortion and premature labor complicated significantly more pregnancies in patients with epilepsy than on controls. Pregnancies from the studied group were terminated by the cesarean section in significantly more cases (11.2%) than in the control group (5.4%). Newborns from mothers with epilepsy had a statistically lower birthweight (3173 +/- 575 g) than those born from healthy mothers (3376 +/- 510g). Fifteen newborns or 11.2% were born with congenital malformations, while among the control group of newborns only two were malformed. It is noticed that the newborns from mothers treated with phenitoin and phenobarbitone had dysmorphic anomalies of the face more frequently. The drugs mentioned above interfere with the metabolism of K vitamin and as a result of this interreaction, mothers and newborns can suffer from coagulation disorders. In conclusion it is important to mention that no anticonvulsant drug seems to be absolutely safe when used during pregnancy since each of them has a teratogenic effect on the fetus.

  1. Citation classics in epilepsy

    Directory of Open Access Journals (Sweden)

    Maryann Wilson

    2013-01-01

    Full Text Available BACKGROUND: The impact of a scientific article is proportional to the citations it has received. In this study, we set out to identify the most cited works in epileptology in order to evaluate research trends in this field. METHODS: According to the Web of Science database, articles with more than 400 citations qualify as "citation classics". We conducted a literature search on the ISI Web of Science bibliometric database for scientific articles relevant to epilepsy. RESULTS: We retrieved 67 highly cited articles (400 or more citations, which were published in 31 journals: 17 clinical studies, 42 laboratory studies, 5 reviews and 3 classification articles. Clinical studies consisted of epidemiological analyses (n=3, studies on the clinical phenomenology of epilepsy (n=5 – including behavioral and prognostic aspects – and articles focusing on pharmacological (n=6 and non-pharmacological (n=3 treatment. The laboratory studies dealt with genetics (n=6, animal models (n=27, and neurobiology (n=9 – including both neurophysiology and neuropathology studies. The majority (61% of citation classics on epilepsy were published after 1986, possibly reflecting the expansion of research interest in laboratory studies driven by the development of new methodologies, specifically in the fields of genetics and animal models. Consequently, clinical studies were highly cited both before and after the mid 80s, whilst laboratory researches became widely cited after 1990. CONCLUSIONS: Our study indicates that the main drivers of scientific impact in the field of epileptology have increasingly become genetic and neurobiological studies, along with research on animal models of epilepsy. These articles are able to gain the highest numbers of citations in the time span of a few years and suggest potential directions for future research.

  2. Prioritization of epilepsy associated candidate genes by convergent analysis.

    Science.gov (United States)

    Jia, Peilin; Ewers, Jeffrey M; Zhao, Zhongming

    2011-02-24

    Epilepsy is a severe neurological disorder affecting a large number of individuals, yet the underlying genetic risk factors for epilepsy remain unclear. Recent studies have revealed several recurrent copy number variations (CNVs) that are more likely to be associated with epilepsy. The responsible gene(s) within these regions have yet to be definitively linked to the disorder, and the implications of their interactions are not fully understood. Identification of these genes may contribute to a better pathological understanding of epilepsy, and serve to implicate novel therapeutic targets for further research. In this study, we examined genes within heterozygous deletion regions identified in a recent large-scale study, encompassing a diverse spectrum of epileptic syndromes. By integrating additional protein-protein interaction data, we constructed subnetworks for these CNV-region genes and also those previously studied for epilepsy. We observed 20 genes common to both networks, primarily concentrated within a small molecular network populated by GABA receptor, BDNF/MAPK signaling, and estrogen receptor genes. From among the hundreds of genes in the initial networks, these were designated by convergent evidence for their likely association with epilepsy. Importantly, the identified molecular network was found to contain complex interrelationships, providing further insight into epilepsy's underlying pathology. We further performed pathway enrichment and crosstalk analysis and revealed a functional map which indicates the significant enrichment of closely related neurological, immune, and kinase regulatory pathways. The convergent framework we proposed here provides a unique and powerful approach to screening and identifying promising disease genes out of typically hundreds to thousands of genes in disease-related CNV-regions. Our network and pathway analysis provides important implications for the underlying molecular mechanisms for epilepsy. The strategy can be

  3. Prioritization of epilepsy associated candidate genes by convergent analysis.

    Directory of Open Access Journals (Sweden)

    Peilin Jia

    2011-02-01

    Full Text Available Epilepsy is a severe neurological disorder affecting a large number of individuals, yet the underlying genetic risk factors for epilepsy remain unclear. Recent studies have revealed several recurrent copy number variations (CNVs that are more likely to be associated with epilepsy. The responsible gene(s within these regions have yet to be definitively linked to the disorder, and the implications of their interactions are not fully understood. Identification of these genes may contribute to a better pathological understanding of epilepsy, and serve to implicate novel therapeutic targets for further research.In this study, we examined genes within heterozygous deletion regions identified in a recent large-scale study, encompassing a diverse spectrum of epileptic syndromes. By integrating additional protein-protein interaction data, we constructed subnetworks for these CNV-region genes and also those previously studied for epilepsy. We observed 20 genes common to both networks, primarily concentrated within a small molecular network populated by GABA receptor, BDNF/MAPK signaling, and estrogen receptor genes. From among the hundreds of genes in the initial networks, these were designated by convergent evidence for their likely association with epilepsy. Importantly, the identified molecular network was found to contain complex interrelationships, providing further insight into epilepsy's underlying pathology. We further performed pathway enrichment and crosstalk analysis and revealed a functional map which indicates the significant enrichment of closely related neurological, immune, and kinase regulatory pathways.The convergent framework we proposed here provides a unique and powerful approach to screening and identifying promising disease genes out of typically hundreds to thousands of genes in disease-related CNV-regions. Our network and pathway analysis provides important implications for the underlying molecular mechanisms for epilepsy. The

  4. LGI2 truncation causes a remitting focal epilepsy in dogs.

    Directory of Open Access Journals (Sweden)

    Eija H Seppälä

    2011-07-01

    Full Text Available One quadrillion synapses are laid in the first two years of postnatal construction of the human brain, which are then pruned until age 10 to 500 trillion synapses composing the final network. Genetic epilepsies are the most common neurological diseases with onset during pruning, affecting 0.5% of 2-10-year-old children, and these epilepsies are often characterized by spontaneous remission. We previously described a remitting epilepsy in the Lagotto romagnolo canine breed. Here, we identify the gene defect and affected neurochemical pathway. We reconstructed a large Lagotto pedigree of around 34 affected animals. Using genome-wide association in 11 discordant sib-pairs from this pedigree, we mapped the disease locus to a 1.7 Mb region of homozygosity in chromosome 3 where we identified a protein-truncating mutation in the Lgi2 gene, a homologue of the human epilepsy gene LGI1. We show that LGI2, like LGI1, is neuronally secreted and acts on metalloproteinase-lacking members of the ADAM family of neuronal receptors, which function in synapse remodeling, and that LGI2 truncation, like LGI1 truncations, prevents secretion and ADAM interaction. The resulting epilepsy onsets at around seven weeks (equivalent to human two years, and remits by four months (human eight years, versus onset after age eight in the majority of human patients with LGI1 mutations. Finally, we show that Lgi2 is expressed highly in the immediate post-natal period until halfway through pruning, unlike Lgi1, which is expressed in the latter part of pruning and beyond. LGI2 acts at least in part through the same ADAM receptors as LGI1, but earlier, ensuring electrical stability (absence of epilepsy during pruning years, preceding this same function performed by LGI1 in later years. LGI2 should be considered a candidate gene for common remitting childhood epilepsies, and LGI2-to-LGI1 transition for mechanisms of childhood epilepsy remission.

  5. Correlation of EEG with neuropsychological status in children with epilepsy.

    Science.gov (United States)

    Hsu, David A; Rayer, Katherine; Jackson, Daren C; Stafstrom, Carl E; Hsu, Murielle; Ferrazzano, Peter A; Dabbs, Kevin; Worrell, Gregory A; Jones, Jana E; Hermann, Bruce P

    2016-02-01

    To determine correlations of the EEG frequency spectrum with neuropsychological status in children with idiopathic epilepsy. Forty-six children ages 8-18 years old with idiopathic epilepsy were retrospectively identified and analyzed for correlations between EEG spectra and neuropsychological status using multivariate linear regression. In addition, the theta/beta ratio, which has been suggested as a clinically useful EEG marker of attention-deficit hyperactivity disorder (ADHD), and an EEG spike count were calculated for each subject. Neuropsychological status was highly correlated with posterior alpha (8-15 Hz) EEG activity in a complex way, with both positive and negative correlations at lower and higher alpha frequency sub-bands for each cognitive task in a pattern that depends on the specific cognitive task. In addition, the theta/beta ratio was a specific but insensitive indicator of ADHD status in children with epilepsy; most children both with and without epilepsy have normal theta/beta ratios. The spike count showed no correlations with neuropsychological status. (1) The alpha rhythm may have at least two sub-bands which serve different purposes. (2) The theta/beta ratio is not a sensitive indicator of ADHD status in children with epilepsy. (3) The EEG frequency spectrum correlates more robustly with neuropsychological status than spike count analysis in children with idiopathic epilepsy. (1) The role of posterior alpha rhythms in cognition is complex and can be overlooked if EEG spectral resolution is too coarse or if neuropsychological status is assessed too narrowly. (2) ADHD in children with idiopathic epilepsy may involve different mechanisms from those in children without epilepsy. (3) Reliable correlations with neuropsychological status require longer EEG samples when using spike count analysis than when using frequency spectra. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights

  6. Nonpharmacological treatment of epilepsy

    Directory of Open Access Journals (Sweden)

    V S Saxena

    2011-01-01

    Full Text Available Nonpharmacological treatment of epilepsy includes surgery, vagal nerve stimulation, ketogenic diet, and other alternative/complementary therapies, e.g., yoga, Ayurveda, electroencephalography (EEG biofeedback technique, aerobic exercise, music therapy, transcranial magnetic stimulation, acupuncture, and herbal remedies (traditional Chinese medicine. Alternative therapies, despite the term, should not be considered as an alternative to antiepileptic medication; they complement accepted drug treatment. Alternative therapies like yoga, through techniques that relax the body and mind, reduce stress, improve seizure control, and also improve quality of life. Ketogenic diet is a safe and effective treatment for intractable epilepsies; it has been recommended since 1921. The diet induces ketosis, which may control seizures. The most successful treatment of epilepsy is with modern antiepileptic drugs, which can achieve control of seizures in 70-80% cases. Patients opt for alternative therapies because they may be dissatisfied with antiepileptic drugs due to their unpleasant side effects, the long duration of treatment, failure to achieve control of seizures, cultural beliefs and, in the case of women, because they wish to get pregnant Surgical treatment may lead to physical and psychological sequelae and is an option only for a minority of patients. This article presents supportive evidence from randomized controlled trials done to assess the benefit of non-pharmacological treatment.

  7. Progressive myoclonic epilepsies

    Science.gov (United States)

    Michelucci, Roberto; Canafoglia, Laura; Striano, Pasquale; Gambardella, Antonio; Magaudda, Adriana; Tinuper, Paolo; La Neve, Angela; Ferlazzo, Edoardo; Gobbi, Giuseppe; Giallonardo, Anna Teresa; Capovilla, Giuseppe; Visani, Elisa; Panzica, Ferruccio; Avanzini, Giuliano; Tassinari, Carlo Alberto; Bianchi, Amedeo; Zara, Federico

    2014-01-01

    Objective: To define the clinical spectrum and etiology of progressive myoclonic epilepsies (PMEs) in Italy using a database developed by the Genetics Commission of the Italian League against Epilepsy. Methods: We collected clinical and laboratory data from patients referred to 25 Italian epilepsy centers regardless of whether a positive causative factor was identified. PMEs of undetermined origins were grouped using 2-step cluster analysis. Results: We collected clinical data from 204 patients, including 77 with a diagnosis of Unverricht-Lundborg disease and 37 with a diagnosis of Lafora body disease; 31 patients had PMEs due to rarer genetic causes, mainly neuronal ceroid lipofuscinoses. Two more patients had celiac disease. Despite extensive investigation, we found no definitive etiology for 57 patients. Cluster analysis indicated that these patients could be grouped into 2 clusters defined by age at disease onset, age at myoclonus onset, previous psychomotor delay, seizure characteristics, photosensitivity, associated signs other than those included in the cardinal definition of PME, and pathologic MRI findings. Conclusions: Information concerning the distribution of different genetic causes of PMEs may provide a framework for an updated diagnostic workup. Phenotypes of the patients with PME of undetermined cause varied widely. The presence of separate clusters suggests that novel forms of PME are yet to be clinically and genetically characterized. PMID:24384641

  8. A comparison of the efficacy and tolerability of oxcarbazepine oral suspension between infants and children with epilepsy: a retrospective chart review at a single medical center in Taiwan.

    Science.gov (United States)

    Wei, Shu-Hao; Liu, Cheng-Chao; Fan, Pi-Chuan

    2014-02-01

    Few clinical studies have assessed the efficacy and safety of oxcarbazepine (OXC) oral suspension in Asian pediatric patients and particularly in infants. The aim of this study was to investigate and compare the efficacy, tolerability, and side effects of OXC oral suspension in Taiwanese infants and children with various types of epilepsy. A retrospective review of the efficacy, tolerability, and side effects of OXC oral suspension in a tertiary medical center in Taiwan was conducted and included children (1-9 years old) and infants (effects (30 vs. 21 %, p = 0.525) after OXC oral suspension treatment. The efficacy was significantly correlated with the epilepsy subtype (p effective and well tolerated in both infants and children with partial epilepsy in Taiwan. Treatment efficacy was related to epilepsy subtype and number of combined AEDs before OXC treatment. Monotherapy had an excellent therapeutic response in partial epilepsy but not in multifocal epilepsy.

  9. Mechanical testing of newly developed biomaterial designed for intra-articular reinforcement of partially ruptured cranial cruciate ligament: ex vivo pig model

    Directory of Open Access Journals (Sweden)

    Petra Fedorová

    2014-01-01

    Full Text Available The study deals with mechanical testing of newly developed material polyethylene terephtalate coated with polycaprolactone nanofibers in combination with biodagradable Hexalon ACL/PCL screws as a new possibility of intra-articular reinforcement of partially ruptured cranial cruciate ligament. Four groups of ex vivo models of pig stifle joints were prepared and tested: a model with intact CCL (group 1, a model with partial CCL rupture (group 2, a model with CCL rupture stabilized with 7 mm Mersilene® strip (group 3, and a model with CCL rupture stabilized with 5 mm PET/PCL biomaterial strip (group 4. The models were loaded in the standing angle of 100° and the maximum load (N and the shift (mm were monitored. The mean maximum peak power and the shift were 1266.0 ± 146.9 N and 13.7 ± 2.5 mm for group 1, and 1164.7 ± 228.2 N and 1 6.8 ± 3.3 mm for group 2, respectively. In all cases after reaching the maximum load, a tibial fracture occurred but never a CCL rupture. In groups 3 and 4, the initial fixation failure occurred in the mean values of 375.7 ± 81.5 and 360.4 ± 52.0 N, respectively, and with a bigger shift of 52.3 ± 11.9 mm and 39.4 ± 14.6 mm, respectively, compared to group 1. A critical point of failure was the anchoring in the bone. It can be concluded that the PET/PCL substitute in the ex vivo model has mechanically comparable properties with the clinically used Mersilene®, and based on its proven ability to carry stem cells it could be appropriate for partially ruptured CCL protection.

  10. Biological and mechanical properties of an experimental glass-ionomer cement modified by partial replacement of CaO with MgO or ZnO

    Directory of Open Access Journals (Sweden)

    Dong-Ae KIM

    2015-08-01

    Full Text Available AbstractSome weaknesses of conventional glass ionomer cement (GIC as dental materials, for instance the lack of bioactive potential and poor mechanical properties, remain unsolved.Objective The purpose of this study was to investigate the effects of the partial replacement of CaO with MgO or ZnO on the mechanical and biological properties of the experimental glass ionomer cements.Material and Methods Calcium fluoro-alumino-silicate glass was prepared for an experimental glass ionomer cement by melt quenching technique. The glass composition was modified by partial replacement (10 mol% of CaO with MgO or ZnO. Net setting time, compressive and flexural properties, and in vitrorat dental pulp stem cells (rDPSCs viability were examined for the prepared GICs and compared to a commercial GIC.Results The experimental GICs set more slowly than the commercial product, but their extended setting times are still within the maximum limit (8 min specified in ISO 9917-1. Compressive strength of the experimental GIC was not increased by the partial substitution of CaO with either MgO or ZnO, but was comparable to the commercial control. For flexural properties, although there was no significance between the base and the modified glass, all prepared GICs marked a statistically higher flexural strength (p<0.05 and comparable modulus to control. The modified cements showed increased cell viability for rDPSCs.Conclusions The experimental GICs modified with MgO or ZnO can be considered bioactive dental materials.

  11. Biological and mechanical properties of an experimental glass-ionomer cement modified by partial replacement of CaO with MgO or ZnO

    Science.gov (United States)

    Dong-Ae, KIM; Hany, ABO-MOSALLAM; Hye-Young, LEE; Jung-Hwan, LEE; Hae-Won, KIM; Hae-Hyoung, LEE

    2015-01-01

    Some weaknesses of conventional glass ionomer cement (GIC) as dental materials, for instance the lack of bioactive potential and poor mechanical properties, remain unsolved. Objective The purpose of this study was to investigate the effects of the partial replacement of CaO with MgO or ZnO on the mechanical and biological properties of the experimental glass ionomer cements. Material and Methods Calcium fluoro-alumino-silicate glass was prepared for an experimental glass ionomer cement by melt quenching technique. The glass composition was modified by partial replacement (10 mol%) of CaO with MgO or ZnO. Net setting time, compressive and flexural properties, and in vitro rat dental pulp stem cells (rDPSCs) viability were examined for the prepared GICs and compared to a commercial GIC. Results The experimental GICs set more slowly than the commercial product, but their extended setting times are still within the maximum limit (8 min) specified in ISO 9917-1. Compressive strength of the experimental GIC was not increased by the partial substitution of CaO with either MgO or ZnO, but was comparable to the commercial control. For flexural properties, although there was no significance between the base and the modified glass, all prepared GICs marked a statistically higher flexural strength (p<0.05) and comparable modulus to control. The modified cements showed increased cell viability for rDPSCs. Conclusions The experimental GICs modified with MgO or ZnO can be considered bioactive dental materials. PMID:26398508

  12. The extratemporal lobe epilepsies in the epilepsy monitoring unit

    Science.gov (United States)

    Dash, Deepa; Tripathi, Manjari

    2014-01-01

    Extratemporal lobe epilepsies (ETLE) are characterized by the epileptogenic foci outside the temporal lobe. They have a wide spectrum of semiological presentation depending upon the site of origin. They can arise from frontal, parietal, occipital lobes and from hypothalamic hamartoma. We discuss in this review the semiology of different types of ETLE encountered in the epilepsy monitoring unit. PMID:24791090

  13. Understanding of Epilepsy by Children and Young People with Epilepsy

    Science.gov (United States)

    Lewis, Ann; Parsons, Sarah

    2008-01-01

    There is a striking dearth of studies focusing sensitively and in depth on the mainstream educational experiences of children with epilepsy, as viewed by those children themselves. The one-year project (2006-7) reported here addresses that gap. Children's perceptions about mainstream teachers' understanding of epilepsy and school-based needs are…

  14. Study of the water retention and the consolidation of partially saturated soils in a thermo-hydro-mechanical framework

    International Nuclear Information System (INIS)

    Salager, Simon

    2007-01-01

    This work is concerned with the study of water retention and consolidation of unsaturated soils in a thermo-hydro-mechanical framework. It is organized into two parts which deal respectively with deformation and temperature effects on hydric behaviour, and suction and temperature effects on mechanical behaviour. In the first part, we point out the relevance of the characteristic surface concept for soils as opposed to the retention curve, which has limited modelling power in the case of deformable media. The characteristic surface concept is experimentally illustrated for the example of a clayey silty sand. Its modelling is based on a large sample of experimental investigations with about 240 measurements of the triplet void ratio, water content, suction. In addition, a thermo-hydric behaviour model is proposed in order to determine the characteristic surface and the retention curve for a given temperature. This model is validated for the case of two materials: a ceramic and a clayey silty sand through direct testing, and for other materials on the basis of an analysis of the literature. Finally, we present an application to the determination of the permeability of unsaturated soils taking into account deformation and temperature. In the second part, temperature and suction effects on the mechanical behaviour are studied through consolidation tests on 'Sion' silt. These tests are performed for different temperatures and suctions. For each test, swelling and compression indexes, as well as the pre-consolidation pressure are measured. The influence of temperature and suction on these essential parameters of mechanical behaviour is determined. Finally, we propose a theoretical model which account for pre-consolidation pressure as a function of temperature and suction. (author)

  15. Cannabinoids for epilepsy.

    Science.gov (United States)

    Gloss, David; Vickrey, Barbara

    2014-03-05

    Marijuana appears to have anti-epileptic effects in animals. It is not currently known if it is effective in patients with epilepsy. Some states in the United States of America have explicitly approved its use for epilepsy. To assess the efficacy and safety of cannabinoids when used as monotherapy or add-on treatment for people with epilepsy. We searched the Cochrane Epilepsy Group Specialized Register (9 September 2013), Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (2013, Issue 8), MEDLINE (Ovid) (9 September 2013), ISI Web of Knowledge (9 September 2013), CINAHL (EBSCOhost) (9 September 2013), and ClinicalTrials.gov (9 September 2013). In addition, we included studies we personally knew about that were not found by the searches, as well as searched the references in the identified studies. Randomized controlled trials (RCTs) whether blinded or not. Two authors independently selected trials for inclusion and extracted the data. The primary outcome investigated was seizure freedom at one year or more, or three times the longest interseizure interval. Secondary outcomes included responder rate at six months or more, objective quality of life data, and adverse events. We found four randomized trial reports that included a total of 48 patients, each of which used cannabidiol as the treatment agent. One report was an abstract and another was a letter to the editor. Anti-epileptic drugs were continued in all studies. Details of randomisation were not included in any study report. There was no investigation of whether the control and treatment participant groups were the same or different. All the reports were low quality.The four reports only answered the secondary outcome about adverse effects. None of the patients in the treatment groups suffered adverse effects. No reliable conclusions can be drawn at present regarding the efficacy of cannabinoids as a treatment for epilepsy. The dose of 200 to 300 mg daily of cannabidiol was

  16. ILAE Classification of the Epilepsies Position Paper of the ILAE Commission for Classification and Terminology

    Science.gov (United States)

    Scheffer, Ingrid E; Berkovic, Samuel; Capovilla, Giuseppe; Connolly, Mary B; French, Jacqueline; Guilhoto, Laura; Hirsch, Edouard; Jain, Satish; Mathern, Gary W.; Moshé, Solomon L; Nordli, Douglas R; Perucca, Emilio; Tomson, Torbjörn; Wiebe, Samuel; Zhang, Yue-Hua; Zuberi, Sameer M

    2017-01-01

    Summary The ILAE Classification of the Epilepsies has been updated to reflect our gain in understanding of the epilepsies and their underlying mechanisms following the major scientific advances which have taken place since the last ratified classification in 1989. As a critical tool for the practising clinician, epilepsy classification must be relevant and dynamic to changes in thinking, yet robust and translatable to all areas of the globe. Its primary purpose is for diagnosis of patients, but it is also critical for epilepsy research, development of antiepileptic therapies and communication around the world. The new classification originates from a draft document submitted for public comments in 2013 which was revised to incorporate extensive feedback from the international epilepsy community over several rounds of consultation. It presents three levels, starting with seizure type where it assumes that the patient is having epileptic seizures as defined by the new 2017 ILAE Seizure Classification. After diagnosis of the seizure type, the next step is diagnosis of epilepsy type, including focal epilepsy, generalized epilepsy, combined generalized and focal epilepsy, and also an unknown epilepsy group. The third level is that of epilepsy syndrome where a specific syndromic diagnosis can be made. The new classification incorporates etiology along each stage, emphasizing the need to consider etiology at each step of diagnosis as it often carries significant treatment implications. Etiology is broken into six subgroups, selected because of their potential therapeutic consequences. New terminology is introduced such as developmental and epileptic encephalopathy. The term benign is replaced by the terms self-limited and pharmacoresponsive, to be used where appropriate. It is hoped that this new framework will assist in improving epilepsy care and research in the 21st century. PMID:28276062

  17. Wnt/β-catenin signalling pathway mediated aberrant hippocampal neurogenesis in kainic acid-induced epilepsy.

    Science.gov (United States)

    Qu, Zhengyi; Su, Fang; Qi, Xueting; Sun, Jianbo; Wang, Hongcai; Qiao, Zhenkui; Zhao, Hong; Zhu, Yulan

    2017-10-01

    Temporal lobe epilepsy is a chronic disorder of nerve system, mainly characterized by hippocampal sclerosis with massive neuronal loss and severe gliosis. Aberrant neurogenesis has been shown in the epileptogenesis process of temporal lobe epilepsy. However, the molecular mechanisms underlying aberrant neurogenesis remain unclear. The roles of Wnt signalling cascade have been well established in neurogenesis during multiple aspects. Here, we used kainic acid-induced rat epilepsy model to investigate whether Wnt/β-catenin signalling pathway is involved in the aberrant neurogenesis in temporal lobe epilepsy. Immunostaining and western blotting results showed that the expression levels of β-catenin, Wnt3a, and cyclin D1, the key regulators in Wnt signalling pathway, were up-regulated during acute epilepsy induced by the injection of kainic acids, indicating that Wnt signalling pathway was activated in kainic acid-induced temporal lobe epilepsy. Moreover, BrdU labelling results showed that blockade of the Wnt signalling by knocking down β-catenin attenuated aberrant neurogenesis induced by kainic acids injection. Altogether, Wnt/β-catenin signalling pathway mediated hippocampal neurogenesis during epilepsy, which might provide new strategies for clinical treatment of temporal lobe epilepsy. Temporal lobe epilepsy is a chronic disorder of nerve system, mainly characterized by hippocampal sclerosis. Aberrant neurogenesis has been shown to involve in the epileptogenesis process of temporal lobe epilepsy. In the present study, we discovered that Wnt3a/β-catenin signalling pathway serves as a link between aberrant neurogenesis and underlying remodelling in the hippocampus, leading to temporal lobe epilepsy, which might provide new strategies for clinical treatment of temporal lobe epilepsy. Copyright © 2017 John Wiley & Sons, Ltd.

  18. Submikroskopiske kromosomforandringer disponerer til epilepsi

    DEFF Research Database (Denmark)

    Møller, Rikke Steensbjerre; Hjalgrim, Helle

    2011-01-01

    Idiopathic generalised epilepsies (IGEs) affect up to 0.3% of the general population. Genetic factors play a predominant role in the aetiology of IGEs. Molecular genetic studies have mainly identified causative gene mutations in rare monogenic forms of idiopathic epilepsies. However, the genetic ...

  19. The Music Student with Epilepsy

    Science.gov (United States)

    Murdock, Matthew C.; Morgan, Joseph A.; Laverghetta, Thomas S.

    2012-01-01

    The teacher-student relationship can afford the music educator an opportunity to be the first to identify behaviors associated with epilepsy. A case of a student with epilepsy, based on the authors' experience, is described in which the music educators were the first and only individuals to become aware of a change in the student's behavior, after…

  20. Electroencephalography in dogs with epilepsy

    DEFF Research Database (Denmark)

    Berendt, Martin Ole; Høgenhaven, H; Flagstad, Annette Borgbjerg

    1999-01-01

    To investigate the diagnostic value of electroencephalography (EEG) in dogs with epilepsy, applying human criteria for EEG abnormalities observed with this disorder.......To investigate the diagnostic value of electroencephalography (EEG) in dogs with epilepsy, applying human criteria for EEG abnormalities observed with this disorder....

  1. Epilepsy and Comorbid Mental Retardation

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2007-08-01

    Full Text Available Preventable and unpreventable causes of childhood-onset epilepsy associated with mental retardation were determined in 692 patients with epilepsy onset between 1977 and 1985 in a Nova Scotia population-based cohort studied in the Department of Pediatrics, Dalhousie University, Halifax, Canada.

  2. Epilepsy in tropics: Indian perspective

    OpenAIRE

    Shejoy P Joshua; Ashok Kumar Mahapatra

    2013-01-01

    Epilepsy is a common neurological disorder affecting 0.5-1% of the population in India. The causes and treatment protocols vary widely. A proper understanding of the causes and treatment strategies is essential for managing this patient group. This article analyzes the common causes of epilepsy in India and provides a brief summary on the available treatment strategies.

  3. Epilepsy in tropics: Indian perspective

    Directory of Open Access Journals (Sweden)

    Shejoy P Joshua

    2013-01-01

    Full Text Available Epilepsy is a common neurological disorder affecting 0.5-1% of the population in India. The causes and treatment protocols vary widely. A proper understanding of the causes and treatment strategies is essential for managing this patient group. This article analyzes the common causes of epilepsy in India and provides a brief summary on the available treatment strategies.

  4. The ketogenic diet: metabolic influences on brain excitability and epilepsy

    Science.gov (United States)

    Lutas, Andrew; Yellen, Gary

    2012-01-01

    A dietary therapy for pediatric epilepsy known as the ketogenic diet has seen a revival in its clinical use in the past decade. Though the diet’s underlying mechanism remains unknown, modern scientific approaches like genetic disruption of glucose metabolism are allowing for more detailed questions to be addressed. Recent work indicates that several mechanisms may exist for the ketogenic diet including disruption of glutamatergic synaptic transmission, inhibition of glycolysis, and activation of ATP-sensitive potassium channels. Here we describe on-going work in these areas that is providing a better understanding of metabolic influences on brain excitability and epilepsy. PMID:23228828

  5. Insight into the mechanism of methanol assistance with syngas conversion over partially hydroxylated γ-Al2O3(110D) surface in slurry bed.

    Science.gov (United States)

    Bai, Bing; Bai, Hui; Cao, Hao-Jie; Gao, Zhi-Hua; Zuo, Zhi-Jun; Huang, Wei

    2018-04-27

    Despite numerous studies devoted to the various properties of γ-Al2O3, the explorations of its catalytic activity remain scarce. In this study, density functional theory calculations are performed to study the elementary adsorption and reaction mechanisms for syngas conversion on partially hydroxylated γ-Al2O3(110D) surface in liquid paraffin. It is found that the partially hydroxylated γ-Al2O3(110D) surface with the hydroxyl coverage of 8.9 OH nm-2 is formed by two dissociative adsorptions of H2O on the dry γ-Al2O3(110D) surface. The hydroxyl coverage conditions play a key role in determining the dominant reaction mechanism on account of the existence of strong hydrogen bonds. The preferential pathway for syngas conversion with assistance of methanol over the partially hydroxylated γ-Al2O3(110D) surface in liquid paraffin has been proven to be CH3OH → CH3O + H → CH3 + OH, CH3 + CO → CH3CO. C2H5OH is then formed by successive hydrogenation via the pathway CH3CO + 3H → CH3CHO + 2H → CH3CH2O + H → C2H5OH. Here, CH3CHO formation by CH3CO hydrogenation is not inhibited. Actually, with the assistance of partially hydroxylated γ-Al2O3, CH3CHO has been synthesized with high selectivity in our previous experiment by the reaction of methanol and syngas, which provides favorable evidence for our results. The rate-limiting step is the formation of CH3O from CH3OH dehydrogenation with an activation barrier of 122.2 kJ mol-1. Moreover, the reaction barrier of CO insertion into the adsorbed CH3 group is at least 89.4 kJ mol-1, lower than those of CH4, C2H6, and CH3OCH3 formations. ADCH charge and ESP analyses indicate that the typical (Al, O) Lewis acid-base pair may have a significant effect upon the initial C-C chain formation. Thus, the present study provides a new approach for the rational tailoring and designing of new catalysts with superior reactivity involved in syngas conversion.

  6. Epilepsy, language, and social skills.

    Science.gov (United States)

    Caplan, Rochelle

    2017-10-04

    Language and social skills are essential for intrapersonal and interpersonal functioning and quality of life. Since epilepsy impacts these important domains of individuals' functioning, understanding the psychosocial and biological factors involved in the relationship among epilepsy, language, and social skills has important theoretical and clinical implications. This review first describes the psychosocial and biological factors involved in the association between language and social behavior in children and in adults and their relevance for epilepsy. It reviews the findings of studies of social skills and the few studies conducted on the inter-relationship of language and social skills in pediatric and adult epilepsy. The paper concludes with suggested future research and clinical directions that will enhance early identification and treatment of epilepsy patients at risk for impaired language and social skills. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. The social and economic consequences of epilepsy

    DEFF Research Database (Denmark)

    Jennum, Poul; Gyllenborg, Jesper; Kjellberg, Jakob

    2011-01-01

    Epilepsy causes a significant burden to patients and to society. We aimed to calculate the factual excess in direct and indirect costs associated with epilepsy.......Epilepsy causes a significant burden to patients and to society. We aimed to calculate the factual excess in direct and indirect costs associated with epilepsy....

  8. 38 CFR 4.122 - Psychomotor epilepsy.

    Science.gov (United States)

    2010-07-01

    ... of a chronic mental disorder associated with psychomotor epilepsy, like those of the seizures, are... Psychomotor epilepsy. The term psychomotor epilepsy refers to a condition that is characterized by seizures... psychomotor epilepsy vary from patient to patient and in the same patient from seizure to seizure. (b) A...

  9. Rationale for treating epilepsy in children

    NARCIS (Netherlands)

    Guerrini, R; Arzimanoglou, A; Brouwer, O

    2002-01-01

    Growing evidence indicates that the effects of antiepileptic drugs on childhood epilepsies are partly linked to the specific type of epilepsy or epilepsy syndrome. Most (but not all) types of epilepsy can be classified into categories that are conceptually meaningful. It is likewise logical to set

  10. An Experimental Investigation of Mechanical Properties in Clay Brick Masonry by Partial Replacement of Fine Aggregate with Clay Brick Waste

    Science.gov (United States)

    Kumavat, Hemraj Ramdas

    2016-09-01

    The compressive stress-strain behavior and mechanical properties of clay brick masonry and its constituents clay bricks and mortar, have been studied by several laboratory tests. Using linear regression analysis, a analytical model has been proposed for obtaining the stress-strain curves for masonry that can be used in the analysis and design procedures. The model requires only the compressive strengths of bricks and mortar as input data, which can be easily obtained experimentally. Development of analytical model from the obtained experimental results of Young's modulus and compressive strength. Simple relationships have been identified for obtaining the modulus of elasticity of bricks, mortar, and masonry from their corresponding compressive strengths. It was observed that the proposed analytical model clearly demonstrates a reasonably good prediction of the stress-strain curves when compared with the experimental curves.

  11. Post-epilepsy stroke: A review.

    Science.gov (United States)

    Jin, Jing; Chen, Rong; Xiao, Zheng

    2016-01-01

    Stroke and epilepsy are two of the most common neurological disorders and share a complicated relationship. It is well established that stroke is one of the most important causes of epilepsy, particularly new-onset epilepsy among the elderly. However, post-epilepsy stroke has been overlooked. In recent years, it has been demonstrated that epilepsy patients have increased risk and mortality from stroke when compared with the general population. Additionally, it was proposed that post-epilepsy stroke might be associated with antiepileptic drugs (AEDs), epileptic seizures and the lifestyle of epileptic patients. Here, we comprehensively review the epidemiology, causes and interventions for post-epilepsy stroke.

  12. The role of nicotinic acetylcholine receptors in autosomal dominant nocturnal frontal lobe epilepsy.

    Directory of Open Access Journals (Sweden)

    Andrea eBecchetti

    2015-02-01

    Full Text Available Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE is a focal epilepsy with attacks typically arising in the frontal lobe during non rapid eye movement (NREM sleep. It is characterized by clusters of complex and stereotyped hypermotor seizures, frequently accompanied by sudden arousals. Cognitive and psychiatric symptoms may be also observed. Approximately 12% of the ADNFLE families carry mutations on genes coding for subunits of the heteromeric neuronal nicotinic receptors (nAChRs. This is consistent with the widespread expression of these receptors, particularly the α4β2* subtype, in the neocortex and thalamus. However, understanding how mutant nAChRs lead to partial frontal epilepsy is far from being straightforward because of the complexity of the cholinergic regulation in both developing and mature brains. The relation with the sleep-waking cycle must be also explained. We discuss some possible pathogenetic mechanisms in the light of recent advances about the nAChR role in prefrontal regions as well as the studies carried out in murine models of ADNFLE. Functional evidence points to alterations in prefrontal GABA release, and the synaptic unbalance probably arises during the cortical circuit maturation. Although most of the available functional evidence concerns mutations on nAChR subunit genes, other genes have been recently implicated in the disease, such as KCNT1 (coding for a Na+-dependent K+ channel, DEPD5 (Dishevelled, Egl-10 and Pleckstrin Domain-containing protein 5, and CRH (Corticotropin-Releasing Hormone. Overall, the uncertainties about both the etiology and the pathogenesis of ADNFLE point to the current gaps in our knowledge the regulation of neuronal networks in the cerebral cortex.

  13. Processing of Words and Faces by Patients with Left and Right Temporal Lobe Epilepsy

    Directory of Open Access Journals (Sweden)

    Andrew W. Ellis

    1991-01-01

    Full Text Available Tests of word and face processing were given to patients with complex partial epilepsy focussed on the left or right temporal lobe, and to non-epileptic control subjects. The left TLE group showed the greatest impairment on object naming and on reading tests, but the right TLE group also showed a lesser impairment relative to the normal control subjects on both tests. The right TLE group was selectively impaired on distinguishing famous from non-famous faces while the left TLE group was impaired at naming famous faces they had successfully recognized as familiar. There was no significant difference between the three groups on recognition memory for words. The implications of the results for theories of the role of the temporal lobes in word and face processing, and the possible neural mechanisms responsible for the deficits in TLE patients, are discussed.

  14. Analysis of Mechanical Properties of Self Compacted Concrete by Partial Replacement of Cement with Industrial Wastes under Elevated Temperature

    Directory of Open Access Journals (Sweden)

    Junaid Mansoor

    2018-03-01

    Full Text Available Self-Compacting Concrete (SCC differs from the normal concrete as it has the basic capacity to consolidate under its own weight. The increased awareness regarding environmental disturbances and its hazardous effects caused by blasting and crushing procedures of stone, it becomes a delicate and obvious issue for construction industry to develop an alternative remedy as material which can reduce the environmental hazards and enable high-performance strength to the concrete, which would make it durable and efficient for work. A growing trend is being established all over the world to use industrial byproducts and domestic wastes as a useful raw material in construction, as it provides an eco-friendly edge to the construction process and especially for concrete. This study aims to enlighten the use and comparative analysis for the performance of concrete with added industrial byproducts such as Ground Granulated Blast Furnace Slag (GGBFS, Silica fumes (SF and Marble Powder (MP in the preparation of SCC. This paper deals with the prediction of mechanical properties (i.e., compressive, tensile and flexural Strength of self-compacting concrete by considering four major factors such as type of additive, percentage additive replaced, curing days and temperature using Artificial Neural Networks (ANNs.

  15. Review: Hippocampal sclerosis in epilepsy: a neuropathology review

    Science.gov (United States)

    Thom, Maria

    2014-01-01

    Hippocampal sclerosis (HS) is a common pathology encountered in mesial temporal lobe epilepsy (MTLE) as well as other epilepsy syndromes and in both surgical and post-mortem practice. The 2013 International League Against Epilepsy (ILAE) classification segregates HS into typical (type 1) and atypical (type 2 and 3) groups, based on the histological patterns of subfield neuronal loss and gliosis. In addition, granule cell reorganization and alterations of interneuronal populations, neuropeptide fibre networks and mossy fibre sprouting are distinctive features of HS associated with epilepsies; they can be useful diagnostic aids to discriminate from other causes of HS, as well as highlighting potential mechanisms of hippocampal epileptogenesis. The cause of HS remains elusive and may be multifactorial; the contribution of febrile seizures, genetic susceptibility, inflammatory and neurodevelopmental factors are discussed. Post-mortem based research in HS, as an addition to studies on surgical samples, has the added advantage of enabling the study of the wider network changes associated with HS, the long-term effects of epilepsy on the pathology and associated comorbidities. It is likely that HS is heterogeneous in aspects of its cause, epileptogenetic mechanisms, network alterations and response to medical and surgical treatments. Future neuropathological studies will contribute to better recognition and understanding of these clinical and patho-aetiological subtypes of HS. PMID:24762203

  16. Mu-opiate receptors measured by positron emission tomography are increased in temporal lobe epilepsy.

    Science.gov (United States)

    Frost, J J; Mayberg, H S; Fisher, R S; Douglass, K H; Dannals, R F; Links, J M; Wilson, A A; Ravert, H T; Rosenbaum, A E; Snyder, S H

    1988-03-01

    Neurochemical studies in animal models of epilepsy have demonstrated the importance of multiple neurotransmitters and their receptors in mediating seizures. The role of opiate receptors and endogenous opioid peptides in seizure mechanisms is well developed and is the basis for measuring opiate receptors in patients with epilepsy. Patients with complex partial seizures due to unilateral temporal seizure foci were studied by positron emission tomography using 11C-carfentanil to measure mu-opiate receptors and 18F-fluoro-deoxy-D-glucose to measure glucose utilization. Opiate receptor binding is greater in the temporal neocortex on the side of the electrical focus than on the opposite side. Modeling studies indicate that the increase in binding is due to an increase in affinity or the number of unoccupied receptors. No significant asymmetry of 11C-carfentanil binding was detected in the amygdala or hippocampus. Glucose utilization correlated inversely with 11C-carfentanil binding in the temporal neocortex. Increased opiate receptors in the temporal neocortex may represent a tonic anticonvulsant system that limits the spread of electrical activity from other temporal lobe structures.

  17. Epilepsy and anxiety

    Directory of Open Access Journals (Sweden)

    Marly de Albuquerque

    1993-09-01

    Full Text Available We have analyzed 155 subjects with STAI (State-Trait Anxiety Inventory: 75 epileptic patients and 80 normal subjects used as a control group. A higher trait-anxiety score (chronic anxiety than that of controls was found for the epileptic group. For the epileptic group higher levels of the A-trait occurred in patients with EEG abnormalities with left temporal localization. We have also observed that the shorter the epilepsy lasts (less than two years, the higher the trait-anxiety levels. Convulsions and awareness loss during epileptic seizures do not modify state and trait-anxiety scores.

  18. Late onset myoclonic epilepsy in Down syndrome and dementia

    Directory of Open Access Journals (Sweden)

    Annapia Verri

    2012-09-01

    Full Text Available Specific forms of epilepsy may be found at various ages in Down Syndrome (DS and a sharp increase in the incidence of epilepsy with age has been documented. A specific type of myoclonic epilepsy associated with cognitive decline has been reported as “senile myoclonic epilepsy” or “late onset myoclonic epilepsy in DS” (LOMEDS. We report a new case of LOMEDS, documented by clinical and neurophysiological evaluation and psychometric assessment (DSDS and DMR. MF, male, affected by DS, was referred in 2004 at 40 years of age; he had no personal or familial history of epilepsy. Since one year, the patient presented cognitive deterioration, characterized by regression of language abilities, loss of memory, and loss of sphincters control. A brain TC showed mild brainstem and sub-cortical atrophy. In 2006, myoclonic jerks involving upper limbs occurred mainly after awakening. EEG showed a low voltage 8 Hz background activity with diffuse slow activity, intermingled with spikes or polyspikes, persisting during NREM sleep. MF was initially treated with clonazepam and after with topiramate, resulting in partial seizures control. MRI (2008 demonstrated diffuse brain atrophy, associated with marked ventricular enlargement. At the psychometric evaluation, onset of dementia was evident late in 2004, with transition to the middle stage in 2006. Last assessment (2009 showed the clinical signs of a late stage of deterioration, with loss of verbal abilities and autonomous ambulation. Using levetiracetam till 2,000 mg/die, myoclonic jerks decreased but are still present every day after awakening. On the EEG slow and poorly organized background activity with bilateral polyspike-wave discharges was recorded. Therefore, we documented a parallel progression of dementia and myoclonic epilepsy in a DS subject.

  19. WONOEP appraisal: new genetic approaches to study epilepsy

    Science.gov (United States)

    Rossignol, Elsa; Kobow, Katja; Simonato, Michele; Loeb, Jeffrey A.; Grisar, Thierry; Gilby, Krista L.; Vinet, Jonathan; Kadam, Shilpa D.; Becker, Albert J.

    2014-01-01

    -coding RNAs involved in modifying gene expression following seizures. In addition, genetically-based bioluminescent reporters are providing new opportunities to assess neuronal activity and neurotransmitter levels both in vitro and in vivo in the context of epilepsy. Finally, genetically rederived neurons generated from patient iPS cells and genetically-modified zebrafish have become high-throughput means to investigate disease mechanisms and potential new therapies. Significance Genetics has considerably changed the field of epilepsy research and is paving the way for better diagnosis and therapies for patients with epilepsy. PMID:24965021

  20. The ketogenic diet and epilepsy.

    Science.gov (United States)

    Kim, Do Young; Rho, Jong M

    2008-03-01

    The ketogenic diet has long been used to treat medically refractory epilepsy. The mechanisms underlying its clinical effects, however, have remained a mystery. The evidence to date suggests that a fundamental shift from glycolysis to intermediary metabolism induced by the ketogenic diet is necessary and sufficient for clinical efficacy. This notion is supported by a growing number of studies indicating that glucose restriction, ketone bodies and polyunsaturated fatty acids may all play mechanistic roles, possibly by enhancing mitochondrial respiration and ATP production, and decreasing reactive oxygen species production. Recent reports indicate that ketone bodies can reduce oxidative stress and that fatty acid-induced mitochondrial uncoupling may also yield similar protective effects. Ketone bodies may attenuate spontaneous firing of ATP-sensitive potassium channels in central neurons, and pharmacological inhibition of glycolysis has been shown to retard epileptogenesis in a rat kindling model. While the mechanisms underlying the broad clinical efficacy of the ketogenic diet remain unclear, there is growing evidence that the ketogenic diet alters the fundamental biochemistry of neurons in a manner that not only inhibits neuronal hyperexcitability but also induces a protective effect. Thus, the ketogenic diet may ultimately be useful in the treatment of a variety of neurological disorders.

  1. Why epilepsy challenges social life.

    Science.gov (United States)

    Steiger, Bettina K; Jokeit, Hennric

    2017-01-01

    Social bonds are at the center of our daily living and are an essential determinant of our quality of life. In people with epilepsy, numerous factors can impede cognitive and affective functions necessary for smooth social interactions. Psychological and psychiatric complications are common in epilepsy and may hinder the processing of social information. In addition, neuropsychological deficits such as slowed processing speed, memory loss or attentional difficulties may interfere with enjoyable reciprocity of social interactions. We consider societal, psychological, and neuropsychological aspects of social life with particular emphasis on socio-cognitive functions in temporal lobe epilepsy. Deficits in emotion recognition and theory of mind, two main aspects of social cognition, are frequently observed in individuals with mesial temporal lobe epilepsy. Results from behavioural studies targeting these functions will be presented with a focus on their relevance for patients' daily life. Furthermore, we will broach the issue of pitfalls in current diagnostic tools and potential directions for future research. By giving a broad overview of individual and interpersonal determinants of social functioning in epilepsy, we hope to provide a basis for future research to establish social cognition as a key component in the comprehensive assessment and care of those with epilepsy. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  2. [Epilepsy, cognition and ketogenic diet].

    Science.gov (United States)

    Garcia-Penas, J J

    2018-03-01

    Most individuals with epilepsy will respond to pharmacologic treatment; however, approximately 20-30% will develop medically refractory epilepsy. Cognitive side effects of antiepileptic drugs are common and can negatively affect tolerability, compliance, and long-term retention of the treatment. Ketogenic diet is an effective and well-tolerated treatment for these children with refractory epilepsy without any negative effect on cognition or behavior. To review the current state of experimental and clinical data concerning the neuroprotective and cognitive effects of the ketogenic diet in both humans and animals. In different animal models, with or without epilepsy, the ketogenic diet seems to have neuroprotective and mood-stabilizing effects. In the observational studies in pediatric epilepsy, improvements during treatment with the ketogenic diet are reported in behavior and cognitive function, particularly with respect to attention, alertness, activity level, socialization, and sleep quality. One randomized controlled trial in patients with pediatric refractory epilepsy showed a mood and cognitive activation during ketogenic diet treatment. Ketogenic diet shows a positive impact on behavioral and cognitive functioning in children and adolescents with refractory epilepsy. More specifically, an improvement is observed in mood, sustained attention, and social interaction.

  3. Epilepsy care in general practice.

    LENUS (Irish Health Repository)

    Varley, J

    2009-06-01

    Epilepsy care in Ireland is shared between primary, secondary and tertiary care services with the General Practitioner (GP) managing the process. Barriers to effective epilepsy care in Irish general practice remain undocumented although sub-optimal and fragmented services are frequently anecdotally reported. This survey of Irish GPs reports on such barriers to epilepsy care and on the Information & Communication Technology (ICT) issues potentially relevant to the use of an epilepsy specific Electronic Patient Record (EPR). The response rate was 247\\/700 (35.3%). Respondents supported the concept of shared care for epilepsy 237 (96%) however they were very dissatisfied with existing neurology services, including pathways of referral 207 (84%) and access to specialist neurology advice and investigations 232 (94%). They reported that neurology services and investigations may be accessed more expeditiously by patients with private health insurance than those without 178 (72%). Consequently many patients are referred to the emergency department for assessment and treatment 180 (73%). A deficit in epilepsy care expertise among GPs was acknowledged 86 (35%). While computerisation of GP practices appears widespread 230 (93%), just over half the respondents utilise available electronic functionalities specific to chronic disease management. GP specific electronic systems infrequently link or communicate with external electronic sources 133 (54%). While the current pathways of care for epilepsy in Ireland appear fragmented and inadequate, further investigations to determine the quality and cost effectiveness of the current service are required.

  4. Joan of Arc: Sanctity, witchcraft or epilepsy?

    Science.gov (United States)

    Nicastro, Nicolas; Picard, Fabienne

    2016-04-01

    The objective of this article is to describe whether Joan of Arc had epilepsy and how that may have influenced her sense of mission and ability to encourage thousands of people to help her to chase the English out of France. Documentation of her Trial of Condemnation in 1431 provides a description of her episodes of experienced voices and visions. From the age of thirteen, Joan of Arc experienced frequent episodes of auditory hallucinations associated with elementary or complex visual hallucinations (e.g., a great light or human faces). These had sudden onset, lasting seconds or minutes at most, and occurred when awake or during sleep, arousing her. Some could be triggered by an auditory stimulus. She had no disorganized thought between the episodes. The semiology of the episodes is very suggestive of epileptic seizures, which have been considered as ecstatic by some authors or as partial epilepsy with auditory features by others, which seems more concordant with the ictal symptoms. The auditory and visual hallucinations could have had a religious content because during her childhood and adolescence, she was brought up in a religious environment, insomuch as this content first undefined only appeared after a few seizures. We can suppose that such hallucinations, without the knowledge of their medical origin, gave her a sense of divine mission, hence, a real strength to try to accomplish the orders she heard during the episodes. Her role during the Hundred Years' War and her narration of her strange episodes led her to be burned for heresy at the age of nineteen, yet rehabilitated 25 years later and to be canonized for her achievements in 1920. This article is part of a Special Issue entitled "Epilepsy, Art, and Creativity". Copyright © 2016 Elsevier Inc. All rights reserved.

  5. SPECT in Focal Epilepsies

    Directory of Open Access Journals (Sweden)

    Roderick Duncan

    2000-01-01

    Full Text Available Brain perfusion changes during seizures were first observed in the 1930s. Single Photon Emission Computed Tomography (SPECT was developed in the 1970s, and tracers suitable for the imaging of regional cerebral perfusion (rCP became available in the 1980s. The method was first used to study rCP in the interictal phase, and this showed areas of low perfusion in a proportion of cases, mainly in patients with temporal lobe epilepsies. However, the trapping paradigm of tracers such as hexamethyl propyleneamine oxime (HMPAO provided a practicable method of studying changes in rCP during seizures, and a literature was established in the late 1980s and early 1990s showing a typical sequence of changes during and after seizures of mesial temporal lobe origin; the ictal phase was associated with large increases in perfusion throughout the temporal lobe, with first the lateral, then the mesial temporal lobe becoming hypoperfused in the postictal phase. Activation and inhibition of other structures, such as the basal ganglia and frontal cortex, were also seen. Studies of seizures originating elsewhere in the brain have shown a variety of patterns of change, according to the structures involved. These changes have been used practically to aid the process of localisation of the epileptogenic zone so that epilepsy surgery can be planned.

  6. Epilepsy in Dostoevsky's novels.

    Science.gov (United States)

    Voskuil, Piet H A

    2013-01-01

    Fyodor Mikhailovich Dostoevsky (1821-1881) suffered from epilepsy. Some type of psychopathology can be found in about 25% of the characters of his novels. Some of them have seizures. In at least five of them Dostoevsky clearly intends them to have epilepsy. Others are more likely to be created as people with hysteria or sometimes, for instance, possession. In this essay an inventory is given by more or less comprehensive quotes of different types of seizures in five novels. The seizures are named in the novels with a varying vocabulary based on the concepts of nosology in the 19th century, the knowledge of Dostoevsky of these concepts, his own experiences, and problems in translation and transliteration. In the discussion, analysis of the role these factors played in the understanding of what Dostoevsky really expressed is given attention. Special attention is given to the so-called ecstatic aura. This element of focal epileptic seizures is so rare that in the past the description of it raised doubts on its existence as such and therefore the embellishment by Dostoevsky, describing his own experience and/or that of his epileptic characters Kirillov and Myshkin. The consequence of this analytic approach, however, should not be losing one's amazement of the genius polyphonic creativity of Dostoevsky to integrate so many profound aspects of the human and especially the Russian soul in the characters of his novels. Copyright © 2013 S. Karger AG, Basel.

  7. Talking about epilepsy: Challenges parents face when communicating with their child about epilepsy and epilepsy-related issues.

    Science.gov (United States)

    O'Toole, Stephanie; Lambert, Veronica; Gallagher, Pamela; Shahwan, Amre; Austin, Joan K

    2016-04-01

    The aim of this qualitative study was to explore the challenges that parents of children with epilepsy experienced when engaging in dialog with their child about epilepsy and epilepsy-related issues. Using a qualitative exploratory approach, interviews were conducted with 34 parents of children with epilepsy (aged 6-16 years), consisting of 27 mothers and 7 fathers. Data were transcribed verbatim and thematically analyzed. Findings revealed five main themes: normalizing epilepsy, the invisibility of epilepsy, information concealment, fear of misinforming the child, and difficulty in discussing particular epilepsy-related issues. Many of the communicative challenges experienced by parents impacted on their ability to engage openly in parent-child dialog about epilepsy in the home. Parents face specific challenges when choosing to communicate with their child about epilepsy, relating to creating a sense of normality, reducing fear of causing their child worry, and having a lack of epilepsy-related knowledge. Healthcare professionals who work closely with families living with epilepsy should remain mindful of the importance of discussing family communication surrounding epilepsy and the challenges parents of children with epilepsy face when talking about epilepsy within the home. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Autistic spectrum disorder: evaluating a possible contributing or causal role of epilepsy.

    Science.gov (United States)

    Deonna, Thierry; Roulet, Eliane

    2006-01-01

    The onset of epilepsy in brain systems involved in social communication and/or recognition of emotions can occasionally be the cause of autistic symptoms or may aggravate preexisting autistic symptoms. Knowing that cognitive and/or behavioral abnormalities can be the presenting and sometimes the only symptom of an epileptic disorder or can even be caused by paroxysmal EEG abnormalities without recognized seizures, the possibility that this may apply to autism has given rise to much debate. Epilepsy and/or epileptic EEG abnormalities are frequently associated with autistic disorders in children but this does not necessarily imply that they are the cause; great caution needs to be exercised before drawing any such conclusions. So far, there is no evidence that typical autism can be attributed to an epileptic disorder, even in those children with a history of regression after normal early development. Nevertheless, there are several early epilepsies (late infantile spasms, partial complex epilepsies, epilepsies with CSWS, early forms of Landau-Kleffner syndrome) and with different etiologies (tuberous sclerosis is an important model of these situations) in which a direct relationship between epilepsy and some features of autism may be suspected. In young children who primarily have language regression (and who may have autistic features) without evident cause, and in whom paroxysmal focal EEG abnormalities are also found, the possible direct role of epilepsy can only be evaluated in longitudinal studies.

  9. 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

    1989-01-01

    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)

  10. Self-concept and gender effects in Korean adolescents with epilepsy.

    Science.gov (United States)

    Lee, Sang-Ahm; Choi, Eun-Ju; Kwon, Soonhak; Eom, Soyong

    2016-08-01

    We aimed to determine whether adolescents with epilepsy (AWE) have a compromised self-concept, whether a lower self-concept is related to mental health, and whether there are sex differences in self-concept in AWE. A total of 179 AWE and 259 control adolescents without epilepsy participated in this cross-sectional, multicenter study. Self-concept was measured using the Harter's Self-Perception Profile for Children. Depressive symptoms and anxiety were assessed by the Hospital Anxiety Depression Scale (HADS). A group-by-sex interaction was evaluated using an analysis of covariance controlling for age. Adolescents with epilepsy had a lower level of self-concept, especially in domains of behavioral conduct (partial eta(2): 0.257) and social acceptance (partial eta(2): 0.116), than controls (pself-concept did not differ by sex in the group with epilepsy. A group-by-sex interaction effect was found on social acceptance (p=0.042). Unlike the control group, age was not correlated with self-concept in AWE. Physical appearance was negatively correlated with HADS-anxiety scores (r=-0.291, pself-concept, especially in the domains of behavioral conduct and social acceptance, than controls. Sex differences in self-concept were identified in the control group but not in the group with epilepsy. Physical appearance was negatively correlated with anxiety in girls with epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Seizure drawings: insight into the self-image of children with epilepsy.

    Science.gov (United States)

    Stafstrom, Carl E; Havlena, Janice

    2003-02-01

    Epilepsy is a chronic disorder that is associated with numerous psychological challenges, especially in children. Drawings have been underutilized as a method to obtain insight into psychological issues in children with epilepsy. We asked 105 children with epilepsy, ages 5 to 18 years, to draw a picture of what it is like to have a seizure. Across ages and epilepsy syndromes, the drawings showed evidence of impaired self-concept, low self-esteem, and a sense of helplessness and vulnerability. Overall, the drawings of human figures were less developed than expected for chronological age. In some drawings, indicators of underlying depression were found. When considered by epilepsy syndrome or seizure type, some specific artistic features were noted. Children with simple partial (motor) seizures drew distorted body parts, especially limbs. Those with complex partial seizures depicted sensory symptoms and mental status changes such as confusion. Children with generalized tonic-clonic seizures showed shaking extremities. Drawings by children with absence seizures illustrated mainly staring. In conclusion, drawings are a powerful method to examine the self-concept of children with epilepsy and gain insight into their feelings about themselves and their world.

  12. Depression and genetic causal attribution of epilepsy in multiplex epilepsy families.

    Science.gov (United States)

    Sorge, Shawn T; Hesdorffer, Dale C; Phelan, Jo C; Winawer, Melodie R; Shostak, Sara; Goldsmith, Jeff; Chung, Wendy K; Ottman, Ruth

    2016-10-01

    Rapid advances in genetic research and increased use of genetic testing have increased the emphasis on genetic causes of epilepsy in patient encounters. Research in other disorders suggests that genetic causal attributions can influence patients' psychological responses and coping strategies, but little is known about how epilepsy patients and their relatives will respond to genetic attributions of epilepsy. We investigated the possibility that among members of families containing multiple individuals with epilepsy, depression, the most frequent psychiatric comorbidity in the epilepsies, might be related to the perception that epilepsy has a genetic cause. A self-administered survey was completed by 417 individuals in 104 families averaging 4 individuals with epilepsy per family. Current depression was measured with the Patient Health Questionnaire. Genetic causal attribution was assessed by three questions addressing the following: perceived likelihood of having an epilepsy-related mutation, perceived role of genetics in causing epilepsy in the family, and (in individuals with epilepsy) perceived influence of genetics in causing the individual's epilepsy. Relatives without epilepsy were asked about their perceived chance of developing epilepsy in the future, compared with the average person. Prevalence of current depression was 14.8% in 182 individuals with epilepsy, 6.5% in 184 biologic relatives without epilepsy, and 3.9% in 51 individuals married into the families. Among individuals with epilepsy, depression was unrelated to genetic attribution. Among biologic relatives without epilepsy, however, prevalence of depression increased with increasing perceived chance of having an epilepsy-related mutation (p = 0.02). This association was not mediated by perceived future epilepsy risk among relatives without epilepsy. Depression is associated with perceived likelihood of carrying an epilepsy-related mutation among individuals without epilepsy in families containing

  13. Migraine and epilepsy: a focus on overlapping clinical, pathophysiological, molecular, and therapeutic aspects.

    Science.gov (United States)

    Bianchin, Marino Muxfeldt; Londero, Renata Gomes; Lima, José Eduardo; Bigal, Marcelo Eduardo

    2010-08-01

    The association of epilepsy and migraine has been long recognized. Migraine and epilepsy are both chronic disorders with episodic attacks. Furthermore, headache may be a premonitory or postdromic symptom of seizures, and migraine headaches may cause seizures per se (migralepsy). Migraine and epilepsy are comorbid, sharing pathophysiological mechanisms and common clinical features. Several recent studies identified common genetic and molecular substrates for migraine and epilepsy, including phenotypic-genotypic correlations with mutations in the CACNA1A, ATP1A2, and SCN1A genes, as well as in syndromes due to mutations in the SLC1A3, POLG, and C10orF2 genes. Herein, we review the relationship between migraine and epilepsy, focusing on clinical aspects and some recent pathophysiological and molecular studies.

  14. MRI in patients with temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Kodama, Kazuhiro

    1992-01-01

    The present study investigated magnetic resonance imaging (MRI) features in temporal lobe epilepsy and correlated them with clinical variables, such as age, illness duration, past history, and the frequency of seizure. Cerebral MRI was performed in 45 patients with temporal lobe epilepsy of unknown etiology, using a 0.5 T and/or a 1.5 T MRI systems. The temporal lobe was seen as high signal intensity on T2-weighted images and/or proton density-weighted images in 6 patients, although it was missed on CT and T1-weighted images. The high intensity area seemed to reflect sclerosis of the temporal lobe. This finding was significantly associated with partial seizure. Of these patients, 3 had a history of febrile convulsions. Ten patients had slight dilatation of the inferior horn of the lateral ventricle. They were significantly old at the time of onset and examination, as compared with those without dilatation. Furthermore, 6 patients with unilateral dilatation were significantly younger than the other 4 with bilateral dilatation. Nine patients had small multiple high signal areas in white matter, mainly in the parietal lobe, which suggested vascular origin. These patients were significantly old at the time of onset and examination, as compared with those having no such findings. In depicting high signal intensity areas, a 1.5 T MRI system was not always superior to a 0.5 T MRI system. Proton density-weighted images were better than T2-weighted images in some patients. (N.K.)

  15. Patients' and neurologists' perception of epilepsy and psychogenic nonepileptic seizures.

    Science.gov (United States)

    Whitehead, Kimberley; Kandler, Rosalind; Reuber, Markus

    2013-04-01

    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

  16. Neuroinflammatory targets and treatments for epilepsy validated in experimental models.

    Science.gov (United States)

    Aronica, Eleonora; Bauer, Sebastian; Bozzi, Yuri; Caleo, Matteo; Dingledine, Raymond; Gorter, Jan A; Henshall, David C; Kaufer, Daniela; Koh, Sookyong; Löscher, Wolfgang; Louboutin, Jean-Pierre; Mishto, Michele; Norwood, Braxton A; Palma, Eleonora; Poulter, Michael O; Terrone, Gaetano; Vezzani, Annamaria; Kaminski, Rafal M

    2017-07-01

    A large body of evidence that has accumulated over the past decade strongly supports the role of inflammation in the pathophysiology of human epilepsy. Specific inflammatory molecules and pathways have been identified that influence various pathologic outcomes in different experimental models of epilepsy. Most importantly, the same inflammatory pathways have also been found in surgically resected brain tissue from patients with treatment-resistant epilepsy. New antiseizure therapies may be derived from these novel potential targets. An essential and crucial question is whether targeting these molecules and pathways may result in anti-ictogenesis, antiepileptogenesis, and/or disease-modification effects. Therefore, preclinical testing in models mimicking relevant aspects of epileptogenesis is needed to guide integrated experimental and clinical trial designs. We discuss the most recent preclinical proof-of-concept studies validating a number of therapeutic approaches against inflammatory mechanisms in animal models that could represent novel avenues for drug development in epilepsy. Finally, we suggest future directions to accelerate preclinical to clinical translation of these recent discoveries. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  17. Gain-of-function HCN2 variants in genetic epilepsy.

    Science.gov (United States)

    Li, Melody; Maljevic, Snezana; Phillips, A Marie; Petrovski, Slave; Hildebrand, Michael S; Burgess, Rosemary; Mount, Therese; Zara, Federico; Striano, Pasquale; Schubert, Julian; Thiele, Holger; Nürnberg, Peter; Wong, Michael; Weisenberg, Judith L; Thio, Liu Lin; Lerche, Holger; Scheffer, Ingrid E; Berkovic, Samuel F; Petrou, Steven; Reid, Christopher A

    2018-02-01

    Genetic generalized epilepsy (GGE) is a common epilepsy syndrome that encompasses seizure disorders characterized by spike-and-wave discharges (SWDs). Pacemaker hyperpolarization-activated cyclic nucleotide-gated channels (HCN) are considered integral to SWD genesis, making them an ideal gene candidate for GGE. We identified HCN2 missense variants from a large cohort of 585 GGE patients, recruited by the Epilepsy Phenome-Genome Project (EPGP), and performed functional analysis using two-electrode voltage clamp recordings from Xenopus oocytes. The p.S632W variant was identified in a patient with idiopathic photosensitive occipital epilepsy and segregated in the family. This variant was also independently identified in an unrelated patient with childhood absence seizures from a European cohort of 238 familial GGE cases. The p.V246M variant was identified in a patient with photo-sensitive GGE and his father diagnosed with juvenile myoclonic epilepsy. Functional studies revealed that both p.S632W and p.V246M had an identical functional impact including a depolarizing shift in the voltage dependence of activation that is consistent with a gain-of-function. In contrast, no biophysical changes resulted from the introduction of common population variants, p.E280K and p.A705T, and the p.R756C variant from EPGP that did not segregate with disease. Our data suggest that HCN2 variants can confer susceptibility to GGE via a gain-of-function mechanism. © 2017 Wiley Periodicals, Inc.

  18. Management of genetic epilepsies: From empirical treatment to precision medicine.

    Science.gov (United States)

    Striano, Pasquale; Vari, Maria Stella; Mazzocchetti, Chiara; Verrotti, Alberto; Zara, Federico

    2016-05-01

    Despite the over 20 antiepileptic drugs (AEDs) now licensed for epilepsy treatment, seizures can be effectively controlled in about ∼70% of patients. Thus, epilepsy treatment is still challenging in about one third of patients and this may lead to a severe medically, physically, and socially disabling condition. However, there is clear evidence of heterogeneity of response to existing AEDs and a significant unmet need for effective intervention. A number of studies have shown that polymorphisms may influence the poor or inadequate therapeutic response as well as the occurrence of adverse effects. In addition, the new frontier of genomic technologies, including chromosome microarrays and next-generation sequencing, improved our understanding of the genetic architecture of epilepsies. Recent findings in some genetic epilepsy syndromes provide insights into mechanisms of epileptogenesis, unrevealing the role of a number of genes with different functions, such as ion channels, proteins associated to the vesical synaptic cycle or involved in energy metabolism. The rapid progress of high-throughput genomic sequencing and corresponding analysis tools in molecular diagnosis are revolutionizing the practice and it is a fact that for some monogenic epilepsies the molecular confirmation may influence the choice of the treatment. Moreover, the novel genetic methods, that are able to analyze all known genes at a reasonable price, are of paramount importance to discover novel therapeutic avenues and individualized (or precision) medicine. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Drug-Resistant Epilepsy: Multiple Hypotheses, Few Answers

    Directory of Open Access Journals (Sweden)

    Fei Tang

    2017-07-01

    Full Text Available Epilepsy is a common neurological disorder that affects over 70 million people worldwide. Despite the recent introduction of new antiseizure drugs (ASDs, about one-third of patients with epilepsy have seizures refractory to pharmacotherapy. Early identification of patients who will become refractory to ASDs could help direct such patients to appropriate non-pharmacological treatment, but the complexity in the temporal patterns of epilepsy could make such identification difficult. The target hypothesis and transporter hypothesis are the most cited theories trying to explain refractory epilepsy, but neither theory alone fully explains the neurobiological basis of pharmacoresistance. This review summarizes evidence for and against several major theories, including the pharmacokinetic hypothesis, neural network hypothesis, intrinsic severity hypothesis, gene variant hypothesis, target hypothesis, and transporter hypothesis. The discussion is mainly focused on the transporter hypothesis, where clinical and experimental data are discussed on multidrug transporter overexpression, substrate profiles of ASDs, mechanism of transporter upregulation, polymorphisms of transporters, and the use of transporter inhibitors. Finally, future perspectives are presented for the improvement of current hypotheses and the development of treatment strategies as guided by the current understanding of refractory epilepsy.

  20. Structure and mechanical properties of Cresco-Ti laser-welded joints and stress analyses using finite element models of fixed distal extension and fixed partial prosthetic designs.

    Science.gov (United States)

    Uysal, Hakan; Kurtoglu, Cem; Gurbuz, Riza; Tutuncu, Naki

    2005-03-01

    The Cresco-Ti System uses a laser-welded process that provides an efficient technique to achieve passive fit frameworks. However, mechanical behavior of the laser-welded joint under biomechanical stress factors has not been demonstrated. This study describes the effect of Cresco-Ti laser-welding conditions on the material properties of the welded specimen and analyzes stresses on the weld joint through 3-dimensional finite element models (3-D FEM) of implant-supported fixed dentures with cantilever extensions and fixed partial denture designs. Twenty Grade III (ASTM B348) commercially pure titanium specimens were machine-milled to the dimensions described in the EN10002-1 tensile test standard and divided into test (n = 10) and control (n = 10) groups. The test specimens were sectioned and laser-welded. All specimens were subjected to tensile testing to determine yield strength (YS), ultimate tensile strength (UTS), and percent elongation (PE). The Knoop micro-indentation test was performed to determine the hardness of all specimens. On welded specimens, the hardness test was performed at the welded surface. Data were analyzed with the Mann-Whitney U test and Student's t test (alpha=.05). Fracture surfaces were examined by scanning electron microscopy to characterize the mode of fracture and identify defects due to welding. Three-dimensional FEMs were created that simulated a fixed denture with cantilever extensions supported by 5 implants (M1) and a fixed partial denture supported by 2 implants (M2), 1 of which was angled 30 degrees mesio-axially. An oblique load of 400 N with 15 degrees lingual-axial inclinations was applied to both models at various locations. Test specimens fractured between the weld and the parent material. No porosities were observed on the fractured surfaces. Mean values for YS, UTS, PE, and Knoop hardness were 428 +/- 88 MPa, 574 +/- 113 MPa, 11.2 +/- 0.4%, 270 +/- 17 KHN, respectively, for the control group and 642 +/- 2 MPa, 772 +/- 72

  1. Porous 45S5 Bioglass®-based scaffolds using stereolithography: Effect of partial pre-sintering on structural and mechanical properties of scaffolds.

    Science.gov (United States)

    Thavornyutikarn, Boonlom; Tesavibul, Passakorn; Sitthiseripratip, Kriskrai; Chatarapanich, Nattapon; Feltis, Bryce; Wright, Paul F A; Turney, Terence W

    2017-06-01

    Scaffolds made from 45S5 Bioglass® ceramic (BG) show clinical potential in bone regeneration due to their excellent bioactivity and ability to bond to natural bone tissue. However, porous BG scaffolds are limited by their mechanical integrity and by the substantial volume contractions occurring upon sintering. This study examines stereolithographic (SLA) methods to fabricate mechanically robust and porous Bioglass®-based ceramic scaffolds, with regular and interconnected pore networks and using various computer-aided design architectures. It was found that a diamond-like (DM) architecture gave scaffolds the most controllable results without any observable closed porosity in the fired scaffolds. When the pore dimensions of the DM scaffolds of the same porosity (~60vol%) were decreased from 700 to 400μm, the compressive strength values increased from 3.5 to 6.7MPa. In addition, smaller dimensional shrinkage could be obtained by employing partially pre-sintered bioglass, compared to standard 45S5 Bioglass®. Scaffolds derived from pre-sintered bioglass also showed marginally improved compressive strength. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. [Sexual disorders in epilepsy. Results of a multidisciplinary evaluation].

    Science.gov (United States)

    Silva, H C; Carvalho, M J; Jorge, C L; Cunha Neto, M B; Goes, P M; Yacubian, E M

    1999-09-01

    Eleven epileptic men who complained of epilepsy and sexual dysfunction were submitted to a multidisciplinary evaluation. Mean age was 27 years (20-34), mean epilepsy duration was 19 years (0.5-32) and the mean seizure frequency was two by week (0-7). Ten patients had partial seizures and one other had myoclonic epilepsy. Ten patients were treated with antiepileptic drugs (phenytoin--1, carbamazepine--8, clonazepam--3, clobazam--2, valproic acid--3, vigabatrin--1). As defined in the DSM III-R, the complaints were: erectile disorder (9), hypoactive sexual desire disorder (4), frotteurism (4), inhibited orgasm (3), premature ejaculation (3), fetishism (2), voyeurism (2), exhibitionism (2), pedophilia (1) and sexual aversion disorder (1). Two patients showed hypogonadotropic hypogonadism on endocrinologic screening. Urological evaluation disclosed organic erectile dysfunction in other two. One patient had a diagnosis of psychogenic sexual disorder. In six patients a conclusive etiologic diagnosis was not reached. This report shows the multifactorial nature of sexual disorder in epilepsy and underlies the need of a multidisciplinar evaluation.

  3. The epilepsy of Fyodor Mikhailovitch Dostoevsky (1821-1881).

    Science.gov (United States)

    Voskuil, P H

    1983-12-01

    Over 100 years ago, on the 27th of January 1881, Fyodor Mikhailovitch Dostoevsky died. Since that time, many biographies, monographs, memoirs, and, to a lesser extent, articles in the medical literature have discussed the fact that Dostoevsky was a patient with epilepsy. An attempt is made here to integrate the details of his illness into a medical case history, as we now do for every patient who visits a physician for the first time. The information pertinent to the case history includes: a description of all seizures, frequency of seizures, provocative factors, course of the disease, treatment, and family history. Even though we do not have the benefits of the results of electroencephalography (invented by Hans Berger in 1929), classification of the type of epilepsy Dostoevsky had is attempted. The existence or absence of the so-called ecstatic aura is crucial to such classification. Based on the data, it is likely that Dostoevsky suffered from partial complex epilepsy with secondarily generalized nocturnal seizures rather than primary generalized epilepsy.

  4. Familial temporal lobe epilepsy due to focal cortical dysplasia type IIIa.

    Science.gov (United States)

    Fabera, Petr; Krijtova, Hana; Tomasek, Martin; Krysl, David; Zamecnik, Josef; Mohapl, Milan; Jiruska, Premysl; Marusic, Petr

    2015-09-01

    Focal cortical dysplasia (FCD) represents a common cause of refractory epilepsy. It is considered a sporadic disorder, but its occasional familial occurrence suggests the involvement of genetic mechanisms. Siblings with intractable epilepsy were referred for epilepsy surgery evaluation. Both patients were examined using video-EEG monitoring, MRI examination and PET imaging. They underwent left anteromedial temporal lobe resection. Electroclinical features pointed to left temporal lobe epilepsy and MRI examination revealed typical signs of left-sided hippocampal sclerosis and increased white matter signal intensity in the left temporal pole. PET examination confirmed interictal hypometabolism in the left temporal lobe. Histopathological examination of resected tissue demonstrated the presence FCD type IIIa, i.e. hippocampal sclerosis and focal cortical dysplasia in the left temporal pole. We present a unique case of refractory mesial temporal lobe epilepsy in siblings, characterized by an identical clinical profile and histopathology of FCD type IIIa, who were successfully treated by epilepsy surgery. The presence of such a high concordance between the clinical and morphological data, together with the occurrence of epilepsy and febrile seizures in three generations of the family pedigree points towards a possible genetic nature of the observed FCD type IIIa. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  5. Epilepsy during the Middle Ages, the Renaissance and the Enlightenment.

    Science.gov (United States)

    Diamantis, Aristidis; Sidiropoulou, Kalliopi; Magiorkinis, Emmanouil

    2010-05-01

    The purpose of this study was to pinpoint the views on epilepsy as a disease and symptom during medieval times and the Renaissance. A thorough study of texts, medical books and reports along with a review of the available literature in PubMed was undertaken. With the exception of some early Byzantine doctors in the East and some of the representatives of Arab medicine, scientific views and observations on epilepsy in the West were overrun by the domination of the Catholic Church. This led to the formulation of superstitious views of the disease; epileptics were considered possessed and, therefore, only religious methods could possibly cure it. Near the end of the fourteenth century, physicians were emancipated from Catholic intervention. The Renaissance is marked by a plethora of new treatises on epilepsy regarding the mechanisms of epileptic convulsions, the connection with various clinical conditions such as tumors and venereal diseases and the collection of interesting cases.

  6. Stress, the hippocampus, and epilepsy

    NARCIS (Netherlands)

    Joëls, M.

    2009-01-01

    Stress is among the most frequently self-reported precipitants of seizures in patients with epilepsy. This review considers how important stress mediators like corticotropin-releasing hormone, corticosteroids, and neurosteroids could contribute to this phenomenon. Cellular effects of stress

  7. Behavior Problems Antedating Epilepsy Onset

    OpenAIRE

    J Gordon Millichap

    2001-01-01

    The prevalence and nature of behavior problems among 224 children (ages 4 to 14 years) with epilepsy, in the six month period before the first recognized seizure, were studied at the Indiana School of Nursing, Indianapolis.

  8. Treating seizures and epilepsy with anticoagulants?

    Directory of Open Access Journals (Sweden)

    Nicola eMaggio

    2013-03-01

    Full Text Available Thrombin is a serine protease playing an essential role in the blood coagulation cascade. Recent work, however, has identified a novel role for thrombin-mediated signaling pathways in the central nervous system. Binding of thrombin to protease-activated receptors (PARs in the brain appears to have multiple actions affecting both health and disease. Specifically, thrombin has been shown to lead to the onset of seizures via PAR-1 activation. In this perspective article, we review the putative mechanisms by which thrombin causes seizures and epilepsy. We propose a potential role of PAR-1 antagonists and novel thrombin inhibitors as new, possible antiepileptic drugs.

  9. Alternative psychosis (forced normalisation in epilepsy

    Directory of Open Access Journals (Sweden)

    Vongani Titi Raymond Ntsanwisi

    2011-06-01

    Full Text Available Abstract Forced normalization is a paradoxical relationship between seizure activity and behavioural problems. A 20 year old male with recurrent refractory tonic clonic epilepsy experienced forced normalization, whilst on medication with multiple anti- epileptic drugs (AEDs.(Valproate Sodium, Carbamazepine, and Topiramate. A reduction in the seizure burden correlated with sudden behavioural changes manifesting with aggressive outbursts and violence.. The present case may help clarify the mechanism of forced normalization whilst providing some helpful hints regarding the diagnosis and treatment of symptoms observed in recurrent refractory seizures.

  10. Mechanisms Underlying Testicular Damage and Dysfunction in Mice With Partial IGF-1 Deficiency and the Effectiveness of IGF-1 Replacement Therapy.

    Science.gov (United States)

    Castilla-Cortázar, Inma; Gago, Alberto; Muñoz, Úrsula; Ávila-Gallego, Elena; Guerra-Menéndez, Lucía; Sádaba, María Cruz; García-Magariño, Mariano; Olleros Santos-Ruiz, María; Aguirre, G A; Puche, Juan Enrique

    2015-12-01

    To determine whether insulin-like growth factor (IGF-1) deficiency can cause testicular damage and to examine changes of the testicular morphology and testicular function-related gene expression caused by IGF-1 deficiency. Therefore, this study aims to determine the benefits of low doses of IGF-1 and to explore the mechanisms underlying the IGF-1 replacement therapy. A murine model of IGF-1 deficiency was used to avoid any factor that could contribute to testicular damage. Testicular weight, score of histopathological damage, and gene expressions were studied in 3 experimental groups of mice: controls (wild-type Igf1(+/+)), heterozygous Igf1(+/-) with partial IGF-1 deficiency, and heterozygous Igf1(+/-) treated with IGF-1. Results show that the partial IGF-1 deficiency induced testicular damage and altered expression of genes involved in IGF-1 and growth hormone signaling and regulation, testicular hormonal function, extracellular matrix establishment and its regulation, angiogenesis, fibrogenesis, inflammation, and cytoprotection. In addition, proteins involved in tight junction expression were found to be reduced. However, low doses of IGF-1 restored the testicular damage and most of these parameters. IGF-1 deficiency caused the damage of the blood-testis barrier and testicular structure and induced the abnormal testicular function-related gene expressions. However, low doses of IGF-1 constitute an effective replacement therapy that restores the described testicular damage. Data herein show that (1) cytoprotective activities of IGF-1 seem to be mediated by heat shock proteins and that (2) connective tissue growth factor could play a relevant role together with IGF-1 in the extracellular matrix establishment. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Management of epilepsy in elderly

    OpenAIRE

    Harsono Harsono

    2003-01-01

    Management of epilepsy in elderly requires understanding the unique biochemical and pharmacological characteristics of these patients. Management decisions must be based on accurate classification of seizures or epilepsy syndromes, a thorough neurological assessment to define etiology, and a comprehensive assessment of the patient’s health and living situation. Concomitant illnesses such as neurological, psychiatric, metabolic, or cardiac disorders will require individualization of plans and ...

  12. Predictors of intractable childhood epilepsy

    International Nuclear Information System (INIS)

    Malik, M.A.; Ahmed, T.M.

    2008-01-01

    To determine the prognosis of seizures in epileptic children and identify early predictors of intractable childhood epilepsy. All children (aged 1 month to 16 years) with idiopathic or cryptogenic epilepsy who were treated and followed at the centre during the study period were included. The patients who had marked seizures even after two years of adequate treatment were labeled as intractable epileptics (cases). Children who had no seizure for more than one year at last follow-up visit were the controls. Adequate treatment was described as using at least three anti-epileptic agents either alone or in combination with proper compliance and dosage. Records of these patients were reviewed to identify the variables that may be associated with seizure intractability. Of 442 epileptic children, 325 (74%) intractable and 117 (26%) control epileptics were included in the study. Male gender (OR=3.92), seizures onset in infancy >10 seizures before starting treatment (OR=3.76), myoclonic seizures (OR=1.37), neonatal seizures (OR=3.69), abnormal EEG (OR=7.28) and cryptogenic epilepsy (OR=9.69) and head trauma (OR=4.07) were the factors associated with intractable epilepsy. Seizure onset between 5-7 years of age, idiopathic epilepsy, and absence seizures were associated with favourable prognosis in childhood epilepsy. Intractable childhood epilepsy is expected if certain risk factors such as type, age of onset, gender and cause of epilepsy are found. Early referral of such patients to the specialized centres is recommended for prompt and optimal management. (author)

  13. The Managing Epilepsy Well Network:: Advancing Epilepsy Self-Management.

    Science.gov (United States)

    Sajatovic, Martha; Jobst, Barbara C; Shegog, Ross; Bamps, Yvan A; Begley, Charles E; Fraser, Robert T; Johnson, Erica K; Pandey, Dilip K; Quarells, Rakale C; Scal, Peter; Spruill, Tanya M; Thompson, Nancy J; Kobau, Rosemarie

    2017-03-01

    Epilepsy, a complex spectrum of disorders, affects about 2.9 million people in the U.S. Similar to other chronic disorders, people with epilepsy face challenges related to management of the disorder, its treatment, co-occurring depression, disability, social disadvantages, and stigma. Two national conferences on public health and epilepsy (1997, 2003) and a 2012 IOM report on the public health dimensions of epilepsy highlighted important knowledge gaps and emphasized the need for evidence-based, scalable epilepsy self-management programs. The Centers for Disease Control and Prevention translated recommendations on self-management research and dissemination into an applied research program through the Prevention Research Centers Managing Epilepsy Well (MEW) Network. MEW Network objectives are to advance epilepsy self-management research by developing effective interventions that can be broadly disseminated for use in people's homes, healthcare providers' offices, or in community settings. The aim of this report is to provide an update on the MEW Network research pipeline, which spans efficacy, effectiveness, and dissemination. Many of the interventions use e-health strategies to eliminate barriers to care (e.g., lack of transportation, functional limitations, and stigma). Strengths of this mature research network are the culture of collaboration, community-based partnerships, e-health methods, and its portfolio of prevention activities, which range from efficacy studies engaging hard-to-reach groups, to initiatives focused on provider training and knowledge translation. The MEW Network works with organizations across the country to expand its capacity, help leverage funding and other resources, and enhance the development, dissemination, and sustainability of MEW Network programs and tools. Guided by national initiatives targeting chronic disease or epilepsy burden since 2007, the MEW Network has been responsible for more than 43 scientific journal articles, two

  14. Vigilance, sleep and epilepsy.

    Science.gov (United States)

    Vieth, J

    1986-01-01

    The correlations between vigilance and epilepsy are manifold. Nearly all epileptic seizures cause a diminution of vigilance extending to unconsciousness. Many of the influences triggering or inhibiting epileptic seizures produce alterations of vigilance or are produced by them. Nearly all chemical influences more or less cause diminution of vigilance. The enhancement of vigilance may inhibit seizures. Decreasing vigilance may act vice versa. As a means to enhance vigilance afferent stimuli are able to trigger seizures. This may be accomplished when singular or rhythmic stimulation of afferents gets the already excited neuronal system oscillating. This principle is also responsible for the strong correlation between triggering of seizures and the sleep/waking cycle with its different grades of neuronal synchronization. On the other hand, inhibition of seizures is possible by a continuously applied stimulation load, which may disturb the increasing excitatory oscillation. Also, conditioning may trigger or inhibit seizures. But the EEG biofeedback only is used to decrease abnormal neuronal activity.

  15. Video material and epilepsy.

    Science.gov (United States)

    Harding, G F; Jeavons, P M; Edson, A S

    1994-01-01

    Nine patients who had epileptic attacks while playing computer games were studied in the laboratory. Patients had an EEG recorded as well as their response to intermittent photic stimulation (IPS) at flash rates of 1-60 fps. In addition, pattern sensitivity was assessed in all patients by a gratings pattern. Only 2 patients had no previous history of convulsions, and only 2 had a normal basic EEG. All but 1 were sensitive to IPS, and all but 1 were pattern sensitive. Most patients were male, but although this appears to conflict with previously published literature results regarding the sex ratio in photosensitivity, it was due to the male predominance of video game usage. We compared our results with those reported in the literature. Diagnosing video game epilepsy requires performing an EEG with IPS and pattern stimulation. We propose a standard method of testing.

  16. Preparation of polymer nanocomposites with enhanced mechanical properties using hybrid of graphene and partially wrapped multi-wall carbon nanotube as nanofiller

    Institute of Scientific and Technical Information of China (English)

    Jiao You; Jiang-Yong-Quan Cao; Si-Chong Chen; Yu-Zhong Wang

    2017-01-01

    Triblock copolymer of poly(p-dioxanone) and polyethylene glycol end-capped with pyrene moieties ((Py-PPDO)2-b-PEG) was synthesized and used as modifier for multi-wall carbon nanotubes (MWCNTs).Nano-aggregates ((Py-PPDO)2-b-PEG@NWCNTs) with shish-kebab like partially wrapped morphology and very good stability were obtained by incorporating the copolymer with MWCNTs.The bare MWCNT sections of (Py-PPDO)2-b-PEG@MWCNTs were able to induce π-π interactions with graphene (GE) and resulted in a novel GE/(Py-PPDO)2-b-PEG@MWCNTs hybrid.The dispersity of GE in solution or polymer matrix was therefore greatly improved.The PCL nanocomposite films using GE/(Py-PPDO)2-b-PEG@MWCNTs as hybrid nanofiller exhibited obviously improved mechanical properties especially at very low hybrid nanofiller content.The influence of the nanofiller content and feed ratio of GE/ MWCNTs on the mechanical properties of composites films was evaluated.When the feed ratio of GE to MWCNTs is 2:8 and the total loading of nanofiller is only 0.01 wt%,the tensile strength of the composite film increased by 163% and the elongation at break increased by 17% compared to those of neat PCL These results can be attributed to fine dispersion of the nanofillers in PCL matrix and the hybrid interactions between GE and MWCNTs.Therefore,this work provides a novel method for preparing polymer nanocomposites with high mechanical performance and low nanofiller loading.

  17. MR imaging in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Fobben, E.S.; Zimmerman, R.A.; Sperling, M.R.; Kohn, M.I.; Atlas, S.W.; Hackney, D.B.; Goldberg, H.I.; Bilaniuk, L.T.; Grossman, R.I.

    1988-01-01

    MR imaging examinations of 31 patients undergoing temporal lobe resection for refractory partial epilepsy were reviewed retrospectively for the presence of signal abnormalities as well as atrophy. High-signal abnormalities were present in only two of the described 31 patients (6.5%). Pathologically, these represented mesial temporal sclerosis and a hamartoma. Of the remaining 29 cases, 13 showed pathologically varying degrees of mesial temporal sclerosis and gliosis and 16 were pathologically normal. Atrophy, as determined by gross asymmetry, sulcal and temporal horn enlargement, and computer volume measurements, was observed in 23 of 31 patients, correlating with the clinically affected side in 20 and the contralateral side in three. In this series, in contrast to others reported, focal MR signal abnormalities were not detected in the vast majority of patients with mesial temporal sclerosis

  18. Partial Cancellation

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Partial Cancellation. Full Cancellation is desirable. But complexity requirements are enormous. 4000 tones, 100 Users billions of flops !!! Main Idea: Challenge: To determine which cross-talker to cancel on what “tone” for a given victim. Constraint: Total complexity is ...

  19. The role of executive functioning in memory performance in pediatric focal epilepsy

    Science.gov (United States)

    Sepeta, Leigh N.; Casaletto, Kaitlin Blackstone; Terwilliger, Virginia; Facella-Ervolini, Joy; Sady, Maegan; Mayo, Jessica; Gaillard, William D.; Berl, Madison M.

    2016-01-01

    Objective Learning and memory are essential for academic success and everyday functioning, but the pattern of memory skills and its relationship to executive functioning in children with focal epilepsy is not fully delineated. We address a gap in the literature by examining the relationship between memory and executive functioning in a pediatric focal epilepsy population. Methods Seventy children with focal epilepsy and 70 typically developing children matched on age, intellectual functioning, and gender underwent neuropsychological assessment, including measures of intelligence (WASI/DAS), as well as visual (CMS Dot Locations) and verbal episodic memory (WRAML Story Memory and CVLT-C). Executive functioning was measured directly (WISC-IV Digit Span Backward; CELF-IV Recalling Sentences) and by parent report (Behavior Rating Inventory of Executive Function (BRIEF)). Results Children with focal epilepsy had lower delayed free recall scores than controls across visual and verbal memory tasks (p = 0.02; partial η2 = .12). In contrast, recognition memory performance was similar for patients and controls (p = 0.36; partial η2 = .03). Children with focal epilepsy demonstrated difficulties in working memory (p = 0.02; partial η2 = .08) and planning/organization (p = 0.02) compared to controls. Working memory predicted 9–19% of the variance in delayed free recall for verbal and visual memory; organization predicted 9–10% of the variance in verbal memory. Patients with both left and right focal epilepsy demonstrated more difficulty on verbal versus visual tasks (p = 0.002). Memory performance did not differ by location of seizure foci (temporal vs. extra-temporal, frontal vs. extra-frontal). Significance Children with focal epilepsy demonstrated memory ability within age-level expectations, but delayed free recall was inefficient compared to typically developing controls. Memory difficulties were not related to general cognitive impairment or seizure localization

  20. Multiple treatment comparisons in epilepsy monotherapy trials

    Directory of Open Access Journals (Sweden)

    Chadwick David W

    2007-11-01

    Full Text Available Abstract Background The choice of antiepileptic drug for an individual should be based upon the highest quality evidence regarding potential benefits and harms of the available treatments. Systematic reviews and meta-analysis of randomised controlled trials should be a major source of evidence supporting this decision making process. We summarise all available individual patient data evidence from randomised controlled trials that compared at least two out of eight antiepileptic drugs given as monotherapy. Methods Multiple treatment comparisons from epilepsy monotherapy trials were synthesized in a single stratified Cox regression model adjusted for treatment by epilepsy type interactions and making use of direct and indirect evidence. Primary outcomes were time to treatment failure and time to 12 month remission from seizures. A secondary outcome was time to first seizure. Results Individual patient data for 6418 patients from 20 randomised trials comparing eight antiepileptic drugs were synthesized. For partial onset seizures (4628 (72% patients, lamotrigine, carbamazepine and oxcarbazepine provide the best combination of seizure control and treatment failure. Lamotrigine is clinically superior to all other drugs for treatment failure but estimates suggest a disadvantage compared to carbamazepine for time to 12 month remission [Hazard Ratio (95% Confidence Interval = 0.87(0.73 to 1.04] and time to first seizure [1.29(1.13 to 1.48]. Phenobarbitone may delay time to first seizure [0.77(0.61 to 0.96] but at the expense of increased treatment failure [1.60(1.22 to 2.10]. For generalized onset tonic clonic seizures (1790 (28% patients estimates suggest valproate or phenytoin may provide the best combination of seizure control and treatment failure but some uncertainty remains about the relative effectiveness of other drugs. Conclusion For patients with partial onset seizures, results favour carbamazepine, oxcarbazepine and lamotrigine. For

  1. PET imaging in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Semah, F.

    2006-01-01

    structural abnormalities outside of the mesial formations were detected in 65% of the cases. Neither the severity of HS nor temporal atrophy appeared related to the topography of hypo-metabolism. However, temporal hypo-metabolism was more extended when temporo-polar signal changes were detected. Among operated patients (n=43), a seizure-free outcome was obtained in 82%. A positive surgical outcome appeared more favorable in the mesial group, however the difference between the 4 groups was not significant. Our results suggest that hypo-metabolism in MTLE may be related to ictal discharge generation and spread pathways, even though structural changes and epilepsy duration may also play a role. The role of the basal ganglia in the control of seizures is suggested by studies in animal models and epileptic patients. It is suggested that circuits of the basal ganglia may control epileptic seizures and that striatal dopaminergic transmission plays a key role in seizure interruption. We first studied patients with ring chromosome 20 (r(20) ) epilepsy which is a very homogenous type of epilepsy and that is clinically characterized by long-lasting seizures suggesting a dysfunction in the seizure control system. The hypothesis that these long-lasting seizures are associated with a reduction of striatal dopamine was addressed in our study. We used [ 18 F]fluoro-L-DOPA PET in 14 patients with r(20) epilepsy. We found that [ 18 F]fluoro-L-DOPA uptake was significantly decreased bilaterally in the putamen and in the caudate nucleus of patients. This reduction was equal for both nuclei and was not correlated with the percentage of cells with r(20) (Biraben, 2004). This study suggested that dysfunction of this neurotransmission may impair the mechanisms which interrupt seizures. This study was followed by a pilot study in patients with MTLE and in patients with the absence of medically refractory seizures to investigate if this abnormality could be related with the ring chromosome 20

  2. PET imaging in temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Semah, F. [Service Hospitalier Frederic Joliot, DSV-CEA, 91 Orsay (France)

    2006-07-01

    structural abnormalities outside of the mesial formations were detected in 65% of the cases. Neither the severity of HS nor temporal atrophy appeared related to the topography of hypo-metabolism. However, temporal hypo-metabolism was more extended when temporo-polar signal changes were detected. Among operated patients (n=43), a seizure-free outcome was obtained in 82%. A positive surgical outcome appeared more favorable in the mesial group, however the difference between the 4 groups was not significant. Our results suggest that hypo-metabolism in MTLE may be related to ictal discharge generation and spread pathways, even though structural changes and epilepsy duration may also play a role. The role of the basal ganglia in the control of seizures is suggested by studies in animal models and epileptic patients. It is suggested that circuits of the basal ganglia may control epileptic seizures and that striatal dopaminergic transmission plays a key role in seizure interruption. We first studied patients with ring chromosome 20 (r(20) ) epilepsy which is a very homogenous type of epilepsy and that is clinically characterized by long-lasting seizures suggesting a dysfunction in the seizure control system. The hypothesis that these long-lasting seizures are associated with a reduction of striatal dopamine was addressed in our study. We used [{sup 18}F]fluoro-L-DOPA PET in 14 patients with r(20) epilepsy. We found that [ {sup 18}F]fluoro-L-DOPA uptake was significantly decreased bilaterally in the putamen and in the caudate nucleus of patients. This reduction was equal for both nuclei and was not correlated with the percentage of cells with r(20) (Biraben, 2004). This study suggested that dysfunction of this neurotransmission may impair the mechanisms which interrupt seizures. This study was followed by a pilot study in patients with MTLE and in patients with the absence of medically refractory seizures to investigate if this abnormality could be related with the ring chromosome

  3. Epilepsy - what to ask your doctor - adult

    Science.gov (United States)

    What to ask your doctor about epilepsy - adult; Seizures - what to ask your doctor - adult; Seizure - what to ask your doctor ... call to find more information about driving and epilepsy? What should I discuss with my boss at ...

  4. Epilepsy - what to ask your doctor - child

    Science.gov (United States)

    What to ask your doctor about epilepsy - child; Seizures - what to ask your doctor - child ... should I discuss with my child's teachers about epilepsy? Will my child need to take medicines during ...

  5. Pragmatic communication deficits in children with epilepsy

    NARCIS (Netherlands)

    Broeders, Mark; Geurts, Hilde; Jennekens-Schinkel, Aag

    2010-01-01

    Background: Various psychiatric and neurological disorders including epilepsy have been associated with language deficits. Pragmatic language deficits, however, have seldom been the focus of earlier studies in children with epilepsy. Moreover, it is unknown whether these pragmatic deficits are

  6. Social-Psychiatric Aspects of Epilepsy

    African Journals Online (AJOL)

    TYDSKRIF. 1035. Social-Psychiatric Aspects of Epilepsy ... watersrand, as well as with the Department of Psychiatry, .... Is the response to therapy different in the three groups? 6. .... epilepsy in the occupational and the social spheres and.

  7. Parenting and restrictions in childhood epilepsy

    NARCIS (Netherlands)

    Rodenburg, R.; Meijer, A.M.; Scherphof, C.; Carpay, J.A.; Augustijn, P.; Aldenkamp, A.P.; Deković, M.

    2013-01-01

    Purpose: From the overprotection literature, the predictive and interactional (moderation) effects of controlling and indulgent parenting on restrictions in children with epilepsy were examined. Methods: Parents of 73 children with epilepsy completed questionnaires on parenting, restrictions, and

  8. Comorbidities associated with epilepsy and headaches

    Directory of Open Access Journals (Sweden)

    Thalles P. Ferreira

    2012-04-01

    Full Text Available Comorbidities are often associated with chronic neurological diseases, such as headache and epilepsy. OBJECTIVES: To identify comorbidities associated with epilepsy and headaches, and to determine possible drug interactions. METHODS: A standardized questionnaire with information about type of epilepsy/headache, medical history, and medication was administered to 80 adult subjects (40 with epilepsy and 40 with chronic headache. RESULTS: Patients with epilepsy had an average of two comorbidities and those with headache of three. For both groups, hypertension was the most prevalent. On average, patients with epilepsy were taking two antiepileptic medications and those with headache were taking only one prophylactic medication. Regarding concomitant medications, patients with epilepsy were in use, on average, of one drug and patients with headache of two. CONCLUSIONS: Patients with chronic neurological diseases, such as epilepsy and headaches, have a high number of comorbidities and they use many medications. This may contribute to poor adherence and interactions between different medications.

  9. Vagus Nerve Stimulation for Treating Epilepsy

    Science.gov (United States)

    ... and their FAMILIES VAGUS NERVE STIMULATION FOR TREATING EPILEPSY This information sheet is provided to help you ... how vagus nerve stimulation (VNS) may help treat epilepsy. The American Academy of Neurology (AAN) is the ...

  10. A theoretical study on the mechanism of hydrogen evolution on non-precious partially oxidized nickel-based heterostructures for fuel cells.

    Science.gov (United States)

    Pan, Xinju; Zhou, Gang

    2018-03-28

    It is desirable, yet challenging, to utilize non-precious metals instead of noble-metals as efficient catalysts in the renewable energy manufacturing industry. Using first principles calculations, we study the structural characteristics of partially oxidized nickel-based nanoheterostructures (NiO/Ni NHSs), and the interfacial effects on hydrogen evolution. The origin of the enhanced hydrogen evolution performance is discussed at the microscopic level. This study identifies two types of active sites of the exposed Ni surface available for the hydrogen evolution reaction (HER). One is the hcp-hollow sites near the perimeter boundary that exhibit a more excellent HER performance than platinum (Pt), and the other the second nearest neighbor fcc-hollow sites away from the boundary that exhibit a similar performance to Pt. The interfacial effects result from the competitive charge transfer between NiO and Ni surfaces in NHSs, and enhance the reactivity of NiO/Ni NHSs by shifting the d-states of surface atoms down in energy. The illumination of the mechanism would be helpful for the design of more efficient and cheap transition metal-based catalysts.

  11. Partial processing

    International Nuclear Information System (INIS)

    1978-11-01

    This discussion paper considers the possibility of applying to the recycle of plutonium in thermal reactors a particular method of partial processing based on the PUREX process but named CIVEX to emphasise the differences. The CIVEX process is based primarily on the retention of short-lived fission products. The paper suggests: (1) the recycle of fission products with uranium and plutonium in thermal reactor fuel would be technically feasible; (2) it would, however, take ten years or more to develop the CIVEX process to the point where it could be launched on a commercial scale; (3) since the majority of spent fuel to be reprocessed this century will have been in storage for ten years or more, the recycling of short-lived fission products with the U-Pu would not provide an effective means of making refabrication fuel ''inaccessible'' because the radioactivity associated with the fission products would have decayed. There would therefore be no advantage in partial processing

  12. Pregnancy Among Women With Epilepsy

    Directory of Open Access Journals (Sweden)

    Thomas S V

    1999-01-01

    Full Text Available Problems related to pregnancy and birth defects in the baby are major concerns for women with epilepsy. Hardly any data from this country is available in this regards to provide factual information to people with epilepsy. This study was undertaken to survey the outcome of pregnancies in women with epilepsy in this part of the country. Women with epilepsy (20to55 year of age who had attended this institute between March 1997 and march 1997 were sent a questionnaire by post regarding their martial status, reproductive history and outcome of pregnancies including any birth defects in their children. The data on clinical aspects and treatment were extracted from their medical records. 184 women (mean age 28.5 + 8 years were included in this study. 108 (58.7% of them were married. Women with epilepsy had three times higher rate of abortions (24.1% than general population(8%. Their mean family size (1.6 was lower than that is Kerala State (2.3. The proportion of women without children (13.9% was also higher than that for the state (9.8%. The frequency of birth defects among their children was twice (4% that in the community (2%. Women taking sodium valproate had higher frequency of birth defects in their children (15% as compared to other drugs but this was not statistically significant. There is a tendency for lower fertility among women with epilepsy. There is a slight increase in the frequency of birth defects among children born to mothers with epilepsy.

  13. Partial gigantism

    Directory of Open Access Journals (Sweden)

    М.М. Karimova

    2017-05-01

    Full Text Available A girl with partial gigantism (the increased I and II fingers of the left foot is being examined. This condition is a rare and unresolved problem, as the definite reason of its development is not determined. Wait-and-see strategy is recommended, as well as correcting operations after closing of growth zones, and forming of data pool for generalization and development of schemes of drug and radial therapeutic methods.

  14. Childhood epilepsy: Management in resource-limited setting

    Directory of Open Access Journals (Sweden)

    Valvi Chhaya

    2008-01-01

    Full Text Available Objective: To optimize the use of phenobarbital and/or phenytoin as frontline drugs for treatment of childhood epilepsy. Design: Before-and -after study. Setting: Epilepsy clinic at paediatric OPD, Sassoon General Hospital, Pune. Materials and Methods: Epilepsy is a condition in which seizures are triggered recurrently from within the brain. For epidemiological classification purpose epilepsy is considered to be present when two or more unprovoked seizures occur at an interval greater than twenty four hours apart. Seizures were classified as generalized and partial seizures, with underlying etiology investigated with EEG, CT scan in majority of the patients. Follow - up rate, seizure - control and antiepileptic drugs used among 151 children enrolled as on 31 March 2005 were compared with 106 children with new onset epilepsy enrolled as on February 2006. Eight children with breakthrough convulsion after a seizure free period of five to eighteen months were followed up after injection vitamin D. Nineteen children with poor control of seizures receiving polytherapy with newer antiepileptic drugs were assessed with frontline antiepileptic medication of phenobarbital and/or phenytoin. Serum calcium, phosphorus, alkaline phosphatase were done in seventy two consecutive children with seizure disorder. Results: During post protocol period good seizure control was achieved in 84.8% as against 80.7% and use of phenobarbital and/or phenytoin increased to 65.11% from 22.87%. Of the 8 cases with breakthrough seizures seven remained seizure free after vitamin D administration and with no dose enhancement of AED medications of the nineteen. Children receiving polytherapy thirteen children could be successfully switched to phenobarbital and/or phenytoin. Forty four (61% children had hypocalcemia (less than 9 mg%, fifty seven (79% children had raised alkaline phosphatase levels (more than 270 IU. Comments: Phenobarbital and/or phenytoin have been found to be

  15. Subependymal heterotopia: a distinct neuronal migration disorder associated with epilepsy.

    Science.gov (United States)

    Raymond, A A; Fish, D R; Stevens, J M; Sisodiya, S M; Alsanjari, N; Shorvon, S D

    1994-01-01

    Subependymal heterotopia has recently been recognised as a cause of epilepsy, but the clinical and investigational features have not been fully described. The clinical, psychometric, imaging, and electroencephalographic features of 13 adult patients with subependymal heterotopia and epilepsy have been reviewed. Age at seizure onset ranged from 18 months to 20 years (median 13 years). There were significantly more female (12) than male (1) patients (p < 0.01). Diagnosis of subependymal heterotopia was made by MRI in 11 patients and CT in two. The heterotopic grey matter was nodular in 11 patients and diffuse in two; bilateral in eight and unilateral in five. There were significantly more patients with predominant right than left cerebral hemisphere involvement (p < 0.01). The most commonly involved site was the occipital horn of the lateral ventricles (10 of 13 patients). Eleven patients presented with partial epilepsy, 10 of whom also had secondarily generalised seizures. The clinical description of the seizures often suggested either an occipital (four patients) or temporal (five patients) onset. Two patients presented with absence attacks without clear focal features. Patients demonstrated normal early milestones (12 of 13 patients), including normal motor development (all patients) and average or above average intelligence (10 of 13 patients). An EEG examination showed normal background activity in all but two patients, one of whom had large intracranial haematomas. Epileptiform activity was usually widespread (10 of 13 patients) and in three patients, there was generalised 3-Hz spike and wave activity that had previously led to an erroneous diagnosis of concomitant primary generalised epilepsy. Onset of epilepsy in the second decade of life, normal developmental milestones and intelligence, and the finding of an overwhelming female preponderance differentiates subependymal heterotopia from other cortical dysgeneses. The female preponderance supports the

  16. MRI findings in glutamic acid decarboxylase associated autoimmune epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Fredriksen, Jason R.; Carr, Carrie M.; Koeller, Kelly K.; Verdoorn, Jared T.; Kotsenas, Amy L. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Gadoth, Avi; Pittock, Sean J. [Mayo Clinic, Department of Neurology, Rochester, MN (United States)

    2018-03-15

    Glutamic acid decarboxylase (GAD65) has been implicated in a number of autoimmune-associated neurologic syndromes, including autoimmune epilepsy. This study categorizes the spectrum of MRI findings in patients with a clinical diagnosis of autoimmune epilepsy and elevated serum GAD65 autoantibodies. An institutional database search identified patients with elevated serum GAD65 antibodies and a clinical diagnosis of autoimmune epilepsy who had undergone brain MRI. Imaging studies were reviewed by three board-certified neuroradiologists and one neuroradiology fellow. Studies were evaluated for cortical/subcortical and hippocampal signal abnormality, cerebellar and cerebral volume loss, mesial temporal sclerosis, and parenchymal/leptomeningeal enhancement. The electronic medical record was reviewed for relevant clinical information and laboratory markers. A study cohort of 19 patients was identified. The majority of patients were female (84%), with a mean age of onset of 27 years. Serum GAD65 titers ranged from 33 to 4415 nmol/L (normal < 0.02 nmol/L). The most common presentation was medically intractable, complex partial seizures with temporal lobe onset. Parenchymal atrophy was the most common imaging finding (47%), with a subset of patients demonstrating cortical/subcortical parenchymal T2 hyperintensity (37%) or abnormal hippocampal signal (26%). No patients demonstrated abnormal parenchymal/leptomeningeal enhancement. The most common MRI finding in GAD65-associated autoimmune epilepsy is disproportionate parenchymal atrophy for age, often associated with abnormal cortical/subcortical T2 hyperintensities. Hippocampal abnormalities are seen in a minority of patients. This constellation of findings in a patient with medically intractable epilepsy should raise the possibility of GAD65 autoimmunity. (orig.)

  17. Introduction-Pediatric epilepsy surgery techniques.

    Science.gov (United States)

    Rydenhag, Bertil; Cukiert, Arthur

    2017-04-01

    This supplement includes the proceedings from the Pediatric Epilepsy Surgery Techniques Meeting held in Gothenburg (July 4-5, 2014), which focused on presentations and discussions regarding specific surgical technical issues in pediatric epilepsy surgery. Pediatric epilepsy neurosurgeons from all over the world were present and active in very fruitful and live presentations and discussions. These articles represent a synopsis of the areas and subjects dealt with there. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  18. Oxidative Stress Associated with Neuronal Apoptosis in Experimental Models of Epilepsy

    Directory of Open Access Journals (Sweden)

    Marisela Méndez-Armenta

    2014-01-01

    Full Text Available Epilepsy is considered one of the most common neurological disorders worldwide. Oxidative stress produced by free radicals may play a role in the initiation and progression of epilepsy; the changes in the mitochondrial and the oxidative stress state can lead mechanism associated with neuronal death pathway. Bioenergetics state failure and impaired mitochondrial function include excessive free radical production with impaired synthesis of antioxidants. This review summarizes evidence that suggest what is the role of oxidative stress on induction of apoptosis in experimental models of epilepsy.

  19. PET studies in epilepsy

    Science.gov (United States)

    Sarikaya, Ismet

    2015-01-01

    Various PET studies, such as measurements of glucose, serotonin and oxygen metabolism, cerebral blood flow and receptor bindings are availabe for epilepsy. 18Fluoro-2-deoxyglucose (18F-FDG) PET imaging of brain glucose metabolism is a well established and widely available technique. Studies have demonstrated that the sensitivity of interictal FDG-PET is higher than interictal SPECT and similar to ictal SPECT for the lateralization and localization of epileptogenic foci in presurgical patients refractory to medical treatments who have noncontributory EEG and MRI. In addition to localizing epileptogenic focus, FDG-PET provide additional important information on the functional status of the rest of the brain. The main limitation of interictal FDG-PET is that it cannot precisely define the surgical margin as the area of hypometabolism usually extends beyond the epileptogenic zone. Various neurotransmitters (GABA, glutamate, opiates, serotonin, dopamine, acethylcholine, and adenosine) and receptor subtypes are involved in epilepsy. PET receptor imaging studies performed in limited centers help to understand the role of neurotransmitters in epileptogenesis, identify epileptic foci and investigate new treatment approaches. PET receptor imaging studies have demonstrated reduced 11C-flumazenil (GABAA-cBDZ) and 18F-MPPF (5-HT1A serotonin) and increased 11C-cerfentanil (mu opiate) and 11C-MeNTI (delta opiate) bindings in the area of seizure. 11C-flumazenil has been reported to be more sensitive than FDG-PET for identifying epileptic foci. The area of abnormality on GABAAcBDZ and opiate receptor images is usually smaller and more circumscribed than the area of hypometabolism on FDG images. Studies have demonstrated that 11C-alpha-methyl-L-tryptophan PET (to study synthesis of serotonin) can detect the epileptic focus within malformations of cortical development and helps in differentiating epileptogenic from non-epileptogenic tubers in patients with tuberous sclerosis complex

  20. Studies of the antitumor mechanism of action of dermaseptin B2, a multifunctional cationic antimicrobial peptide, reveal a partial implication of cell surface glycosaminoglycans.

    Directory of Open Access Journals (Sweden)

    Célia Dos Santos

    Full Text Available Dermaseptin-B2 (DRS-B2 is a multifunctional cationic antimicrobial peptide (CAP isolated from frog skin secretion. We previously reported that DRS-B2 possesses anticancer and antiangiogenic activities in vitro and in vivo. In the present study, we evaluated the antiproliferative activity of DRS-B2 on numerous tumor cell lines, its cell internalization and studies of its molecular partners as well as their influences on its structure. Confocal microscopy using ([Alexa594]-(Cys0-DRS-B2 shows that in sensitive human tumor cells (PC3, DRS-B2 seems to accumulate rapidly at the cytoplasmic membranes and enters the cytoplasm and the nucleus, while in less sensitive tumor cells (U87MG, DRS-B2 is found packed in vesicles at the cell membrane. Furthermore FACS analysis shows that PC3 cells viability decreases after DRS-B2 treatment while U87 MG seems to be unaffected. However, "pull down" experiments performed with total protein pools from PC3 or U87MG cells and the comparison between the antiproliferative effect of DRS-B2 and its synthetic analog containing all D-amino acids suggest the absence of a stereo-selective protein receptor. Pretreatment of PC3 cells with sodium chlorate, decreases the antiproliferative activity of DRS-B2. This activity is partially restored after addition of exogenous chondroitin sulfate C (CS-C. Moreover, we demonstrate that at nanomolar concentrations CS-C potentiates the antiproliferative effect of DRS-B2. These results highlight the partial implication of glycosaminoglycans in the mechanism of antiproliferative action of DRS-B2. Structural analysis of DRS-B2 by circular dichroism in the presence of increasing concentration of CS-C shows that DRS-B2 adopts an α-helical structure. Finally, structure-activity-relationship studies suggest a key role of the W residue in position 3 of the DRS-B2 sequence for its antiproliferative activity.

  1. Etiology of epilepsy a prospective study of 210 cases

    Directory of Open Access Journals (Sweden)

    Walter Oleschko Arruda

    1991-09-01

    Full Text Available The objective of this study was to establish the etiology of epilepsy in 210 chronic epileptics (110 female, 100 male, aged 14-82 years (34.2±13.3. Patients less than 10 years-old and alcoholism were excluded. All underwent neurological examination, routine blood tests, EEG and CT-scan. Twenty patients (10.5% were submitted to spinal tap for CSF examination. Neurological examination was abnormal in 26 (12.4%, the EEG in 68 (45.5%, and CT-scan in 93 (44.3%. According to the International Classification of Epileptic Seizures (1981, 101 (48.1% have generalized seizures, 66 (31.4% partial seizures secondarily generalized, 25 (11.8% simple partial and complex partial seizures, and 14 (6.6% generalized and partial seizures. Four patients (2.0% could not be classified. In 125 (59.5% patients the etiology was unknown. Neurocysticercosis accounted for 57 (27.1% of cases, followed by cerebrovascular disease 8 (3.8%, perinatal damage 5 (2.4%, familial epilepsy 4 (1.9%, head injury 4 (1.9%, infective 1 (0.5%, and miscelanea 6 (2.8%.

  2. Gene expression profile in temporal lobe epilepsy

    NARCIS (Netherlands)

    Aronica, Eleonora; Gorter, Jan A.

    2007-01-01

    Epilepsy is one of the most common neurological disorders. Temporal lobe epilepsy (TLE) represents the most frequent epilepsy syndrome in adult patients with resistance to pharmacological treatment. In TLE, the origin of seizure activity typically involves the hippocampal formation, which displays

  3. Gene expression profile in temporal lobe epilepsy.

    NARCIS (Netherlands)

    Aronica, E.M.A.; Gorter, J.A.

    2007-01-01

    Epilepsy is one of the most common neurological disorders. Temporal lobe epilepsy (TLE) represents the most frequent epilepsy syndrome in adult patients with resistance to pharmacological treatment. In TLE, the origin of seizure activity typically involves the hippocampal formation, which displays

  4. Neuropsychological Research Approaches in the Epilepsies ...

    African Journals Online (AJOL)

    The contributions of electro-encephalography to neurology and neurosurgery have tended to overshadow its value for the neuropsychologist as a tool for the study of instability of brain function in relation to the epilepsies and the borderlands of epilepsy. Studies of criminal behaviour have shown a high incidence of epilepsy ...

  5. Vascular anomalies associated with epilepsy - case report

    International Nuclear Information System (INIS)

    Drgova, M.; Polacek, H.; Stevik, M.; Zelenak, K.

    2014-01-01

    Epilepsy is a common neurological disorder in which the individual has recurrent seizures. These seizures occur when there is an imbalance in the electrical activity of the brain. The malfunction may be in a small area of the brain or spread to the entire brain. Epilepsy usually begins in childhood or adolescence. About 2.3 million people have seizures or epilepsy. (author)

  6. Epilepsy. NICHCY Disability Fact Sheet #6

    Science.gov (United States)

    National Dissemination Center for Children with Disabilities, 2010

    2010-01-01

    Epilepsy is a seizure disorder. According to the Epilepsy Foundation of America, a seizure happens when a brief, strong surge of electrical activity affects part or all of the brain. About three million Americans have epilepsy. Of the 200,000 new cases diagnosed each year, nearly 45,000 are children and adolescents. Following a brief story of a…

  7. The concept of symptomatic epilepsy and the complexities of assigning cause in epilepsy.

    Science.gov (United States)

    Shorvon, Simon

    2014-03-01

    The concept of symptomatic epilepsy and the difficulties in assigning cause in epilepsy are described. A historical review is given, emphasizing aspects of the history which are relevant today. The historical review is divided into three approximately semicentenial periods (1860-1910, 1910-1960, 1960-present). A definition of symptomatic epilepsy and this is followed by listing of causes of symptomatic epilepsy. The fact that not all the causes of idiopathic epilepsy are genetic is discussed. A category of provoked epilepsy is proposed. The complexities in assigning cause include the following: the multifactorial nature of epilepsy, the distinction between remote and proximate causes, the role of nongenetic factors in idiopathic epilepsy, the role of investigation in determining the range of causes, the fact that not all symptomatic epilepsy is acquired, the nosological position of provoked epilepsy and the view of epilepsy as a process, and the differentiation of new-onset and established epilepsy. The newly proposed ILAE classification of epilepsy and its changes in terminologies and the difficulties in the concept of acute symptomatic epilepsy are discussed, including the inconsistencies and gray areas and the distinction between idiopathic, symptomatic, and provoked epilepsies. Points to be considered in future work are listed. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. A Comparative Study on the Formation Mechanism of Wear Scars during the Partial and Full Scale Fretting Wear Tests of Spacer Grids

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Ho; Shin, Chang Hwan; Oh, Dong Seok; Kang, Heung Seok [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2012-05-15

    traces without considering flow field effects. So, in this study, fretting wear tests of nuclear fuel rod with partial and full scale spacer girds have been performed to compare the morphology of wear scars at each test condition and to verify the flow field effect on the variation of fretting wear mechanism

  9. A Comparative Study on the Formation Mechanism of Wear Scars during the Partial and Full Scale Fretting Wear Tests of Spacer Grids

    International Nuclear Information System (INIS)

    Lee, Young Ho; Shin, Chang Hwan; Oh, Dong Seok; Kang, Heung Seok

    2012-01-01

    traces without considering flow field effects. So, in this study, fretting wear tests of nuclear fuel rod with partial and full scale spacer girds have been performed to compare the morphology of wear scars at each test condition and to verify the flow field effect on the variation of fretting wear mechanism

  10. Epilepsy surgery: Recommendations for India

    Directory of Open Access Journals (Sweden)

    Chandra P

    2010-01-01

    Full Text Available The following article recommends guidelines for epilepsy surgery for India. This article reviews the indications, the various surgical options available and the outcome of surgery for drug resistant epilepsy based on current evidence. Epilepsy surgery is a well-established option for patients who have been diagnosed to have drug resistant epilepsy (DRE (on at least two appropriate, adequate anti-epileptic drugs (AEDs (either in monotherapy or in combination with continuing seizures, where the presurgical work-up has shown concordance of structural imaging (magnetic resonance imaging and electrical mapping data (electroencephalography (EEG, video EEG. There may be a requirement of functional imaging techniques in a certain number of DRE like positron emission tomography (PET, single photon emission tomography, (SPECT. Invasive monitoring should be restricted to a few when all noninvasive investigations are inconclusive, there is a dual pathology or there is a discordance of noninvasive data. The types of surgery could be curative (resective surgeries: amygdalo hippocampectomy, lesionectomy and multilobar resections; functional surgeries: hemispherotomy and palliative (multiple subpial transaction, corpus callosotomy, vagal nerve stimulation. Epilepsy surgery in indicated cases has a success range from 50 to 86% in achieving seizure freedom as compared with < 5% success rate with AEDs only in persons with DRE. Centers performing surgery should be categorized into Level I and Level II.

  11. Smoking prevalence and seizure control in Chinese males with epilepsy.

    Science.gov (United States)

    Gao, Hui; Sander, Josemir W; Du, Xudong; Chen, Jiani; Zhu, Cairong; Zhou, Dong

    2017-08-01

    Smoking has a negative effect on most diseases, yet it is under-investigated in people with epilepsy; thus its role is not clear in the general population with epilepsy. We performed a retrospective pilot study on males with epilepsy to determine the smoking rate and its relationship with seizure control using univariate analysis to calculate odds ratios (ORs) and also used a multi-variate logistic regression model. The smoking rate in our sample of 278 individuals was 25.5%, which is lower than the general Chinese population smoking rate among males of 52.1%. We used two classifications: the first classified epilepsy as generalized, or by presumed topographic origin (temporal, frontal, parietal and occipital). The second classified the dominant seizure type of an individual as generalized tonic clonic seizure (GTCS), myoclonic seizure (MS), complex partial seizure (CPS), simple partial seizure (SPS), and secondary GTCS (sGTCS). The univariable analysis of satisfactory seizure control profile and smoking rate in both classifications showed a trend towards a beneficial effect of smoking although most were not statistically significant. Considering medication is an important confounding factor that would largely influence seizure control, we also conducted multi-variable analysis for both classifications with drug numbers and dosage. The result of our model also suggested that smoking is a protective factor. Our findings seem to suggest that smoking could have a potential role in seizure control although confounders need exploration particularly in view of the potential long term health effects. Replication in a much larger sample is needed as well as case control studies to elucidate this issue. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Baseline Cognition, Behavior, and Motor Skills in Children with New-Onset, Idiopathic Epilepsy

    Science.gov (United States)

    Bhise, Vikram V.; Burack, Gail D.; Mandelbaum, David E.

    2010-01-01

    Aim: Epilepsy is associated with difficulties in cognition and behavior in children. These problems have been attributed to genetics, ongoing seizures, psychosocial issues, underlying abnormality of the brain, and/or antiepileptic drugs. In a previous study, we found baseline cognitive differences between children with partial versus generalized…

  13. Significant variables associated with epilepsy

    International Nuclear Information System (INIS)

    Cheema, F.A.; Qayyum, K.; Ahmad, N.; Makhdoomi, A.; Safdar, A.; Asif, A.; Chaudhry, H.R.

    2003-01-01

    Objective: To study the characteristics of the epileptics and the risk factors contributing to the development of epilepsy. Results: Majority of the subjects were single (77.84%), 1st born among their siblings (25.95%), belonged to low social class (50.63%), and unemployed(25.31%). The major risk factors were family history of illness (23.52%) and positive medical problem around birth (12.66%). The presence of family history of illness, positive medical problem around birth and advanced maternal age at birth were associated with early onset of epilepsy. Vulnerability for the epilepsy also increases among hospital deliveries. Conclusion: Although the present study has identified various risk factors, yet the results need to be further confirmed through case-control studies. (author)

  14. Epilepsy, physical activity and sports

    Directory of Open Access Journals (Sweden)

    Carrizosa-Moog, Jaime

    2017-01-01

    Full Text Available People with epilepsy are prone to be sedentary compared with the general population. The causes of inactivity are ignorance, prejudice, overprotection, fear and shame. There is no scientific evidence supporting a limitation of physical exercise in persons with epilepsy. The benefits of exercise in these patients are huge. Positive aspects are: physical conditioning, prevention of seizures, emotional wellbeing, social interaction, drug treatment adherence, osteoporosis prevention and better quality of life for patients and their families. Having in mind the individual characteristics, physical exercise should be prescribed and guided. Available evidence underlies the complementary therapeutic effects of physical activity with large positive results at a low cost. Sports or regular physical activity should be a standard indication for persons with epilepsy.

  15. Pediatric epilepsy - an Indian perspective.

    Science.gov (United States)

    Udani, Vrajesh

    2005-04-01

    Prevalence studies from India suggest that epilepsy prevalence is similar to developed nations. Neurocysticercosis (NCC) predominates as an etiology. A large treatment gap is still a public health problem. Benign epilepsies and West syndrome appear to be underrepresented in studies on classification of seizures/syndromes. Febrile seizures prevalence in India is similar to other countries and appear to be as benign. Risk factors of intractable epilepsy (IE) in Indian studies include early age of onset, neurodevelopmental abnormalities and certain seizure types. Perinatal injuries underlie many IE. Many IE are not truly intractable and respond to simple therapeutic measures. The ketogenic diet and surgery are other methods now being used in Indian centers. Neurocysticercosis and neonatal hypoglycemic brain injury, two widely prevalent etiologies are reviewed in detail.

  16. Pediatric epilepsy -- an Indian perspective.

    Science.gov (United States)

    Udani, Vrajesh

    2005-04-01

    Prevalence studies from India suggest that epilepsy prevalence is similar to developed nations. Neurocysticercosis (NCC) predominates as an etiology. A large treatment gap is still a public health problem. Benign epilepsies and West syndrome appear to be underrepresented in studies on classification of seizures/syndromes. Febrile seizures prevalence in India is similar to other countries and appear to be as benign. Risk factors of intractable epilepsy (IE) in Indian studies include early age of onset, neurodevelopmental abnormalities and certain seizure types. Perinatal injuries underlie many IE. Many IE are not truly intractable and respond to simple therapeutic measures. The ketogenic diet and surgery are other methods now being used in Indian centers. Neurocysticercosis and neonatal hypoglycemic brain injury, two widely prevalent etiologies are reviewed in detail.

  17. [Possibilities of psychoprophylaxis in epilepsy].

    Science.gov (United States)

    Bilikiewicz, A

    1976-01-01

    The psychiatrist should be given also their share in the prevetion of epilepsy by means of raising the psychiatric culture of the society and teaching the population the principles of mental hygiene and psychoprophylaxia. The possibilities of psychiatry in prophylactic management of patients with developed epilepsy include: 1. Energetic measures for controlling attacks which has many psychoprophylactic aspects. 2. Prevention of psychotraumatizing situations leading to secondary neurotic, psychotic and other reactions and behaviour disorders of the type of homilopathy and sociopathy, 3. Counteracting the development of mental and social disability in epileptics. Treatment of epilepsy should be conducted from its very beginning in cooperation with psychiatrists and therapeutic psychologists. The probems of prophylaxis cannot be separated from prophylactic treatment, psychotherapy sociotherapy and rehabilitation.

  18. Auricular Electroacupuncture Reduced Inflammation-Related Epilepsy Accompanied by Altered TRPA1, pPKCα, pPKCε, and pERk1/2 Signaling Pathways in Kainic Acid-Treated Rats

    Directory of Open Access Journals (Sweden)

    Yi-Wen Lin

    2014-01-01

    Full Text Available Background. Inflammation is often considered to play a crucial role in epilepsy by affecting iron status and metabolism. In this study, we investigated the curative effect of auricular acupuncture and somatic acupuncture on kainic acid- (KA- induced epilepsy in rats. Methods. We established an epileptic seizure model in rats by KA (12 mg, ip. The 2 Hz electroacupuncture (EA was applied at auricular and applied at Zusanli and Shangjuxu (ST36-ST37 acupoints for 20 min for 3 days/week for 6 weeks beginning on the day following the KA injection. Results. The electrophysiological results indicated that neuron overexcitation occurred in the KA-treated rats. This phenomenon could be reversed among either the auricular EA or ST36-ST37 EA treatment, but not in the sham-control rats. The Western blot results revealed that TRPA1, but not TRPV4, was upregulated by injecting KA and could be attenuated by administering auricular or ST36-ST37 EA, but not in the sham group. In addition, potentiation of TRPA1 was accompanied by increased PKCα and reduced PKCε. Furthermore, pERK1/2, which is indicated in inflammation, was also increased by KA. Furthermore, the aforementioned mechanisms could be reversed by administering auricular EA and could be partially reversed by ST36-ST37 EA. Conclusions. These results indicate a novel mechanism for treating inflammation-associated epilepsy and can be translated into clinical therapy.

  19. Accelerated cognitive decline in a rodent model for temporal lobe epilepsy.

    Science.gov (United States)

    Schipper, Sandra; Aalbers, Marlien W; Rijkers, Kim; Lagiere, Melanie; Bogaarts, Jan G; Blokland, Arjan; Klinkenberg, Sylvia; Hoogland, Govert; Vles, Johan S H

    2016-12-01

    Cognitive impairment is frequently observed in patients with temporal lobe epilepsy. It is hypothesized that cumulative seizure exposure causes accelerated cognitive decline in patients with epilepsy. We investigated the influence of seizure frequency on cognitive decline in a rodent model for temporal lobe epilepsy. Neurobehavioral assessment was performed before and after surgery, after the induction of self-sustaining limbic status epilepticus (SSLSE), and in the chronic phase in which rats experienced recurrent seizures. Furthermore, we assessed potential confounders of memory performance. Rats showed a deficit in spatial working memory after the induction of the SSLSE, which endured in the chronic phase. A progressive decline in recognition memory developed in SSLSE rats. Confounding factors were absent. Seizure frequency and also the severity of the status epilepticus were not correlated with the severity of cognitive deficits. The effect of the seizure frequency on cognitive comorbidity in epilepsy has long been debated, possibly because of confounders such as antiepileptic medication and the heterogeneity of epileptic etiologies. In an animal model of temporal lobe epilepsy, we showed that a decrease in spatial working memory does not relate to the seizure frequency. This suggests for other mechanisms are responsible for memory decline and potentially a common pathophysiology of cognitive deterioration and the occurrence and development of epileptic seizures. Identifying this common denominator will allow development of more targeted interventions treating cognitive decline in patients with epilepsy. The treatment of interictal symptoms will increase the quality of life of many patients with epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Modulation of autonomic activity in neurological conditions: Epilepsy and Tourette Syndrome.

    Science.gov (United States)

    Nagai, Yoko

    2015-01-01

    This manuscript considers the central but neglected role of the autonomic nervous system in the expression and control of seizures in epilepsy (small) and tics in Tourette Syndrome (TS). In epilepsy, consideration of autonomic involvement is typically confined to differential diagnoses (e.g., syncope), or in relation to Sudden Unexpected Death in Epilepsy (SUDEP). Investigation is more limited in Tourette Syndrome. The role of the autonomic nervous system in the generation and prevention of epileptic seizures is largely overlooked. Emotional stimuli such as anxiety and stress are potent causes of seizures and tic activity in epilepsy and TS, respectively. This manuscript will describe a possible neural mechanism by which afferent autonomic projections linked to cognition and behavior influence central thalamo-cortical regulation, which appears to be an important means for controlling both seizure and tic activity. It also summarizes the link between the integrity of the default mode network and autonomic regulation in patients with epilepsy as well as the link between impaired motor control and autonomic regulation in patients with TS. Two neurological conditions; epilepsy and TS were chosen, as seizures and tics represent parameters that can be easily measured to investigate influences of autonomic functions. The EDA biofeedback approach is anticipated to gain a strong position within the next generation of treatment for epilepsy, as a non-invasive technique with minimal side effects. This approach also takes advantage of the current practical opportunity to utilize growing digital health technology.

  1. Identifying and Analyzing Novel Epilepsy-Related Genes Using Random Walk with Restart Algorithm

    Directory of Open Access Journals (Sweden)

    Wei Guo

    2017-01-01

    Full Text Available As a pathological condition, epilepsy is caused by abnormal neuronal discharge in brain which will temporarily disrupt the cerebral functions. Epilepsy is a chronic disease which occurs in all ages and would seriously affect patients’ personal lives. Thus, it is highly required to develop effective medicines or instruments to treat the disease. Identifying epilepsy-related genes is essential in order to understand and treat the disease because the corresponding proteins encoded by the epilepsy-related genes are candidates of the potential drug targets. In this study, a pioneering computational workflow was proposed to predict novel epilepsy-related genes using the random walk with restart (RWR algorithm. As reported in the literature RWR algorithm often produces a number of false positive genes, and in this study a permutation test and functional association tests were implemented to filter the genes identified by RWR algorithm, which greatly reduce the number of suspected genes and result in only thirty-three novel epilepsy genes. Finally, these novel genes were analyzed based upon some recently published literatures. Our findings implicate that all novel genes were closely related to epilepsy. It is believed that the proposed workflow can also be applied to identify genes related to other diseases and deepen our understanding of the mechanisms of these diseases.

  2. The relationship of seizure focus with depression, anxiety, and health-related quality of life in children and adolescents with epilepsy.

    Science.gov (United States)

    Schraegle, William A; Titus, Jeffrey B

    2017-03-01

    For youth with epilepsy, comorbid psychiatric conditions, such as depression and anxiety, require further examination as they carry increased risk for reduced health-related quality of life (HRQOL). The current study assessed whether rates of depression, anxiety, and withdrawal behaviors differed based on seizure location. Data included parental ratings on the Behavior Assessment System for Children (BASC-2) and the Quality of Life in Childhood Epilepsy (QOLCE) questionnaire for 132 children and adolescents (mean age=11.34, SD=3.95) with generalized or partial (i.e., frontal [FLE] or temporal lobe epilepsy [TLE]) epilepsy. Our results identified clinically significant internalizing psychopathology in nearly half of our sample (41%). Although rates of internalizing behavior were similar between generalized and partial groups, children and adolescents with TLE demonstrated higher rates of depression compared to youth with FLE. No effects of laterality on internalizing behaviors were identified between TLE and FLE groups. Finally, for youth with TLE, parental depression ratings along with current number of antiepileptic medications (AEDs) were found to be significant barriers to HRQOL above and beyond anxiety, withdrawal, and epilepsy-specific variables. Temporal lobe epilepsy was associated with a two-fold risk of clinically significant depression ratings. These findings highlight the high prevalence of internalizing psychopathology features in pediatric epilepsy and offer further support for the relationship between depression and TLE in children and adolescents with epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Incidence of epilepsy among patients with cerebral palsy (CP in Yayasan Pemeliharaan Anak Cacat (YPAC – Medan

    Directory of Open Access Journals (Sweden)

    Pertin Sianturi

    2002-09-01

    Full Text Available Epilepsy is a chronic condition due to cerebral function disorders. Epilepsy occurs as a common complication of many neurological disorders such as cerebral palsy (CP that can cause further brain damage if especially they are accompanied with prolonged seizure. The incidence of epilepsy among patients with CP varies, 25-35%. The high incidence of epilepsy among patients with CP suggests that these disorders has common or related origins. We carried out a retrospective study to determine the incidence of epilepsy among patients with CP registered July 1988 to June 1998 in YPAC Medan and to determine whether the incidence of epilepsy was different according to type of CP. Data was compiled from medical records, including name, sex, parity, mothers age, prenatal, perinatal, and postnatal history, and EEG resuts. Data were analysed using statistical computer program and its significance was evaluated by chi square test at p < 0.05. There were 67 cases with CP, 53 cases spastic CP, 13 cases mixed CP and one case dyskinetic CP. Of the 67 cases CP, 47.8% were male, 52.2% female with the mean age of 50.3 (SD 36.9 months. There were 25 (37.3% patients CP associated with epilepsy, 72% general seizures, 20% partial seizures, and 8% infantile spasm. The incidence of epilepsy was significantly different among patients with CP associated with the type of CP and gestational age, p < 0.05. We concluded that the incidence of epilepsy among patient with CP in YPAC Medan was 37.3% and showed significant difference in CP according to type and gestational age. (Med J Indones 2002; 11: 158-63 Keywords: epilepsy, cerebral palsy, obstetric history, gestational age

  4. Sex differences in human epilepsy.

    Science.gov (United States)

    Savic, Ivanka

    2014-09-01

    In the majority of neuropsychiatric conditions, marked gender-based differences have been found in the epidemiology, clinical manifestations, and therapy of disease. Emerging data suggest that gender differences exist also in the epidemiology, and pathophysiology of epilepsy. The present review summarizes the current information regarding gender and epilepsy. These differences are regarded from the perspective of innate sex differences in cerebral morphology, structural and functional connections, and assuming that these differences may render men and women differently vulnerable to epileptogenicity. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. CT findings of infant epilepsy

    International Nuclear Information System (INIS)

    Hojoh, Hiroatsu; Kataoka, Kenkichi; Nakagawa, Yoshihiro; Nakano, Shozo; Tomita, Yutaka.

    1982-01-01

    CT diagnosis of infantile epilepsy was evaluated. High incidence of abnormal CT findings in infantile spasms and Lennox-Gastaut syndrome was same as in other reports. Comparison between CT findings and neurological complications and that between CT findings and electroencephalogram findings revealed a stronger relationship existing in the former. This suggested that CT is more useful as a measure to detect underlying diseases which are due to organic change of the brain to cause epilepsy, rather than as that to disclose epileptic primary lesions of functional change. (Ueda, J.)

  6. Epilepsy and restless legs syndrome.

    Science.gov (United States)

    Geyer, James D; Geyer, Emery E; Fetterman, Zachary; Carney, Paul R

    2017-03-01

    Restless legs syndrome (RLS) is a common neurological movement disorder occurring in approximately 10% of the general population. The prevalence of moderately severe RLS is 2.7% overall (3.7% for women and 1.7% for men). Epilepsy is also a common neurological disorder with significant associated morbidity and impact on quality of life. We evaluated the severity and frequency of primary RLS in patients with localization-related temporal lobe epilepsy (TLE) and investigated the role of prodromal RLS symptoms as a warning sign and lateralizing indicator. All epilepsy patients seen in the outpatient clinic were screened for movement disorders from 2005 to 2015. Ninety-eight consecutive patients with localization-related TLE (50 right TLE and 48 left TLE) who met inclusion criteria were seen in the outpatient clinic. The control group consisted of 50 individuals with no history or immediate family history of epilepsy. Each patient was evaluated with the International Restless Legs Study Group (IRLSSG) questionnaire, NIH RLS diagnostic criteria, ferritin level, and comprehensive sleep screening including polysomnography. Furthermore, patients with obstructive sleep apnea or a definite cause of secondary restless legs syndrome such as low serum ferritin or serum iron levels were also excluded from the study. There was a significant association between the type of epilepsy and whether or not patients had RLS χ 2 (1)=10.17, p<.01, using the χ 2 Goodness of Fit Test. Based on the odds ratio, the odds of patients having RLS were 4.60 times higher if they had right temporal epilepsy than if they had left temporal epilepsy, serving as a potential lateralizing indicator. A prodromal sensation of worsening RLS occurred in some patients providing the opportunity to intervene at an earlier stage in this subgroup. We identified frequent moderate to severe RLS in patients with epilepsy. The frequency of RLS was much more common than would typically be seen in patients of similar

  7. Parental Infertility, Fertility Treatment, and Childhood Epilepsy

    DEFF Research Database (Denmark)

    Kettner, Laura O; Ramlau-Hansen, Cecilia Høst; Kesmodel, Ulrik S

    2016-01-01

    . RESULTS: A total of 60 440 pregnancies were included, and 0.8% of the children developed epilepsy.The primary analyses showed no association between parental infertility or fertility treatment, and the overall risk of childhood epilepsy (hazard rate ratios (HRs); 95% confidence intervals (CIs): 1.08 (0......BACKGROUND: A few studies have indicated an increased risk of epilepsy in children conceived by fertility treatment possibly due to characteristics of the infertile couple rather than the treatment. We therefore aimed to investigate the association between parental infertility, fertility treatment......, and epilepsy in the offspring, including the subtypes of epilepsy; idiopathic generalised epilepsy and focal epilepsy. METHODS: This cohort included all pregnancies resulting in liveborn singletons from the Aarhus Birth Cohort, Denmark (1995-2013). Information on time to pregnancy and fertility treatment...

  8. Determinants of felt stigma in epilepsy.

    Science.gov (United States)

    Aydemir, N; Kaya, B; Yıldız, G; Öztura, I; Baklan, B

    2016-05-01

    The present study aimed to determine the level of felt stigma, overprotection, concealment, and concerns related to epilepsy in different life domains by using culturally-specific scales for Turkish individuals with epilepsy. Also, it aimed to detect relations among the study variables and to determine the variables which predict felt stigma. For this purpose, felt stigma scale, overprotection scale, concealment of epilepsy scale, and concerns of epilepsy scale were administered to two hundred adult persons with epilepsy (PWE). The results showed that almost half of the participants reported felt stigma, overprotection, concealment of epilepsy, concerns related to future occupation, and concerns related to social life. Almost all the study variables show correlations with each other. Concealment of epilepsy, concerns related to social life, and concerns related to future occupation were found as the predictors of felt stigma. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Excitatory amino acid transmitters in epilepsy.

    Science.gov (United States)

    Meldrum, B S

    1991-01-01

    For the majority of human epilepsy syndromes, the molecular and cellular basis for the epileptic activity remains largely conjectural. The principal hypotheses currently concern: defects in membrane ionic conductances or transport mechanisms; defects in gamma-aminobutyric acid (GABA)-mediated inhibitory processes; and enhanced or abnormal excitatory synaptic action. Substantial evidence exists in humans and animals for acquired abnormalities in excitatory amino acid neurotransmission that may participate in the abnormal patterns of neuronal discharge, and this could provide the morphological basis for a recurrent excitatory pathway sustaining seizure discharges in temporal lobe epilepsy. In practice, two approaches appear significant in the suppression of seizures. One is to act postsynaptically on receptors to decrease the excitation induced by glutamate, and the other is to decrease synaptic release of glutamate and aspartate. Agents acting upon adenosine or GABAB receptors decrease glutamate release in vitro but do not have significant anticonvulsant activity, probably because of their predominant actions at other sites. Lamotrigine blocks stimulated release of glutamate and shows anticonvulsant activity in a wide range of animal models.

  10. Structural and effective connectivity in focal epilepsy

    Directory of Open Access Journals (Sweden)

    Christopher S. Parker

    2018-01-01

    Full Text Available Patients with medically-refractory focal epilepsy may be candidates for neurosurgery and some may require placement of intracranial EEG electrodes to localise seizure onset. Assessing cerebral responses to single pulse electrical stimulation (SPES may give diagnostically useful data. SPES produces cortico-cortical evoked potentials (CCEPs, which infer effective brain connectivity. Diffusion-weighted images and tractography may be used to estimate structural brain connectivity. This combination provides the opportunity to observe seizure onset and its propagation throughout the brain, spreading contiguously along the cortex explored with electrodes, or non-contiguously. We analysed CCEPs and diffusion tractography in seven focal epilepsy patients and reconstructed the effective and structural brain networks. We aimed to assess the inter-modal similarity of the networks at a large scale across the cortex, the effective and structural connectivity of the ictal-onset zone, and investigate potential mechanisms of non-contiguous seizure spread. We found a significant overlap between structural and effective networks. Effective network CCEP amplitude, baseline variation, and outward connectivity was higher at ictal-onset zones, while structural connection strength within the ictal-onset zone tended to be higher. These findings support the concept of hyperexcitable cortex being associated with seizure generation. The high prevalence of structural and effective connections from the ictal-onset zone to sites of non-contiguous spread suggests that macroscopic structural and effective connections are plausible routes for non-contiguous seizure spread.

  11. Epilepsy-induced behavioral changes during the ictal phase.

    Science.gov (United States)

    Mula, Marco

    2014-01-01

    In epilepsy, experiential phenomena and behavioral manifestations may pose a number of problems in terms of differential diagnosis. From a clinical point of view, ictal psychiatric symptoms represent partial seizures, mainly partial ones. In the majority of cases, they are very brief (lasting from a few seconds to a few minutes), stereotyped, out of context, and frequently associated with subtle or overt automatisms and postictal confusion of variable duration. In some cases, such symptoms are followed by alteration of consciousness as the ictus evolves to a complex partial seizure or a generalized tonic-clonic seizure. This paper reviews clinically relevant behavioral patterns during seizures discussing clinical phenomenology and relevance in terms of lateralizing value. © 2013.

  12. Epilepsy, cognition, and neuropsychiatry (Epilepsy, Brain, and Mind, part 2)

    Czech Academy of Sciences Publication Activity Database

    Korczyn, A.D.; Schachter, S.C.; Brodie, M.J.; Dalal, S.S.; Engel Jr., J.; Guekht, A.; Hecimovic, H.; Jerbi, K.; Kanner, A.M.; Landmark, C.J.; Mareš, Pavel; Marusič, P.; Meletti, S.; Mula, M.; Patsalos, P. N.; Reuber, M.; Ryvlin, P.; Štillová, K.; Tuchman, R.; Rektor, I.

    2013-01-01

    Roč. 28, č. 2 (2013), s. 283-302 ISSN 1525-5050 R&D Projects: GA MŠk(CZ) LC554; GA ČR(CZ) GAP304/10/1274 Institutional support: RVO:67985823 Keywords : epilepsy * psychiatry * clinical studies * experimental models Subject RIV: FH - Neurology Impact factor: 2.061, year: 2013

  13. Failed epilepsy surgery deserves a second chance.

    Science.gov (United States)

    Reed, Chrystal M; Dewar, Sandra; Fried, Itzhak; Engel, Jerome; Eliashiv, Dawn

    2017-12-01

    Resective epilepsy surgery has been shown to have up to 70-80% success rates in patients with intractable seizure disorder. Around 20-30% of patients with Engel Classification III and IV will require reevaluation for further surgery. Common reasons for first surgery failures include incomplete resection of seizure focus, incorrect identification of seizure focus and recurrence of tumor. Clinical chart review of seventeen patients from a single adult comprehensive epilepsy program who underwent reoperation from 2007 to 2014 was performed. High resolution Brain MRI, FDG-PET, Neuropsychometric testing were completed in all cases in both the original surgery and the second procedure. Postoperative outcomes were confirmed by prospective telephone follow up and verified by review of the patient's electronic medical records. Outcomes were classified according to the modified Engel classification system: Engel classes I and II are considered good outcomes. A total of seventeen patients (involving 10 females) were included in the study. The average age of patients at second surgery was 42 (range 23-64 years). Reasons for reoperation included: incomplete first resection (n=13) and recurrence of tumor (n=4). Median time between the first and second surgery was 60 months. After the second surgery, ten of the seventeen patients (58.8%) achieved seizure freedom (Engel Class I), in agreement with other published reports. Of the ten patients who were Engel Class I, seven required extension of the previous resection margins, while three had surgery for recurrence of previously partially resected tumor. We conclude that since the risk of complications from reoperation is low and the outcome, for some, is excellent, consideration of repeat surgery is justified. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. On Degenerate Partial Differential Equations

    OpenAIRE

    Chen, Gui-Qiang G.

    2010-01-01

    Some of recent developments, including recent results, ideas, techniques, and approaches, in the study of degenerate partial differential equations are surveyed and analyzed. Several examples of nonlinear degenerate, even mixed, partial differential equations, are presented, which arise naturally in some longstanding, fundamental problems in fluid mechanics and differential geometry. The solution to these fundamental problems greatly requires a deep understanding of nonlinear degenerate parti...

  15. [Conventional retaining of removable partial dentures

    NARCIS (Netherlands)

    Keltjens, H.M.A.M.; Witter, D.J.; Creugers, N.H.J.

    2009-01-01

    Mechanical and biological criteria have to be met in retaining the metal frame of a removable partial denture. Additionally, a removable partial denture is part of the occlusal interface by the clasps and the denture teeth. With respect to mechanical aspects, all rigid parts of the removable partial

  16. Novel therapeutic approaches for disease-modification of epileptogenesis for curing epilepsy.

    Science.gov (United States)

    Clossen, Bryan L; Reddy, Doodipala Samba

    2017-06-01

    This article describes the recent advances in epileptogenesis and novel therapeutic approaches for the prevention of epilepsy, with a special emphasis on the pharmacological basis of disease-modification of epileptogenesis for curing epilepsy. Here we assess animal studies and human clinical trials of epilepsy spanning 1982-2016. Epilepsy arises from a number of neuronal factors that trigger epileptogenesis, which is the process by which a brain shifts from a normal physiologic state to an epileptic condition. The events precipitating these changes can be of diverse origin, including traumatic brain injury, cerebrovascular damage, infections, chemical neurotoxicity, and emergency seizure conditions such as status epilepticus. Expectedly, the molecular and system mechanisms responsible for epileptogenesis are not well defined or understood. To date, there is no approved therapy for the prevention of epilepsy. Epigenetic dysregulation, neuroinflammation, and neurodegeneration appear to trigger epileptogenesis. Targeted drugs are being identified that can truly prevent the development of epilepsy in at-risk people. The promising agents include rapamycin, COX-2 inhibitors, TRK inhibitors, epigenetic modulators, JAK-STAT inhibitors, and neurosteroids. Recent evidence suggests that neurosteroids may play a role in modulating epileptogenesis. A number of promising drugs are under investigation for the prevention or modification of epileptogenesis to halt the development of epilepsy. Some drugs in development appear rational for preventing epilepsy because they target the initial trigger or related signaling pathways as the brain becomes progressively more prone to seizures. Additional research into the target validity and clinical investigation is essential to make new frontiers in curing epilepsy. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Sleep Disorders, Epilepsy, and Autism

    Science.gov (United States)

    Malow, Beth A.

    2004-01-01

    The purpose of this review article is to describe the clinical data linking autism with sleep and epilepsy and to discuss the impact of treating sleep disorders in children with autism either with or without coexisting epileptic seizures. Studies are presented to support the view that sleep is abnormal in individuals with autistic spectrum…

  18. ECG changes in epilepsy patients

    DEFF Research Database (Denmark)

    Tigaran, S; Rasmussen, V; Dam, M

    1997-01-01

    To investigate the frequency of ECG abnormalities suggestive of myocardial ischaemia in patients with severe drug resistant epilepsy and without any indication of previous cardiac disease, assuming that these changes may be of significance for the group of epileptic patients with sudden unexpected...

  19. Positron emission tomography in epilepsy

    International Nuclear Information System (INIS)

    Gur, R.C.; Gur, R.E.; Sussman, N.M.; Selzer, M.E.

    1985-01-01

    Epilepsy is characterized by paroxysmal alterations in behavior and psychological functions, associated with increased neural discharge that is detectable by EEG. In between these paroxysmal events patients may appear superficially normal, but may have neurological signs and neurpsychological deficits. The neurological signs are sometimes correlated with radiologically detectable lesions, but there is little correlation between the CT abnormalities and the EEG focus, and CT abnormalities are rarely found in ''primary'' or ''idiopathic'' forms of epilepsy. Thus, seizure foci documented by ictal EEG can occur in regions that appear normal on CT. Since brain abnormalities implicated in epilepsy are more clearly reflected in measures of neural activity than in measures of anatomy, PET has particular potential for the study of epileptic pathophysiology. It provides the ability to measure local alterations in brain blood flow and metabolism, which are highly coupled with neural activity, and this makes possible the characterization of metabolic changes associated with epilepsy. Thus PET has the potential for contributing to the localization of epileptic activity as well as to the understanding of its pathophysiology

  20. Periventricular Nodular Heterotopia and Epilepsy

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2006-02-01

    Full Text Available The clinical, MRI, and EEG findings in 54 patients (35 female, 19 male; aged 1 to 64 years with periventricular nodular heterotopia (PNH were analyzed in relation to epileptic outcome and genesis of epileptic discharges, in a study at the Neurological Institute and Epilepsy Surgery Center, Niguarda General Hospital, Milan, Italy.

  1. Neuropsychological Aspects of Epilepsy Surgery

    NARCIS (Netherlands)

    Alpherts, W.C.J. (Willem Cornelis Johan)

    2003-01-01

    Only a small number of patients with epilepsy undergo a neurosurgical operation in which the area from which epileptic neurons generate seizures is removed. From a neuropsychological perspective several different assessments and outcomes are being looked at. Chapter 2 deals with research on the

  2. Trends in pediatric epilepsy surgery.

    Science.gov (United States)

    Shah, Ritesh; Botre, Abhijit; Udani, Vrajesh

    2015-03-01

    Epilepsy surgery has become an accepted treatment for drug resistant epilepsy in infants and children. It has gained ground in India over the last decade. Certain epilepsy surgically remediable syndromes have been delineated and should be offered surgery earlier rather than later, especially if cognitive/behavioral development is being compromised. Advances in imaging, particularly in MRI has helped identify surgical candidates. Pre-surgical evaluation includes clinical assessment, structural and functional imaging, inter-ictal EEG, simultaneous video -EEG, with analysis of seizure semiology and ictal EEG and other optional investigations like neuropsychology and other newer imaging techniques. If data are concordant resective surgery is offered, keeping in mind preservation of eloquent cortical areas subserving motor, language and visual functions. In case of discordant data or non-lesional MRI, invasive EEG maybe useful using a two-stage approach. With multi-focal / generalized disease, palliative surgery like corpus callosotomy and vagal nerve stimulation maybe useful. A good outcome is seen in about 2/3rd of patients undergoing resective surgery with a low morbidity and mortality. This review outlines important learning aspects of pediatric epilepsy surgery for the general pediatrician.

  3. APPROACH TO EPILEPSY IN CHILDHOOD

    African Journals Online (AJOL)

    Enrique

    day care facility, training centre or to receive special needs education. Similar ... access to medical resources and the continuing stigma around epilepsy.1-3 ... information from the EEG, request an awake study with hyperventilation for sus- .... Appear pale and frightened, run to a carer and cling to them and may vomit.

  4. Quantifying interictal metabolic activity in human temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Henry, T.R.; Mazziotta, J.C.; Engel, J. Jr.; Christenson, P.D.; Zhang, J.X.; Phelps, M.E.; Kuhl, D.E.

    1990-01-01

    The majority of patients with complex partial seizures of unilateral temporal lobe origin have interictal temporal hypometabolism on [18F]fluorodeoxyglucose positron emission tomography (FDG PET) studies. Often, this hypometabolism extends to ipsilateral extratemporal sites. The use of accurately quantified metabolic data has been limited by the absence of an equally reliable method of anatomical analysis of PET images. We developed a standardized method for visual placement of anatomically configured regions of interest on FDG PET studies, which is particularly adapted to the widespread, asymmetric, and often severe interictal metabolic alterations of temporal lobe epilepsy. This method was applied by a single investigator, who was blind to the identity of subjects, to 10 normal control and 25 interictal temporal lobe epilepsy studies. All subjects had normal brain anatomical volumes on structural neuroimaging studies. The results demonstrate ipsilateral thalamic and temporal lobe involvement in the interictal hypometabolism of unilateral temporal lobe epilepsy. Ipsilateral frontal, parietal, and basal ganglial metabolism is also reduced, although not as markedly as is temporal and thalamic metabolism

  5. Single-Photon Emission Computed Tomography (SPECT) in childhood epilepsy

    International Nuclear Information System (INIS)

    Gulati, Sheffali; Kalra, Veena; Bal, C.S.

    2000-01-01

    The success of epilepsy surgery is determined strongly by the precise location of the epileptogenic focus. The information from clinical electrophysiological data needs to be strengthened by functional neuroimaging techniques. Single photon emission computed tomography (SPECT) available locally has proved useful as a localising investigation. It evaluates the regional cerebral blood flow and the comparison between ictal and interictal blood flow on SPECT has proved to be a sensitive nuclear marker for the site of seizure onset. Many studies justify the utility of SPECT in localising lesions to possess greater precision than interictal scalp EEG or anatomic neuroimaging. SPECT is of definitive value in temporal lobe epilepsy. Its role in extratemporal lobe epilepsy is less clearly defined. It is useful in various other generalized and partial seizure disorders including epileptic syndromes and helps in differentiating pseudoseizures from true seizures. The need for newer radiopharmaceutical agents with specific neurochemical properties and longer shelf life are under investigation. Subtraction ictal SPECT co-registered to MRI is a promising new modality. (author)

  6. Neurocysticercosis as an infectious acquired epilepsy worldwide.

    Science.gov (United States)

    Reddy, Doodipala Samba; Volkmer, Randy

    2017-11-01

    Aside from brain injury and genetic causes, there is emerging information on brain infection and inflammation as a common cause of epilepsy. Neurocysticercosis (NCC), the most common cause of epilepsy worldwide, is caused by brain cysts from the Taenia solium tapeworm. In this article, we provide a critical analysis of current and emerging information on the relationship between NCC infection and epilepsy occurrence. We searched PubMed and other databases for reports on the prevalence of NCC and incidence of epilepsy in certain regions worldwide. NCC is caused by brain cysts from the T. solium and related tapeworms. Many people with NCC infection may develop epilepsy but the rates are highly variable. MRI imaging shows many changes including localization of cysts as well as the host response to treatment. Epilepsy, in a subset of NCC patients, appears to be due to hippocampal sclerosis. Serologic and brain imaging profiles are likely diagnostic biomarkers of NCC infection and are also used to monitor the course of treatments. Limited access to these tools is a key limitation to identify and treat NCC-related epilepsy in places with high prevalence of this parasite infestation. Overall, NCC is a common infection in many patients with epilepsy worldwide. Additional clinical and animal studies could confirm common pathology of NCC as a postinfectious epilepsy that is curable. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  7. [Building epilepsy care network in Japan].

    Science.gov (United States)

    Otsuki, Taisuke

    2012-01-01

    Number of epilepsy patient in Japan officially surveyed by our government in 2008 is 219,000, which is only 0.17% of the total population and less than one third of the prevalence rate reported in Western countries. Number of epilepsy surgery per year in Japan is also low and less than half of other countries such as US, UK and Korea. These numbers may suggest that epilepsy care in Japan is not sufficient to cover all hidden medical needs of people with epilepsy at present. To solve this issue, our research group funded by the government have started to build an epilepsy care network among primary care physicians, secondary care neurology specialists and tertiary care epilepsy centers by utilizing a web site: Epilepsy Care Network-Japan (http://www.ecn-japan.com/) from July 2012. We are also proposing an epilepsy care algorithm suitable for our complex medical community consisted with various neurology specialists such as pediatric and adult neurologists, neurosurgeons and psychiatrists. Building Epilepsy Care Network in Japan may facilitate better medical and social support for people with epilepsy in Japan.

  8. Deep Brain Stimulation as a Treatment for Refractory Epilepsy: Review of the Current State-of-the-Art.

    Science.gov (United States)

    Ganguli, Malika P; Upton, Adrian R M; Kamath, Markad V

    2017-01-01

    Epilepsy affects ∼ 1% of the global population, and 33% of patients are nonresponsive to medication and must seek alternative treatment options. Alternative options such as surgery and ablation exist but are not appropriate treatment plans for some patients. Neurostimulation methods such as vagal nerve stimulation, responsive neural stimulation, and deep brain stimulation (DBS) are viable alternatives for medically refractory patients. DBS stimulation has been used in the treatment of Parkinson's disease, dystonia, and pain management. For the treatment of epilepsy, DBS has been found to be an effective treatment plan, with promising results of reduced seizure frequency and intensity. In this review, we discuss DBS surgery and equipment, mechanisms of DBS for epilepsy, and efficacy, technological specifications, and suggestions for future research. We also review a historical summary of experiments involving DBS for epilepsy. Our literature review suggests that further studies are warranted for medically refractory epilepsy using DBS.

  9. Cognitive predictors of adaptive functioning in children with symptomatic epilepsy.

    Science.gov (United States)

    Kerr, Elizabeth N; Fayed, Nora

    2017-10-01

    seizure onset and seizure type (generalized or partial) being the main predictors. Intellectual ability was the most powerful predictor of AF in children with epilepsy whose intellectual functioning was above the 2nd percentile. Co-occurring brain-based cognitive and psychosocial issues experienced by children with living epilepsy, particularly complex working memory and diagnosed comorbidities, contribute to AF and may be amenable to intervention. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  10. Isolated amygdala enlargement in temporal lobe epilepsy: A systematic review.

    Science.gov (United States)

    Beh, S M Jessica; Cook, Mark J; D'Souza, Wendyl J

    2016-07-01

    The objective of this study was to compare the seizure characteristics and treatment outcomes in patient groups with temporal lobe epilepsy (TLE) identified with isolated amygdala enlargement (AE) on magnetic resonance imaging studies. PubMed, Embase, and the Cochrane Library were searched for relevant studies using the keywords 'amygdala enlargement', 'epilepsy', and 'seizures' in April 2015. Human studies, written in English, that investigated cohorts of patients with TLE and AE were included. Of 204 abstracts initially identified using the search strategy, 14 studies met the inclusion criteria (11 epilepsy studies and 3 psychiatry studies). Ultimately, 8 full studies on AE and TLE involving 107 unique patients were analyzed. Gender distribution consisted of 50 males and 57 females. Right amygdala enlargement was seen in 39 patients, left enlargement in 58 patients, and bilateral enlargement in 7 patients. Surgical resection was performed in 28 patients, with the most common finding being dysplasia/hamartoma or focal cortical dysplasia. Most studies involved small samples of less than 12 patients. There was a wide discrepancy in the methods used to measure amygdala volume, in both patients and controls, hindering comparisons. Most TLE with AE studies observed a later age of seizure onset (mean: 32.2years) compared with studies involving TLE with HS (mean of mid- to late childhood). A higher frequency of complex partial seizures compared with that of convulsive seizures is seen in patients with AE (67-100% vs. 26-47%), and they have an excellent response to antiepileptic drugs (81.8%-100% of seizure-free patients). All studies that included controls also found a significant difference in frequency of seizure types between their cases and controls. Reliable assessment of amygdala volume remains a critical issue hindering better understanding of the clinical management and research of this focal epilepsy syndrome. Within these limitations, the literature suggests

  11. Review of the use of botanicals for epilepsy in complementary medical systems--Traditional Chinese Medicine.

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    Xiao, Fenglai; Yan, Bo; Chen, Lei; Zhou, Dong

    2015-11-01

    In traditional Chinese medicine, botanical remedies have been used for centuries to treat seizures. This review aimed to summarize the botanicals that have been used in traditional Chinese medicine to treat epilepsy. We searched Chinese online databases to determine the botanicals used for epilepsy in traditional Chinese medicine and identified articles using a preset search syntax and inclusion criteria of each botanical in the PubMed database to explore their potential mechanisms. Twenty-three botanicals were identified to treat epilepsy in traditional Chinese medicine. The pharmacological mechanisms of each botanical related to antiepileptic activity, which were mainly examined in animal models, were reviewed. We discuss the use and current trends of botanical treatments in China and highlight the limitations of botanical epilepsy treatments. A substantial number of these types of botanicals would be good candidates for the development of novel AEDs. More rigorous clinical trials of botanicals in traditional Chinese medicine for epilepsy treatment are encouraged in the future. This article is part of a Special Issue entitled "Botanicals for Epilepsy". Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Epigenetic Histone Deacetylation Inhibition Prevents the Development and Persistence of Temporal Lobe Epilepsy.

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    Reddy, Sandesh D; Clossen, Bryan L; Reddy, Doodipala Samba

    2018-01-01

    Epilepsy is a chronic brain disease characterized by repeated unprovoked seizures. Currently, no drug therapy exists for curing epilepsy or disease modification in people at risk. Despite several emerging mechanisms, there have been few studies of epigenetic signaling in epileptogenesis, the process whereby a normal brain becomes progressively epileptic because of precipitating factors. Here, we report a novel role of histone deacetylation as a critical epigenetic mechanism in epileptogenesis. Experiments were conducted using the histone deacetylase (HDAC) inhibitor sodium butyrate in the hippocampus kindling model of temporal lobe epilepsy (TLE), a classic model heavily used to approve drugs for treatment of epilepsy. Daily treatment with butyrate significantly inhibited HDAC activity and retarded the development of limbic epileptogenesis without affecting after-discharge signal. HDAC inhibition markedly impaired the persistence of seizure expression many weeks after epilepsy development. Moreover, subchronic HDAC inhibition for 2 weeks resulted in a striking retardation of epileptogenesis. HDAC inhibition, unexpectedly, also showed erasure of the epileptogenic state in epileptic animals. Finally, butyrate-treated animals exhibited a powerful reduction in mossy fiber sprouting, a morphologic index of epileptogenesis. Together these results underscore that HDAC inhibition prevents the development of TLE, indicating HDAC's critical signaling role in epileptogenesis. These findings, therefore, envisage a unique novel therapy for preventing or curing epilepsy by targeting the epigenetic HDAC pathway. Copyright © 2017 by The American Society for Pharmacology and Experimental Therapeutics.

  13. Bostezo y epilepsia del lóbulo temporal Yawning and temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    S. Muchnik

    2003-04-01

    particular de epilepsia temporal.Temporal lobe epilepsy is a partial epileptic disorder in which mesial structures are responsible for the principal ictal symptoms. Its characteristic feature is the recurrence of simple and complex partial seizures, associated with postictal confusion and amnesia of the event. The facilitating effect of NREM sleep on the propagation of the seizure, as well as the sleep abnormalities provoked by epilepsy were evident in our two patients. Yawning is a physiological reflex induced by arousal and drowsiness and may appear in different neurological conditions. Its relation with epilepsy of limbic origen has been rarely reported. We describe in a 95 year old male patient, the occurrence of yawning followed by complex partial seizure during a state of drowsiness. His EEG showed independent bilateral interictal foci of temporal sharp waves and after being medicated with carbamazepine 400mg/day, the episode did not recur. Another patient, a 17 year old female, displayed complex partial seizures and secondarily generalized seizures with yawning during the posictal period, after naps. The EEG was normal and her polysomnography showed bilateral synchronous temporal spikes and slow waves with secondarily generalization during stage 2 of NREM sleep that produce paroxysmal microarousals and increased stages 1 and 2 of NREM sleep and REM sleep diminished. After being medicated with divalproex sodium 750 mg/day, she suffered no futher seizures. Temporal lobe epilepsy, sleep- wake cycles and yawning seem not only to share the same anatomic structures but also the same neurochemical mechanisms. The fact that endogenous opiods are considered as part of a protective system that stop and prevent seizures may allow us to postulate that yawning would be the expression of the endogenous opiods induced mechanisms that stop and prevent the recurrence of the temporal lobe epilepsy. Another hypothesis may be that this is only a particular form of temporal lobe epilepsy.

  14. Sign of the Cross (Signum Crucis): observation of an uncommon ictal manifestation of mesial temporal lobe epilepsy.

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    Lin, Katia; Marx, Catherine; Caboclo, Luis O S F; Centeno, Ricardo S; Sakamoto, Américo C; Yacubian, Elza M T

    2009-02-01

    The objective of the study was to describe the clinical characteristics and determine the lateralizing value of ictal Sign of the Cross (SC) as a complex hand automatism (CHA) in patients evaluated by video/EEG monitoring in a comprehensive epilepsy unit. We reviewed video/EEG data of 530 patients with epilepsy recorded in a tertiary epilepsy center from 2002 to 2008. Four patients were found to have manifested a CHA similar to the SC at least once during their complex partial seizures. All patients had unilateral right mesial temporal lobe epilepsy (TLE) refractory to medical treatment. The limbic system is often suggested as the critical site of religious experience. Moreover, it may be localized predominantly to the temporal regions of the right hemisphere. However, this rare and peculiar ictal manifestation may be related not only to the neural substrate and personality characteristics of TLE, but also to the general religious convictions of Brazilians.

  15. A quick review of carbamazepine pharmacokinetics in epilepsy from 1953 to 2012.

    Science.gov (United States)

    Tolou-Ghamari, Zahra; Zare, Mohammad; Habibabadi, Jafar Mehvari; Najafi, Mohammad Reza

    2013-03-01

    Carbamazepine has been used as AEDs since 1965, and is most effective against partial seizures. Two basic mechanisms of action have been proposed: 1) enhancement of sodium channel inactivation by reducing high-frequency repetitive firing of action potentials, 2) and action on synaptic transmission. The aim of this study was to provide a review of carbamazepine pharmacokinetics and its management guidelines in Iranian epileptic population. Directory of Open Access Journals (DOAJ), Google Scholar, Pubmed (NLM), LISTA (EBSCO), Web of Science were searched; 1600, 722 and 167 research and review articles relevant to the topics; carbamazepine pharmacokinetics, carbamazepine pharmacokinetics in epilepsy and review on carbamazepine pharmacokinetics in epilepsy were found, respectively. Carbamazepine is highly bound to plasma proteins. In patients the protein-bound fraction ranged from 75-80% of the total plasma concentration. Bioavailability ranges from 75-85%. The rate or extent of absorption was not be affected by food. It is completely metabolized and the main metabolite is carbamazepine-epoxide (CBZ-E). Carbamazepine induces its own metabolism, leading to increased clearance, shortened serum half-life, and progressive decrease in serum levels. Increases in daily dosage are necessary to maintain plasma concentration. Severe liver dysfunction may cause disordered pharmacokinetics. In cardiac failure, congestion of major vital organs, including kidneys, may result in abnormally slow absorption and metabolism. Carbamazepine shows variability due to its narrow therapeutic window. Therefore clinical management in a3n Iranian epileptic population should focus on results derived from therapeutic drug monitoring in order to reduce inter and intra- individual variability in plasma drug concentrations.

  16. Frequency and characteristics of dual pathology in patients with lesional epilepsy.

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    Cendes, F; Cook, M J; Watson, C; Andermann, F; Fish, D R; Shorvon, S D; Bergin, P; Free, S; Dubeau, F; Arnold, D L

    1995-11-01

    We studied 167 patients who had identifiable lesions and temporal or extratemporal partial epilepsy. Pathology included neuronal migration disorders (NMDs) (48), low-grade tumors (52), vascular malformations (34), porencephalic cysts (16), and gliotic lesions as a result of cerebral insults early in life (17). MRI volumetric studies using thin (1.5- or 3-mm) coronal images were performed in all patients and in 44 age-matched normal controls. An atrophic hippocampal formation (HF), indicating dual pathology, was present in 25 patients (15%). Abnormal HF volumes were present in those with lesions involving temporal (17%) but also extratemporal (14%) areas. Age at onset and duration of epilepsy did not influence the presence of HF atrophy. However, febrile seizures in early childhood were more frequently, although not exclusively, found in patients with hippocampal atrophy. The frequency of hippocampal atrophy in our patients with low-grade tumors (2%) and vascular lesions (9%) was low. Dual pathology was far more common in patients with NMDs (25%), porencephalic cysts (31%), and reactive gliosis (23.5%). Some structural lesions, such as NMDs, are more likely to be associated with hippocampal atrophy, independent of the distance of the lesion from the HF. In other types of lesions, such as vascular malformations, dual pathology was found when the lesion was close to the HF. A common pathogenic mechanism during pre- or perinatal development may explain the occurrence of concomitant mesial temporal sclerosis and other structural lesions because of either (1) associated developmental abnormalities or (2) predisposition to prolonged febrile convulsions.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Clinicopathological study on refractory epilepsy treated by several epilepsy surgeries

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    Yan LI

    2018-04-01

    Full Text Available Objective To observe and investigate the clinicopathological features and types of refractory epilepsy treated by several epilepsy surgeries. Methods There were 19 patients with age less than 20 years who underwent 2 (16/19 or 3 (3/19 epilepsy surgeries. After pathological examination, pathological diagnosis and subtype was made according to focal cortical dysplasia (FCD classification proposed by International League Against Epilepsy (ILAE Diagnostic Methods Commission in 2011 and World Health Organization (WHO Classification of Tumors of Central Nervous System in 2007. Results The operation intervals were 1-10 years (average 4.24 years. The pathological diagnoses after first operation were FCDⅠb in 2 cases (2/19, FCDⅡa in 2 cases (2/19, FCDⅢa in one case (1/19, FCDⅢd in one case (1/19, 5 cases of tumor lesions [2 (2/19 of astrocytoma, one (1/19 of oligoastrocytoma, one (1/ 19 of mixed germ cell tumor, one (1/19 of hysembryoplastic neuroepithelial tumor (DNT], one case (1/19 of hamartoma, one case (1/19 of angioma, one case (1/19 of heterotopic gray matter, and 4 cases (4/19 of ulegyria. The last one (1/19 underwent corpus callosal incision. Pathological diagnoses after reoperation were FCDⅢa in 4 cases (4/19, FCDⅢb in 4 cases (4/19, FCDⅢc in one case (1/19, FCDⅢd in 8 cases (8/19, dual pathology (FCDⅢa with oligoastrocytoma and with glial scar and/or ulegyria in 2 cases (2/19. Patients were followed up for 0.50-5.00 years after second or third operation (average 2.34 years, and the results showed Engel Ⅰ in 10 patients (10/19, Engel Ⅱ in 6 patients (6/19 and Engel Ⅲ in 3 patients (3/19. The rate of good prognosis was 84.21%. Conclusions The pathological diagnoses of brain tissue resected from patients accepting several epilepsy surgeries are mainly FCD Ⅲ and dual pathology. It is suggested that the second or third operation would be effective for refractory epilepsy patients who underwent surgery already. DOI: 10

  18. Genetics Home Reference: spinal muscular atrophy with progressive myoclonic epilepsy

    Science.gov (United States)

    ... myoclonic epilepsy Spinal muscular atrophy with progressive myoclonic epilepsy Printable PDF Open All Close All Enable Javascript ... boxes. Description Spinal muscular atrophy with progressive myoclonic epilepsy (SMA-PME) is a neurological condition that causes ...

  19. Genetics Home Reference: familial focal epilepsy with variable foci

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    ... with FFEVF have developed psychiatric disorders (such as schizophrenia ), behavioral problems, or intellectual disability. It is unclear ... 5 links) American Epilepsy Society Brain Foundation (Australia) CURE: Citizens United for Research in Epilepsy Epilepsy Foundation ...

  20. Long-Term Social Outcomes in Childhood Epilepsy

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2007-12-01

    Full Text Available Population-based longitudinal and cross-sectional studies of social outcomes of children with epilepsy in different countries are reviewed by researchers at Dalhousie University, Halifax, Nova Scotia, Canada.Epilepsy, Chronic Disease, Idiopathic Epilepsy.