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Sample records for partial epileptic status

  1. Differential DNA methylation patterns define status epilepticus and epileptic tolerance.

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    Miller-Delaney, Suzanne F C; Das, Sudipto; Sano, Takanori; Jimenez-Mateos, Eva M; Bryan, Kenneth; Buckley, Patrick G; Stallings, Raymond L; Henshall, David C

    2012-02-01

    Prolonged seizures (status epilepticus) produce pathophysiological changes in the hippocampus that are associated with large-scale, wide-ranging changes in gene expression. Epileptic tolerance is an endogenous program of cell protection that can be activated in the brain by previous exposure to a non-harmful seizure episode before status epilepticus. A major transcriptional feature of tolerance is gene downregulation. Here, through methylation analysis of 34,143 discrete loci representing all annotated CpG islands and promoter regions in the mouse genome, we report the genome-wide DNA methylation changes in the hippocampus after status epilepticus and epileptic tolerance in adult mice. A total of 321 genes showed altered DNA methylation after status epilepticus alone or status epilepticus that followed seizure preconditioning, with >90% of the promoters of these genes undergoing hypomethylation. These profiles included genes not previously associated with epilepsy, such as the polycomb gene Phc2. Differential methylation events generally occurred throughout the genome without bias for a particular chromosomal region, with the exception of a small region of chromosome 4, which was significantly overrepresented with genes hypomethylated after status epilepticus. Surprisingly, only few genes displayed differential hypermethylation in epileptic tolerance. Nevertheless, gene ontology analysis emphasized the majority of differential methylation events between the groups occurred in genes associated with nuclear functions, such as DNA binding and transcriptional regulation. The present study reports select, genome-wide DNA methylation changes after status epilepticus and in epileptic tolerance, which may contribute to regulating the gene expression environment of the seizure-damaged hippocampus.

  2. Practice parameters in management of status epileptics

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    Usha Kant Misra

    2014-01-01

    Full Text Available Status epilepticus (SE is an emergency neurological problem, more common in the developing countries due to high incidence of infection, stroke and head injury. The protocol for management of SE is intravenous benzodiazepine, followed by phenytoin, valproate (VPA and phenobarbitone and if uncontrolled general anesthesia (GA. World Federation of Neurology recommends special guidelines for resource poor countries. Use of GA results in hypotension and respiratory depression needing intensive care management. There is a paucity of intensive care facilities hence the recommended antiepileptic drugs (AEDs which have inherent toxicity of hypotension and respiratory failure cannot be given safely. Under these situations AEDs such as VPA, levetiracetam and lacosamide may be evaluated in SE because of cardiovascular and respiratory safety profile. In this review, the limitations of existing guidelines in the developing countries have been discussed and a way forward has been suggested.

  3. Role of cranial imaging in epileptic status

    International Nuclear Information System (INIS)

    Nair, Pradeep P.; Kalita, Jayantee; Misra, Usha K.

    2009-01-01

    Introduction: There is paucity of studies evaluating the role of cranial imaging in the management of status epilepticus (SE); therefore this study evaluates the role of imaging in predicting the outcome of SE. Methods: Consecutive patients with SE were prospectively evaluated. Clinical evaluation, blood counts, serum chemistry and cerebrospinal fluid (CSF) were carried out. Cranial CT scan was performed on a spiral CT and MRI on a 1.5 T scanner. Patients were treated with IV sodium valproate, phenytoin and benzodiazepines as per fixed protocol. Outcome was defined as seizure control at 1 h and mortality. Various clinical and radiological parameters were correlated. Results: There were 99 patients with SE whose mean age was 35 (1-78) years, 40 females and 17 were below 12 years of age. Fifty six patients had central nervous system (CNS) infections, 15 strokes, 13 metabolic encephalopathy, 5 drug default and in the remaining 10 patients various acute symptomatic causes were present. Cranial imaging was abnormal in 59% patients. CT was abnormal in 21 (47.7%) out of 44 patients whereas MRI was abnormal in 26 (63.4%) out of 41 patients. Both MRI and CT were carried out in 14 patients and 12 revealed abnormalities; 2 had abnormality only on MRI. Imaging revealed cortical lesions in 10, subcortical in 19 and both cortical as well as subcortical in 30 patients. One hour seizure control was achieved in 60, seizures recurred within 24 h in 38 and 27 patients died during hospital stay. Seizure type, duration of SE, seizure control at 1 h and mortality did not correlate with radiological abnormalities. Conclusion: Cranial imaging reveals structural abnormality in 59% patients with SE and was not related to SE control and mortality.

  4. Role of cranial imaging in epileptic status

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    Nair, Pradeep P; Kalita, Jayantee [Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014 (India); Misra, Usha K. [Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014 (India)], E-mail: drukmisra@rediffmail.com

    2009-06-15

    Introduction: There is paucity of studies evaluating the role of cranial imaging in the management of status epilepticus (SE); therefore this study evaluates the role of imaging in predicting the outcome of SE. Methods: Consecutive patients with SE were prospectively evaluated. Clinical evaluation, blood counts, serum chemistry and cerebrospinal fluid (CSF) were carried out. Cranial CT scan was performed on a spiral CT and MRI on a 1.5 T scanner. Patients were treated with IV sodium valproate, phenytoin and benzodiazepines as per fixed protocol. Outcome was defined as seizure control at 1 h and mortality. Various clinical and radiological parameters were correlated. Results: There were 99 patients with SE whose mean age was 35 (1-78) years, 40 females and 17 were below 12 years of age. Fifty six patients had central nervous system (CNS) infections, 15 strokes, 13 metabolic encephalopathy, 5 drug default and in the remaining 10 patients various acute symptomatic causes were present. Cranial imaging was abnormal in 59% patients. CT was abnormal in 21 (47.7%) out of 44 patients whereas MRI was abnormal in 26 (63.4%) out of 41 patients. Both MRI and CT were carried out in 14 patients and 12 revealed abnormalities; 2 had abnormality only on MRI. Imaging revealed cortical lesions in 10, subcortical in 19 and both cortical as well as subcortical in 30 patients. One hour seizure control was achieved in 60, seizures recurred within 24 h in 38 and 27 patients died during hospital stay. Seizure type, duration of SE, seizure control at 1 h and mortality did not correlate with radiological abnormalities. Conclusion: Cranial imaging reveals structural abnormality in 59% patients with SE and was not related to SE control and mortality.

  5. Oral hygiene practices and status of epileptics and controls in Lagos ...

    African Journals Online (AJOL)

    Bacterial plaque is the primary aetiologic agent in inflammatory periodontal disease. This study therefore aims to investigate the oral health practices and status of epileptics and controls. This will form the basis of a more detailed study on the periodontal status and treatment needs of epileptic patients. Materials and Method: ...

  6. How large must an epileptic focus be to cause an electrographic status epilepticus--a case report.

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    Fauser, Susanne; Schulze-Bonhage, Andreas

    2004-10-01

    Based on experimental data from animal studies different theories regarding the size of an epileptic focus have been postulated which range from single pacemaker cells to extended neuronal networks. We report a case which gives further information about the size of a human epileptic focus which can trigger manifest epileptic seizures. We report a 22-year-old man with medically refractory temporal lobe epilepsy. This patient suffered from brief complex partial seizures and frequent epigastric auras. To differentiate a mesiotemporal from a temporolateral seizure origin the patient was implanted with a 10 contact depth electrode from a posterior approach into the right hippocampus, and additional temporobasal/temporolateral subdural strip electrodes. Depth recordings revealed an electrographic status with continuous rhythmic sharp wave activity (1 Hz), the field of which was confined to a diameter of less than 1 cm in the anterior hippocampus, whereas temporobasal subdural strip electrodes did not display this activity. Periodically, spread of this activity occurred to the amygdala, to the posterior part of the hippocampus, and less often to the temporobasal cortex. Most seizure patterns remained subclinical, few of them became symptomatic as partial seizures. This case demonstrates that a hippocampal epileptic focus causing electrographic focal status epilepticus may be limited to a volume of less than 1 cm in diameter. This observation is discussed with regard to implantation strategies and to possible superselective resective or modulatory approaches in the treatment of such limited epileptogenic areas.

  7. Budget impact analysis of adjunctive therapy with lacosamide for partial-onset epileptic seizures in Belgium.

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    Simoens, Steven

    2011-01-01

    This study aims to compute the budget impact of lacosamide, a new adjunctive therapy for partial-onset seizures in epilepsy patients from 16 years of age who are uncontrolled and having previously used at least three anti-epileptic drugs from a Belgian healthcare payer perspective. The budget impact analysis compared the 'world with lacosamide' to the 'world without lacosamide' and calculated how a change in the mix of anti-epileptic drugs used to treat uncontrolled epilepsy would impact drug spending from 2008 to 2013. Data on the number of patients and on the market shares of anti-epileptic drugs were taken from Belgian sources and from the literature. Unit costs of anti-epileptic drugs originated from Belgian sources. The budget impact was calculated from two scenarios about the market uptake of lacosamide. The Belgian target population is expected to increase from 5333 patients in 2008 to 5522 patients in 2013. Assuming that the market share of lacosamide increases linearly over time and is taken evenly from all other anti-epileptic drugs (AEDs), the budget impact of adopting adjunctive therapy with lacosamide increases from €5249 (0.1% of reference drug budget) in 2008 to €242,700 (4.7% of reference drug budget) in 2013. Assuming that 10% of patients use standard AED therapy plus lacosamide, the budget impact of adopting adjunctive therapy with lacosamide is around €800,000-900,000 per year (or 16.7% of the reference drug budget). Adjunctive therapy with lacosamide would raise drug spending for this patient population by as much as 16.7% per year. However, this budget impact analysis did not consider the fact that lacosamide reduces costs of seizure management and withdrawal. The literature suggests that, if savings in other healthcare costs are taken into account, adjunctive therapy with lacosamide may be cost saving.

  8. Syndrome of Electrical Status Epilepticus During Sleep: Epileptic Encephalopathy Related to Brain Development.

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    Chen, Xiao-Qiao; Zhang, Wei-Na; Hu, Lin-Yan; Liu, Meng-Jia; Zou, Li-Ping

    2016-03-01

    Epileptic encephalopathy with electrical status epilepticus during sleep is an age-related and self-limited disorder. The present study analyzed the etiology, demographics, and pathogenesis of patients with electrical status epilepticus during sleep to provide information on the diagnosis and therapy of this syndrome. The etiologies of epileptic encephalopathy with electrical status epilepticus during sleep in patients admitted in Chinese People's Liberation Army General Hospital from 2009 to 2014 were retrospectively analyzed. Patients were classified into the genetic, structural-metabolic, and unknown groups according to the etiology. Demographics and clinical characteristics of all the patients were then analyzed and compared among groups. The etiologies of epileptic encephalopathy with electrical status epilepticus during sleep in 75 patients mainly included benign childhood epilepsy with centrotemporal spikes, Landau-Kleffner syndrome, polymicrogyria, and migration disorders. Age at onset of epilepsy did not show a specific pattern, but age at onset of epileptic encephalopathy with electrical status epilepticus during sleep was concentrated at age 6-9 years. The mean age at onset of epilepsy in the genetic group was significantly older than that in the structural-metabolic group (P status epilepticus during sleep did not significantly differ between the two groups. Electrical status epilepticus during sleep is an epileptic encephalopathy related to brain development and presents an age-dependent occurrence. Copyright © 2016 Elsevier Inc. All rights reserved.

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

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    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.

  10. Does status epilepticus induced at early postnatal period change excitability after cortical epileptic afterdischarges?

    Czech Academy of Sciences Publication Activity Database

    Mareš, Pavel; Kubová, Hana

    2016-01-01

    Roč. 57, č. 8 (2016), E183-E186 ISSN 0013-9580 R&D Projects: GA MŠk(CZ) LH11015; GA ČR(CZ) GBP304/12/G069; GA ČR(CZ) GAP302/10/0971; GA ČR(CZ) GA15-16605S Institutional support: RVO:67985823 Keywords : status epilepticus * cortical stimulation * epileptic afterdischarges * ontogeny * rat Subject RIV: FH - Neurology Impact factor: 5.295, year: 2016

  11. Classifying Normal and Abnormal Status Based on Video Recordings of Epileptic Patients

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    Jing Li

    2014-01-01

    Full Text Available Based on video recordings of the movement of the patients with epilepsy, this paper proposed a human action recognition scheme to detect distinct motion patterns and to distinguish the normal status from the abnormal status of epileptic patients. The scheme first extracts local features and holistic features, which are complementary to each other. Afterwards, a support vector machine is applied to classification. Based on the experimental results, this scheme obtains a satisfactory classification result and provides a fundamental analysis towards the human-robot interaction with socially assistive robots in caring the patients with epilepsy (or other patients with brain disorders in order to protect them from injury.

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

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    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.

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

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    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.

  14. Does status epilepticus modify the effect of ifenprodil on cortical epileptic afterdischarges in immature rats?

    Czech Academy of Sciences Publication Activity Database

    Abbasova, Kenul; Kubová, Hana; Mareš, Pavel

    2018-01-01

    Roč. 70, č. 1 (2018), s. 126-132 ISSN 1734-1140 R&D Projects: GA ČR(CZ) GAP302/10/0971; GA ČR(CZ) GBP304/12/G069; GA ČR(CZ) GA15-16605S; GA MŠk(CZ) LC554; GA MŠk(CZ) LH15032 Institutional support: RVO:67985823 Keywords : status epilepticus * immature rats * ifenprodil * cortical stimulation * epileptic afterdischarges Subject RIV: FH - Neurology OBOR OECD: Neurosciences (including psychophysiology Impact factor: 2.587, year: 2016

  15. Comparative evaluation of oral hygiene status and gingival enlargement among epileptic and healthy children as related to various antiepileptic drugs

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    Neelam Hasmukhbhai Joshi

    2017-01-01

    Full Text Available Background: Epilepsy is a gathering of neurological disorders characterized by epileptic seizures. Epileptic children, who are on active treatment with antiepileptic drugs, have a well-recognized side effect of gingival enlargement. Therefore, all efforts should be made, particularly for the population who are diagnosed or affected by the systemic disease. This study was conducted with an aim to determine oral hygiene status and gingival enlargement among epileptic and healthy children as related to various antiepileptic drugs. Materials and Methods: The cross-sectional observational study was conducted in the department of pedodontics and attached general hospital. A sample size of 120 participants with 60 healthy and 60 epileptic children between age 2 and 14 years were included. Oral health status of participants was examined using oral hygiene simplified index and plaque index. Gingival enlargement was assessed using Miranda–Brunet index. For statistical analysis, one-way ANOVA test, independent t-test, and Pearson's Chi-square test were used. Results: From the total participants included in the study, 49% of participants had good oral hygiene from healthy group, and 28% participants had poor oral hygiene from the epileptic group. Sodium valproate was the most common drug used and was associated with increased gingival enlargement. Conclusion: Conclusion can be drawn that epileptic children under medication had poor oral hygiene and an increased risk for gingival enlargement as compared to their healthy counterparts. It must be stressed that the epileptic patients should be given dental care without conditions and provided with best possible care to restore esthetics and functions.

  16. Regional cerebral blood flow in status epileptics measured by single photon emission computed tomography (SPECT)

    International Nuclear Information System (INIS)

    Ichiseki, Hajime; Terashi, Akiro; Hamamoto, Makoto; Miyazaki, Tokuzo.

    1995-01-01

    We have performed single photon emission computed tomography (SPECT) with 99m Tc-hexamethylpropylene amineoxime (HM-PAO) to evaluate regional cerebral blood flow (rCBF) in status epileptics (SE) caused by a cerebral vascular accident. In addition, we have discussed the neurophysiology of SE based on the SPECT findings. A total of sixteen patients (5 males and 11 females, average age; 78.2 years old) with SE who were suffering from prolonged consciousness disturbance were investigated. When SPECT was performed in the ictal state, there was a remarkable increase in radio isotope (RI) uptake at the focus which correlated well with EEG findings. However, in other cortical regions, basal ganglia and thalamus, there was a relatively demonstrated decrease in RI uptake compared with that of the focus. Additionally in the interictal state, we found a decrease in RI uptake in the epileptic foci and normal recovery of the RI uptake level in other cerebral regions. We speculate that these characteristic patterns of cerebral blood flow distribution shown by SPECT scans in the ictal state reflect the state of consciousness disturbance due to SE. In general, in the elderly, it is difficult to make a differential diagnosis between prolonged consciousness disturbance due to nonconvulsive SE and other diseases such as cardiovascular diseases, dehydration, metabolic disorder, etc. Nevertheless, nonconvulsive SE causes diffuse cell loss and irreversible brain damage. Therefore the elderly who have suffered from prolonged consciousness disturbance due to SE need an exact diagnosis and immediate medical treatment. When we diagnose a nonconvulsive SE, the characteristic findings of SPECT scans in the ictal state are very clear and useful. In conclusion, SPECT is a very simple and non-invasive method that demonstrates abnormalities of brain function exactly. Therefore, we should perform not only EEC but also SPECT scans when making a diagnosis of SE. (author)

  17. Regional cerebral blood flow in status epileptics measured by single photon emission computed tomography (SPECT)

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    Ichiseki, Hajime; Terashi, Akiro [Nippon Medical School, Tokyo (Japan); Hamamoto, Makoto; Miyazaki, Tokuzo

    1995-12-01

    We have performed single photon emission computed tomography (SPECT) with {sup 99m}Tc-hexamethylpropylene amineoxime (HM-PAO) to evaluate regional cerebral blood flow (rCBF) in status epileptics (SE) caused by a cerebral vascular accident. In addition, we have discussed the neurophysiology of SE based on the SPECT findings. A total of sixteen patients (5 males and 11 females, average age; 78.2 years old) with SE who were suffering from prolonged consciousness disturbance were investigated. When SPECT was performed in the ictal state, there was a remarkable increase in radio isotope (RI) uptake at the focus which correlated well with EEG findings. However, in other cortical regions, basal ganglia and thalamus, there was a relatively demonstrated decrease in RI uptake compared with that of the focus. Additionally in the interictal state, we found a decrease in RI uptake in the epileptic foci and normal recovery of the RI uptake level in other cerebral regions. We speculate that these characteristic patterns of cerebral blood flow distribution shown by SPECT scans in the ictal state reflect the state of consciousness disturbance due to SE. In general, in the elderly, it is difficult to make a differential diagnosis between prolonged consciousness disturbance due to nonconvulsive SE and other diseases such as cardiovascular diseases, dehydration, metabolic disorder, etc. Nevertheless, nonconvulsive SE causes diffuse cell loss and irreversible brain damage. Therefore the elderly who have suffered from prolonged consciousness disturbance due to SE need an exact diagnosis and immediate medical treatment. When we diagnose a nonconvulsive SE, the characteristic findings of SPECT scans in the ictal state are very clear and useful. In conclusion, SPECT is a very simple and non-invasive method that demonstrates abnormalities of brain function exactly. Therefore, we should perform not only EEC but also SPECT scans when making a diagnosis of SE. (author).

  18. MDR-1 and MRP2 gene polymorphisms in Mexican epileptic pediatric patients with complex partial seizures.

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    David eEscalante-Santiago

    2014-10-01

    Full Text Available Although the Pgp efflux transport protein is overexpressed in resected tissue of patients with epilepsy, the presence of polymorphisms in MDR1 / ABCB1 and MRP2 / ABCC2 in patients with antiepileptic-drugs resistant epilepsy is controversial. The aim of this study was to perform an exploratory study to identify nucleotide changes and search new and reported mutations in patients with antiepileptic-drugs resistant epilepsy (ADR and patients with good response to anti-epileptic drugs (CTR in a rigorously selected population. We analyzed 22 samples from drug-resistant patients with epilepsy and 7 samples from patients with good response to anti-epileptic drugs. Genomic DNA was obtained from leukocytes. Eleven exons in both genes were genotyped. The concentration of drugs in saliva and plasma was determined. The concentration of valproic acid in saliva was lower in ADR than in CRT. In ABCB1, five reported SNPs and five unreported nucleotide changes were identified; rs2229109 (GA and rs2032582 (AT and AG were found only in the ADR. Of six SNPs associated with the ABCC2 that were found in the study population, rs3740066 (TT and 66744T>A (TG were found only in the ADR. The strongest risk factor in the ABCB1 gene was identified as the TA genotype of rs2032582, whereas for the ABCC2 gene the strongest risk factor was the T allele of rs3740066. The screening of SNPs in ACBC1 and ABCC2 indicates that the Mexican patients with epilepsy in this study display frequently reported ABCC1 polymorphisms; however, in the study subjects with a higher risk factor for drug resistance, new nucleotide changes were found in the ABCC2 gene. Thus, the population of Mexican patients with AED-resistant epilepsy used in this study exhibits genetic variability with respect to those reported in other study populations; however, it is necessary to explore this polymorphism in a larger population of patients with AED-resistant epilepsy.

  19. Transcriptional response of polycomb group genes to status epilepticus in mice is modified by prior exposure to epileptic preconditioning

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    James eReynolds

    2015-03-01

    Full Text Available Exposure of the brain to brief, non-harmful seizures can activate protective mechanisms that temporarily generate a damage-refractory state. This process, termed epileptic tolerance, is associated with large-scale down-regulation of gene expression. Polycomb group proteins are master controllers of gene silencing during development that are re-activated by injury to the brain. Here we explored the transcriptional response of genes associated with polycomb repressor complex (PRC 1 (Ring1A and Ring1B and Bmi1 and PRC2 (Ezh1, Ezh2 and Suz12, as well as additional transcriptional regulators Sirt1, Yy1 and Yy2, in a mouse model of status epilepticus. Findings were contrasted to changes after status epilepticus in mice previously given brief seizures to evoke tolerance. Real-time quantitative PCR showed status epilepticus prompted an early (1 h increase in expression of several genes in PRC1 and PRC2 in the hippocampus, followed by down-regulation of many of the same genes at later times points (4 , 8 and 24 h. Spatio-temporal differences were found among PRC2 genes in epileptic tolerance, including increased expression of Ezh2, Suz12 and Yy2 relative to the normal injury response to status epilepticus. In contrast, PRC1 complex genes including Ring 1B and Bmi1 displayed differential down-regulation in epileptic tolerance. The present study characterizes polycomb group gene expression following status epilepticus and shows prior seizure exposure produces select changes to PRC1 and PRC2 composition that may influence differential gene expression in epileptic tolerance.

  20. Which component of treatment is important for changes of cortical epileptic afterdischarges after status epilepticus in immature rats?

    Czech Academy of Sciences Publication Activity Database

    Tsenov, Grygoriy; Kubová, Hana; Mareš, Pavel

    2017-01-01

    Roč. 644, Mar 22 (2017), s. 1-4 ISSN 0304-3940 R&D Projects: GA ČR(CZ) GBP304/12/G069; GA ČR(CZ) GAP302/10/0971; GA ČR(CZ) GA15-16605S Institutional support: RVO:67985823 Keywords : status epilepticus * immature rats * pilocarpine * lithium chloride * paraldehyde * cortical epileptic afterdischarges Subject RIV: FH - Neurology OBOR OECD: Neuroscience s (including psychophysiology Impact factor: 2.180, year: 2016

  1. De-novo simple partial status epilepticus presenting as Wernicke's aphasia.

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    Patil, Bhimanagouda; Oware, Agyepong

    2012-04-01

    Language disturbances manifesting as brief periods of speech arrest occur with seizures originating in the frontal or temporal lobes. These language disturbances are usually present with other features of seizures or may occur in an episodic fashion suggesting their likely epileptic origin. Sustained but reversible aphasia as the sole manifestation of partial status epilepticus is rare, particularly without a history of prior seizures. A few cases have been described in the literature where Broca's or mixed aphasia seems to be more common than Wernicke's aphasia. Here we describe a patient who presented with Wernicke's aphasia secondary to simple partial status epilepticus but without any other features of seizures. The diagnosis was confirmed on EEG and the aphasia reversed after antiepileptic treatment. Copyright © 2011 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  2. Multifractal detrended cross-correlation analysis for epileptic patient in seizure and seizure free status

    International Nuclear Information System (INIS)

    Ghosh, Dipak; Dutta, Srimonti; Chakraborty, Sayantan

    2014-01-01

    Highlights: • We analyze EEG of patients during seizure and in seizure free interval. • Data from different sections of the brain and seizure activity was analyzed. • Assessment of cross-correlation in seizure and seizure free interval using MF-DXA technique. - Abstract: This paper reports a study of EEG data of epileptic patients in terms of multifractal detrended cross-correlation analysis (MF-DXA). The EEG clinical data were obtained from the EEG Database available with the Clinic of Epileptology of the University Hospital of Bonn, Germany. The data sets (C, D, and E) were taken from five epileptic patients undergoing presurgical evaluations. The data sets consist of intracranial EEG recordings during seizure-free intervals (interictal periods) from within the epileptogenic zone (D) and from the hippocampal formation of the opposite hemisphere of the epileptic patients’ brain, respectively (C). The data set (E) was recorded during seizure activity (ictal periods). MF-DXA is a very rigorous and robust tool for assessment of cross-correlation among two nonlinear time series. The study reveals the degree of cross-correlation is more among seizure and seizure free interval in epileptogenic zone. These data are very significant for diagnosis, onset and prognosis of epileptic patients

  3. Intravenous levetiracetam terminates refractory status epilepticus in two patients with migrating partial seizures in infancy.

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    Cilio, Maria Roberta; Bianchi, Roberto; Balestri, Martina; Onofri, Alfredo; Giovannini, Simona; Di Capua, Matteo; Vigevano, Federico

    2009-09-01

    To evaluate the efficacy and tolerability of intravenous (IV) levetiracetam in refractory status epilepticus of migrating partial seizures in infancy (MPSI). IV levetiracetam was infused in two infants, first as a loading dose of 60mg/kg in 30min, then at 30mg/kg twice a day. Both infants were continuously monitored with video-EEG before, during and after the drug trial. Blood count, liver enzymes, serum creatinine, ammonia and lactate blood levels were performed repeatedly before and after the IV levetiracetam administration. Follow-up was of 16 and 10 months. EEG monitoring allowed the diagnosis of MPSI, showing the typical seizures pattern in both patients. IV levetiracetam was effective in stopping status epilepticus in both infants. Levetiracetam also prevented the recurrence of status epilepticus during follow-up. No adverse reactions were observed during the infusion phase or during follow-up. MPSI is a newly recognized epileptic syndrome characterized by early onset of intractable partial seizures arisingly independently and sequentially from both hemispheres, migrating from one region of the brain to another and from one hemisphere to another. We report the efficacy of intravenous levetiracetam in resolving refractory status epilepticus in two infants with this new epilepsy syndrome.

  4. Newer anti-epileptic drugs, vitamin status and neuropathy: A cross-sectional analysis.

    Science.gov (United States)

    Cahill, V; McCorry, D; Soryal, I; Rajabally, Y A

    Whether new antiepileptic drugs (AEDs) may result in neuropathy is unknown but possible given their effects on vitamin metabolism. This analysis aimed to determine frequency and correlates of neuropathy in subjects treated with new AEDs in relation to drug used, length of exposure and serum vitamin B12 and folate levels. We performed a cross-sectional study of 52 consecutive epileptic subjects. Presence of neuropathy was determined using the Utah Early Neuropathy Score (UENS). Exposure to anti-epileptic drugs was quantified. Serum vitamin B12 and folate levels were measured. Commonly used AEDs were levetiracetam (28/52), carbamazepine (20/52), lamotrigine (20/52), sodium valproate (10/52) and zonisamide (10/52). Eight of 52 (15.4%) patients had neuropathy. There was no association with any particular AED. Neuropathy correlated with age (P=0.038) and total exposure to AEDs (P=0.032). UENS correlated with age (P=0.001), total AED exposure (P=0.001) and serum vitamin B12L (P=0.018). Independent association of neuropathy was found with total AED exposure (P=0.032), but not age. UENS was independently associated with total exposure to AEDs (Pvitamin B12L (P=0.002), but not age. Serum vitamin B12 and folate levels were highly inter-correlated (Pvitamin B12 and folate metabolism. Although further research from controlled studies is needed and despite the presence of other possible confounding factors, monitoring for neuropathy and vitamin B12 and folate levels merits consideration in patients on long-term treatment with new AEDs. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  5. Imaging DC MEG Fields Associated with Epileptic Onset

    Science.gov (United States)

    Weiland, B. J.; Bowyer, S. M.; Moran, J. E.; Jenrow, K.; Tepley, N.

    2004-10-01

    Magnetoencephalography (MEG) is a non-invasive brain imaging modality, with high spatial and temporal resolution, used to evaluate and quantify the magnetic fields associated with neuronal activity. Complex partial epileptic seizures are characterized by hypersynchronous neuronal activity believed to arise from a zone of epileptogenesis. This study investigated the characteristics of direct current (DC) MEG shifts arising at epileptic onset. MEG data were acquired with rats using a six-channel first order gradiometer system. Limbic status epilepticus was induced by IA (femoral) administration of kainic acid. DC-MEG shifts were observed at the onset of epileptic spike train activity and status epilepticus. Epilepsy is also being studied in patients undergoing presurgical mapping from the Comprehensive Epilepsy Center at Henry Ford Hospital using a whole head Neuromagnetometer. Preliminary data analysis shows that DC-MEG waveforms, qualitatively similar to those seen in the animal model, are evident prior to seizure activity in human subjects.

  6. Status epilepticus

    NARCIS (Netherlands)

    Hensiek, AE; Absalom, Anthony

    2006-01-01

    Status epilepticus is defined as epileptic activity that continues for more than 30 minutes as a single seizure or as recurrent seizures without inter-ictal return of consciousness. The seizure activity is usually classified as partial or generalized. Although status epilepticus is an uncommon

  7. Effect of impaired ambulation and anti-epileptic drug intake on vitamin D status of children with cerebral palsy.

    Science.gov (United States)

    Seth, Anju; Aneja, Satinder; Singh, Ritu; Majumdar, Ritu; Sharma, Neera; Gopinath, Muthuselvan

    2017-08-01

    Children with cerebral palsy (CP) are vulnerable to developing vitamin D deficiency. There is little information on the prevalence and severity of vitamin D deficiency in these patients. To study vitamin D status in children with CP with special reference to their intake of anti-epileptic drugs (AED) and ambulatory status. The relative effects of AED use and ambulatory status on the vitamin D status of 120 children with CP aged 2-10 years were examined in this observational study. The patients were classified into four groups (30 in each) on the basis of AED use and ambulatory status: ambulatory (CPA), ambulatory receiving AED (CPAD), non-ambulatory (CPNA) and non-ambulatory receiving AED (CPNAD). A control group of 30 age-matched healthy children was also included. Parameters assessed included dietary calcium intake, sun exposure, serum total and ionised calcium (tCa, iCa), inorganic phosphate (iP), alkaline phosphatase (ALP), parathormone (PTH), 25 hydroxy vitamin D [25(OH)D] levels and a wrist radiograph to detect rickets. Vitamin D status was defined on the basis of serum 25(OH)D levels as normal (>50 nmol/L), mild deficiency (25-50 nmol/L), moderate deficiency (12.5-25 nmol/L), severe deficiency (D levels in patients with CP were 35.6 (26.75-64) nmol/L compared with 60 (37-69.25) nmol/L in controls (p = 0.04). Sixty per cent of children with CP and 36.7% of controls were vitamin D-deficient [25(OH)D D-deficient with median (IQR) 25(OH)D levels of 33.5 (12.5-45.25) nmol/L. Also, 53.3% of them had raised ALP and 17.2% raised PTH levels. Children with CP are highly vulnerable to vitamin D deficiency. In these patients, AED use and lack of sun exposure contribute towards poor vitamin D status, the effect being more pronounced when they co-exist.

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

    Science.gov (United States)

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

    2015-09-01

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

  9. [Consensus clinical practice guidelines of the Andalusian Epilepsy Society: therapeutic recommendations when dealing with a first epileptic seizure and in epileptic status].

    Science.gov (United States)

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

    Most epileptic seizures are brief and self-limiting, but sometimes they can last longer than expected and this entails (in the case of generalised seizures) a high risk of morbidity and mortality, which increases as they get longer. This severity justifies the need to draw up a set of consensus-based practice guidelines based on implicit evidence, to use Liberati's nomenclature, concerning aspects related to the recommended therapeutic management of a patient with prolonged seizures who is being attended in an emergency department. A selective search was conducted on PubMed-Medline for scientific information related to the subject using scientific evidence filters. This search was completed in other scientific evidence search engines, such as Tripdatabase, Biblioteca Cochrane Plus or DARE. The selected references were analysed and discussed by the authors, and the available evidence and any recommendations that could be drawn from it were collected. The search revealed the existence of 33 primary documents and six practice guidelines or protocols related with the topic under study. The recommendations were inserted in the text explicitly. The therapeutic protocol must be started when faced with any seizures that last more than five minutes. First, steps must be taken to ensure proper respiratory and cardiocirculatory functioning, and then fast-acting antiepileptic drugs are administered intravenously and in high doses until the cause is identified and controlled. Due to their lower level of morbidity and mortality, prolonged non-convulsive seizures do not generally require therapy that is so vigorous and with such a high risk of complications.

  10. Partial status epilepticus - rapid genetic diagnosis of Alpers' disease.

    LENUS (Irish Health Repository)

    McCoy, Bláthnaid

    2011-11-01

    We describe four children with a devastating encephalopathy characterised by refractory focal seizures and variable liver dysfunction. We describe their electroencephalographic, radiologic, genetic and pathologic findings. The correct diagnosis was established by rapid gene sequencing. POLG1 based Alpers\\' disease should be considered in any child presenting with partial status epilepticus.

  11. Effect of epileptic seizures on the cerebrospinal fluid--A systematic retrospective analysis.

    Science.gov (United States)

    Tumani, Hayrettin; Jobs, Catherine; Brettschneider, Johannes; Hoppner, Anselm C; Kerling, Frank; Fauser, Susanne

    2015-08-01

    Analyses of the cerebrospinal fluid (CSF) are obligatory when epileptic seizures manifest for the first time in order to exclude life-threatening causes or treatable diseases such as acute infections or autoimmune encephalitis. However, there are only few systematic investigations on the effect of seizures themselves on CSF parameters and the significance of these parameters in differential diagnosis. CSF samples of 309 patients with epileptic and 10 with psychogenic seizures were retrospectively analyzed. CSF samples were collected between 1999 and 2008. Cell counts, the albumin quotient, lactate and Tau-protein levels were determined. Findings were correlated with seizure types, seizure etiology (symptomatic, cryptogenic, occasional seizure), and seizure duration. Pathological findings were only observed in patients with epileptic but not with psychogenic seizures. The lactate concentration was elevated in 14%, the albumin quotient in 34%, and the Tau protein level in 36% of CSF samples. Cell counts were only slightly elevated in 6% of patients. Different seizure types influenced all parameters except for the cell count: In status epilepticus highest, in simple partial seizures lowest values were seen. Symptomatic partial and generalized epileptic seizures had significantly higher Tau-protein levels than cryptogenic partial seizures. In patients with repetitive and occasional epileptic seizures, higher Tau-protein levels were seen than in those with psychogenic seizures. Duration of epileptic seizures was positively correlated with the albumin quotient, lactate and Tau-protein levels. High variability of investigated CSF parameters within each subgroup rendered a clear separation between epileptic and psychogenic seizures impossible. Elevated cell counts are infrequently observed in patients with epileptic seizures and should therefore not uncritically be interpreted as a postictal phenomenon. However, blood-CSF barrier disruption, increased glucose metabolism

  12. Laboratory findings in neurosyphilis patients with epileptic seizures alone as the initial presenting symptom.

    Science.gov (United States)

    Tong, Man-Li; Liu, Li-Li; Zeng, Yan-Li; Zhang, Hui-Lin; Liu, Gui-Li; Zheng, Wei-Hong; Dong, Jie; Wu, Jing-Yi; Su, Yuan-Hui; Lin, Li-Rong; Yang, Tian-Ci

    2013-04-01

    A retrospective chart review was performed to characterize the clinical presentation, the characteristic combination of serologic and cerebrospinal fluid (CSF) abnormalities, and the neuroimaging findings of neurosyphilis (NS) patients who had epileptic seizures alone as an initial presenting symptom. In a 6.75-year period, 169 inpatients with NS were identified at Zhongshan Hospital (from June 2005 to February 2012). We demonstrated that 13 (7.7%) of the 169 NS patients had epileptic seizures alone as an initial presenting feature. Epileptic seizures occurred in NS patients with syphilitic meningitis (2 cases), meningovascular NS (5 cases), and general paresis (6 cases). The types of epileptic seizures included simple partial, complex partial with secondary generalization (including status epilepticus), and generalized seizures (no focal onset reported). Nine of NS patients with only epileptic seizures as primary symptom were misdiagnosed, and the original misdiagnosis was 69.23% (9/13). Ten (10/13, 76.9%) patients had an abnormal magnetic resonance imaging, and 7 (7/13 53.8%) patients had abnormal electroencephalogram recordings. In addition, the sera rapid plasma reagin (RPR) and Treponema pallidum particle agglutination (TPPA) from all 13 patients were positive. The overall positive rates of the CSF-RPR and CSF-TPPA were 61.5% and 69.2%, respectively. Three patients demonstrated CSF pleocytosis, and 9 patients exhibited elevated CSF protein levels. Therefore, NS with only epileptic seizures at the initial presentation exhibits a lack of specificity. It is recommended that every patient with clinically evident symptoms of epileptic seizures should have a blood test performed for syphilis. When the serology results are positive, all of the patients should undergo a CSF examination to diagnose NS. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Daytime encopresis associated with gland mal epileptic seizures: case report.

    Science.gov (United States)

    Oyatsi, D P

    2005-08-01

    Sphincteric incontinence of stool and urine are not unusual features of generalised epileptic seizures. Isolated secondary encopresis as a manifestation of an epileptic seizure is unusual. This report is of, a four year old boy, with daytime secondary non-retentive encopresis. The onset of encopresis was preceded by several episodes of nocturnal generalised tonic clonic epileptic seizures. An electroencephalogram showed features consistent with complex partial seizures. He was commenced on anti-epileptic treatment with phenytoin sodium, and by the third day of treatment, the patient had achieved stool control.

  14. Recurrent epileptic Wernicke aphasia.

    Science.gov (United States)

    Sahaya, Kinshuk; Dhand, Upinder K; Goyal, Munish K; Soni, Chetan R; Sahota, Pradeep K

    2010-04-15

    We report a patient with recurrent epileptic Wernicke aphasia who prior to this presentation, had been misdiagnosed as transient ischemic attacks for several years. This case report emphasizes the consideration of epileptic nature of aphasia when a clear alternate etiology is unavailable, even when EEG fails to show a clear ictal pattern. We also present a brief discussion of previously reported ictal aphasias. Copyright 2010 Elsevier B.V. All rights reserved.

  15. Domoic Acid Epileptic Disease

    Directory of Open Access Journals (Sweden)

    John S. Ramsdell

    2014-03-01

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

  16. Treatment of Epileptic Encephalopathies.

    Science.gov (United States)

    Balestrini, Simona; Sisodiya, Sanjay M

    2017-01-01

    Epileptic encephalopathies represent the most severe epilepsies, with onset in infancy and childhood and seizures continuing in adulthood in most cases. New genetic causes are being identified at a rapid rate. Treatment is challenging and the overall outcome remains poor. Available targeted treatments, based on the precision medicine approach, are currently few. To provide an overview of the treatment of epileptic encephalopathies with known genetic determinants, including established treatment, anecdotal reports of specific treatment, and potential tailored precision medicine strategies. Genes known to be associated to epileptic encephalopathy were selected. Genes where the association was uncertain or with no reports of details on treatment, were not included. Although some of the genes included are associated with multiple epilepsy phenotypes or other organ involvement, we have mainly focused on the epileptic encephalopathies and their antiepileptic treatments. Most epileptic encephalopathies show genotypic and phenotypic heterogeneity. The treatment of seizures is difficult in most cases. The available evidence may provide some guidance for treatment: for example, ACTH seems to be effective in controlling infantile spams in a number of genetic epileptic encephalopathies. There are potentially effective tailored precision medicine strategies available for some of the encephalopathies, and therapies with currently unexplained effectiveness in others. Understanding the effect of the mutation is crucial for targeted treatment. There is a broad range of disease mechanisms underlying epileptic encephalopathies, and this makes the application of targeted treatments challenging. However, there is evidence that tailored treatment could significantly improve epilepsy treatment and prognosis. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  17. 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

  18. 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

  19. Idiopathic epileptic syndromes and cognition.

    Science.gov (United States)

    Hommet, Caroline; Sauerwein, Hannelore C; De Toffol, Bertrand; Lassonde, Maryse

    2006-01-01

    Epilepsy is frequently associated with cognitive impairments which result from various interacting factors. The present paper deals with the contribution of neuropsychology to the characterization of the type of epilepsy and the possible mechanisms underlying idiopathic epileptic syndromes. The non-lesional, so-called idiopathic epilepsies, constitute an interesting model for assessing the relationship between epileptiform EEG discharges and cognition. Among the idiopathic generalized epilepsies, disorders of social integration and personality have been frequently reported in juvenile myoclonic epilepsy (JME). Since similar disturbances are observed in frontal-lobe-lesioned patients, impairments in other frontal lobe functions (e.g. executive functions) might be expected in JME. This gives rise to speculation about the possible underlying pathophysiological mechanisms in JME. With regard to partial idiopathic epilepsies, benign childhood epilepsy with centrotemporal spikes (BCECTS) may provide a useful model for the study of the relationship between epileptiform EEG discharges in the peri-sylvian region and language functions. Furthermore, the description of mild cognitive dysfunctions in BCECTS, and their persistence into adulthood, can provide information about compensatory mechanisms and may allow for the generation of remedial strategies. Thus, 'lesional' neuropsychology has given way to 'dynamic' neuropsychology based on specific postulates. By using the cognitive profile to specify the mechanism underlying the behavioral disturbances observed in different types of epilepsy, neuropsychology may eventually contribute to a revision of the present classification of epileptic syndromes. In addition, the neuropsychological data may help predict the extent and limits of functional recovery and cerebral plasticity.

  20. [Unusual dreams in epileptics].

    Science.gov (United States)

    Boldyrev, A I

    1984-01-01

    The author discusses bizarre dreams characteristic of epileptics and never occurring in normal subjects which have an important practical implication especially for early detection of epilepsy and the prevention of severe forms of the disease. This group of dreams includes vivid nightmares with vital fear, dreams not infrequently transforming into pro-dream states; persistently repeated stereotyped dreams and dreams with invariably the same unpleasant sensations representing an isolated aura of subsequent epileptic attacks. Diagnostically important may also be dreams with the symptoms of derealization and depersonalization, vague dream images and the deja vu phenomenon.

  1. Oxidant-Antioxidant Balance In Epileptic Children

    International Nuclear Information System (INIS)

    Moawad, A.T.; Mohammed, A.A.; El-Maghraby, D.M.F.

    2011-01-01

    Epilepsy is one of the most common neurological disorders which are characterized by recurrent unprovoked seizures. It is usually controlled, but cannot be cured with medications, although surgery may be considered in difficult cases. Over 30% of people with epilepsy don't have seizure control even with the best available medications. In epileptic children, oxidant-antioxidant balance is disturbed. Glutathione homeostasis may be altered as a consequence of reactive metabolites and/or reactive oxygen species produced during treatment with antiepileptic drugs. Per-oxidation of membrane lipid caused by an increase in generation of free radical or decrease in the activities of antioxidant defense systems have been suggested to be critically involved in seizure control. The effect of antiepileptic monotherapy as valproic acid (VPA) or carbamazepine (CBZ) or both on level of glutathione-S-transferase (GST) as an index of antioxidant and the plasma of malondialdehyde (MDA) as an index of oxidative stress were studied in this study. Forty children (18 males and 22 females) with idiopathic generalized epilepsy, diagnosed in the Pediatric Neurology Unit, Children Hospital, Ain Shams University, Cairo, Egypt, were selected to represent group (1) with mean age of 5.13 ± 4.36 years. Thirty healthy children (14 males and 16 females) matched in age, sex and social life status served as normal control group (2). The results revealed that there was high significant increase in the plasma level of MDA in patients with idiopathic epilepsy as compared to the control while the serum level of GST was significantly decreased in epileptic children as compared to the control group. Non-significant difference in plasma level of MDA and serum level of GST among the epileptic subgroups was observed. In uncontrolled epileptic patients (seizures more than 4/month), the plasma level of MDA displayed higher significant increase than in controlled epileptic patients. On the other hand, serum GST

  2. Evaluation of the Periodontal Status of Abutment Teeth in Removable Partial Dentures.

    Science.gov (United States)

    Correia, André Ricardo Maia; da Silva Lobo, Fábio Daniel; Miranda, Mónica Célia Pereira; Framegas de Araújo, Filipe Miguel Soares; Santos Marques, Tiago Miguel

    2017-12-15

    The purpose of this study was to evaluate whether the use of removable partial dentures affects the periodontal status of abutment teeth. An observational cross-sectional study was done on a sample of patients rehabilitated with removable partial dentures (2010 to 2013). At a recall appointment, a clinical examination was done to collect data related to the rehabilitation and periodontal status of the abutment teeth. Of 145 invited patients, 54 attended the requested follow-up appointment (37.2%). Mean patient age was 59.1 years, and the study population was 42.6% male and 57.4% female. The mean follow-up time for the prosthesis was 26 months. Abutment teeth had higher values in all periodontal variables (P removable partial dentures is affected by these rehabilitations. A recall program for these patients involving removable prosthodontics and periodontology appointments is mandatory.

  3. CT findings in epileptic children

    International Nuclear Information System (INIS)

    Koide, Nobuo; Kimura, Shigeru; Watanabe, Jun; Haneda, Satoshi; Takebe, Yukinao

    1981-01-01

    CT findings in 43 children with generalized seizures (grand mal seizures) (GM group) and in 50 children with partial seizures (P group), classified according to clinical seizure type, were studied. 1) CT abnormalities were demonstrated in 19% (8/43) in GM group and in 40% (20/50) in P group, including localized CT abnormalities in 9.3% (4/43) and in 34% (17/50) respectively. CT abnormalities were found more frequently in cases with abnormal past histories and/or mental defects (MD) than in those without them. 2) In P group, localized CT abnormalities and generalized brain atrophy were observed in 13 and 7 cases respectively. In 40 cases with focal epileptic discharges (FED) in EEG, localized CT abnormalities were demonstrated in 23% (9/40). The sites of localized CT abnormalities corresponded in 73% (11/15) to the sites of focal suppression in EEG (i.e., slowing, low amplitude and lazy pattern) regardless of FED. 3) The bicaudate cerebro-ventricular index (B-CVI) in 19 cases in the normal control group over 2 years of age was 10.0 +- 1.2 (mean +- SD). Ventricular narrowing (VN), with B-CVI less than 8.2 (mean - 1.5 SD), was observed in 5, 17 and 27% in control, GM and P groups respectively, indicating more frequently in epileptic children than in normal controls. Seizures were well controlled in 85% (11/13) in VN group and in 70% (26/36) in normal ventricular group. Brain atrophy in CT findings to inspection was ascertained in all cases by measuring B-CVI. (author)

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

    DEFF Research Database (Denmark)

    Beniczky, Sándor; Conradsen, Isa; Moldovan, Mihai

    2015-01-01

    Our objective was the clinical validation of an automated algorithm based on surface electromyography (EMG) for differentiation between convulsive epileptic and psychogenic nonepileptic seizures (PNESs). Forty-four consecutive episodes with convulsive events were automatically analyzed with the a......%) and 18 PNESs (95%). The overall diagnostic accuracy was 95%. This algorithm is useful for distinguishing between epileptic and psychogenic convulsive seizures....

  5. Computed tomography of epileptic children

    International Nuclear Information System (INIS)

    Kurihara, Mana; Yamashita, Sumimasa; Miyake, Shota; Yamada, Michiko; Iwamoto, Hiroko

    1986-01-01

    The aim of this study was to analyze the changes seen on cranial computed tomography (CT) of epileptic children, especially in the area of the temporal horn. The subjects were 242 epileptic children excluding those with encephalitis, brain tumor, neurocutaneous syndromes, degenerative disease, hydrocephalus etc. The control subjects were 195 children without any neurological disease and symptoms. CT scan were taken with a TCT-60A whole body scanner, and 14 check points were evaluated excluding the temporal horn. 195 epileptic children (N-group) and all control children were normal at 14 check points. Next, the areas of the temporal horns and adjoining hemispheres of the epileptic children (N-group) and control children were examined with Muto-Tablet-Desitizer. The temporal horn ratio ((area of temporal horn/area of ipsilateral hemisphere) x 100) was greater in younger children of the control group, and it was higher in epileptic than in control children. Enlargement of the temporal horn was seen in 1 % of the controls and in 35 % of the 125 epileptic children with normal measurements at 14 points on CT scans (p < 0.01). The frequency of enlargement of temporal horns was not variable among different epileptic types. In the epileptic children with normal CT scans except for enlargement of temporal horns behavioral disturbances were 6 boys and 5 had enlarged temporal horns (bilateral 1 case, left side 1 case, right side 3 cases). (author)

  6. Danish epileptics given Thorotrast

    International Nuclear Information System (INIS)

    Olsen, J.H.; Anderson, M.; Boice, J.D. Jr.

    1989-01-01

    Cancer incidence among 8004 patients hospitalized for epilepsy between 1933 and 1962 was compared to that of the general population. Among 140 epileptics given Thorotrast during cerebral angiography, a significant excess of cancer was observed. Thorotrast exposure was linked to significant excesses of liver cancer, leukaemia and lung cancer. An excess of brain cancer occurred shortly after hospital admission, suggesting brain tumours were the cause of the seizure disorder and are not due to Thorotrast. Haemangiosarcomas of the liver appeared uniquely related to Thorotrast, as did the rare subtypes of leukaemia observed. Cholangiocarcinomas also occurred in excess. The preponderance of anaplastic lung cancer is provocative and suggests the possibility that thoron exposure from the decay of Thorotrast might be involved. The cumulative risk of developing cancer at 40 years, excluding the brain cancer risk, was 60±6%. (author)

  7. An animal model of nonconvulsive status epilepticus: a contribution to clinical controversies

    Czech Academy of Sciences Publication Activity Database

    Kršek, Pavel; Mikulecká, Anna; Druga, Rastislav; Hliňák, Zdeněk; Kubová, Hana; Mareš, Pavel

    2001-01-01

    Roč. 42, č. 2 (2001), s. 171-180 ISSN 0013-9580 R&D Projects: GA ČR GA309/97/0552; GA AV ČR IAA7011603 Institutional research plan: CEZ:AV0Z5011922 Keywords : complex partial status epilepticus * pilocarpine * epileptic brain damage Subject RIV: ED - Physiology Impact factor: 3.271, year: 2001

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

    LENUS (Irish Health Repository)

    O'Sullivan, S S

    2013-02-01

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

  9. Continuous partial status cause of hyperintensity in cerebral cortex in magnetic resonance imaging

    International Nuclear Information System (INIS)

    Lopez L, Ingeborg; Gonzalez L, Daniela; Quezada R, Patricio; Cartier R, Luis

    2012-01-01

    Magnetic Resonance Imaging has demonstrated functional changes of the cerebral cortex in relation to status epilepticus, which can eventually localize the origin of the crisis. The purpose of this presentation is relevant to this condition and pretends to highlight the action of incidental situations that can modify it. We present a 29 year old woman with a neurosurgical intervention for a neuroblastoma irradiated fifteen years ago, which incidentally starts a continuous partial status epilepticus, expressed by clonies of the face and left limbs associated with functional impotence, resistant to oral therapy. Faced with the suspicion of recurrence of the tumor, a brain MRI is performed, showing hyperintensity of all neural areas the right hemisphere, with no evidence of tumor recurrence. Once submitted the status epilepticus, the hyperintensity disappeared in the hemisphere. This extensive reaction of the neural structures might be related to a permanent effect of radiation, which may have caused a mismatch functional glia, of the blood-brain barrier and interneural network

  10. Pharmacokinetics of Anti-Epileptic Drugs and their Clinical Significance

    Directory of Open Access Journals (Sweden)

    Svein I. Johannessen

    1990-01-01

    Full Text Available The serum concentration achieved and maintained following the administration of a fixed drug dosage is a direct consequence of the interactions of a wide variety of interrelated processes, including drug absorption, distribution, metabolism, and excretion, and the physiological status of the patient. These interrelationships are reviewed with specific reference to the major anti-epileptic drugs, phenobarbitone, phenytoin, sodium valproate, and carbamazepine, as well as a new first-line antiepileptic, oxcarbazepine. Both older drugs, such as phenobarbitone and phenytoin, and newer drugs, such as carbamazepine (CBZ and sodium valproate, have been studied extensively over the past years giving valuable information for drug treatment. An important feature of oxcarbazepine (OXC , which was developed through minimal changes in the structure of CBZ in order to improve on the tolerability of CBZ without sacrificing efficacy, is that its metabolites do not include the 11-epoxide which has been implicated in the side-effects of CBZ. In man, OXC is metabolized to a monohydroxy derivative which has independent anti-epileptic properties. OXC seems to lack several disadavantageous pharmacokinetic properties common to other major anti-epileptic drugs. OXC does not influence its own metabolism after repeated administration, in contrast to the auto-induction displayed by CBZ. The metabolism of OXC is not influenced by anti-epileptic co-medication and does not influence the kinetics of other anti-epileptic drugs – or if it does, then to a lesser extent than CBZ.

  11. Interference of partial visual analysis of root filling quality and apical status on retreatment decisions

    Directory of Open Access Journals (Sweden)

    Renata Dornelles Morgental

    2012-04-01

    Full Text Available OBJECTIVE: The presence of periapical radiolucency has been used as a criterion for endodontic treatment failure. However, in addition to the inherent limitations of radiographic examinations, radiographic interpretations are extremely subjective. Thus, this study investigated the effect of partial analysis of root filling quality and periapical status on retreatment decisions by general dentists. MATERIAL AND METHODS: Twelve digitalized periapical radiographs were analyzed by 10 observers. The study was conducted at three time points at 1-week intervals. Radiographs edited with the Adobe Photoshop CS4 software were analyzed at three time points: first, only root filling quality was analyzed; second, only the periapical areas of the teeth under study were visualized; finally, observers analyzed the unedited radiographic image. Spearman ’s coefficient was used to analyze the correlations between the scores assigned when the periapical area was not visible and when the unedited radiograph was analyzed, as well as between the scores assigned when root fillings where not visible and when the unedited radiograph was analyzed. Sensitivity, specificity, positive and negative predictive values between partial images and unedited radiographs were also used to analyze retreatment decisions. The level of significance was set at 5%. RESULTS: The visualization of the root filling on the unedited radiograph affected the interpretation of the periapical status and the technical quality of the fillings has a greater influence on the general dentist’s decision to prescribe endodontic retreatment than the periapical condition. CONCLUSION: In order to make endodontic diagnosis, radiographic interpretation process should not only emphasize technical aspects, but also consider biological factors.

  12. Immune-mediated steroid-responsive epileptic spasms and epileptic encephalopathy associated with VGKC-complex antibodies.

    Science.gov (United States)

    Suleiman, Jehan; Brenner, Tanja; Gill, Deepak; Troedson, Christopher; Sinclair, Adriane J; Brilot, Fabienne; Vincent, Angela; Lang, Bethan; Dale, Russell C

    2011-11-01

    Autoantibodies that bind to voltage-gated potassium-channel complex proteins (VGKC-complex antibodies) occur frequently in adults with limbic encephalitis presenting with cognitive impairment and seizures. Recently, VGKC-complex antibodies have been described in a few children with limbic encephalitis, and children with unexplained encephalitis presenting with status epilepticus. We report a case of infantile-onset epileptic spasms and developmental delay compatible with epileptic encephalopathy. Our patient was a female infant, aged 4 months at presentation. She had evidence of immune activation in the central nervous system with elevated cerebrospinal fluid neopterin and mirrored oligoclonal bands, which prompted testing for autoantibodies. VGKC-complex antibodies were elevated (201 pmol/L, normalVGKC-complex antibodies might represent a marker of immune therapy responsiveness in a subgroup of patients with infantile epileptic encephalopathy. © The Authors. Developmental Medicine & Child Neurology © 2011 Mac Keith Press.

  13. Comparison of functionally orientated tooth replacement and removable partial dentures on the nutritional status of partially dentate older patients: a randomised controlled clinical trial.

    Science.gov (United States)

    McKenna, Gerald; Allen, P Finbarr; O'Mahony, Denis; Flynn, Albert; Cronin, Michael; DaMata, Cristiane; Woods, Noel

    2014-06-01

    The aims of this study were to conduct a randomised controlled clinical trial (RCT) of partially dentate older adults comparing functionally orientated treatment based on the SDA concept with conventional treatment using RPDs to replace missing natural teeth. The two treatment strategies were evaluated according to their impact on nutritional status measured using haematological biomarkers. A randomised controlled clinical trial (RCT) was conducted of partially dentate patients aged 65 years and older (Trial Registration no. ISRCTN26302774). Each patient provided haematological samples which were screened for biochemical markers of nutritional status. Each sample was tested in Cork University Hospital for serum Albumin, serum Cholesterol, Ferritin, Folate, Vitamin B12 and 25-hydroxycholecalciferol (Vitamin D). A mixed model analysis of covariance (ANCOVA) indicated that for Vitamin B12 (p=0.9392), serum Folate (p=0.5827), Ferritin (p=0.6964), Albumin (p=0.8179), Serum Total Cholesterol (p=0.3670) and Vitamin D (p=0.7666) there were no statistically significant differences recorded between the two treatment groups. According to the mixed model analysis of covariance (ANCOVA) for Vitamin D there was a significant difference between levels recorded at post-operative time points after treatment intervention (p=0.0470). There was an increase of 7% in 25-hydroxycholecalciferol levels recorded at 6 months compared to baseline (p=0.0172). There was no further change in recorded levels at 12 months (p=0.6482) and these increases were similar within the two treatment groups (p>0.05). The only measure which illustrated consistent significant improvements in nutritional status for either group were Vitamin D levels. However no significant difference was recorded between the two treatment groups. Functionally orientated prosthodontic rehabilitation for partially dentate older patients was no worse than conventional removable partial dentures in terms of impact on nutritional

  14. Epileptic consciousness: concept and meaning of aura.

    Science.gov (United States)

    Alvarez-Silva, Sergio; Alvarez-Silva, Iria; Alvarez-Rodriguez, Javier; Perez-Echeverria, M J; Campayo-Martinez, Antonio; Rodriguez-Fernandez, F L

    2006-05-01

    This research is based on previous publications that have analyzed certain neuropsychological phenomena that always have the same characteristic clinical features: a vivid experience of sudden onset and automatic development, accompanied by an intense sensation of strangeness. When these automatisms are accompanied by only mental symptoms, the designation paroxysmal psychic automatisms (PPAs) is proposed, and they should be interpreted as partial seizures (PSs) with a psychic content whenever they clearly exhibit the four features of suddenness, passivity, intensity, and strangeness. This interpretation is based on the existence of a wealth of scientific literature indicating an overlap between PPAs and PSs; moreover, bibliographic reviews indicate that the clinical signs just defined as characterizing PPAs are precisely those defining the epileptic consciousness.

  15. Multimodality localization of epileptic foci

    Science.gov (United States)

    Desco, Manuel; Pascau, Javier; Pozo, M. A.; Santos, Andres; Reig, Santiago; Gispert, Juan D.; Garcia-Barreno, Pedro

    2001-05-01

    This paper presents a multimodality approach for the localization of epileptic foci using PET, MRI and EEG combined without the need of external markers. Mutual Information algorithm is used for MRI-PET registration. Dipole coordinates (provided by BESA software) are projected onto the MRI using a specifically developed algorithm. The four anatomical references used for electrode positioning (nasion, inion and two preauricular points) are located on the MRI using a triplanar viewer combined with a surface-rendering tool. Geometric transformation using deformation of the ideal sphere used for dipole calculations is then applied to match the patient's brain size and shape. Eight treatment-refractory epileptic patients have been studied. The combination of the anatomical information from the MRI, hipoperfusion areas in PET and dipole position and orientation helped the physician in the diagnosis of epileptic focus location. Neurosurgery was not indicated for patients where PET and dipole results were inconsistent; in two cases it was clinically indicated despite the mismatch, showing a negative follow up. The multimodality approach presented does not require external markers for dipole projection onto the MRI, this being the main difference with previous methods. The proposed method may play an important role in the indication of surgery for treatment- refractory epileptic patients.

  16. Outcomes of breast cancer patients with triple negative receptor status treated with accelerated partial breast irradiation.

    Science.gov (United States)

    Wilkinson, J Ben; Reid, Robert E; Shaitelman, Simona F; Chen, Peter Y; Mitchell, Christine K; Wallace, Michelle F; Marvin, Kimberly S; Grills, Inga S; Margolis, Jeffrey M; Vicini, Frank A

    2011-11-01

    Triple negative receptor status (TNRS) of patients undergoing breast-conserving therapy treated with whole-breast irradiation has been associated with increased distant metastasis and decreased disease-free and overall survival. This paper reports the outcomes of TNRS patients treated with accelerated partial breast irradiation (APBI). We studied 455 patients who received APBI at our institution, using interstitial, intracavitary, and three-dimensional conformal radiation therapy. TNRS was assigned if a patient tested negative for all three (ER [estrogen receptor], PR [progesterone receptor], and HER2/neu) receptors. Of 202 patients with all receptor results available, 20 patients were designated TNRS, and 182 patients had at least one receptor positive (RP). We analyzed ipsilateral breast tumor recurrence (IBTR), regional nodal failure (RNF), distant metastasis (DM), and overall survival (OS). Mean follow-up was 4.1 years for the TNRS group and 5.1 years for the RP cohort (p = 0.11). TNRS patients had a higher histologic grade (59% TNRS vs. 13% RP; p 0.52). OS for the RP cohort was 93% at 5 years (p > 0.28). In our patient population, TNRS conferred a clinical outcome similar to that of patients with RP disease treated with APBI. Further investigation with larger patient populations and longer follow-up periods is warranted to confirm that APBI is a safe and effective treatment for patients with localized TNRS breast cancer. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Outcomes of Breast Cancer Patients With Triple Negative Receptor Status Treated With Accelerated Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Wilkinson, J. Ben; Reid, Robert E.; Shaitelman, Simona F.; Chen, Peter Y.; Mitchell, Christine K.; Wallace, Michelle F.; Marvin, Kimberly S.; Grills, Inga S.; Margolis, Jeffrey M.; Vicini, Frank A.

    2011-01-01

    Purpose: Triple negative receptor status (TNRS) of patients undergoing breast-conserving therapy treated with whole-breast irradiation has been associated with increased distant metastasis and decreased disease-free and overall survival. This paper reports the outcomes of TNRS patients treated with accelerated partial breast irradiation (APBI). Methods and Materials: We studied 455 patients who received APBI at our institution, using interstitial, intracavitary, and three-dimensional conformal radiation therapy. TNRS was assigned if a patient tested negative for all three (ER [estrogen receptor], PR [progesterone receptor], and HER2/neu) receptors. Of 202 patients with all receptor results available, 20 patients were designated TNRS, and 182 patients had at least one receptor positive (RP). We analyzed ipsilateral breast tumor recurrence (IBTR), regional nodal failure (RNF), distant metastasis (DM), and overall survival (OS). Results: Mean follow-up was 4.1 years for the TNRS group and 5.1 years for the RP cohort (p = 0.11). TNRS patients had a higher histologic grade (59% TNRS vs. 13% RP; p 0.52). OS for the RP cohort was 93% at 5 years (p > 0.28). Conclusions: In our patient population, TNRS conferred a clinical outcome similar to that of patients with RP disease treated with APBI. Further investigation with larger patient populations and longer follow-up periods is warranted to confirm that APBI is a safe and effective treatment for patients with localized TNRS breast cancer.

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

    Directory of Open Access Journals (Sweden)

    Ijeoma Kanu

    2005-01-01

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

  19. The Persistence of Erroneous Familiarity in an Epileptic Male: Challenging Perceptual Theories of Deja Vu Activation

    Science.gov (United States)

    O'Connor, Akira R.; Moulin, Christopher J. A.

    2008-01-01

    We report the case of a 39-year-old, temporal lobe epileptic male, MH. Prior to complex partial seizure, experienced up to three times a day, MH often experiences an aura experienced as a persistent sensation of deja vu. Data-driven theories of deja vu formation suggest that partial familiarity for the perceived stimulus is responsible for the…

  20. Impact of Lymph Node Status on Clinical Outcomes After Accelerated Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag; Wilkinson, J. Ben; Shaitelman, Simona [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Grills, Inga S.; Chen, Peter Y. [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Oakland University William Beaumont School of Medicine, Royal Oak, MI (United States); Dekhne, Nayana [Breast Care Center, Beaumont Health System, William Beaumont Hospital, Royal Oak, MI (United States); Jaiyesimi, Ishmael [Department of Medical Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Wallace, Michelle; Mitchell, Christina K. [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Oakland University William Beaumont School of Medicine, Royal Oak, MI (United States)

    2012-03-01

    Purpose: To compare outcomes after accelerated partial breast irradiation (APBI) between node-negative and node-positive patients. Methods and Materials: A total of 534 patients with early-stage breast cancer received APBI including 39 node-positive (N+) cases. Clinical, pathologic, and treatment-related factors were compared between node-negative (N-) and N+ cohorts. Local recurrence (LR), regional recurrence (RR), axillary failure (AF), distant metastases (DM), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS) were analyzed. Results: N+ patients were younger (p = 0.04), had larger tumors (p < 0.001), and were more likely to receive chemotherapy (p < 0.001). Mean follow-up was 7.8 years for N+ patients and 6.3 years for N- patients (p = 0.06). No differences were seen in 5-year actuarial rates of LR (2.2% vs. 2.6%, p = 0.86), AF (0% vs. 0%, p = 0.69), DFS (90.0% vs. 88.0%, p = 0.79), or OS (91.0 vs. 84.0%, p = 0.65) between the two groups, whereas higher rates of RR (0% vs. 6.1%, p < 0.001) and DM (2.2% vs. 8.9%, p = 0.005) were noted in N+ patients. A trend for improved CSS (p = 0.06), was seen in N- patients. Age, tumor size, receptor status, T-stage, chemotherapy, APBI technique, and nodal status (p = 0.86) were not associated with LR, while a trend for an association with LR was noted with close/positive margins, (p = 0.07), and failure to receive adjuvant hormonal therapy (p = 0.06). Conclusions: No differences were seen in the rates of LR or AF between N- and N+ patients after APBI. These results support the continued enrollment of node-positive patients in Phase III trials evaluating the efficacy of APBI including the National Surgical Adjuvant Breast and Bowel Project-B39/Radiation Therapy Oncology Group 0413.

  1. Wavelet analysis of epileptic spikes

    Science.gov (United States)

    Latka, Miroslaw; Was, Ziemowit; Kozik, Andrzej; West, Bruce J.

    2003-05-01

    Interictal spikes and sharp waves in human EEG are characteristic signatures of epilepsy. These potentials originate as a result of synchronous pathological discharge of many neurons. The reliable detection of such potentials has been the long standing problem in EEG analysis, especially after long-term monitoring became common in investigation of epileptic patients. The traditional definition of a spike is based on its amplitude, duration, sharpness, and emergence from its background. However, spike detection systems built solely around this definition are not reliable due to the presence of numerous transients and artifacts. We use wavelet transform to analyze the properties of EEG manifestations of epilepsy. We demonstrate that the behavior of wavelet transform of epileptic spikes across scales can constitute the foundation of a relatively simple yet effective detection algorithm.

  2. Wavelet analysis of epileptic spikes

    CERN Document Server

    Latka, M; Kozik, A; West, B J; Latka, Miroslaw; Was, Ziemowit; Kozik, Andrzej; West, Bruce J.

    2003-01-01

    Interictal spikes and sharp waves in human EEG are characteristic signatures of epilepsy. These potentials originate as a result of synchronous, pathological discharge of many neurons. The reliable detection of such potentials has been the long standing problem in EEG analysis, especially after long-term monitoring became common in investigation of epileptic patients. The traditional definition of a spike is based on its amplitude, duration, sharpness, and emergence from its background. However, spike detection systems built solely around this definition are not reliable due to the presence of numerous transients and artifacts. We use wavelet transform to analyze the properties of EEG manifestations of epilepsy. We demonstrate that the behavior of wavelet transform of epileptic spikes across scales can constitute the foundation of a relatively simple yet effective detection algorithm.

  3. Mortality predictors of epilepsy and epileptic seizures among hospitalized elderly

    Directory of Open Access Journals (Sweden)

    Telma M. R Assis

    2015-06-01

    Full Text Available Epilepsy and epileptic seizures are common brain disorders in the elderly and are associated with increased mortality that may be ascribed to the underlying disease or epilepsy-related causes.Objective To describe mortality predictors of epilepsy and epileptic seizures in elderly inpatients.Method Retrospective analysis was performed on hospitalized elderly who had epilepsy or epileptic seizures, from January 2009 to December 2010. One hundred and twenty patients were enrolled.Results The most common etiology was ischemic stroke (37%, followed by neoplasias (13%, hemorrhagic stroke (12%, dementias (11.4% and metabolic disturbances (5.5%. In a univariate analysis, disease duration (p = 0.04, status epilepticus (p < 0.001 and metabolic etiology (p = 0.005 were associated with mortality. However after adjustment by logistic regression, only status epilepticus remained an independent predictor of death (odds ratio = 13; 95%CI = 2.3 to 72; p = 0.004.Conclusion In this study status epilepticus was an independent risk factor for death during hospitalization.

  4. Ketogenic Diet in Epileptic Encephalopathies

    OpenAIRE

    Sharma, Suvasini; Tripathi, Manjari

    2013-01-01

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

  5. Video electroencephalography monitoring differentiates between epileptic and non-epileptic seizures

    DEFF Research Database (Denmark)

    Nørmark, Mette Borch; Erdal, Jesper; Kjær, Troels Wesenberg

    2011-01-01

    Epilepsy is often misdiagnosed and approximately one in every four patients diagnosed with refractory epilepsy does not have epilepsy, but instead non-epileptic seizures. Video electroencephalography monitoring (VEM) is the gold standard for differentiation between epileptic and non...

  6. Complete remission of epileptic psychosis after temporal lobectomy: case report

    Directory of Open Access Journals (Sweden)

    Marchetti Renato Luiz

    2001-01-01

    Full Text Available We report a case of a female patient with refractory complex partial seizures since 15 years of age, recurrent postictal psychotic episodes since 35 which evolved to a chronic refractory interictal psychosis and MRI with right mesial temporal sclerosis (MTS. After a comprehensive investigation (video-EEG intensive monitoring, interictal and ictal SPECT, and a neuropsychological evaluation including WADA test she was submitted to a right temporal lobectomy. Since then, she has been seizure-free with remission of psychosis, although with some persistence of personality traits (hiperreligiosity, viscosity which had been present before surgery. This case supports the idea that temporal lobectomy can be a safe and effective therapeutic measure for patients with MTS, refractory epilepsy and recurrent postictal epileptic psychosis or interictal epileptic psychosis with postictal exacerbation.

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

    Science.gov (United States)

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

    2017-08-01

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

  8. Drug resistance in colorectal cancer cell lines is partially associated with aneuploidy status in light of profiling gene expression

    DEFF Research Database (Denmark)

    Guo, Jiao; Xu, Shaohang; Huang, Xuanlin

    2016-01-01

    A priority in solving the problem of drug resistance is to understand the molecular mechanism of how a drug induces the resistance response within cells. Because many cancer cells exhibit chromosome aneuploidy, we explored whether changes of aneuploidy status result in drug resistance. Two typical...... colorectal cancer cells, HCT116 and LoVo, were cultured with the chemotherapeutic drugs irinotecan (SN38) or oxaliplatin (QxPt), and the non- and drug-resistant cell lines were selected. Whole exome sequencing (WES) was employed to evaluate the aneuploidy status of these cells, and RNAseq and LC-MS/MS were...... the aneuploidy status in cancer cells, which was partially associated with the acquired drug resistance....

  9. Cerebellar atrophy in epileptic patients

    International Nuclear Information System (INIS)

    Taneva, N.

    1991-01-01

    52 patients with epileptic seizures of different form, frequency and duration who had received long term treatment with anticonvulsive drugs were examined on Siretom 2000, a brain scanner of II generation. 6 standard incisions were made in all patients in the area of cerebellum, side ventricules and high convexity. Additional scanning with an incision width of 5 mm was made when pathological changes were detected. There were found 3 cases of cerebellar atrophy, 3 - cerebral atrophy, 1 - combined atrophy and 4 - with other changes. It was difficult to establish any relation between the rerebellar atrophy and the type of anticonvulsant used because treatment had usually been complex. 1 fig., 1 tab., 4 refs

  10. [A modified approach to the diagnosis and therapy of epileptic seizures in the third stage of life].

    Science.gov (United States)

    Gavranović, Muhamed; Delilović, Jasminka; Kurtović, Azra; Alibegović, Sakib; Rajić, Zeljka; Ajanović, Zakira

    2003-01-01

    Incidence of seizures in the elderly is nowadays greater than the one characteristic for children up to 10 years of age. Epileptic seizures are the third most common serious neurological disorder in this age group, after stroke and dementia. Optimal care for those patients, regarding to the seizures, demands some modification in diagnostic and treatment approach. Aim of this report was to point out problems in diagnostics, treatment and most common mistakes in practice. Fifty one patients were assessed, aged 65-83 years, (30 female and 21 male), with diagnosis of epilepsy and established antiepileptic treatment. All patients were re-examined, and following procedures were utilised: auto and heteroanamnesis (especially data provided by eyewitnesses), clinical examination, biochemical status, complete cardiological examination, EEG registration, serum concentrations of antiepileptic drugs, CT and MRI scan. Out of 51 patients 11 were misdiagnosed (syncope, provoked seizures, TIA). The most common form of seizures were partial seizures with or without secondary generalization (31 cases). Etiologic factors: stroke (25 cases), arteriosclerosis (7 cases), tumours (3 cases), trauma (2 cases), unknown (3 cases) cardiovascular diseases (29 casec) diabetes mellitus (20 cases), respiratory disturbance (12 cases) renal disturbances (8 cases). Only 30 patients had monotherapy from the beginning, with either carbamazepine or valproate. Rest were treated from the beginning with 2 antiepileptic drugs (phenobarbital + carbamazepine or pheytoin + phenobarbital). Adverse effects were recorded in 21 patients. I. It is crucial to distingiush unprovoked and provoked seizures during diagnostic procedures, as well as epileptic and non-epileptic attacks; 2. Principle of monotherapy is conditio sine qua non, and in treatment attention should be paid to co-morbidity, multitherapy, drug interactions, intoxication, diminished detoxication and elimination of drugs, as well as increased

  11. Elevated VGKC-Complex Antibodies in a Boy with Fever-Induced Refractory Epileptic Encephalopathy in School-Age Children (FIRES)

    Science.gov (United States)

    Illingworth, Marjorie A.; Hanrahan, Donncha; Anderson, Claire E.; O'Kane, Kathryn; Anderson, Jennifer; Casey, Maureen; de Sousa, Carlos; Cross, J. Helen; Wright, Sukvhir; Dale, Russell C.; Vincent, Angela; Kurian, Manju A.

    2011-01-01

    Fever-induced refractory epileptic encephalopathy in school-age children (FIRES) is a clinically recognized epileptic encephalopathy of unknown aetiology. Presentation in previously healthy children is characterized by febrile status epilepticus. A pharmacoresistant epilepsy ensues, occurring in parallel with dramatic cognitive decline and…

  12. Positron emission tomography in presurgical diagnosis of partial epilepsies

    International Nuclear Information System (INIS)

    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

  13. The offspring of epileptic mother.

    Science.gov (United States)

    Tamer, S K; Misra, S; Jaiswal, S

    1996-01-01

    The offspring of an epileptic mother is an issue-currently getting attention because of its several implications. A complex interaction between epilepsy during pregnancy and its adverse impact on foetus, labor, neonate, congenital malformation, psychosocial and medico-social concern and treatment challenges of such cases is increasingly being realised. Some of the significant observations has been reviewed extensively in this article. Maternal epilepsy is likely to adversely affect the off-spring at its various stages of development amounting to increased morbidity and mortality. Increased seizure frequency during pregnancy with resultant increased risk is well documented but its mechanism is poorly understood. Low apgar score, increased still birth rates (1.3 to 14%) in offspring of epileptic mother (OEM) is reported. So also, the neonatal and perinatal deaths are twice more common in OEMS than normal control. Small for dates, and prematurity in OEM is reported to be 7 to 10% and 4-11% respectively. Adverse impact on labor and delivery like preclampsia, abruptio placentae, polyhydramnios, assisted delivery, cesarean section and IUGR poses particular challenges to the obstetrician. Pediatrician's alertness is needed to anticipate and deal with the bleeding manifestation due to deficiency of Vit-K dependent clotting factors and various anticonvulsant drug (AED) withdrawal symptoms. Significant risk of developing congenital malformation is the result of epilepsy perse and the AED used during pregnancy. AED exposure leads to other distinct clinical syndromes, the orofacial clefts and cardiac anomalies being the commonest manifestation. Epilepsy in mother but not in father has significant adverse impact. Management strategies in the context of available observation has been discussed.

  14. Survey of the status of finite element methods for partial differential equations

    Science.gov (United States)

    Temam, Roger

    1986-01-01

    The finite element methods (FEM) have proved to be a powerful technique for the solution of boundary value problems associated with partial differential equations of either elliptic, parabolic, or hyperbolic type. They also have a good potential for utilization on parallel computers particularly in relation to the concept of domain decomposition. This report is intended as an introduction to the FEM for the nonspecialist. It contains a survey which is totally nonexhaustive, and it also contains as an illustration, a report on some new results concerning two specific applications, namely a free boundary fluid-structure interaction problem and the Euler equations for inviscid flows.

  15. Transient MRI abnormalities associated with partial status epilepticus: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Amato, Carmelo; Elia, Maurizio; Musumeci, Sebastiano A; Bisceglie, Pierluigi; Moschini, Massimo

    2001-04-01

    We report the case of an 18-year-old woman who presented a long-lasting cluster of partial seizures, and MRI cortical abnormalities localized in the left parietal lobe. The MRI changes correlated with the site of the epileptogenic focus, and disappeared within 2 weeks. The recognition of these reversible MRI abnormalities, which are presumably due to a temporary alteration of blood-brain barrier in the epileptogenic zone with subsequent edema, and are not associated with any underlying organic conditions, is extremely useful in the medical management of the patient and allows to avoid other invasive diagnostic procedures.

  16. Transient MRI abnormalities associated with partial status epilepticus: a case report

    International Nuclear Information System (INIS)

    Amato, Carmelo; Elia, Maurizio; Musumeci, Sebastiano A.; Bisceglie, Pierluigi; Moschini, Massimo

    2001-01-01

    We report the case of an 18-year-old woman who presented a long-lasting cluster of partial seizures, and MRI cortical abnormalities localized in the left parietal lobe. The MRI changes correlated with the site of the epileptogenic focus, and disappeared within 2 weeks. The recognition of these reversible MRI abnormalities, which are presumably due to a temporary alteration of blood-brain barrier in the epileptogenic zone with subsequent edema, and are not associated with any underlying organic conditions, is extremely useful in the medical management of the patient and allows to avoid other invasive diagnostic procedures

  17. Cerebrospinal fluid findings after epileptic seizures.

    Science.gov (United States)

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

    2015-12-01

    We aimed to evaluate ictally-induced CSF parameter changes after seizures in adult patients without acute inflammatory diseases or infectious diseases associated with the central nervous system. In total, 151 patients were included in the study. All patients were admitted to our department of neurology following acute seizures and received an extensive work-up including EEG, cerebral imaging, and CSF examinations. CSF protein elevation was found in most patients (92; 60.9%) and was significantly associated with older age, male sex, and generalized seizures. Abnormal CSF-to-serum glucose ratio was found in only nine patients (5.9%) and did not show any significant associations. CSF lactate was elevated in 34 patients (22.5%) and showed a significant association with focal seizures with impaired consciousness, status epilepticus, the presence of EEG abnormalities in general and epileptiform potentials in particular, as well as epileptogenic lesions on cerebral imaging. Our results indicate that non-inflammatory CSF elevation of protein and lactate after epileptic seizures is relatively common, in contrast to changes in CSF-to-serum glucose ratio, and further suggest that these changes are caused by ictal activity and are related to seizure type and intensity. We found no indication that these changes may have further-reaching pathological implications besides their postictal character.

  18. Consciousness in Non-Epileptic Attack Disorder

    OpenAIRE

    Reuber, M.; Kurthen, M.

    2011-01-01

    Non-epileptic attack disorder (NEAD) is one of the most important differential diagnoses of epilepsy. Impairment of\\ud consciousness is the key feature of non-epileptic attacks (NEAs). The first half of this review summarises the clinical research\\ud literature featuring observations relating to consciousness in NEAD. The second half places this evidence in the wider context\\ud of the recent discourse on consciousness in neuroscience and the philosophy of mind. We argue that studies of consci...

  19. Coordination between antioxidant defences might be partially modulated by magnesium status.

    Science.gov (United States)

    Monteiro, Cristina Paula; Matias, Catarina Nunes; Bicho, Manuel; Santa-Clara, Helena; Laires, Maria José

    2016-04-01

    The aim of this study was to compare the redox balance in competitive adult swimmers against recreational practitioners, controlling for Mg intake. Fifteen, competitive swimmers and 16 recreational practitioners, all male and aged 18-25years, were recruited into the study. Oxidative and muscle damage markers, and antioxidant enzymes and non-enzymatic antioxidants were evaluated by photometry (except for thiobarbituric reactive substances (TBARS), which was assessed by fluorimetry). Controlling for the level of exercise, inverse correlations were observed for uric acid and glutathione reductase (GR) or susceptibility of red blood cells to peroxidation (RBCPx); plasma adrenaline oxidase activity (AdOx) and carotenoids; TBARS and GR or Vit E; and direct correlations were observed between AdOx and creatine kinase (CK) or TBARS; CK and superoxide dismutase activity; GR and RBCPx. Controlling for Mg intake in addition to exercise level revealed new inverse correlations: between carotenoids and TBARS or lactate, and new direct correlations between lactate and AdOx or TBARS; cortisol and AdOx, CK, lactate dehydrogenase, or methemoglobin reductase. The associations between uric acid and RBCPx; AdOx and CK or TBARS; and GR and RBCPx lost their significance. All others remained significant. These outcomes suggest that the coordination between antioxidant defences may be partially modulated by Mg, which may be the result of its ability to stabilize cell membranes and oxidation targets, such as adrenaline.

  20. Differentiating epileptic from non-epileptic high frequency intracerebral EEG signals with measures of wavelet entropy.

    Science.gov (United States)

    Mooij, Anne H; Frauscher, Birgit; Amiri, Mina; Otte, Willem M; Gotman, Jean

    2016-12-01

    To assess whether there is a difference in the background activity in the ripple band (80-200Hz) between epileptic and non-epileptic channels, and to assess whether this difference is sufficient for their reliable separation. We calculated mean and standard deviation of wavelet entropy in 303 non-epileptic and 334 epileptic channels from 50 patients with intracerebral depth electrodes and used these measures as predictors in a multivariable logistic regression model. We assessed sensitivity, positive predictive value (PPV) and negative predictive value (NPV) based on a probability threshold corresponding to 90% specificity. The probability of a channel being epileptic increased with higher mean (p=0.004) and particularly with higher standard deviation (pentropy is likely to be epileptic; with a threshold corresponding to 90% specificity our model can reliably select a subset of epileptic channels. Most studies have concentrated on brief ripple events. We showed that background activity in the ripple band also has some ability to discriminate epileptic channels. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  1. Cognitive Dysfunctions in Epileptic Syndromes

    Directory of Open Access Journals (Sweden)

    Semih Ayta

    2014-05-01

    Full Text Available Some children with epilepsy display a low level of intelligence, learning disabilities, attention deficit hyperactivity disorder, mood disorders and anxiety. Besides specific learning disabilities like reading, writing, arithmetics, learning problems may involve other major areas of intellectual functions such as speech and language, attention, memory, fine motor coordination. Even in the presence of common pathology that leads to epilepsy and mental dysfunctions, seizures cause additional cognitive problems. Age at seizure onset, type of seizures and epileptic syndromes are some variables that determine the effect of epilepsy on cognition. As recurrent seizures may have some negative impact on the developing brain, the use of antiepileptic drugs should be considered not only to aim reducing seizures but also to prevent possible seizure-induced cortical dysfunctions. Epilepsy is a disorder requiring a complicated psychological adjustment for the patients and indeed is a disease that affects the whole family. Thus, the management of epilepsy must include educational, psychotherapeutic and behavioral interventions as well as drug treatment.

  2. Clinical and electroencephalographic characteristics of some forms of epileptic encephalopathies in infants: The data of the authors' follow-up observations

    Directory of Open Access Journals (Sweden)

    I. D. Lemeshko

    2016-01-01

    Full Text Available Objective: to study clinical symptoms and brain activity in new forms of infantile epilepsy, such as malignant migrating partial seizures in infancy (MMPSI and Markand-Blume-Ohtahara syndrome (MBOS and to elaborate their differential diagnostic criteria for the timely choice of treatment policy and for the prediction of the disease.Patients and methods. Thirty-eight children aged 1.5 months to 3 years with MMPSI and MBOS were examined. Their medical history and neurological examination data, electroencephalographic and neuroimaging characteristics, and the efficiency of chosen anticonvulsant therapy were investigated.Results and discussion. The investigators revealed the following characteristics of these forms: the causes of these syndromes were highly diverse and unspecific; the neurological status was characterized by a variety of symptoms with an obvious delay in psycho-prespeech development concurrent with a high rate of partial focal (in MMPSI and generalized (in MBOS status epilepticus; The EEC characteristic sign was MISF and«lafa» patterns in the children with MBOS and continuous migrating partial ictal status epilepticus patterns in those with MMPSI. These forms of epileptic encephalopathies are extremely drug-resistant and characterized by a high risk for a fatal outcome.

  3. Predicting epileptic seizures in advance.

    Directory of Open Access Journals (Sweden)

    Negin Moghim

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

  4. Assessing quantitative EEG spectrograms to identify non-epileptic events.

    Science.gov (United States)

    Goenka, Ajay; Boro, Alexis; Yozawitz, Elissa

    2017-09-01

    To evaluate the sensitivity and specificity of quantitative EEG (QEEG) spectrograms in order to distinguish epileptic from non-epileptic events. Seventeen patients with paroxysmal non-epileptic events, captured during EEG monitoring, were retrospectively assessed using QEEG spectrograms. These patients were compared to a control group of 13 consecutive patients (ages 25-60 years) with epileptic seizures of similar semiology. Assessment of raw EEG was employed as the gold standard against which epileptic and non-epileptic events were validated. QEEG spectrograms, available using Persyst 12 EEG system integration software, were each assessed with respect to their usefulness to distinguish epileptic from non-epileptic seizures. The given spectrogram was interpreted as indicating a seizure if, at the time of the clinically identified event, it showed a visually significant change from baseline. Eighty-two clinically identified paroxysmal events were analysed (46 non-epileptic and 36 epileptic). The "seizure detector trend analysis" spectrogram correctly classified 33/46 (71%) non-epileptic events (no seizure indicated during a clinically identified event) vs. 29/36 (81%) epileptic seizures (seizure indicated during a clinically identified event) (p=0.013). Similarly, "rhythmicity spectrogram", FFT spectrogram, "asymmetry relative spectrogram", and integrated-amplitude EEG spectrogram detected 28/46 (61%), 30/46 (65%), 22/46 (48%) and 27/46 (59%) non-epileptic events vs. 27/36 (75%), 25/36 (69%), 25/36 (69%) and 27/36 (75%) epileptic events, respectively. High sensitivities and specificities for QEEG seizure detection analyses suggest that QEEG may have a role at the bedside to facilitate early differentiation between epileptic seizures and non-epileptic events in order to avoid unnecessary administration of antiepileptic drugs and possible iatrogenic consequences.

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

    African Journals Online (AJOL)

    Background: Complex partial seizure is an epileptic seizure which results in impairment of responsiveness or awareness such as altered level of consciousness. Complex partial seizures are often preceded by an aura such as depersonalization, feelings of de javu, jamais vu and fear. The ictal phase of complex partial ...

  6. Accelerometry based detection of epileptic seizures

    NARCIS (Netherlands)

    Nijsen, T.M.E.

    2008-01-01

    Epilepsy is one of the most common neurological disorders. Epileptic seizures are the manifestation of abnormal hypersynchronous discharges of cortical neurons that impair brain function. Most of the people affected can be treated successfully with drug therapy or neurosurgical procedures. But there

  7. Clinical Evaluation of Periodontal Tissue Status in Prosthodontic Treatment of Patients with Partial Tooth Loss and Generalized Periodontitis

    Directory of Open Access Journals (Sweden)

    A. Kushlyk

    2018-01-01

    Full Text Available The problem of selection and application of dental prostheses in periodontal disease is especially relevant in case of severe generalized periodontitis, which is accompanied by mobile tooth removal resulting in overloading the periodontium of the remaining teeth as well as the increase in tooth mobility. Therefore, in generalized periodontitis, it is important to apply the method of direct dental prosthetic rehabilitation since, in case of partial tooth loss, it will prevent the development of generalized periodontitis complications. The objective of the research was to improve the effectiveness of combination therapy for patients with generalized periodontitis and partial tooth loss applying the developed method of direct fixed dental prosthetic rehabilitation based on the study of the periodontal status. Materials and methods. The study included 129 patients with general periodontitis, II-III degree and partial tooth loss over the age of 45 years. According to prosthodontic treatment, all the patients were divided into three groups: Group I consisted of 42 (20 women and 22 men patients who immediately after tooth extraction were rehabilitated with the application of direct plastic laminar immediate prosthesis and selective tooth grinding; permanent dental prosthetic rehabilitation was performed 6 weeks after tooth extraction; Group II included 43 (21 women and 22 men patients who underwent traditional permanent dental prosthetic rehabilitation using fixed dental bridges 6 weeks after mobile tooth removal and wound healing; Group III comprised 44 (21 women and 23 men patients who immediately after mobile tooth removal were rehabilitated with the application of direct fixed sectional dental bridge (Ukrainian patent UA 20995. 2007 Feb 15 and selective tooth grinding; permanent dental prosthetic rehabilitation was performed 6 months after tooth extraction. The control group consisted of 26 people with intact dentitions over the age of 45 years

  8. Pharmacokinetic aspects of the anti-epileptic drug substance vigabatrin

    DEFF Research Database (Denmark)

    Nøhr, Martha Kampp; Frølund, Sidsel; Holm, René

    2014-01-01

    are discussed in detail. Special focus is on the contribution of the proton-coupled amino acid transporter 1 (PAT1) for intestinal vigabatrin absorption. Furthermore, the review gives an overview of the pharmacokinetic parameters of vigabatrin across different species and drug-food and drug-drug interactions......Drug transporters in various tissues, such as intestine, kidney, liver and brain, are recognized as important mediators of absorption, distribution, metabolism and excretion of drug substances. This review gives a current status on the transporter(s) mediating the absorption, distribution......, metabolism and excretion properties of the anti-epileptic drug substance vigabatrin. For orally administered drugs, like vigabatrin, the absorption from the intestine is a prerequisite for the bioavailability. Therefore, transporter(s) involved in the intestinal absorption of vigabatrin in vitro and in vivo...

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

    Directory of Open Access Journals (Sweden)

    Lydia Elshoff

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

  10. The persistence of erroneous familiarity in an epileptic male : Challenging perceptual theories of déjà vu activation

    OpenAIRE

    O'Connor, Akira Robert; Moulin, Christopher J. A.

    2008-01-01

    We report the case of a 39-year-old, temporal lobe epileptic male, MH. Prior to complex partial seizure, experienced up to three times a day, MH often experiences an aura experienced as a persistent sensation of deja vu. Data-driven theories of deja vu formation suggest that partial familiarity for the perceived stimulus is responsible for the sensation. Consequently, diverting attention away from this stimulus should cause the sensation to dissipate. MH, whose sensations of deja vu persist l...

  11. Limited efficacy of the ketogenic diet in the treatment of highly refractory epileptic spasms.

    Science.gov (United States)

    Hussain, Shaun A; Shin, Ji Hyun; Shih, Evan J; Murata, Kristina K; Sewak, Sarika; Kezele, Michele E; Sankar, Raman; Matsumoto, Joyce H

    2016-02-01

    Numerous studies have suggested that the ketogenic diet is effective in the treatment of epileptic spasms, even in refractory cases. However, there has been very limited demonstration of prompt and complete (video-EEG confirmed) response. We set out to describe our center's experience with the ketogenic diet in the treatment of children with highly refractory epileptic spasms, with rigorous seizure outcome assessment. Children treated with the ketogenic diet for epileptic spasms between April, 2010 and June, 2014 were retrospectively identified. Seizure burden was tabulated at baseline and after 1, 3, 6, and 12-months of ketogenic diet exposure. Adverse events were similarly ascertained. We identified a cohort of 22 consecutive patients who received ketogenic diet therapy, with median age of onset of epileptic spasms of 5.2 (IQR 2.0-9.0) months, with diet initiation beginning a median of 26.4 (12.5-38.7) months after onset, and following a median of 7 (IQR 5-7) treatment failures. Only 2 patients exhibited a complete response during ketogenic diet exposure, and response was more reasonably attributed to alternative therapies in both cases. A modest early reduction in seizure frequency was not sustained beyond 1 month of diet exposure. The diet was well tolerated, and continued in 6 patients with subjective and/or partial response. In contrast to prior studies reporting substantial efficacy of the ketogenic diet, our findings suggest limited efficacy, albeit in a highly refractory cohort. Prospective studies in both refractory and new-onset populations, with both video-EEG confirmation of response and rigorous cognitive outcome assessment, would be of great value to more clearly define the utility of the ketogenic diet in the treatment of epileptic spasms. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  12. Biomarkers of epileptic seizures and epilepsy

    Directory of Open Access Journals (Sweden)

    Bogdan Lorber

    2013-07-01

    Full Text Available The purpose of this article is to review biological markers, their importance and usefulness in the diagnosis of epileptic seizure or epilepsy. Assessed are also their prognostic value, their use in the evaluation of antiepileptic therapy effect and some other useful properties. The article reviews prolactin, neuron specific enolase, S–100 protein, creatin kinase, laminin, matrix metalloproteinase, nesfatin–1, ghrelin, obestatin and chromogranin A. The authors stress the need for further research studies in this area.

  13. Consciousness in non-epileptic attack disorder.

    Science.gov (United States)

    Reuber, Markus; Kurthen, M

    2011-01-01

    Non-epileptic attack disorder (NEAD) is one of the most important differential diagnoses of epilepsy. Impairment of consciousness is the key feature of non-epileptic attacks (NEAs). The first half of this review summarises the clinical research literature featuring observations relating to consciousness in NEAD. The second half places this evidence in the wider context of the recent discourse on consciousness in neuroscience and the philosophy of mind. We argue that studies of consciousness should not only distinguish between the 'level' and `content' of consciousness but also between 'phenomenal consciousness' (consciousness of states it somehow "feels to be like") and 'access consciousness' (having certain 'higher' cognitive processes at one's disposal). The existing evidence shows that there is a great intra- and interindividual variability of NEA experience. However, in most NEAs phenomenal experience - and, as a precondition for that experience, vigilance or wakefulness - is reduced to a lesser degree than in those epileptic seizures involving impairment of consciousness. In fact, complete loss of "consciousness" is the exception rather than the rule in NEAs. Patients, as well as external observers, may have a tendency to overestimate impairments of consciousness during the seizures.

  14. Behavioral Problems in Iranian Epileptic Children; A Case Control Study

    Directory of Open Access Journals (Sweden)

    Maryam Aludari

    2017-12-01

    Full Text Available Background Epilepsy is among the most common neurological disorders in childhood, prevalence of which is increasing. Unpredictable and chronic nature of the disease affects physical, social and mental functions of the children and their family. This study was aimed to compare behavioral problems in epileptic children group versus healthy control group. Materials and Methods This study is a case-control one conducted from January 2013 to June 2016 in Tehran, Iran. The epileptic children in age of 7-10 years old that were diagnosed by neurologist referred to the researcher for further process. Their parents were provided with Child Behavior Checklist (CBCL to be completed. For matching by age and gender, the healthy group was sampled after the epilepsy group. Multivariate Analysis of Variance was used for statistical analysis. Results In this study 94 children with epilepsy and 83 healthy children in age of 7-10 years old were studied. The results indicated that there were significantly higher behavioral problems in the children with epilepsy than in control group in nine categories of seclusiveness, physical complaints, anxiety and depression, social problems, thought problems, attention problems, delinquent behaviors, aggressive behaviors, and other problems. Comparison of two generalized and partial epilepsy groups indicated that there was a significant difference only in attention problems (p = 0.024. Conclusion The present study indicates that the children with epilepsy have more behavioral problems as compared to control group. Therefore, educational and psychological interventions are necessary for supporting desirable psychosocial growth and development of such children.

  15. Epileptic seizures in patients with a posterior circulation infarct

    Directory of Open Access Journals (Sweden)

    Yüksel Kaplan

    2014-08-01

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

  16. Preoperative localization of epileptic foci with SPECT brain perfusion imaging, electrocorticography, surgery and pathology

    International Nuclear Information System (INIS)

    Jia Shaowei; Xu Wengui; Chen Hongyan; Weng Yongmei; Yang Pinghua

    2002-01-01

    Objective: The value of preoperative localization of epileptic foci with SPECT brain perfusion imaging was investigated. Methods: The study population consisted of 23 patients with intractable partial seizures which was difficult to control with anticonvulsant for long period. In order to preoperatively locate the epileptic foci, double SPECT brain perfusion imaging was performed during interictal and ictal stage. The foci were confirmed with electrocorticography (EcoG), surgery and pathology. Results: The author checked with EcoG the foci shown by SPECT, 23 patients had all typical spike discharge. The regions of radioactivity increase in ictal matched with the abnormal electrical activity areas that EcoG showed. The spike wave originated in the corresponding cerebrum cortex instead of hyperplastic and adherent arachnoid or tumor itself. Conclusions: SPECT brain perfusion imaging contributes to distinguishing location, size, perfusion and functioning of epileptogenic foci, and has some directive function on to making out a treatment programme at preoperation

  17. Autism spectrum disorder and epileptic encephalopathy: common causes, many questions.

    Science.gov (United States)

    Srivastava, Siddharth; Sahin, Mustafa

    2017-01-01

    Epileptic encephalopathies represent a particularly severe form of epilepsy, associated with cognitive and behavioral deficits, including impaired social-communication and restricted, repetitive behaviors that are the hallmarks of autism spectrum disorder (ASD). With the advent of next-generation sequencing, the genetic landscape of epileptic encephalopathies is growing and demonstrates overlap with genes separately implicated in ASD. However, many questions remain about this connection, including whether epileptiform activity itself contributes to the development of ASD symptomatology. In this review, we compiled a database of genes associated with both epileptic encephalopathy and ASD, limiting our purview to Mendelian disorders not including inborn errors of metabolism, and we focused on the connection between ASD and epileptic encephalopathy rather than epilepsy broadly. Our review has four goals: to (1) discuss the overlapping presentations of ASD and monogenic epileptic encephalopathies; (2) examine the impact of the epilepsy itself on neurocognitive features, including ASD, in monogenic epileptic encephalopathies; (3) outline many of the genetic causes responsible for both ASD and epileptic encephalopathy; (4) provide an illustrative example of a final common pathway that may be implicated in both ASD and epileptic encephalopathy. We demonstrate that autistic features are a common association with monogenic epileptic encephalopathies. Certain epileptic encephalopathy syndromes, like infantile spasms, are especially linked to the development of ASD. The connection between seizures themselves and neurobehavioral deficits in these monogenic encephalopathies remains open to debate. Finally, advances in genetics have revealed many genes that overlap in ties to both ASD and epileptic encephalopathy and that play a role in diverse central nervous system processes. Increased attention to the autistic features of monogenic epileptic encephalopathies is warranted for

  18. Evaluation of the pentylenetetrazole seizure threshold test in epileptic mice as surrogate model for drug testing against pharmacoresistant seizures.

    Science.gov (United States)

    Töllner, Kathrin; Twele, Friederike; Löscher, Wolfgang

    2016-04-01

    Resistance to antiepileptic drugs (AEDs) is a major problem in epilepsy therapy, so that development of more effective AEDs is an unmet clinical need. Several rat and mouse models of epilepsy with spontaneous difficult-to-treat seizures exist, but because testing of antiseizure drug efficacy is extremely laborious in such models, they are only rarely used in the development of novel AEDs. Recently, the use of acute seizure tests in epileptic rats or mice has been proposed as a novel strategy for evaluating novel AEDs for increased antiseizure efficacy. In the present study, we compared the effects of five AEDs (valproate, phenobarbital, diazepam, lamotrigine, levetiracetam) on the pentylenetetrazole (PTZ) seizure threshold in mice that were made epileptic by pilocarpine. Experiments were started 6 weeks after a pilocarpine-induced status epilepticus. At this time, control seizure threshold was significantly lower in epileptic than in nonepileptic animals. Unexpectedly, only one AED (valproate) was less effective to increase seizure threshold in epileptic vs. nonepileptic mice, and this difference was restricted to doses of 200 and 300 mg/kg, whereas the difference disappeared at 400mg/kg. All other AEDs exerted similar seizure threshold increases in epileptic and nonepileptic mice. Thus, induction of acute seizures with PTZ in mice pretreated with pilocarpine does not provide an effective and valuable surrogate method to screen drugs for antiseizure efficacy in a model of difficult-to-treat chronic epilepsy as previously suggested from experiments with this approach in rats. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Epileptic seizures precipited by eating: a case report

    Directory of Open Access Journals (Sweden)

    Fernando Carlos Aleixo Sepulveda

    1981-03-01

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

  20. [Subacute encephalopathy with epileptic seizures in an alcoholic patient].

    Science.gov (United States)

    Kozian, R; Otto, F G

    2000-09-01

    We introduce a case of a 66 year-old male with chronic alcoholism who suffered from confusion, Wernicke-aphasia and epileptic seizures. Several EEG revealed periodic lateralized epileptiform discharges. The patient's case resembles the symptoms of a subacute encephalopathy with epileptic seizures which can occur in alcoholics.

  1. Temporal epileptic seizures and occupational exposure to solvents

    DEFF Research Database (Denmark)

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

    1994-01-01

    Long term exposure to organic solvents is usually not considered as a possible cause of chronic epileptic seizures. A case that shows a remarkable coincidence between exposure to organic solvents and occurrence of epileptic seizures is reported. The man was a 58 year old sign writer with lifelong...

  2. Clinical Presentation of Epilepsy among Adult Sudanese Epileptic ...

    African Journals Online (AJOL)

    Objective: To study the pattern of clinical presentation of epilepsy among adult Sudanese epileptic patients. Methods: 120 patients with epilepsy were included in a prospective cross-sectional study. Setting: The study was conducted at Sheik Mohamed Kheir Friday Epileptic Clinic .Duration: May 2003 Oct 2006. Results: ...

  3. Efficacy of sodium channel blockers in SCN2A early infantile epileptic encephalopathy.

    Science.gov (United States)

    Dilena, Robertino; Striano, Pasquale; Gennaro, Elena; Bassi, Laura; Olivotto, Sara; Tadini, Laura; Mosca, Fabio; Barbieri, Sergio; Zara, Federico; Fumagalli, Monica

    2017-04-01

    Recent clinical evidence supports a targeted therapeutic approach for genetic epileptic encephalopathies based on the molecular dysfunction. A 2-day-old male infant presented with epileptic encephalopathy characterized by burst-suppression EEG background and tonic-clonic migrating partial seizures. The condition was refractory to phenobarbital, pyridoxine, pyridoxal phosphate and levetiracetam, but a dramatic response to an intravenous loading dose of phenytoin was documented by video-EEG monitoring. Over weeks phenytoin was successfully switched to carbamazepine to prevent seizure relapses associated with difficulty in maintaining proper blood levels of phenytoin. Genetic analysis identified a novel de novo heterozygous mutation (c.[4633A>G]p.[Met1545Val]) in SCN2A. At two years and three months of age the patient is still seizure-free on carbamazepine, although a developmental delay is evident. Sodium channel blockers represent the first-line treatment for confirmed or suspected SCN2A-related epileptic encephalopathies. In severe cases with compatible electro-clinical features we propose a treatment algorithm based on a test trial with high dose intravenous phenytoin followed in case of a positive response by carbamazepine, more suitable for long-term maintenance treatment. Because of their rarity, collaborative studies are needed to delineate shared therapeutic protocols for EIEE based on the electro-clinical features and the presumed underlying genetic substrate. Copyright © 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  4. Electrical stimulation of the epileptic focus in absence epileptic WAG/RIJ rats: assessment of local and network excitability

    NARCIS (Netherlands)

    Luttjohann, A.K.; Zhang, S.W.; Peijper, R.A.G. de; Luijtelaar, E.L.J.M. van

    2011-01-01

    [Objective] The study aims to investigate whether there is a higher excitability in the deep cortical layers of the pen-oral region of the somatosensory cortex as compared to other cortical regions in absence epileptic WAG/Rij rats and whether this is unique for this type of epileptic rats, as would

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

    Science.gov (United States)

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

    2015-03-01

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

  6. Neo-Timm staining in the thalamus of chronically epileptic rats

    Directory of Open Access Journals (Sweden)

    Hamani C.

    2005-01-01

    Full Text Available The thalamus is an important modulator of seizures and is severely affected in cholinergic models of epilepsy. In the present study, chronically epileptic rats had their brains processed for neo-Timm and acetylcholinesterase two months after the induction of status epilepticus with pilocarpine. Both controls and pilocarpine-treated animals presented neo-Timm staining in the anterodorsal nucleus, laterodorsal nucleus, reticular nucleus, most intralaminar nuclei, nucleus reuniens, and rhomboid nucleus of the thalamus, as well as in the zona incerta. The intensity of neo-Timm staining was similar in control and pilocarpine-treated rats, except for the nucleus reuniens and the rhomboid nucleus, which had a lower intensity of staining in the epileptic group. In animal models of temporal lobe epilepsy, zinc seems to modulate glutamate release and to decrease seizure activity. In this context, a reduction of neo-Timm-stained terminals in the midline thalamus could ultimately result in an increased excitatory activity, not only within its related nuclei, but also in anatomical structures that receive their efferent connections. This might contribute to the pathological substrate observed in chronic pilocarpine-treated epileptic animals.

  7. Focal epileptic seizures with secondary generalization in cortical atrophy and gliosis dysplasia in the left temporal lobe and hemimegalencephaly in the left occipital lobe

    International Nuclear Information System (INIS)

    Manchev, I.; Mancheva-Ganeva, V.; Manolova, T.; Manchev, L.

    2016-01-01

    It is a case of an eight-year-old patient with cortical dysplasia and gliosis in the left temporal lobe clinically manifested with focal epileptic seizures with secondary generalization. Signs of mental retardation and a number of somatic complications - diabetes, etc., were found. The complex therapy with anticonvulsant medications, immunovenin, plasmaphoresis and anti-diabetic drugs was partially effective

  8. Studies on glucose metabolism and blood perfusion in childhood partial seizure by positron emission CT

    International Nuclear Information System (INIS)

    Michihiro, Narumi

    1986-01-01

    To investigate the glucose metabolism and blood perfusion of the interictal epileptic focus, 15 positron emission tomography (PET) measurements were performed in 14 children with partial seizures (2 with simple partial seizures, 2 with complex partial seizures, and 10 with partial seizures evolving to secondary generalized seizures), comprising 7 males and 7 females aged 1 to 12 years old at the onset of the epileptic seizures. The intervals between the seizure onset and PET examinations were 1 month to 7 years (mean 3 1/4 years). Radiopharmaceuticals such as 11 C-glucose, 11 CO 2 and 11 CO were used as indicators of local cerebral glucose metabolism, blood perfusion and blood flow, respectively. Apart from 2 cases, none of the patients showed abnormal x-ray computed tomographic scans (X-CT). The abnormal X-CT findings included cortical atrophy of the cerebrum apart from the epiletic focus in one case and cavum vergae in the other. Hypometabolism and hypoperfusion at the epileptic focus were observed in 10 patients undergoing single examinations who had suffered from epileptic seizures for more than 1 year. Out of 4 patients who had suffered from epileptic seizures for 1 year or less, one revealed a zone of hypometabolism and hypoperfusion in the epileptic focus and expanded region larger than that of the epileptic focus on the electroencephalogram. Two other patients revealed a zone of hypometabolism and hypoperfusion in an area contralateral to the epileptic focus. In the remaining one patient, PET examinations were performed twice. The initial PET pictures one year after seizure onset revealed a zone of hypermetabolism and hyperperfusion in the cerebellum ipsilateral to the epileptic focus, and the second PET at 6 months after the initial examination revealed hypometabolism and hypoperfusion in the focus, similarly to the 10 cases mentioned above. (J.P.N.)

  9. Epileptic peri-ictal psychosis, a reversible cause of psychosis.

    Science.gov (United States)

    González Mingot, C; Gil Villar, M P; Calvo Medel, D; Corbalán Sevilla, T; Martínez Martínez, L; Iñiguez Martínez, C; Santos Lasaosa, S; Mauri Llerda, J A

    2013-03-01

    Epileptic psychoses are categorised as peri-ictal and interictal according to their relationship with the occurrence of seizures. There is a close temporal relationship between peri-ictal psychosis and seizures, and psychosis may present before (preictal), during (ictal) or after seizures (postictal). Epileptic psychoses usually have acute initial and final phases, with a short symptom duration and complete remission with a risk of recurrence. There is no temporal relationship between interictal or chronic psychosis and epileptic seizures. Another type of epileptic psychosis is related to the response to epilepsy treatment: epileptic psychosis caused by the phenomenon of forced normalisation (alternative psychosis), which includes epileptic psychosis secondary to epilepsy surgery. Although combination treatment with antiepileptic and neuroleptic drugs is now widely used to manage this condition, there are no standard treatment guidelines for epileptic psychosis. We present 5 cases of peri-ictal epileptic psychosis in which we observed an excellent response to treatment with levetiracetam. Good control was achieved over both seizures and psychotic episodes. Levetiracetam was used in association with neuroleptic drugs with no adverse effects, and our patients did not require high doses of the latter. Categorising psychotic states associated with epilepsy according to their temporal relationship with seizures is clinically and prognostically useful because it provides important information regarding disease treatment and progression. The treatment of peri-ictal or acute mental disorders is based on epileptic seizure control, while the treatment of interictal or chronic disorders has more in common with managing disorders which are purely psychiatric in origin. In addition to improving the patient's quality of life and reducing disability, achieving strict control over seizures may also prevent the development of interictal psychosis. For this reason, we believe that

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

    Directory of Open Access Journals (Sweden)

    K. Yu. Mukhin

    2017-01-01

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

  11. Epileptic Seizure Forewarning by Nonlinear Techniques

    International Nuclear Information System (INIS)

    Hively, L.M.

    2001-01-01

    Nicolet Biomedical Inc. (NBI) is collaborating with Oak Ridge National Laboratory (ORNL) under a Cooperative Research and Development Agreement (CRADA) to convert ORNL's patented technology for forewarning of epileptic seizures to a clinical prototype. This technical report describes the highlights of the first year's effort. The software requirements for the clinical device were specified from which the hardware specifications were obtained. ORNL's research-class FORTRAN was converted to run under a graphical user interface (GUI) that was custom-built for this application by NBI. The resulting software package was cloned to desktop computers that are being tested in five different clinical sites. Two hundred electroencephalogram (EEG) datasets from those clinical sites were provided to ORNL for detailed analysis and improvement of the forewarning methodology. Effort under this CRADA is continuing into the second year as planned

  12. Parental anxiety and quality of life of epileptic children.

    Science.gov (United States)

    Li, Yong; Ji, Cheng-Ye; Qin, Jiong; Zhang, Zhi-Xiang

    2008-06-01

    To investigate the prevalence of parental anxiety associated with epileptic children, and to explore whether and how this specific condition affects children's quality of life (QOL), and what are the significant determinants for parental anxiety. Three hundred and forty parents whose children were affected with known epilepsy were enrolled in the study. Questionnaires for quality of life in childhood epilepsy (QOLCE), and hospital anxiety and depression (HAD) of parents were used to collect demographic data of both children and their parents, as well as clinical manifestations of epilepsy and family status. Parental anxiety (of any severity) was observed in 191 subjects at interview, giving a prevalence rate of 56.2%. Of the 191 subjects, 18.5% reported mild anxiety, 24.4% moderate anxiety, and 13.2% severe anxiety. Factors associated with parental anxiety included frequency of seizure in children, average monthly income per person and parents' knowledge about epilepsy (P < 0.05). Parental anxiety significantly (P = 0.000) correlated with quality of life of children with epilepsy. Parents of children with epilepsy are at high risk of having anxiety. Factors associated with parental anxiety originate both from children and from parents. Parental anxiety is significantly related with children's QOL. It is important for experts concerned to recognize such a relationship to improve the QOL of children and their parents.

  13. Continuous partial status cause of hyperintensity in cerebral cortex in magnetic resonance imaging; Estatus parcial continuo, causa de hiperintensidad de la corteza cerebral en la resonancia nuclear magnetica

    Energy Technology Data Exchange (ETDEWEB)

    Lopez L, Ingeborg; Gonzalez L, Daniela [Departamento de Ciencias Neurologicas Oriente. Facultad de Medicina, Universidad de Chile, Santiago (Chile); Quezada R, Patricio [Servicio de Neurologia, Hospital Salvador, Santiago (Chile); Cartier R, Luis [Departamento de Ciencias Neurologicas Oriente. Facultad de Medicina, Universidad de Chile, Santiago (Chile)

    2012-07-01

    Magnetic Resonance Imaging has demonstrated functional changes of the cerebral cortex in relation to status epilepticus, which can eventually localize the origin of the crisis. The purpose of this presentation is relevant to this condition and pretends to highlight the action of incidental situations that can modify it. We present a 29 year old woman with a neurosurgical intervention for a neuroblastoma irradiated fifteen years ago, which incidentally starts a continuous partial status epilepticus, expressed by clonies of the face and left limbs associated with functional impotence, resistant to oral therapy. Faced with the suspicion of recurrence of the tumor, a brain MRI is performed, showing hyperintensity of all neural areas the right hemisphere, with no evidence of tumor recurrence. Once submitted the status epilepticus, the hyperintensity disappeared in the hemisphere. This extensive reaction of the neural structures might be related to a permanent effect of radiation, which may have caused a mismatch functional glia, of the blood-brain barrier and interneural network.

  14. Knowledge about epilepsy among teachers and epileptic patients

    Directory of Open Access Journals (Sweden)

    Maria F. Valls Tosetti

    1991-09-01

    Full Text Available 223 epileptics patients and their families and 136 teachers from public and private schools were submitted to similar questionnaires related to inheritance, transmission, cure, complilcation rates, care during seizures, need for information on the disease, habits, comparison with other diseases and to the educational and social performances of epileptics. Cure and complication nates accounted for the main differences between those populations. Epileptics could recognize a bigger number of complications but still expected to be cured from the disease. The majority of teachers and patients have never been informed about epilepsy and this finding was related to the big number of equivocal answers obtained from them. Put together, the data showed that social and educational performance of epileptic patients could be disturbed by medical and social parameters. Some, of them could be improved by an educational program towards these aspects of epilepsy.

  15. ‘Transient epileptic amnesia’ : een caus en loteratuuroverzicht

    NARCIS (Netherlands)

    Thissen, S.; Vlooswijk, Marielle; Hendriks, M.P.H.; Majoie, Marian

    ‘Transient epileptic amnesia’ (TEA) wordt gezien als een weinig voorkomende vorm van temporaalkwabepilepsie, gekarakteriseerd door aanvallen van specifieke amnesie door epileptische activiteit (ictaalof postictaal). TEA treft voornamelijk mannen bovende 40 jaar. Aanvallen duren korter dan 60 minuten

  16. EPILEPTIC ENCEPHALOPATHY WITH CONTINUOUS SPIKES-WAVES ACTIVITY DURING SLEEP

    Directory of Open Access Journals (Sweden)

    E. D. Belousova

    2012-01-01

    Full Text Available The author represents the review and discussion of current scientific literature devoted to epileptic encephalopathy with continuous spikes-waves activity during sleep — the special form of partly reversible age-dependent epileptic encephalopathy, characterized by triad of symptoms: continuous prolonged epileptiform (spike-wave activity on EEG in sleep, epileptic seizures and cognitive disorders. The author describes the aspects of classification, pathogenesis and etiology, prevalence, clinical picture and diagnostics of this disorder, including the peculiar anomalies on EEG. The especial attention is given to approaches to the treatment of epileptic encephalopathy with continuous spikeswaves activity during sleep. Efficacy of valproates, corticosteroid hormones and antiepileptic drugs of other groups is considered. The author represents own experience of treatment this disorder with corticosteroids, scheme of therapy and assessment of efficacy.

  17. Effect Of Cognitive Stimulation On Hippocampal Ripples In Epileptic Patients

    Czech Academy of Sciences Publication Activity Database

    Brázdil, M.; Cimbálník, J.; Roman, R.; Stead, M.; Daniel, P.; Halámek, Josef; Jurák, Pavel

    2013-01-01

    Roč. 54, S3 (2013), s. 268-268 ISSN 0013-9580. [International Epilepsy Congress /30./. 23.06.2013-27.06.2013, Montreal] Institutional support: RVO:68081731 Keywords : Cognitive Stimulation * Epileptic Patients Subject RIV: FH - Neurology

  18. Genetics Home Reference: early infantile epileptic encephalopathy 1

    Science.gov (United States)

    ... Early infantile epileptic encephalopathy 1 (EIEE1) is a seizure disorder characterized by a type of seizure known as ... 2 links) Health Topic: Developmental Disabilities Health Topic: Epilepsy Genetic and Rare Diseases Information Center (1 link) ...

  19. MICROARRAY PROFILE OF SEIZURE DAMAGE-REFRACTORY HIPPOCAMPAL CA3 IN A MOUSE MODEL OF EPILEPTIC PRECONDITIONING

    OpenAIRE

    HATAZAKI, S.; BELLVER-ESTELLES, C.; JIMENEZ-MATEOS, E. M.; MELLER, R.; BONNER, C.; MURPHY, N.; MATSUSHIMA, S.; TAKI, W.; PREHN, J. H. M.; SIMON, R. P.; HENSHALL, D. C.

    2007-01-01

    A neuroprotected state can be acquired by preconditioning brain with a stimulus that is subthreshold for damage (tolerance). Acquisition of tolerance involves coordinate, bi-directional changes to gene expression levels and the re-programmed phenotype is determined by the preconditioning stimulus. While best studied in ischemic brain there is evidence brief seizures can confer tolerance against prolonged seizures (status epilepticus). Presently, we developed a model of epileptic preconditioni...

  20. Cortical GABAergic excitation contributes to epileptic activities around human glioma

    Science.gov (United States)

    Pallud, Johan; Varlet, Pascale; Cresto, Noemie; Baulac, Michel; Duyckaerts, Charles; Kourdougli, Nazim; Chazal, Geneviève; Devaux, Bertrand; Rivera, Claudio; Miles, Richard; Capelle, Laurent; Huberfeld, Gilles

    2015-01-01

    Rationale Diffuse brain gliomas induce seizures in a majority of patients. As in most epileptic disorders, excitatory glutamatergic mechanisms are involved in the generation of epileptic activities in the neocortex surrounding gliomas. However, chloride homeostasis is known to be perturbed in glial tumor cells. Thus the contribution of GABAergic mechanisms which depend on intracellular chloride and which are defective or pro-epileptic in other structural epilepsies merits closer study. Objective We studied in neocortical slices from the peritumoral security margin resected around human brain gliomas, the occurrence, networks, cells and signaling basis of epileptic activities. Results Postoperative glioma tissue from 69% of patients spontaneously generated interictal-like discharges. These events were synchronized, with a high frequency oscillation signature, in superficial layers of neocortex around glioma areas with tumor infiltration. Interictal-like events depended on both glutamatergic transmission and on depolarizing GABAergic signaling. About 65% of pyramidal cells were depolarized by GABA released by interneurons. This effect was related to perturbations in Chloride homeostasis, due to changes in expression of chloride co-transporters: KCC2 was reduced and expression of NKCC1 increased. Ictal-like activities were initiated by convulsant stimuli exclusively in these epileptogenic areas. Conclusions Epileptic activities are sustained by excitatory effects of GABA in the peritumoral human neocortex, as in temporal lobe epilepsies. Glutamate and GABA signaling are involved in oncogenesis and chloride homeostasis is perturbed. These same factors, induce an imbalance between synaptic excitatory and inhibition underly epileptic discharges in tumor patients. PMID:25009229

  1. The effects of partial replacement of soybean meal by xylose-treated soybean meal in the starter concentrate on performance, health status, and blood metabolites of Holstein calves

    Directory of Open Access Journals (Sweden)

    Mehdi Kazemi-Bonchenari

    2015-04-01

    Full Text Available The objective was to study the effects of partial replacement of soybean meal (SBM with xylose-treated SBM (XSBM as a source of rumen undegradable protein (RUP in the starter concentrate of calves on performance, health status and selected blood metabolites. Twenty-one female Holstein dairy calves (body weight=39.6±2.3 kg were randomly assigned to 3 groups (n=7 each: i starter concentrate with 25% SBM [control (CTR]; ii starter concentrate with 17.5% SBM +7.5% XSBM (7.5XSBM; and iii starter concentrate with 12.5% SBM+12.5% XSBM (12.5XSBM. Calves received 2 L of milk twice daily, with ad libitum access to starter concentrates from d 4 until weaning (d 56. Performance and health status were recorded throughout the experiment. Blood samples collected on d 4, 35 and 56 were assayed for concentrations of glucose, total protein (TP, and plasma urea nitrogen (PUN. Starter intake (560, 400, and 420 g/d for CTR, 7.5XSBM, and 12.5XSBM, respectively, average daily gain (0.67, 0.6 and 0.57 kg/d, and feed to gain ratio (0.83, 0.67, and 0.74 were affected by treatments (P<0.05. Hearth girth, height at withers, body length, rectal temperature, faecal score, and respiratory score did not differ among treatments. Mean plasma glucose and TP were not affected by treatments, whereas PUN in the 12.5XSBM group was lower than in the other groups (P<0.05. In conclusion, the present results showed that partial replacement of SBM by XSBM may improve efficiency of dietary protein utilisation in pre-weaned calves, which warrants further studies.

  2. Association of macrophage inhibitory cytokine-1 with nutritional status, body composition and bone mineral density in patients with anorexia nervosa: the influence of partial realimentation.

    Science.gov (United States)

    Dostálová, Ivana; Kaválková, Petra; Papežová, Hana; Domluvilová, Daniela; Zikán, Vít; Haluzík, Martin

    2010-04-23

    Macrophage inhibitory cytokine-1 (MIC-1) is a key inducer of cancer-related anorexia and weight loss. However, its possible role in the etiopathogenesis of nutritional disorders of other etiology such as anorexia nervosa (AN) is currently unknown. We measured fasting serum concentrations of MIC-1 in patients with AN before and after 2-month nutritional treatment and explored its relationship with nutritional status, metabolic and biochemical parameters. Sixteen previously untreated women with AN and twenty-five normal-weight age-matched control women participated in the study. We measured serum concentrations of MIC-1 and leptin by ELISA, free fatty acids by enzymatic colorimetric assay, and biochemical parameters by standard laboratory methods; determined resting energy expenditure by indirect calorimetry; and assessed bone mineral density and body fat content by dual-energy X-ray absorptiometry. ANOVA, unpaired t-test or Mann-Whitney test were used for groups comparison as appropriate. The comparisons of serum MIC-1 levels and other studied parameters in patients with AN before and after partial realimentation were assessed by paired t-test or Wilcoxon Signed Rank Test as appropriate. At baseline, fasting serum MIC-1 concentrations were significantly higher in patients with AN relative to controls. Partial realimentation significantly reduced serum MIC-1 concentrations in patients with AN but it still remained significantly higher compared to control group. In AN group, serum MIC-1 was inversely related to Buzby nutritional risk index, serum insulin-like growth factor-1, serum glucose, serum total protein, serum albumin, and lumbar bone mineral density and it significantly positively correlated with the duration of AN and age. MIC-1 concentrations in AN patients are significantly higher relative to healthy women. Partial realimentation significantly decreased MIC-1 concentration in AN group. Clinical significance of these findings needs to be further clarified.

  3. Association of macrophage inhibitory cytokine-1 with nutritional status, body composition and bone mineral density in patients with anorexia nervosa: the influence of partial realimentation

    Directory of Open Access Journals (Sweden)

    Zikán Vít

    2010-04-01

    Full Text Available Abstract Background Macrophage inhibitory cytokine-1 (MIC-1 is a key inducer of cancer-related anorexia and weight loss. However, its possible role in the etiopathogenesis of nutritional disorders of other etiology such as anorexia nervosa (AN is currently unknown. Methods We measured fasting serum concentrations of MIC-1 in patients with AN before and after 2-month nutritional treatment and explored its relationship with nutritional status, metabolic and biochemical parameters. Sixteen previously untreated women with AN and twenty-five normal-weight age-matched control women participated in the study. We measured serum concentrations of MIC-1 and leptin by ELISA, free fatty acids by enzymatic colorimetric assay, and biochemical parameters by standard laboratory methods; determined resting energy expenditure by indirect calorimetry; and assessed bone mineral density and body fat content by dual-energy X-ray absorptiometry. ANOVA, unpaired t-test or Mann-Whitney test were used for groups comparison as appropriate. The comparisons of serum MIC-1 levels and other studied parameters in patients with AN before and after partial realimentation were assessed by paired t-test or Wilcoxon Signed Rank Test as appropriate. Results At baseline, fasting serum MIC-1 concentrations were significantly higher in patients with AN relative to controls. Partial realimentation significantly reduced serum MIC-1 concentrations in patients with AN but it still remained significantly higher compared to control group. In AN group, serum MIC-1 was inversely related to Buzby nutritional risk index, serum insulin-like growth factor-1, serum glucose, serum total protein, serum albumin, and lumbar bone mineral density and it significantly positively correlated with the duration of AN and age. Conclusions MIC-1 concentrations in AN patients are significantly higher relative to healthy women. Partial realimentation significantly decreased MIC-1 concentration in AN group

  4. Knowledge and attitude of epilepsy among secondary schools students (epileptic and non-epileptic) in Assiut city Egypt.

    Science.gov (United States)

    Shehata, Ghaydaa A; Mahran, Dalia G

    2011-06-01

    This study was designed to assess knowledge and attitude with respect to epilepsy among secondary school students (epileptic and none) in Assiut city, Egypt. A cross sectional study was applied among secondary school students in Assiut city, Egypt. A 13-item questionnaire was self administered by 2226 students who selected randomly. All students either epileptic or non-epileptic had been heard about epilepsy. Only 7.1% of epileptic students and 8.5% of non-epileptic students thought that the epilepsy is a brain disease. Out of 2198 non-epileptic students, 28.4% thought that person with epilepsy (PWE) should not marry and 92% of them refused to marry from PWE. The correct knowledge of epilepsy was significantly positive correlated with positive attitude towards PWE. However, students still feel persons with epilepsy are stigmatized and are different from others. Secondary school students in Egypt have a vague knowledge about the etiology of epilepsy. Misconceptions about and negative attitudes towards epilepsy are unexpectedly high among those students. Copyright © 2011 Elsevier B.V. All rights reserved.

  5. Epileptic seizures due to multiple cerebral cavernomatosis

    Directory of Open Access Journals (Sweden)

    Spasić Mirjana

    2007-01-01

    Full Text Available Background. Cavernous angiomas are angiographically occult vascular malformations that are present in 0.4−0.9 % of people, and represent around 5% of all cerebrovascular malformations. They can be single or multiple, and sporadic or familial. The presence of multiple lesions is more frequent in familial cavernomatosis. Ten to 30 % are associated with familial clustering. Case report. We presented the case of a 43-year-old man, admitted to the Emergency Department due to unprovoked seizure during the wide awake and everyday activities. Neurological examination was with no focal signs. A 32-channel standard digital EEG was without any significant changes of normal baseline activity. After sleep deprivation EEG showed multifocal, bilateral and asymmetric polyspikes and sharpwaves activity. Hyperventilation induced generalized epileptiform discharges. MRI scan demonstrated multiple small cavernous angiomas. Neuropsychological testing demonstrated a delayed memory impairment. Neurosurgery treatment was not recommended, and the therapy with valproate 1 250 mg/day had an excellent efficacy with no singnificant adverse effects. Conclusion. This patient considered as a rare case with multiple cavernomatosis highlights the importance of neuroradiological examination in adult patients with the first epileptic seizure but with no focal neurological signs. .

  6. Reflex epileptic mechanisms in humans: Lessons about natural ictogenesis.

    Science.gov (United States)

    Wolf, Peter

    2017-06-01

    The definition of reflex epileptic seizures is that specific seizure types can be triggered by certain sensory or cognitive stimuli. Simple triggers are sensory (most often visual, more rarely tactile or proprioceptive; simple audiogenic triggers in humans are practically nonexistent) and act within seconds, whereas complex triggers like praxis, reading and talking, and music are mostly cognitive and work within minutes. The constant relation between a qualitatively, often even quantitatively, well-defined stimulus and a specific epileptic response provides unique possibilities to investigate seizure generation in natural human epilepsies. For several reflex epileptic mechanisms (REMs), this has been done. Reflex epileptic mechanisms have been reported less often in focal lesional epilepsies than in idiopathic "generalized" epilepsies (IGEs) which are primarily genetically determined. The key syndrome of IGE is juvenile myoclonic epilepsy (JME), where more than half of the patients present reflex epileptic traits (photosensitivity, eye closure sensitivity, praxis induction, and language-induced orofacial reflex myocloni). Findings with multimodal investigations of cerebral function concur to indicate that ictogenic mechanisms in IGEs largely (ab)use preexisting functional anatomic networks (CNS subsystems) normally serving highly complex physiological functions (e.g., deliberate complex actions and linguistic communication) which supports the concept of system epilepsy. Whereas REMs in IGEs, thus, are primarily function-related, in focal epilepsies, they are primarily localization-related. This article is part of a Special Issue entitled "Genetic and Reflex Epilepsies, Audiogenic Seizures and Strains: From Experimental Models to the Clinic". Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Genetic epileptic encephalopathies: is all written into the DNA?

    Science.gov (United States)

    Striano, Pasquale; de Jonghe, Peter; Zara, Federico

    2013-11-01

    Epileptic encephalopathy is a condition in which epileptic activity, clinical or subclinical, is thought to be responsible for any disturbance of cognition, behavior, or motor control. However, experimental evidence supporting this clinical observation are still poor and the causal relationship between pharmacoresistant seizures and cognitive outcome is controversial. In the past two decades, genetic studies shed new light onto complex mechanisms underlying different severe epileptic conditions associated with intellectual disability and behavioral abnormalities, thereby providing important clues on the relationship between seizures and cognitive outcome. Dravet syndrome is a childhood disorder associated with loss-of-function mutations in SCN1A and is characterized by frequent seizures and severe cognitive impairment, thus well illustrating the concept of epileptic encephalopathy. However, it is difficult to determine the causative role of the underlying sodium channel dysfunction and that of the consequent seizures in influencing cognitive outcome in these children. It is also difficult to demonstrate whether a recognizable profile of cognitive impairment or a definite behavioral phenotype exists. Data from the laboratory and the clinics may provide greater insight into the degree to which epileptic activity may contribute to cognitive impairment in individual syndromes. Wiley Periodicals, Inc. © 2013 International League Against Epilepsy.

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

    Science.gov (United States)

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

    2013-12-30

    This study investigated the incidence of posttraumatic stress disorder (PTSD) and psychiatric co-morbidity following epileptic seizure, whether alexithymia mediated the relationship between self-efficacy and psychiatric outcomes, and whether the mediational effect was moderated by the severity of PTSD from other traumas. Seventy-one (M=31, F=40) people with a diagnosis of epilepsy recruited from support groups in the United Kingdom completed the Posttraumatic Stress Diagnostic Scale, the Hospital Anxiety and Depression Scale, the Toronto Alexithymia Scale-20 and the Generalized Self-Efficacy Scale. They were compared with 71 people (M=29, F=42) without epilepsy. For people with epilepsy, 51% and 22% met the diagnostic criteria for post-epileptic seizure PTSD and for PTSD following one other traumatic life event respectively. For the control group, 24% met the diagnostic criteria for PTSD following other traumatic life events. The epilepsy group reported significantly more anxiety and depression than the control. Partial least squares (PLS) analysis showed that self-efficacy was significantly correlated with alexithymia, post-epileptic seizure PTSD and psychiatric co-morbidity. Alexithymia was also significantly correlated with post-epileptic seizure PTSD and psychiatric co-morbidity. Mediation analyses confirmed that alexithymia mediated the path between self-efficacy and post-epileptic seizure PTSD and psychiatric co-morbidity. Moderated mediation also confirmed that self-efficacy and PTSD from one other trauma moderated the effect of alexithymia on outcomes. To conclude, people can develop posttraumatic stress disorder symptoms and psychiatric co-morbidity following epileptic seizure. These psychiatric outcomes are closely linked with their belief in personal competence to deal with stressful situations and regulate their own functioning, to process rather than defend against distressing emotions, and with the degree of PTSD from other traumas. © 2013 Elsevier

  9. Epileptic seizure predictors based on computational intelligence techniques: a comparative study with 278 patients.

    Science.gov (United States)

    Alexandre Teixeira, César; Direito, Bruno; Bandarabadi, Mojtaba; Le Van Quyen, Michel; Valderrama, Mario; Schelter, Bjoern; Schulze-Bonhage, Andreas; Navarro, Vincent; Sales, Francisco; Dourado, António

    2014-05-01

    The ability of computational intelligence methods to predict epileptic seizures is evaluated in long-term EEG recordings of 278 patients suffering from pharmaco-resistant partial epilepsy, also known as refractory epilepsy. This extensive study in seizure prediction considers the 278 patients from the European Epilepsy Database, collected in three epilepsy centres: Hôpital Pitié-là-Salpêtrière, Paris, France; Universitätsklinikum Freiburg, Germany; Centro Hospitalar e Universitário de Coimbra, Portugal. For a considerable number of patients it was possible to find a patient specific predictor with an acceptable performance, as for example predictors that anticipate at least half of the seizures with a rate of false alarms of no more than 1 in 6 h (0.15 h⁻¹). We observed that the epileptic focus localization, data sampling frequency, testing duration, number of seizures in testing, type of machine learning, and preictal time influence significantly the prediction performance. The results allow to face optimistically the feasibility of a patient specific prospective alarming system, based on machine learning techniques by considering the combination of several univariate (single-channel) electroencephalogram features. We envisage that this work will serve as benchmark data that will be of valuable importance for future studies based on the European Epilepsy Database. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. Temporal lobe epileptic signs and correlative behaviors displayed by normal populations.

    Science.gov (United States)

    Persinger, M A; Makarec, K

    1987-04-01

    With regard to epileptic signs and correlative behaviors, one hypothesis is that the experiences and nonconvulsive behaviors of patients with electrical foci within the temporal lobe are also displayed, but with less intensity, by normal people. If this is correct, then there should be quantitative relationships between the numbers of major complex partial epileptic signs (CPES) and the occurrence of other frequent clinical experiences and behaviors. An inventory to answer this question was developed. Over a 3-year period, 414 (6 groups) university students were administered an inventory that included themes of CPES as well as control and information items. Strong correlations were consistently found between CPES scores and reports of paranormal (mystical, with religious overtones) experiences and "a sense of presence." Results from three personality (CPI, MMPI, and IPAT anxiety) inventories clearly demonstrated similar profiles. In addition to being more anxious, people who displayed higher CPES scores were more suspicious, aloof, stereotyped in their behavior, ruminative (overthinking), intellectually inefficient, and overly judgmental. CPES scores were significantly (p less than .001) correlated with the schizophrenia and mania subscales of the MMPI. The results suggest that functional hyperconnectionism of cortical-limbic systems within the brain may be more prevalent in the normal population than previously suspected.

  11. Is there anything distinctive about epileptic deja vu?

    Science.gov (United States)

    Warren-Gash, Charlotte; Zeman, Adam

    2014-02-01

    Déjà vu can occur as an aura of temporal lobe epilepsy and in some psychiatric conditions but is also common in the general population. It is unclear whether any clinical features distinguish pathological and physiological forms of déjà vu. 50 epileptic patients with ictal déjà vu, 50 non-epileptic patients attending general neurology clinics and 50 medical students at Edinburgh University were recruited. Data were collected on demographic factors, the experience of déjà vu using a questionnaire based on Sno's Inventory for Déjà Vu Experiences Assessment, symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale as well as seizure characteristics, anti-epileptic medications, handedness, EEG and neuroimaging findings for epileptic patients. 73.5% of neurology patients, 88% of students and (by definition) all epilepsy patients had experienced déjà vu. The experience of déjà vu itself was similar in the three groups. Epileptic déjà vu occurred more frequently and lasted somewhat longer than physiological déjà vu. Epilepsy patients were more likely to report prior fatigue and concentrated activity, associated derealisation, olfactory and gustatory hallucinations, physical symptoms such as headaches, abdominal sensations and fear. After controlling for study group, anxiety and depression scores were not associated with déjà vu frequency. Déjà vu is common and qualitatively similar whether it occurs as an epileptic aura or normal phenomenon. However ictal déjà vu occurs more frequently and is accompanied by several distinctive features. It is distinguished primarily by 'the company it keeps'.

  12. Effects of anticonvulsants and inactivity on bone disease in epileptics

    Science.gov (United States)

    Murchison, Lilian E.; Bewsher, P. D.; Chesters, Marion; Gilbert, J.; Catto, G.; Law, Elizabeth; McKay, E.; Ross, H. S.

    1975-01-01

    No significant biochemical or radiological features of vitamin D deficiency were found in groups of juvenile and adult epileptics and control groups of non-epileptic patients in hospitals for the mentally retarded. There was evidence of hepatic enzyme induction in patients on anticonvulsants, in that urinary D-glucaric acid concentration and excretion were raised. No effect was found of prolonged anticonvulsant therapy on bone densitometry, but in children immobility was closely associated with decreased bone density. The evidence suggests that disuse osteoporosis is the major bone disease in these mentally retarded children. PMID:1161672

  13. Pharmacological response of systemically derived focal epileptic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Remler, M.P.; Sigvardt, K.; Marcussen, W.H.

    1986-11-01

    Focal epileptic lesions were made in rats by systemic focal epileptogenesis. In this method, a focal lesion of the blood-brain barrier (BBB) is produced by focal alpha irradiation followed by repeated systemic injection of a convulsant drug that cannot cross the normal BBB, resulting in a chronic epileptic focus. Changes in the spike frequency of these foci in response to various drugs was recorded. The controls, saline and chlorpromazine, produced no change. Phenytoin, phenobarbital, chlordiazepoxide, and valproic acid produced the expected decrease in spike frequency. Pentobarbital and diazepam produced a paradoxical increase in spike frequency.

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

    Science.gov (United States)

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

    2014-07-01

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

  15. Sleep deprivation and spike-wave discharges in epileptic rats

    OpenAIRE

    Drinkenburg, W.H.I.M.; Coenen, A.M.L.; Vossen, J.M.H.; Luijtelaar, E.L.J.M. van

    1995-01-01

    The effects of sleep deprivation were studied on the occurrence of spike-wave discharges in the electroencephalogram of rats of the epileptic WAG/Rij strain, a model for absence epilepsy. This was done before, during and after a period of 12 hours of near total sleep deprivation. A substantial increase in the number of spike-wave discharges was found during the first 4 hours of the deprivation period, whereas in the following deprivation hours epileptic activity returned to baseline values. I...

  16. Partial Edentulism and its Correlation to Age, Gender, Socio-economic Status and Incidence of Various Kennedy’s Classes– A Literature Review

    OpenAIRE

    Jeyapalan, Vidhya; Krishnan, Chitra Shankar

    2015-01-01

    Partial edentulism, one or more teeth missing is an indication of healthy behaviour of dental practices in the society and attitude towards dental and oral care. The pattern of partial edentulism has been evaluated in many selected populations in different countries by different methods. Most of the studies have evaluated partial edentulism by surveying of Removable Partial Dentures (RPDs), patients visiting clinics, clinical records and population in particular locality.

  17. Correlation between regional cerebral blood flow and degree of brain tissue injury of interictal epileptic activity in patients with epilepsy

    International Nuclear Information System (INIS)

    Ma Huan; Chen Xuehong; Wang Zhengjiang; Ma Dongmei; Feng Jianzhong; Liu Jiangyan

    2011-01-01

    Objective: To explore the correlation between the change of regional cerebral blood flow (rCBF) and brain tissue injury from interictal epileptic activity in patients with epilepsy. Methods: Forty-eight patients with epilepsy and 30 healthy persons were included in the study from which the serum S100β protein levels were determined by double antibody sandwich ELISA method. SPECT rCBF imaging was performed in all patients. The visual and semi-quantitative analyses were used to analyze the epileptic foci. SPSS 11.0 was applied for variance and linear correlation analyses. Results: Serum S-100β in patients with interictal epileptic activity was significantly higher than that in control group ((0.572±0.163) μg/L vs (0.218±0.134) μg/L, t =9.96, P<0.01). According to epilepsy control criteria, 20 cases achieved complete control (CC), 18 cases achieved partial control (PR). However, 10 cases got no improvement,whose serum S-100β protein ((0.809±0.056) μg/L) and the percentage change of rCBF ((0.337±0.060) %) were significantly higher than those of CC ((0.443±0.083) μg/L, (0.035±0.038) %) and those of PC ((0.585±0.108) μg/L, (0.187±0.075)%), F=56. 740, 92. 316, P<0.01. There were high correlation between serum S-100β and the percentage change of rCBF in epilepsy patients (r =0.887, P<0.01). Conclusion: Serum S-100β protein assay combined with rCBF on SPECT imaging can make semi-quantitative diagnosis of epilepsy and help evaluate the brain damage from interictal epileptic activity. (authors)

  18. The origin of the concept of partial epilepsy.

    Science.gov (United States)

    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.

  19. Partial Edentulism and its Correlation to Age, Gender, Socio-economic Status and Incidence of Various Kennedy's Classes- A Literature Review.

    Science.gov (United States)

    Jeyapalan, Vidhya; Krishnan, Chitra Shankar

    2015-06-01

    Partial edentulism, one or more teeth missing is an indication of healthy behaviour of dental practices in the society and attitude towards dental and oral care. The pattern of partial edentulism has been evaluated in many selected populations in different countries by different methods. Most of the studies have evaluated partial edentulism by surveying of Removable Partial Dentures (RPDs), patients visiting clinics, clinical records and population in particular locality. The objective of the study is to review the prevalence of partial edentulousness and its correlation to age,gender, arch predominance, socio economic factors and incidence of various Kennedy's Classes. Key observations drawn from the review are as below. There is no gender correlation for partial edentulism.Prevalence of partial edentulism is more common in mandibular arch than maxillary arch.Younger adults have more Class III and IV RPDs. Elders have more distal extension RPDs Class I and II.

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

    African Journals Online (AJOL)

    owner

    2013-03-01

    Mar 1, 2013 ... Childhood masturbation is re- garded as one of the paroxysmal, non-epileptic disorders in children, which incorporate several potential diagno- ses. Therefore, if not recognized, it could pose diagnos- tic difficulties, unnecessary investigative spending and considerable parental anxiety.3. There is paucity of ...

  1. GRIN1 Mutations in Early-Onset Epileptic Encephalopathy

    Directory of Open Access Journals (Sweden)

    Wenjuan Chen

    2015-06-01

    Full Text Available Investigators from Yokohama City University and other medical centers in Israel and Japan reported mutations on N-methyl-D-aspartate (NMDA receptors subunit GRIN1 (GluN1 identified in patients with nonsyndromic intellectual disability and early-onset epileptic encephalopathy.

  2. Epilepsy, anti-epileptic medication use and risk of cancer

    DEFF Research Database (Denmark)

    Kaae, Jeanette; Carstensen, Lisbeth; Wohlfahrt, Jan

    2014-01-01

    Whether the powerful medications used to treat epilepsy increase the risk of cancer has been debated for decades, but until now no study could disentangle the contributions of anti-epileptic medications and epilepsy itself to cancer risk. Using a cohort comprising all Danish residents ≥ 16 years ...

  3. Sleep deprivation and spike-wave discharges in epileptic rats

    NARCIS (Netherlands)

    Drinkenburg, W.H.I.M.; Coenen, A.M.L.; Vossen, J.M.H.; Luijtelaar, E.L.J.M. van

    1995-01-01

    The effects of sleep deprivation were studied on the occurrence of spike-wave discharges in the electroencephalogram of rats of the epileptic WAG/Rij strain, a model for absence epilepsy. This was done before, during and after a period of 12 hours of near total sleep deprivation. A substantial

  4. Behavioral problems of siblings of epileptic children in Enugu ...

    African Journals Online (AJOL)

    Materials and Methods: Epileptic patients who consecutively referred to the Pediatric Neurology Clinic of the University of Nigeria Teaching Hospital, Enugu, from October 1999 to September 2000 were recruited. Demographic data were obtained, with a questionnaire administered to the parents. Information on the behavior ...

  5. Exfoliative Dermatitis Due To Carbamazepine In An Epileptic Patient

    Directory of Open Access Journals (Sweden)

    Ghosh Sadhan Kr

    1995-01-01

    Full Text Available A young epileptic girl of 17 years who was being treated with carbamazepine suddenly developed exanthematous skin eruption all over the body resulting in exfoliative dermatitis within 2 days of onset. The drug was withdrawn and the patient responded well with symptomatic treatment.

  6. The determinants of seizure severity in Nigerian epileptics | Imam ...

    African Journals Online (AJOL)

    This assesses generalisation of seizures, falls, injuries, urinary incontinence, warning interval before loss of consciousness, automatisms and time of recovery on a graded scale. Results: The most frequent indices of seizure severity in Nigerian epileptics is the generalisation of seizures in 85.7% of subjects, incontinence of ...

  7. Preictal Dynamics of EEG Complexity in Intracranially Recorded Epileptic Seizure

    Czech Academy of Sciences Publication Activity Database

    Bob, P.; Roman, R.; Světlák, M.; Kukleta, M.; Chládek, Jan; Brázdil, M.

    2014-01-01

    Roč. 93, č. 23 (2014), el151:1-4 ISSN 0025-7974 R&D Projects: GA MŠk(CZ) LO1212 Institutional support: RVO:68081731 Keywords : EEG * epileptic Seizure Subject RIV: FS - Medical Facilities ; Equipment Impact factor: 5.723, year: 2014

  8. Epileptic aura and perception of self-control

    DEFF Research Database (Denmark)

    Lohse, Allan; Kjaer, Troels W; Sabers, Anne

    2015-01-01

    OBJECTIVE: The health locus of control is the subjective perception of control over one's health. It has been studied for years as one of several factors that determine patient health-related behaviors. The aim of this study was to investigate how the epileptic aura is associated with the health...

  9. Glutamate decarboxylase activity in rat brain during experimental epileptic seizures induced by pilocarpine

    Energy Technology Data Exchange (ETDEWEB)

    Netopilova, M; Drsata, J [Department of Biochemical Sciences, Faculty of Pharmacy, Charles University, 50005 Hradec Kralove (Czech Republic); Haugvicova, R; Kubova, H; Mares, P [Institute of Physiology, Czech Academy of Sciences, 14220 Prague (Czech Republic)

    1998-07-01

    Glutamate decarboxylase (GAD) activity was studied rat brain parts in a pilocarpine model of epileptic seizures. An increased enzyme activity was found in hippocampus a cerebellum during the acute phase of seizures, while the cortex and cerebellum showed increased GAD activity in the chronic phase of the process. Systematic administration of pilocarpine to rats induces status epilepticus. The aim of this research was to find out if seizures induced by pilocarpine are connected changes in glutamate decarboxylase activity, the enzyme that catalyzes synthesis of inhibitory neurotransmitter GABA. GAD was assayed by means of radiometric method using {sup 14}C-carboxyl-labelled glutamate and measurement of {sup 14}CO{sub 2} radioactivity. Obtained results suggest that pilocarpine seizures are connected with changes of GAD activity in individual parts of rat brain. (authors)

  10. Glutamate decarboxylase activity in rat brain during experimental epileptic seizures induced by pilocarpine

    International Nuclear Information System (INIS)

    Netopilova, M.; Drsata, J.; Haugvicova, R.; Kubova, H.; Mares, P.

    1998-01-01

    Glutamate decarboxylase (GAD) activity was studied rat brain parts in a pilocarpine model of epileptic seizures. An increased enzyme activity was found in hippocampus a cerebellum during the acute phase of seizures, while the cortex and cerebellum showed increased GAD activity in the chronic phase of the process. Systematic administration of pilocarpine to rats induces status epilepticus. The aim of this research was to find out if seizures induced by pilocarpine are connected changes in glutamate decarboxylase activity, the enzyme that catalyzes synthesis of inhibitory neurotransmitter GABA. GAD was assayed by means of radiometric method using 14 C-carboxyl-labelled glutamate and measurement of 14 CO 2 radioactivity. Obtained results suggest that pilocarpine seizures are connected with changes of GAD activity in individual parts of rat brain. (authors)

  11. Ketogenic diet efficacy in the treatment of intractable epileptic spasms.

    Science.gov (United States)

    Kayyali, Husam R; Gustafson, Megan; Myers, Tara; Thompson, Lindsey; Williams, Michelle; Abdelmoity, Ahmad

    2014-03-01

    To determine the efficacy of the ketogenic diet in controlling epileptic spasms after failing traditional antiepileptic medication therapy. This is a prospective, case-based study of all infants with epileptic spasms who were referred for treatment with the ketogenic diet at our hospital between 2009 and 2012. All subjects continued to have epileptic spasms with evidence of hypsarrhythmia or severe epileptic encephalopathy on electroencephalography despite appropriate medication treatments. The diet efficacy was assessed through clinic visits, phone communications, and electroencephalography. Quality of life improvement was charted based on the caregiver's perspective. Twenty infants (15 males) were included in the study. The mean age at seizure onset was 4.5 months. Age at ketogenic diet initiation was 0.3 to 2.9 years (mean 1.20, standard deviation 0.78). Fifteen patients had epileptic spasms of unknown etiology; three had perinatal hypoxic ischemic encephalopathy, one had lissencephaly, and one had STXBP1 mutation. Fifteen infants failed to respond to adrenocorticotropin hormone and/or vigabatrin before going on the ketogenic diet. Three months after starting the diet, >50% seizure reduction was achieved in 70% of patients (95% CI 48-86). These results were maintained at 6- and 12-month intervals. All eight of the patients followed for 24 months had >50% seizure reduction (95% CI 63-100). At least 90% seizure reduction was reported in 20% of patients at 3 months (95% CI 7-42), 22% (95% CI 8-46) at 6 months, and 35% (95% CI 17-59) at 12 months. The majority of patients (63%) achieved improvement of their spasms within 1 month after starting the diet. Sixty percent of patients had electroencephalographic improvement. All caregivers reported improvement of the quality of life at the 3-month visit (95% confidence interval 81-100). This ratio was 94% at 6 months (95% CI 72-99) and 82% at 12 months (95% CI 58-95). The ketogenic diet is a safe and potentially

  12. 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

  13. Dose-Dependent Effect of Curcumin on Learning and Memory Deficit in Kainate-Epileptic Rats

    Directory of Open Access Journals (Sweden)

    Zahra Kiasalari

    2014-09-01

    Full Text Available Background & objectives : Epileptic seizures accompany disturbances in learning, memory, and cognitive skills. With regard to antiepileptic potential of curcumin and its beneficial effect on memory, the effect of its administration on learning and memory in kainate-epileptic rats was investigated.   Methods: Forty male rats were divided into sham, positive control ( valproate-treated epileptic, epileptic, and two curcumin-treated epileptic groups. Rat model of epilepsy was induced by unilateral intrahippocampal administration of 4 μg of kainate per rat. Rats received intraperitoneal injection of curcumin (50 and 100 mg/kg daily for 1 week before surgery. For evaluation of learning and memory, initial (IL and step-through latencies (STL were determined using passive avoidance test and alternation behavior percentage was obtained according to Y maze test.   Results: Regarding IL, there was no significant difference between the groups. In contrast, STL significantly decreased in curcumin-50-treated epileptic group (p<0.05 (a change from 263.1 to 184.5 s. However, this parameter significantly increased in curcumin-100-treated epileptic group as compared to epileptic group (p<0.01 (a change from 263.1 to 220.3 s. In addition, STL was also significantly higher in valproic acid-treated epileptic group versus epileptic group (p<0.05 (a change from 145.7 to 210.3 s. Alternation percentage was also significantly higher in curcumin-50- and curcumin-100-treated epileptic groups relative to epileptic group (p<0.05 (a change from 60.5 to 77.6 and 80.3%.   Conclusion: Curcumin could dose-dependently enhance the consolidation and recall in epileptic animals and could improve spatial memory in such animals.

  14. MRI findings in 100 epileptic children

    Energy Technology Data Exchange (ETDEWEB)

    Suzukawa, Junko; Sugimoto, Tateo; Araki, Atsushi (Kansai Medical School, Moriguchi, Osaka (Japan)) (and others)

    1993-02-01

    Findings of magnetic resonance imaging (MRI) of the brain were retrospectively reviewed in 100 consecutive pediatric patients with epilepsy in relation to the type of epilepsy and prognosis. There were 65 boys and 35 girls, ranging in age from 3 months to 25 years. Among 100 patients, 67 (a total of 102 lesions) showed abnormal findings on MRI. Morphological abnormalities, including ventricular enlargement, atrophy and malformation, were seen in 54 patients. Periventricular (n=14), frontal (n=3), temporal (n=8) and occipital (n=7) areas were of high signal intensity on T2-weighted images. According to the type of epilepsy, MRI abnormality was seen in 34 (61%) of 56 patients with partial seizures and 33 (76%) of 44 patients with generalized seizures. When associated with cerebral palsy and mental retardation, the incidence of MRI abnormality was high. There was no sigificant correlation between MRI findings and prognosis. (N.K.).

  15. MRI findings in 100 epileptic children

    International Nuclear Information System (INIS)

    Suzukawa, Junko; Sugimoto, Tateo; Araki, Atsushi

    1993-01-01

    Findings of magnetic resonance imaging (MRI) of the brain were retrospectively reviewed in 100 consecutive pediatric patients with epilepsy in relation to the type of epilepsy and prognosis. There were 65 boys and 35 girls, ranging in age from 3 months to 25 years. Among 100 patients, 67 (a total of 102 lesions) showed abnormal findings on MRI. Morphological abnormalities, including ventricular enlargement, atrophy and malformation, were seen in 54 patients. Periventricular (n=14), frontal (n=3), temporal (n=8) and occipital (n=7) areas were of high signal intensity on T2-weighted images. According to the type of epilepsy, MRI abnormality was seen in 34 (61%) of 56 patients with partial seizures and 33 (76%) of 44 patients with generalized seizures. When associated with cerebral palsy and mental retardation, the incidence of MRI abnormality was high. There was no sigificant correlation between MRI findings and prognosis. (N.K.)

  16. Development of a neurostimulator for studies of epileptic crisis

    Energy Technology Data Exchange (ETDEWEB)

    Niro, J [Universidad Tecnologica Nacional / Secretaria de Proyectos Especiales, Buenos Aires (Argentina); Manso, J [Universidad Tecnologica Nacional / Secretaria de Proyectos Especiales, Buenos Aires (Argentina); Ballina, F [Universidad Tecnologica Nacional / Secretaria de Proyectos Especiales, Buenos Aires (Argentina); Periolo, S [Universidad Tecnologica Nacional / Secretaria de Proyectos Especiales, Buenos Aires (Argentina); D' Atellis, C [Universidad Tecnologica Nacional / Secretaria de Proyectos Especiales, Buenos Aires (Argentina); Ponce, S [Universidad Tecnologica Nacional / Secretaria de Proyectos Especiales, Buenos Aires (Argentina); Barroso, M [Universidad Nacional de Buenos Aires / Facultad de Medicina, Centro de Epilepsia UBA - CONICET, Buenos Aires (Argentina); Anessi, C [Universidad Nacional de Buenos Aires / Facultad de Medicina, Centro de Epilepsia UBA - CONICET, Buenos Aires (Argentina); Kochen, S [Universidad Nacional de Buenos Aires / Facultad de Medicina, Centro de Epilepsia UBA - CONICET, Buenos Aires (Argentina)

    2007-11-15

    This work describes the development and use of a multi-channel, programmable physiological stimulator. The device is intended for the detection of epileptic events and crisis prediction using encephalograms. The animals were followed by the kindling model. The system program accepts several inputs of stimulation parameters such as, pulse width, separation between pulses, pulse intensity and total number of pulses. The stimulator generates constant-current, bipolar pulses with a maximum amplitude of 5 mA and a resolution of 50{mu}A. As regards voltage, the maximum amplitude is 150 V. The stimulator was constructed with a microcontroller (PIC18F4550), the latter version being controlled by a personal computer. Experiments of achieving the epileptic events were carried out on rats.

  17. Development of a neurostimulator for studies of epileptic crisis

    International Nuclear Information System (INIS)

    Niro, J; Manso, J; Ballina, F; Periolo, S; D'Atellis, C; Ponce, S; Barroso, M; Anessi, C; Kochen, S

    2007-01-01

    This work describes the development and use of a multi-channel, programmable physiological stimulator. The device is intended for the detection of epileptic events and crisis prediction using encephalograms. The animals were followed by the kindling model. The system program accepts several inputs of stimulation parameters such as, pulse width, separation between pulses, pulse intensity and total number of pulses. The stimulator generates constant-current, bipolar pulses with a maximum amplitude of 5 mA and a resolution of 50μA. As regards voltage, the maximum amplitude is 150 V. The stimulator was constructed with a microcontroller (PIC18F4550), the latter version being controlled by a personal computer. Experiments of achieving the epileptic events were carried out on rats

  18. Mutations of PTPN23 in developmental and epileptic encephalopathy

    KAUST Repository

    Sowada, Nadine

    2017-10-31

    Developmental and epileptic encephalopathies (DEE) are a heterogeneous group of neurodevelopmental disorders with poor prognosis. Recent discoveries have greatly expanded the repertoire of genes that are mutated in epileptic encephalopathies and DEE, often in a de novo fashion, but in many patients, the disease remains molecularly uncharacterized. Here, we describe a new form of DEE in patients with likely deleterious biallelic variants in PTPN23. The phenotype is characterized by early onset drug-resistant epilepsy, severe and global developmental delay, microcephaly, and sometimes premature death. PTPN23 encodes a tyrosine phosphatase with strong brain expression, and its knockout in mouse is embryonically lethal. Structural modeling supports a deleterious effect of the identified alleles. Our data suggest that PTPN23 mutations cause a rare severe form of autosomal-recessive DEE in humans, a finding that requires confirmation.

  19. Multidisciplinary approach to hospitalized epileptic children and their families

    Directory of Open Access Journals (Sweden)

    Angela Cristina Pontes

    2006-06-01

    Full Text Available Objective: Epilepsy is the most frequent diagnosis in the ward;due to the high degree of complexity of its investigation andtreatment, the objective of this work was to proceed to an analysisof the interventions of the team with hospitalized epileptic childrenand their families. Methods: The data were obtained from theclinical handbooks and individual registers of the specialties.Results: There were 235 elective admissions, 88 regarding theEpilepsy. The services for specialties were distributed among those88 epileptic children: physiotherapy (34%, psychology (41% andoccupational therapy (88.6%. Conclusion: Given the severity ofthe social and biological sequelae associated with the diagnosisof epilepsy and the need for a family intervention, themultidisciplinary work focused on the child, in stimulationinterventions and promotion of his/her development, with a viewto minimize the sequelae; and providing the family with orientationand support, in order to give them more elaborate strategies forcoping with the disease and improve conditions for supplying postdischargeinfant treatment.

  20. Inferences from a community study about non-epileptic events

    Directory of Open Access Journals (Sweden)

    Gomes Marleide da Mota

    2002-01-01

    Full Text Available OBJECTIVE: To demonstrate the epidemiological importance of the different types of non-epileptic events (NEE in a low-income urban community. METHOD: The patients suspected of having epilepsy, who were detected in the first phase (screening one of this prevalence study, were interviewed by a neurologist in a non-structured neurological interview. These NEE were classified as physiological and psychogenic, subdivided by various types. The psychogenic NEE were classified according to the DSM-IV criteria. RESULTS: We compared the cases suspected of having epilepsy (n=176 with those not suspected (n=806 and discovered that those cases suspected of having epilepsy had a greater median age (<0.01 and female predominance (p<0.01. Among the cases suspected of having epilepsy there were different diagnosis: epileptic events without identifiable cause (n=20 or with identifiable causes (e.g., febrile convulsions and eclampsia. The most prevalent diagnosis for those suspected of having epilepsy was syncope (n=63; 35.8%. In terms of physiological events, the most frequent were: epileptic seizures, paroxysmal toxic phenomena (including alcoholism and brain trauma, besides syncope; in terms of psychogenic events the most frequent were: dissociative and anxiety disorders. Regarding gender differences, paroxysmal toxic problems were significantly more prevalent in men (p= 0.02, and dissociative disorders (p=0.01 in women. CONCLUSION: This survey confirms the epidemiological importance of syncope in a populational sample with NEE. However, among the psychogenic disorders of this NEE sample, the most frequent were dissociative and anxiety phenomena. This finding contrasts with the literature based on samples from tertiary epileptic centers with video-EEG resources, which found somatoform disorders to be more prevalent than dissociative and anxiety phenomena.

  1. The clinical presentation and diagnosis of epileptic autonomic auras

    Directory of Open Access Journals (Sweden)

    Marina Revditovna Kremenchugskaya

    2012-01-01

    Full Text Available Objective: to refine the pattern of clinical manifestations of epileptic autonomic auras (EAA and to reveal clinical, electroencephalographic, and neuroimaging ratios. Patients and methods. Eighteen patients (8, 41% men and 10, 59% women aged 9 to 27years (mean 18±5years were examined. The examination encompassed analysis of history data, clinical and neurological studies, long-term video-assisted electroencephalographic monitoring, and magnetic resonance imaging (MRI of the brain. Results. In most patients (n = 12, 67%, the symptoms of EAA corresponded to the criteria for abdominal one. In the other patients, the clinical manifestations resembled autonomic paroxysms as attacks of panic. Interictal pathological changes on an electroencephalogram (EEG were present in the frontal, temporal, and frontotemporal regions in 4 (22%, 6 (33%, and 7 (39% patients, respectively, as well as in both the left and right hemispheres without significant differences. Pathological EEG changes were not found in one case. MRI detected that 13 (72% patients had structural changes that were potentially eliptogenic. Conclusion. The clinical symptoms of EAA give information on the site of a primary pathological focus. It is necessary to differentiate EAA from non-epileptic paroxysmal states. The autonomic phenomena of epileptic genesis help study the functional organizations of the autonomic nervous system.

  2. Epileptic Seizures Versus Syncope: Pathophysiology and Clinical Approach

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    Marios Charalambous

    2017-02-01

    Full Text Available Generalised epileptic seizures and syncope are two syndromes with similar clinical manifestation and their differentiation can be quite challenging. The aim of this review is to use an evidence-based approach in differentiating these two syndromes through the comprehension of the pathophysiological mechanisms involved and their clinical signs. Both syndromes affect regions of the forebrain and consciousness level, although, different mechanisms are involved. Syncope is a paroxysmal event secondary to a short-term decrease in cerebral perfusion, oxygenation or essential nutrients delivery. Generalised epileptic seizure activity is defined as the clinical manifestation of transient paroxysmal disturbances in brain function secondary to an imbalance between excitatory and inhibitory neurotransmitters. Clinical criteria, including precipitating events, clinical signs preceding, during and following the episodes and event duration, can be used to differentiate the two syndromes. Although these criteria might be useful for the practitioner, definite conclusions should be precluded due to the lack of original research articles and weak evidence on this specific field.Application: The review might be a useful tool for the general practitioner and clinical scientist as it will aid towards the differentiation of two syndromes, i.e. generalised epileptic seizures and syncope, with similar clinical presentation.

  3. Microarray profile of seizure damage-refractory hippocampal CA3 in a mouse model of epileptic preconditioning.

    Science.gov (United States)

    Hatazaki, S; Bellver-Estelles, C; Jimenez-Mateos, E M; Meller, R; Bonner, C; Murphy, N; Matsushima, S; Taki, W; Prehn, J H M; Simon, R P; Henshall, D C

    2007-12-05

    A neuroprotected state can be acquired by preconditioning brain with a stimulus that is subthreshold for damage (tolerance). Acquisition of tolerance involves coordinate, bi-directional changes to gene expression levels and the re-programmed phenotype is determined by the preconditioning stimulus. While best studied in ischemic brain there is evidence brief seizures can confer tolerance against prolonged seizures (status epilepticus). Presently, we developed a model of epileptic preconditioning in mice and used microarrays to gain insight into the transcriptional phenotype within the target hippocampus at the time tolerance had been acquired. Epileptic tolerance was induced by an episode of non-damaging seizures in adult C57Bl/6 mice using a systemic injection of kainic acid. Neuron and DNA damage-positive cell counts 24 h after status epilepticus induced by intraamygdala microinjection of kainic acid revealed preconditioning given 24 h prior reduced CA3 neuronal death by approximately 45% compared with non-tolerant seizure mice. Microarray analysis of over 39,000 transcripts (Affymetrix 430 2.0 chip) from microdissected CA3 subfields was undertaken at the point at which tolerance was acquired. Results revealed a unique profile of small numbers of equivalently up- and down-regulated genes with biological functions that included transport and localization, ubiquitin metabolism, apoptosis and cell cycle control. Select microarray findings were validated post hoc by real-time polymerase chain reaction and Western blotting. The present study defines a paradigm for inducing epileptic preconditioning in mice and first insight into the global transcriptome of the seizure-damage refractory brain.

  4. Mental Development of Children with Non-epileptic Paroxysmal States in Medical History

    Directory of Open Access Journals (Sweden)

    Turovskaya N.G.,

    2015-10-01

    Full Text Available The author studied mental functions disorders in children with a history of paroxysmal states of various etiologies and compared mental development disorder patterns in patients with epileptic and non-epileptic paroxysms. Study sample were 107 children, aged 6 to 10 years. The study used experimental psychological and neuropsychological techniques. According to the empirical study results, non-epileptic paroxysms unlike epileptic much less combined with a number of mental functions disorders and intelligence in general. However, non-epileptic paroxysmal states as well as epileptic seizure associated with increasing activity exhaustion and abnormal function of the motor analyzer (dynamic and kinesthetic dyspraxia. Visual memory disorders and modal-nonspecific memory disorders have more pronounced importance in the mental ontogenesis structure in children with convulsive paroxysms compared to children with cerebral pathology without paroxysms history

  5. Examinations with computerized cranial axial tomography carried out on patients with epileptic seizures, taking into consideration the EEG and the clinical picture

    International Nuclear Information System (INIS)

    Geiser, R.

    1982-01-01

    204 patients suffering from epileptic seizures were examined with the help of computerized cranial X-ray tomography; the results were compared with anamnestic, clinical, and EEC-findings. In good agreement with results published in literature, in 54% of the patients pathologic CT's such as tumours, attack scars, changes in ventricles and arachnoid spaces etc. were found. A pathological CT is very likely to appear in male patients who are 30 or even 50 years of age, having partial attacks with elementary symptoms, focal diagnosis in the EEG and a neurological unilateral finding. Especially noteworthy is the tumour detecting rate achieved by CT and the fact that in nearly 5% of the cases CT detected a cerebral lesion which has not been suspected, neither clinically nor in the EEG (4 tumours). This shows clearly that CT represents a heighly valuable diagnostic help, especially for patients with epileptic seizures. (orig./MG) [de

  6. Targeted resequencing in epileptic encephalopathies identifies de novo mutations in CHD2 and SYNGAP1

    DEFF Research Database (Denmark)

    Carvill, Gemma L; Heavin, Sinéad B; Yendle, Simone C

    2013-01-01

    Epileptic encephalopathies are a devastating group of epilepsies with poor prognosis, of which the majority are of unknown etiology. We perform targeted massively parallel resequencing of 19 known and 46 candidate genes for epileptic encephalopathy in 500 affected individuals (cases) to identify...... CHD2 and SYNGAP1 mutations are new causes of epileptic encephalopathies, accounting for 1.2% and 1% of cases, respectively. We also expand the phenotypic spectra explained by SCN1A, SCN2A and SCN8A mutations. To our knowledge, this is the largest cohort of cases with epileptic encephalopathies...

  7. 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.

  8. Differences in mortality based on worsening ratio of partial pressure of oxygen to fraction of inspired oxygen corrected for immune system status and respiratory support.

    Science.gov (United States)

    Miles, Lachlan F; Bailey, Michael; Young, Paul; Pilcher, David V

    2012-03-01

    To define the relationship between worsening oxygenation status (worst PaO(2)/FiO(2) ratio in the first 24 hours after intensive care unit admission) and mortality in immunosuppressed and immunocompetent ICU patients in the presence and absence of mechanical ventilation. Retrospective cohort study. Data were extracted from the Australian and New Zealand Intensive Care Society Adult Patient Database. Adult patients admitted to 129 ICUs in Australasia, 2000-2010. In hospital and ICU mortality; relationship between mortality and declining PaO(2)/FiO(2) ratio by ventilation status and immune status. 457 750 patient records were analysed. Worsening oxygenation status was associated with increasing mortality in all groups. Higher mortality was seen in immunosuppressed patients than immunocompetent patients. After multivariate analysis, in mechanically ventilated patients, declining PaO(2)/FiO(2) ratio in the first 24 hours of ICU admission was associated with a more rapidly rising mortality rate in immunosuppressed patients than non-immunosuppressed patients. Immunosuppression did not affect the relationship between oxygenation status and mortality in non-ventilated patients. Immunosuppression increases the risk of mortality with progressively worsening oxygenation status, but only in the presence of mechanical ventilation. Further research into the impact of mechanical ventilation in immunosuppressed patients is required.

  9. Prevalence of Autism among Epileptic Children Referring to Imam Reza Clinic and Comparing to Control Group (non Epileptic Children During2013-2014

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    LS mohammadijahromi

    2017-06-01

    Discussion: According to this study, the prevalence of autism among epileptic children is higher than non epileptic ones. As the age of the onset of seizure is lower the prevalence of autism will be higher. Also, the prevalence of autism among epileptic children will be higher as abnormal findings of imaging and known etiologies of seizureincrease. Loss of significant correlations among prevalence of autism and some variables of seizure can be due to few numbers of autistic cases, which were diagnosed in this study comparing with previous studies.

  10. FOCAL EPILEPTIC MYOCLONUS IN KOZHEVNIKOV–RASMUSSEN SYNDROME

    Directory of Open Access Journals (Sweden)

    N. E. Kvaskova

    2016-01-01

    Full Text Available The article presents the clinical, electroencephalographic (EEG and neuroimaging features, as well as the results of treatment of patients with focal epileptic myoclonus (FEM with the Kozhevnikov–Rasmussen syndrome (KRS. FEM in KRS-patients was identified in 11 cases, accounting for 0.9 % of all the cases of epilepsy with the onset of seizures up to 18 years (n = 1261. The age at onset of KRS ranged from 3 to 21 years (average – 9.2 ± 5.7 years. In the active period of the disease of all patients in the clinical picture the active FEM appeared and increasing frequency of the secondary generalized seizures (SGS. In addition SGS and FEM, the clinical picture of the disease in most patients (91 % the focal motor (clonic and the somatosensory focal seizures were observed. As the disease progressed, the FEM became more pronounced in frequency and intensity, seized more muscle groups, localizing mainly in the muscles of the trunk and limbs. The typical EEG pattern of FEM patients with KRS was regional epileptiform activity that occurs in the structure of the continued regional slowing localizing maximum of the fronto-central-temporal region. During the magnetic resonance tomography of the brain in dynamics all the patients observed the increase in total cortical hemiatrophy. In all the cases, the appointment of antiepileptic therapy resulted in a slowing of the FEM, however, a complete remission was reached at none of the patients. Two patients were made surgical treatment of epilepsy. In one case remission of epileptic seizures was observed after right-side hemispherotomy. Our study showed that FEM is very resistant type of epileptic seizures. This fact calls for the identification of the FEM at the early stages of the disease with the purpose to improve the prognosis, as well as for an earlier surgical treatment.

  11. Transfer function between EEG and BOLD signals of epileptic activity

    Directory of Open Access Journals (Sweden)

    Marco eLeite

    2013-01-01

    Full Text Available Simultaneous EEG-fMRI recordings have seen growing application in the evaluation of epilepsy, namely in the characterization of brain networks related to epileptic activity. In EEG-correlated fMRI studies, epileptic events are usually described as boxcar signals based on the timing information retrieved from the EEG, and subsequently convolved with a heamodynamic response function to model the associated BOLD changes. Although more flexible approaches may allow a higher degree of complexity for the haemodynamics, the issue of how to model these dynamics based on the EEG remains an open question. In this work, a new methodology for the integration of simultaneous EEG-fMRI data in epilepsy is proposed, which incorporates a transfer function from the EEG to the BOLD signal. Independent component analysis (ICA of the EEG is performed, and a number of metrics expressing different models of the EEG-BOLD transfer function are extracted from the resulting time courses. These metrics are then used to predict the fMRI data and to identify brain areas associated with the EEG epileptic activity. The methodology was tested on both ictal and interictal EEG-fMRI recordings from one patient with a hypothalamic hamartoma. When compared to the conventional analysis approach, plausible, consistent and more significant activations were obtained. Importantly, frequency-weighted EEG metrics yielded superior results than those weighted solely on the EEG power, which comes in agreement with previous literature. Reproducibility, specificity and sensitivity should be addressed in an extended group of patients in order to further validate the proposed methodology and generalize the presented proof of concept.

  12. Subacute encephalopathy with epileptic seizures in alcoholism (SESA): case report.

    Science.gov (United States)

    Otto, F G; Kozian, R

    2001-10-01

    The case of a 66-year-old patient is reported in view of the rarity of his condition: a case of subacute encephalopathy with seizures in alcoholics (SESA syndrome), described first in 1981 by Niedermeyer, et al. Wernicke-type aphasia, epileptic seizures (generalized tonic-clonic) and PLEDs EEG pattern dominated the neurological picture, in addition to hepatomegaly and rhabdomyolysis. This condition differs from all other known CNS complications in chronic alcoholism and is withdrawal-independent. It is prognostically favorable as far as the syndrome as such is concerned.

  13. Automatic Epileptic Seizure Onset Detection Using Matching Pursuit

    DEFF Research Database (Denmark)

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

    2010-01-01

    . The combination of Matching Pursuit and SVM for automatic seizure detection has never been tested before, making this a pilot study. Data from red different patients with 6 to 49 seizures are used to test our model. Three patients are recorded with scalp electroencephalography (sEEG) and three with intracranial...... electroencephalography (iEEG). A sensitivity of 78-100% and a detection latency of 5-18s has been achieved, while holding the false detection at 0.16-5.31/h. Our results show the potential of Matching Pursuit as a feature xtractor for detection of epileptic seizures....

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

    DEFF Research Database (Denmark)

    Conradsen, Isa

    convulsive seizures tested. Another study was performed, involving quantitative parameters in the time and frequency domain. The study showed, that there are several differences between tonic seizures and the tonic phase of GTC seizures and furthermore revealed differences of the epileptic (tonic and tonic...... phase of GTC) and simulated seizures. This was valuable information concerning a seizure detection algorithm, and the findings from this research provided evidence for a change in the definition of these seizures by the International League Against Epilepsy (ILAE). Our final study presents a novel...

  15. Psycho-Social Aspects of Educating Epileptic Children: Roles for School Psychologists.

    Science.gov (United States)

    Frank, Brenda B.

    1985-01-01

    Epileptic children may have physical and emotional needs which can interfere with learning and socialization. Current prevalence estimates, definitions, and classifications of epilepsy are surveyed. Factors affecting the epileptic child's school performance and specific learning problems are addressed. Specific roles are presented for school…

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

    Directory of Open Access Journals (Sweden)

    Abhik Sinha

    2012-01-01

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

  17. 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)

  18. Population pharmacokinetic analysis for 10-monohydroxy derivative of oxcarbazepine in pediatric epileptic patients shows no difference between Japanese and other ethnicities.

    Science.gov (United States)

    Sugiyama, Ikuo; Bouillon, Thomas; Yamaguchi, Masayuki; Suzuki, Hikoe; Hirota, Takashi; Fink, Martin

    2015-04-01

    Oxcarbazepine is an anti-epileptic drug, which is almost completely metabolized by cytosolic enzymes in the liver to the active 10-monohyroxy metabolite (MHD) following oral administration. The pharmacokinetic (PK) profiles of MHD were evaluated in pediatric epileptic patients and a possible ethnic difference in PK of MHD between Japanese and non-Japanese pediatric patients was assessed. A non-linear mixed effect modeling approach was used to determine the PK of MHD. A one-compartment population model with first-order absorption appropriately described the PK of MHD. No clinically relevant differences were found for using body surface area or weight to explain between-patient variability, therefore the final model included the effects of body weight on apparent clearance (CL/F) and apparent volume of distribution (V/F) of MHD, and in addition, the effect of 3 concomitant anti-epileptic drugs (carbamazepine, phenobarbital and phenytoin) on CL/F of MHD. Inclusion of ethnicity as a covariate in the final model, concluded no ethnic difference with respect to CL/F of MHD between Japanese and non-Japanese patients. Hence, oxcarbazepine can be generally applied using the same dosage and administration for the treatment of partial onset seizures in pediatric patients, regardless of ethnicity. Copyright © 2014 The Japanese Society for the Study of Xenobiotics. Published by Elsevier Ltd. All rights reserved.

  19. Localisation of epileptic foci using novel imaging modalities

    Science.gov (United States)

    De Ciantis, Alessio; Lemieux, Louis

    2013-01-01

    Purpose of review This review examines recent reports on the use of advanced techniques to map the regions and networks involved during focal epileptic seizure generation in humans. Recent findings A number of imaging techniques are capable of providing new localizing information on the ictal processes and epileptogenic zone. Evaluating the clinical utility of these findings has been mainly performed through post-hoc comparison with the findings of invasive EEG and ictal single-photon emission computed tomography, using postsurgical seizure reduction as the main outcome measure. Added value has been demonstrated in MRI-negative cases. Improved understanding of the human ictiogenic processes and the focus vs. network hypothesis is likely to result from the application of multimodal techniques that combine electrophysiological, semiological, and whole-brain coverage of brain activity changes. Summary On the basis of recent research in the field of neuroimaging, several novel imaging modalities have been improved and developed to provide information about the localization of epileptic foci. PMID:23823464

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

    Directory of Open Access Journals (Sweden)

    Niraldo de Oliveira Santos

    2014-12-01

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

  1. Network dynamics in the healthy and epileptic developing brain

    Directory of Open Access Journals (Sweden)

    Richard Rosch

    2018-03-01

    Full Text Available Electroencephalography (EEG allows recording of cortical activity at high temporal resolution. EEG recordings can be summarized along different dimensions using network-level quantitative measures, such as channel-to-channel correlation, or band power distributions across channels. These reveal network patterns that unfold over a range of different timescales and can be tracked dynamically. Here we describe the dynamics of network state transitions in EEG recordings of spontaneous brain activity in normally developing infants and infants with severe early infantile epileptic encephalopathies (n = 8, age: 1–8 months. We describe differences in measures of EEG dynamics derived from band power, and correlation-based summaries of network-wide brain activity. We further show that EEGs from different patient groups and controls may be distinguishable on a small set of the novel quantitative measures introduced here, which describe dynamic network state switching. Quantitative measures related to the sharpness of switching from one correlation pattern to another show the largest differences between groups. These findings reveal that the early epileptic encephalopathies are associated with characteristic dynamic features at the network level. Quantitative network-based analyses like the one presented here may in the future inform the clinical use of quantitative EEG for diagnosis.

  2. [Epilepsy and epileptic syndromes during the first year of life].

    Science.gov (United States)

    Durá-Travé, T; Yoldi-Petri, M E; Hualde-Olascoaga, J; Etayo-Etayo, V

    To analyse the epidemiological characteristics and the relative distribution of the different types of epilepsy and epileptic syndromes during the first year of life. An analysis was performed of the patient records of all patients with epilepsy diagnosed during their first year of life who were submitted to a developmental check-up in the year 2007. The sample consisted of 60 patients (27 boys and 33 girls). Epidemiological and clinical data were collected, together with the findings from complementary examinations. The diagnostic criteria applied were those of the International League Against Epilepsy. The mean age at the time of diagnosis was 6.3 months. The mean follow-up time was 7.6 years. The aetiology was symptomatic in 40 cases (66.7%), cryptogenic in 16 (26.7%) and idiopathic in four cases (6.7%). Neuroimaging tests detected abnormalities in 34 patients (56.7%). West's syndrome (30%), symptomatic focal epilepsies (23.3%) and epilepsies linked to specific syndromes (16.7%) were the epileptic syndromes with the highest prevalence. Learning disabilities were observed in 82.5% of the children. Most epilepsies that present during the first year of life are symptomatic and/or cryptogenic, and are accompanied by psychoneurological impairment and/or resistance to therapy, which condition cognitive disorders that are eligible for specialised psycho-pedagogical intervention.

  3. Hyperspherical Manifold for EEG Signals of Epileptic Seizures

    Directory of Open Access Journals (Sweden)

    Tahir Ahmad

    2012-01-01

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

  4. 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

  5. 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.

  6. The new ILAE report on terminology and concepts for organization of epileptic seizures: a clinician's critical view and contribution.

    Science.gov (United States)

    Panayiotopoulos, Chrysostomos P

    2011-12-01

    focal seizures which should be described according to their manifestations." Such a proposition defies the essence and the principle of any classification that requires an organization and a common language for communication. Free text descriptions are fine in a manual of differential diagnosis but not as a classification system. Another striking weakness is that even the accepted types of epileptic seizure are listed by name only, without defining them. The result is avoidable confusion. Furthermore, the report fails to consider reflex epileptic seizures. Status epilepticus is the most conspicuous omission despite immense advances of our understanding of it and its relevance on the classification. It appears that the new ILAE report does not fulfill its intent to improve the previous classifications and it may be premature to submit anything similar to this for approval by the ILAE General Assembly. The ILAE Commission could benefit by asking experts in basic and clinical science to provide a concise statement in their field of expertise as, for example, what are focal, myoclonic, or absence seizures, and their subtypes, their manifestations, and their possible pathophysiology. Areas of certainties and uncertainties, agreements and disagreements should be identified and stated clearly, with documentation of the reasons for it. Probably this is the only way forward for a truly scientific, sound, and clinically meaningful organizational system for the epileptic seizures and the epilepsies. Wiley Periodicals, Inc. © 2011 International League Against Epilepsy.

  7. Determination of Four Anti-epileptic Drugs in Plasma Using Ultra Performance Liquid Chromatography with Mass Detection Technique.

    Science.gov (United States)

    Hassib, Sonia T; Hashem, Hanaa M A; Mahrouse, Marianne A; Mostafa, Eman A

    2018-04-10

    Status epilepticus (SE) is considered the second most frequent neurologic emergency. Its therapeutic management is performed using sequential anti-epileptic drug regimens. Diazepam (DIA), midazolam (MID), phenytoin (PHT) and phenobarbital (PB) are four drugs of different classes used sequentially in the management of SE. A sensitive, selective, accurate and precise method was developed and validated for simultaneous determination of the four anti-epileptic drugs in human plasma. Their separation and quantification were achieved using ultra performance liquid chromatography (UPLC) with mass detection using carbamazepine as internal standard (IS). For the first three drugs and IS, UPLC-MS/MS with electrospray ionization working in multiple reaction monitoring mode was used at the following transitions: m/z 285→193 for DIA, m/z 326→291 for MID, m/z 253→182 for PHT and m/z 237→194, 237→192 for IS. For the fourth drug (PB), molecular ion peak of PB [M+H] + at m/z 233 was used for its quantitation. The method was linear over concentration ranges of 5-500 ng/ml for DIA and MID and 0.25-20 μg/ml for PHT and PB, respectively. Bio-analytical validation of the developed method was carried out according to European Medicines Agency guidelines. The developed method can be applied for routine drug analysis, therapeutic drug monitoring and bioequivalence studies. This article is protected by copyright. All rights reserved.

  8. 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 ...

  9. Hidden pattern discovery on epileptic EEG with 1-D local binary patterns and epileptic seizures detection by grey relational analysis.

    Science.gov (United States)

    Kaya, Yılmaz

    2015-09-01

    This paper proposes a novel approach to detect epilepsy seizures by using Electroencephalography (EEG), which is one of the most common methods for the diagnosis of epilepsy, based on 1-Dimension Local Binary Pattern (1D-LBP) and grey relational analysis (GRA) methods. The main aim of this paper is to evaluate and validate a novel approach, which is a computer-based quantitative EEG analyzing method and based on grey systems, aimed to help decision-maker. In this study, 1D-LBP, which utilizes all data points, was employed for extracting features in raw EEG signals, Fisher score (FS) was employed to select the representative features, which can also be determined as hidden patterns. Additionally, GRA is performed to classify EEG signals through these Fisher scored features. The experimental results of the proposed approach, which was employed in a public dataset for validation, showed that it has a high accuracy in identifying epileptic EEG signals. For various combinations of epileptic EEG, such as A-E, B-E, C-E, D-E, and A-D clusters, 100, 96, 100, 99.00 and 100% were achieved, respectively. Also, this work presents an attempt to develop a new general-purpose hidden pattern determination scheme, which can be utilized for different categories of time-varying signals.

  10. Historic, clinical, and prognostic features of epileptic encephalopathies caused by CDKL5 mutations.

    Science.gov (United States)

    Moseley, Brian D; Dhamija, Radhika; Wirrell, Elaine C; Nickels, Katherine C

    2012-02-01

    Mutations within the X-linked cyclin-dependent kinase-like 5 (CDKL5) gene are important causes of early-onset epileptic encephalopathies. We sought to determine the historic, clinical, and prognostic features of epilepsy secondary to CDKL5 mutations. We performed retrospective chart reviews of children at our institution with epilepsy and CDKL5 mutations. Six children were identified. One manifested a deletion in exons 10-15 of the CDKL5 gene, another manifested a single base-pair duplication in exon 3, and the rest manifested base-pair exchanges. The mean age of seizure onset was 1.8 months (range, 1-3 months). Although the majority (4/6, 67%) presented with partial-onset seizures, all children developed infantile spasms. All children demonstrated developmental delay and visual impairment. Although such mutations are X-linked, two children were boys. They did not present with more severe phenotypes than their female counterparts. Despite trials of antiepileptic drugs (mean, 5; range, 3-7), steroids/adrenocorticotropic hormone (4/6; 67%), and the ketogenic diet (6/6; 100%), all children manifested refractory seizures at last follow-up. Although no treatment eliminated seizures, topiramate, vigabatrin, and the ketogenic diet were most helpful at reducing seizure frequency. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Regional cerebral blood flow in epileptic foci using [I-123] IMP-SPECT

    International Nuclear Information System (INIS)

    Konishi, Tohru

    1989-01-01

    Fifty-six epileptic patients, whose ages ranged from 6 months to 16 years (a mean age, 8 years and 2 months), were examined by single photon emission computed tomography (SPECT) with [I-123] N-isopropyl p-iodoamphetamine (IMP). Of these patients, 44 had partial seizures (PS) and 12 had generalized seizures (GS). SPECT revealed abnormality of regional cerebral blood flow (rCBF) in 24 PS patients (54.5%), being correlated with EEG abnormality. Among the 24 patients, 22 had a decreased rCBF and 2 others had an increased rCBF. According to the PS type, rCBF abnormality in the foci was less frequently observed for benign age-related partial epilepsy (2/9) than for the other types of partial epilepsy (22/35). Among 35 patients with the other types of partial epilepsy, SPECT showed foci in the frontal (12), central (3), parietal (4), temporal (6), and occipital (6) regions, and diffuse spike-wave or the lack of paroaxysmals (4). The EEG foci was of the left hemisphere in 12 patients, and of the right hemisphere in 18 patients. Higher incidence of rCBF abnormality was associated with the temporal, partietal, and frontal foci than with the occipital foci. There was no correlation between the incidence of rCBF abnormlaity and the frequency of seizure activities on EEG. Complex partial seizures had a tendency to be associated with rCBF abnormality. In comparing IMP uptake in evaluable 17 patients with a decreased rCBF, a mean %CBF in foci compared to that in the contralateral area was 91.9%. All of the 12 GS patients showed no focal reduction of rCBF around the cortex. Patients with tonic-clonic seizure and myoclonic seizure had almost normal IMP images. The IMP images of organic lesions were a marked reduction of rCBF. IMP-SPECT may also be suitable for evaluating the underlying organic and secondary involving disorders with epilepsy. (N.K.)

  12. The ketogenic diet can be used successfully in combination with corticosteroids for epileptic encephalopathies.

    Science.gov (United States)

    Ville, Dorothée; Chiron, Catherine; Laschet, Jacques; Dulac, Olivier

    2015-07-01

    Hormonal therapy or ketogenic diet often permits overcoming the challenging periods of many epileptic encephalopathies (West and Lennox-Gastaut syndromes and encephalopathy with continuous spike-waves in slow sleep), but relapse affects over 20% of patients. We report here a monocenter pilot series of 42 consecutive patients in whom we combined oral steroids with the ketogenic diet for corticosteroid-resistant or -dependent epileptic encephalopathy. We retrospectively evaluated the effect on seizure frequency, interictal spike activity, neuropsychological course, and steroid treatment course. Twenty-three patients had West syndrome (WS), 13 had encephalopathy with continuous spike-waves in slow sleep (CSWS), and six others had miscellaneous epileptic encephalopathies. All patients succeeded to reach 0.8 to 1.6g/l ketone bodies in the urine following the usual KD regimen. For at least 6 months, 14/42 responded to the addition of the ketogenic diet: 4/23 with WS, 8/13 with CSWS, and 2/6 with miscellaneous epileptic encephalopathies. The addition of the KD allowed withdrawing steroids in all responders. Among them, 10/15 had been patients with steroid-dependent epileptic encephalopathy and 4/27 patients with steroid-resistant epileptic encephalopathy. Therefore, the ketogenic diet can be used successfully in combination with corticosteroids for epileptic encephalopathies. Patients presenting with steroid-dependent CSWS seem to be the best candidates. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Rare GABRA3 variants are associated with epileptic seizures, encephalopathy and dysmorphic features.

    Science.gov (United States)

    Niturad, Cristina Elena; Lev, Dorit; Kalscheuer, Vera M; Charzewska, Agnieszka; Schubert, Julian; Lerman-Sagie, Tally; Kroes, Hester Y; Oegema, Renske; Traverso, Monica; Specchio, Nicola; Lassota, Maria; Chelly, Jamel; Bennett-Back, Odeya; Carmi, Nirit; Koffler-Brill, Tal; Iacomino, Michele; Trivisano, Marina; Capovilla, Giuseppe; Striano, Pasquale; Nawara, Magdalena; Rzonca, Sylwia; Fischer, Ute; Bienek, Melanie; Jensen, Corinna; Hu, Hao; Thiele, Holger; Altmüller, Janine; Krause, Roland; May, Patrick; Becker, Felicitas; Balling, Rudi; Biskup, Saskia; Haas, Stefan A; Nürnberg, Peter; van Gassen, Koen L I; Lerche, Holger; Zara, Federico; Maljevic, Snezana; Leshinsky-Silver, Esther

    2017-11-01

    Genetic epilepsies are caused by mutations in a range of different genes, many of them encoding ion channels, receptors or transporters. While the number of detected variants and genes increased dramatically in the recent years, pleiotropic effects have also been recognized, revealing that clinical syndromes with various degrees of severity arise from a single gene, a single mutation, or from different mutations showing similar functional defects. Accordingly, several genes coding for GABAA receptor subunits have been linked to a spectrum of benign to severe epileptic disorders and it was shown that a loss of function presents the major correlated pathomechanism. Here, we identified six variants in GABRA3 encoding the α3-subunit of the GABAA receptor. This gene is located on chromosome Xq28 and has not been previously associated with human disease. Five missense variants and one microduplication were detected in four families and two sporadic cases presenting with a range of epileptic seizure types, a varying degree of intellectual disability and developmental delay, sometimes with dysmorphic features or nystagmus. The variants co-segregated mostly but not completely with the phenotype in the families, indicating in some cases incomplete penetrance, involvement of other genes, or presence of phenocopies. Overall, males were more severely affected and there were three asymptomatic female mutation carriers compared to only one male without a clinical phenotype. X-chromosome inactivation studies could not explain the phenotypic variability in females. Three detected missense variants are localized in the extracellular GABA-binding NH2-terminus, one in the M2-M3 linker and one in the M4 transmembrane segment of the α3-subunit. Functional studies in Xenopus laevis oocytes revealed a variable but significant reduction of GABA-evoked anion currents for all mutants compared to wild-type receptors. The degree of current reduction correlated partially with the phenotype

  14. 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

  15. 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.

  16. Epileptic seizures and headache/migraine: a review of types of association and terminology.

    Science.gov (United States)

    Cianchetti, Carlo; Pruna, Dario; Ledda, Mariagiuseppina

    2013-11-01

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

  17. Dextromethorphan in the treatment of early myoclonic encephalopathy evolving into migrating partial seizures in infancy

    Directory of Open Access Journals (Sweden)

    Yin-Hsuan Chien

    2012-05-01

    Full Text Available Epileptic encephalopathy with suppression-burst in electroencephalography (EEG can evolve into a few types of epileptic syndromes. We present here an unusual case of early myoclonic encephalopathy that evolved into migrating partial seizures in infancy. A female neonate initially had erratic myoclonus movements, hiccups, and a suppression-burst pattern in EEG that was compatible with early myoclonic encephalopathy. The seizures were controlled with dextromethorphan (20 mg/kg, and a suppression-burst pattern in EEG was reverted to relatively normal background activity. However, at 72 days of age, alternating focal tonic seizures, compatible with migrating partial seizures in infancy, were demonstrated by the 24-hour EEG recording. The seizures responded poorly to dextromethorphan. To our knowledge, this is the first reported case of early myoclonic encephalopathy evolving into migrating partial seizure in infancy. Whether it represents another age-dependent epilepsy evolution needs more clinical observation.

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

    Science.gov (United States)

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

    1996-06-01

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

  19. Do video games evoke specific types of epileptic seizures?

    Science.gov (United States)

    Piccioli, Marta; Vigevano, Federico; Buttinelli, Carla; Kasteleijn-Nolst Trenité, Dorothée G A

    2005-11-01

    We determined whether epileptic clinical manifestations evoked by playing video games (VG) differ from those evoked by intermittent photic stimulation (IPS) or striped patterns (P). We exposed nine children who had TV- and VG-evoked seizures in daily life to 12 VG after standardized photic stimulation and pattern stimulation. Their EEGs were recorded continuously, analyzed, and then correlated with a video of their behavior. Similar types of clinical signs were seen during VG, P, and IPS, but the signs we observed were more subtle during the VG. Eight patients showed a clear lateralization. A new observation was the lowering of the eyelids to a state of half-closed. Our study suggests that the type of visual stimulus provoking a photoparoxysmal response or seizure is not particularly relevant. The children belonged to different epilepsy groups, and our findings add to the discussion on the boundaries of the epilepsy types.

  20. Collective excitability in a mesoscopic neuronal model of epileptic activity

    Science.gov (United States)

    Jedynak, Maciej; Pons, Antonio J.; Garcia-Ojalvo, Jordi

    2018-01-01

    At the mesoscopic scale, the brain can be understood as a collection of interacting neuronal oscillators, but the extent to which its sustained activity is due to coupling among brain areas is still unclear. Here we address this issue in a simplified situation by examining the effect of coupling between two cortical columns described via Jansen-Rit neural mass models. Our results show that coupling between the two neuronal populations gives rise to stochastic initiations of sustained collective activity, which can be interpreted as epileptic events. For large enough coupling strengths, termination of these events results mainly from the emergence of synchronization between the columns, and thus it is controlled by coupling instead of noise. Stochastic triggering and noise-independent durations are characteristic of excitable dynamics, and thus we interpret our results in terms of collective excitability.

  1. Mental development of tuberous sclerosis with regard to epileptic seizures and CT findings

    International Nuclear Information System (INIS)

    Katafuchi, Yukihiko; Ishihara, Osamu; Matsuishi, Toyojiro; Shiotsuki, Yuko; Yamaguchi, Yoichiro; Imuta, Fusae

    1985-01-01

    The relation of mental development to epileptic seizures and CT findings was examined in 17 patients with tuberous sclerosis. Epileptic seizures occurred in 16 of the 17 patients. The earlier it occurred, the higher the incidence of mental retardation was. There was no constant correlation between mental development and the type of epileptic seizures or the attainment of inhibition of seizures. In two patients in whom calcification spreading to the cerebral cortex and subcortical region was detected on CT, in addition to calcified tubercles around the cerebral ventricle, an intelligence quotient was significantly lower than in the other patients. (Namekawa, K.)

  2. Health-related quality of life in epilepsy patients receiving anti-epileptic drugs at National Referral Hospitals in Uganda: a cross-sectional study.

    Science.gov (United States)

    Nabukenya, Anne M; Matovu, Joseph K B; Wabwire-Mangen, Fred; Wanyenze, Rhoda K; Makumbi, Fredrick

    2014-04-12

    Epilepsy is a devastating disorder that impacts on patients' quality of life, irrespective of use of anti epileptic drugs (AEDs). This study estimates the health-related quality of life (HRQOL) and its associated predictors among epilepsy patients receiving AEDs. A total of 175 epilepsy patients already receiving AED for at least 3 months were randomly selected and interviewed from mental clinics at Mulago and Butabika national referral hospitals in Uganda between May - July 2011. A HRQOL index, the primary outcome, was constructed using items from Quality Of Life in Epilepsy Inventory (QOLIE-31) and the Hospital Anxiety and Depression Scale (HADS) questionnaires. The internal consistency and adequacy of these items was also computed using Cronbach's alpha and Kaiser-Meyer-Olkin tests. Partial correlations were used to evaluate the contribution of the health dimensions (mental, psychological, social, physical functioning and emotional well being) and, multiple linear regressions to determine factors independently associated with HRQOL. Just about half of the respondents (54%) were males, and nearly two thirds (62%) had received AEDs for at least 12 months. The average age was 26.6 years (SD = 11.1). The overall HRQOL mean score was 58 (SD = 13) on a scale of 0-100. The average scores of different dimensions or subscales ranged from 41 (physical) to 65 (psychological). At least three quarters (75%) of all subscales had good internal consistency and adequacy. The largest variations in the overall HRQOL were explained by social and mental functioning; each accounting for about 30% of the difference in the HRQOL but seizure control features explained a little (6%) variation. Factors negatively associated with HRQOL were poly-therapy (-1.16, p = 0.01) and frequency of seizures (-2.29, p = 0.00). Other factors associated with overall HRQOL included drug side effects, sex, marital status and education. Duration on AEDs was not a significant predictor of HRQOL. The HRQOL

  3. Psychogenic non-epileptic seizures: our video-EEG experience.

    Science.gov (United States)

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

    2011-09-01

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

  4. Effect of partial supplementation of sun-dried Azolla as a protein source on the immunity and antioxidant status of commercial broilers

    Directory of Open Access Journals (Sweden)

    Biswal Chichilichi

    2015-09-01

    Full Text Available Aim: The present study was conducted to evaluate the effect of partial supplementation of sun-dried Azolla as a protein source on the immunity of commercial broilers in coastal Odisha. Materials and Methods: A 180 day-old broiler chicks were distributed in six dietary treatments viz. C1: Basal diet, C2: Basal diet + enzyme, T1: Basal diet +5% protein from Azolla, T2: Basal diet + 5% protein from Azolla + enzyme, T3: Basal diet +10% protein from Azolla, and T4: Basal diet + 10% protein from Azolla + enzyme. Cutaneous basophilc hypersensitivity (CBH and humoral immunity response were determined at the 38th day of age. At 42nd day, the weight of lymphoid organs, an antioxidant enzyme, and lipid peroxidation activity were determined. Results: The CBH response did not differ significantly among the treated groups, but the sheep red blood cells response was significantly higher in T4. The weight of lymphoid organs or immune organs of all the treated groups did not differ significantly (p>0.05. The erythrocyte catalase level of T4 group was found to be significantly higher than rest of the treated groups except T3. Conclusion: It may be concluded that supplementation of Azolla at 10% of dietary protein requirement along with enzyme supplementation in an isonitrogenous diet showed a better immune response in broilers.

  5. Effect of partial supplementation of sun-dried Azolla as a protein source on the immunity and antioxidant status of commercial broilers.

    Science.gov (United States)

    Chichilichi, Biswal; Mohanty, G P; Mishra, S K; Pradhan, C R; Behura, N C; Das, A; Behera, K

    2015-09-01

    The present study was conducted to evaluate the effect of partial supplementation of sun-dried Azolla as a protein source on the immunity of commercial broilers in coastal Odisha. A 180 day-old broiler chicks were distributed in six dietary treatments viz. C1: Basal diet, C2: Basal diet + enzyme, T1: Basal diet +5% protein from Azolla, T2: Basal diet + 5% protein from Azolla + enzyme, T3: Basal diet +10% protein from Azolla, and T4: Basal diet + 10% protein from Azolla + enzyme. Cutaneous basophilc hypersensitivity (CBH) and humoral immunity response were determined at the 38(th) day of age. At 42(nd) day, the weight of lymphoid organs, an antioxidant enzyme, and lipid peroxidation activity were determined. The CBH response did not differ significantly among the treated groups, but the sheep red blood cells response was significantly higher in T4. The weight of lymphoid organs or immune organs of all the treated groups did not differ significantly (p>0.05). The erythrocyte catalase level of T4 group was found to be significantly higher than rest of the treated groups except T3. It may be concluded that supplementation of Azolla at 10% of dietary protein requirement along with enzyme supplementation in an isonitrogenous diet showed a better immune response in broilers.

  6. High expression of cystine-glutamate antiporter xCT (SLC7A11) is an independent biomarker for epileptic seizures at diagnosis in glioma

    DEFF Research Database (Denmark)

    Sørensen, Mai Froberg; Heimisdóttir, Sólborg Berglind; Sørensen, Mia Dahl

    2018-01-01

    Epileptic seizures are an important cause of morbidity in glioma patients. Substantial lines of evidence support the concept of the excitatory neurotransmitter glutamate being a crucial mediator of glioma-associated seizures. In gliomas, non-vesicular secretion of glutamate via the cystine...... tumor using tissue microarrays. In addition to histological grading of the tumors, isocitrate dehydrogenase 1 (IDH1) R132H mutational status was determined by immunohistochemistry. 215 consecutive glioma patients were included in the study (7.4% grade II, 7.0% grade III, 85.6% grade IV). High x...

  7. De novo mutations in synaptic transmission genes including DNM1 cause epileptic encephalopathies

    DEFF Research Database (Denmark)

    2014-01-01

    in five individuals and de novo mutations in GABBR2, FASN, and RYR3 in two individuals each. Unlike previous studies, this cohort is sufficiently large to show a significant excess of de novo mutations in epileptic encephalopathy probands compared to the general population using a likelihood analysis (p...... = 8.2 × 10(-4)), supporting a prominent role for de novo mutations in epileptic encephalopathies. We bring statistical evidence that mutations in DNM1 cause epileptic encephalopathy, find suggestive evidence for a role of three additional genes, and show that at least 12% of analyzed individuals have...... analyzed exome-sequencing data of 356 trios with the "classical" epileptic encephalopathies, infantile spasms and Lennox Gastaut syndrome, including 264 trios previously analyzed by the Epi4K/EPGP consortium. In this expanded cohort, we find 429 de novo mutations, including de novo mutations in DNM1...

  8. Fertility rate oF epileptic women at Kenyatta national Hospital

    African Journals Online (AJOL)

    2008-07-07

    Jul 7, 2008 ... multifaceted, and both epilepsy and antiepileptic drug (aeDs) use may alter fertility and pregnancy ... Conclusion: Fertility rate in epileptic women is decreased by two thirds ..... The effect of this bias on our primary aim was.

  9. An acardiac acephalic monster following in-utero anti-epileptic drug exposure.

    Science.gov (United States)

    Kutlay, B; Bayramoglu, S; Kutlar, A I; Yesildaglar, N

    1996-04-01

    Acardia, the absence of the heart, is one of the rarest medical anomalies. The exact mechanism which causes this anomaly is still unknown. The authors report the acardiac acephalic fetus of an epileptic mother who was on primidone therapy. The mother who received no antenatal care stopped taking primidone (her sole medication) in the third month of pregnancy with the fear of delivering a malformed baby and had three convulsions until delivery. This is the first reported case of acardia associated with anti-epileptic medication. The cause of the anomaly in this patient may be an unknown genetic defect, the maternal epileptic disorder, the convulsions, the anti-epileptic medication, or a combination of these factors.

  10. Combined Effects of Feedforward Inhibition and Excitation in Thalamocortical Circuit on the Transitions of Epileptic Seizures

    Science.gov (United States)

    Fan, Denggui; Duan, Lixia; Wang, Qian; Luan, Guoming

    2017-01-01

    The mechanisms underlying electrophysiologically observed two-way transitions between absence and tonic-clonic epileptic seizures in cerebral cortex remain unknown. The interplay within thalamocortical network is believed to give rise to these epileptic multiple modes of activity and transitions between them. In particular, it is thought that in some areas of cortex there exists feedforward inhibition from specific relay nucleus of thalamus (TC) to inhibitory neuronal population (IN) which has even more stronger functions on cortical activities than the known feedforward excitation from TC to excitatory neuronal population (EX). Inspired by this, we proposed a modified computational model by introducing feedforward inhibitory connectivity within thalamocortical circuit, to systematically investigate the combined effects of feedforward inhibition and excitation on transitions of epileptic seizures. We first found that the feedforward excitation can induce the transition from tonic oscillation to spike and wave discharges (SWD) in cortex, i.e., the epileptic tonic-absence seizures, with the fixed weak feedforward inhibition. Thereinto, the phase of absence seizures corresponding to strong feedforward excitation can be further transformed into the clonic oscillations with the increasing of feedforward inhibition, representing the epileptic absence-clonic seizures. We also observed the other fascinating dynamical states, such as periodic 2/3/4-spike and wave discharges, reversed SWD and clonic oscillations, as well as saturated firings. More importantly, we can identify the stable parameter regions representing the tonic-clonic oscillations and SWD discharges of epileptic seizures on the 2-D plane composed of feedforward inhibition and excitation, where the physiologically plausible transition pathways between tonic-clonic and absence seizures can be figured out. These results indicate the functional role of feedforward pathways in controlling epileptic seizures and

  11. The lateralizing and localizing value of peri-ictal cough in epileptic seizures

    OpenAIRE

    Korkmaz, Bektaş; Erşen, Gülsün; Delil, Şakir; Özkara, Çiğdem; Yeni, S. Naz

    2013-01-01

    Introduction. Coughing may be observed as an epiphenomenon during or after epileptic seizures. Aim. In this paper we discuss the lateralization and localization value of cough as an epileptic peri/post ictal semiological phenomenon. Material and Methods. Seven patients presenting cough as a part of their symptomatology are presented. We will discuss cough in the context of these seven patients. Results. Six out of these seven patients were multidrug resistant temporal lobe epilepsy patient...

  12. Recurrent occurrences of CDKL5 mutations in patients with epileptic encephalopathy.

    Science.gov (United States)

    Yamamoto, Toshiyuki; Shimojima, Keiko; Kimura, Nobusuke; Mogami, Yukiko; Usui, Daisuke; Takayama, Rumiko; Ikeda, Hiroko; Imai, Katsumi

    2015-01-01

    The cyclin-dependent kinase-like 5 gene (CDKL5) is recognized as one of the genes responsible for epileptic encephalopathy. We identified CDKL5 mutations in five Japanese patients (one male and four female) with epileptic encephalopathy. Although all mutations were of de novo origin, they were located in the same positions as previously reported pathogenic mutations. These recurrent occurrences of de novo mutations in the same loci may indicate hot spots of nucleotide alteration.

  13. Epileptic seizure, as the first symptom of hypoparathyroidism in children, does not require antiepileptic drugs

    OpenAIRE

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

    2016-01-01

    Objective Patients with hypoparathyroidism exhibit metabolic disorders (hypocalcemia) and brain structural abnormalities (brain calcifications). Currently, studies have determined whether antiepileptic drug (AED) treatment is required for epileptic seizures in children with hypoparathyroidism. Method This study aims to evaluate the data of two medical centers in Beijing based on the diagnosis of epileptic seizures as the first symptom of hypoparathyroidism in children. Result A total of 42 pa...

  14. Application of magnetic source imaging in localizing the epileptic foci in patients with grey matter heterotopia

    International Nuclear Information System (INIS)

    Sun Jilin; Wu Jie; Jia Xiuchuan; Li Sumin

    2011-01-01

    Objective: To evaluate the value of magnetic source imaging (MSI) in localizing the epileptic foci of patients with histologically proved grey matter heterotopia (GMH) and seizure. Methods: MSI examinations were performed on 8 patients with GMH and seizure. The location of the epileptic foci defined by MSI was compared with the results of the ECoG. After imaging examinations, all patients received operation with 13-48 months follow up to observe the effectiveness of the operation. Results: Among the 8 patients, 1 had hippocampal sclerosis, 2 had focal cortical dysplasia of type Ⅰ B and 1 had focal cortical dysplasia of type Ⅱ B. MRI showed normal findings in 2 cases, subcortical heterotopia in 4 cases, and nodular heterotopia in 2 cases with one having schizencephaly. The epileptic foci defined by MSI were at right temporal lobe in 2 cases, left frontal lobe in 2 cases, biparietal lobe in 1 case, left parietal lobe in 1 case, left temporal lobe in 1 case, and left frontal-parietal lobe in 1 case. The epileptic foci defined by MSI were completely overlaid with area of GMH in 4 cases, closely behind the area of GMH in case, and partly overlaid with area of CMH in 1 cases with size larger than that of the latter. One patient showed two epileptic foci with one located within the area of GMH and the other one 2 centimeters anterior to the area of GMH. One case's epileptic focus located 2 centimeters posteolateral to the area of GMH. The locations of the epileptic foci defined by MSI showed no difference with those defined by ECoG in all patients. According to Engel classification of treatment effect of epilepsy, 6 patients achieved Engle class Ⅰ ( seizure free after operation), and 2 patients Engel class Ⅳ (no changes in the frequency of occurrence of seizures before and after operation). Conclusion: MSI can noninvasively and precisely localize the epileptic foci before operation in patients with GMH and seizure. (authors)

  15. Combined Effects of Feedforward Inhibition and Excitation in Thalamocortical Circuit on the Transitions of Epileptic Seizures

    Directory of Open Access Journals (Sweden)

    Denggui Fan

    2017-07-01

    Full Text Available The mechanisms underlying electrophysiologically observed two-way transitions between absence and tonic-clonic epileptic seizures in cerebral cortex remain unknown. The interplay within thalamocortical network is believed to give rise to these epileptic multiple modes of activity and transitions between them. In particular, it is thought that in some areas of cortex there exists feedforward inhibition from specific relay nucleus of thalamus (TC to inhibitory neuronal population (IN which has even more stronger functions on cortical activities than the known feedforward excitation from TC to excitatory neuronal population (EX. Inspired by this, we proposed a modified computational model by introducing feedforward inhibitory connectivity within thalamocortical circuit, to systematically investigate the combined effects of feedforward inhibition and excitation on transitions of epileptic seizures. We first found that the feedforward excitation can induce the transition from tonic oscillation to spike and wave discharges (SWD in cortex, i.e., the epileptic tonic-absence seizures, with the fixed weak feedforward inhibition. Thereinto, the phase of absence seizures corresponding to strong feedforward excitation can be further transformed into the clonic oscillations with the increasing of feedforward inhibition, representing the epileptic absence-clonic seizures. We also observed the other fascinating dynamical states, such as periodic 2/3/4-spike and wave discharges, reversed SWD and clonic oscillations, as well as saturated firings. More importantly, we can identify the stable parameter regions representing the tonic-clonic oscillations and SWD discharges of epileptic seizures on the 2-D plane composed of feedforward inhibition and excitation, where the physiologically plausible transition pathways between tonic-clonic and absence seizures can be figured out. These results indicate the functional role of feedforward pathways in controlling epileptic

  16. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  18. Transplantation of bone marrow mononuclear cells modulates hippocampal expression of growth factors in chronically epileptic animals.

    Science.gov (United States)

    Zanirati, Gabriele; Azevedo, Pamella Nunes; Marinowic, Daniel Rodrigo; Rodrigues, Felipe; de Oliveira Dias, Ana Christina; Venturin, Gianina Teribele; Greggio, Samuel; Simão, Fabrício; DaCosta, Jaderson Costa

    2015-05-01

    In previous studies, transplantation of bone marrow mononuclear cells (BMMCs) in epileptic animals has been found to be neuroprotective. However, the mechanism by which the BMMCs act remains unclear. We hypothesize that BMMCs may provide neuroprotection to the epileptic brain through trophic support. To test our hypothesis, we studied the temporal expression of neurotrophins after BMMC transplantation in the epileptic rat hippocampus. Chronically epileptic rats were intravenously transplanted with 1 × 10(7) BMMCs isolated from GFP transgenic mice. Expression levels of BDNF, GDNF, NGF, VEGF, and TGF-β1, and their receptors, were evaluated by ELISA and/or qRT-PCR analysis. Our data revealed increased protein expression of BDNF, GDNF, NGF, and VEGF and reduced levels of TGF-β1 in the hippocampus of transplanted epileptic animals. Additionally, an increase in the mRNA expression of BDNF, GDNF, and VEGF, a reduction in TGF-β1, and a decrease in mRNA levels of the TrkA and TGFR-β1 receptors were also observed. The gain provided by transplanted BMMCs in the epileptic brain may be related to the ability of these cells in modulating the network of neurotrophins and angiogenic signals. © 2015 John Wiley & Sons Ltd.

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  20. Two cases of childhood narcolepsy mimicking epileptic seizures in video-EEG/EMG.

    Science.gov (United States)

    Yanagishita, Tomoe; Ito, Susumu; Ohtani, Yui; Eto, Kaoru; Kanbayashi, Takashi; Oguni, Hirokazu; Nagata, Satoru

    2018-06-06

    Narcolepsy is characterized by excessive sleepiness, hypnagogic hallucinations, and sleep paralysis, and can occur with or without cataplexy. Here, we report two children with narcolepsy presenting with cataplexy mimicking epileptic seizures as determined by long-term video-electroencephalography (EEG) and electromyography (EMG) monitoring. Case 1 was a 15-year-old girl presenting with recurrent episodes of "convulsions" and loss of consciousness, who was referred to our hospital with a diagnosis of epilepsy showing "convulsions" and "complex partial seizures". The long-term video-polygraph showed a clonic attack lasting for 15 s, which corresponded to 1-2 Hz with interruption of mentalis EMG discharges lasting for 70-300 ms without any EEG changes. Narcolepsy was suspected due to the attack induced by hearty laughs and the presence of sleep attacks, and confirmed by low orexin levels in cerebrospinal fluid (CSF). Case 2 was an 11-year-old girl presenting with recurrent episodes of myoclonic attacks simultaneously with dropping objects immediately after hearty laughs, in addition to sleep attacks, hypnagogic hallucinations, and sleep paralysis. The long-term video-polygraph showed a subtle attack, characterized by dropping chopsticks from her hand, which corresponded to an interruption of ongoing deltoid EMG discharges lasting 140 ms without any EEG changes. A diagnosis of narcolepsy was confirmed by the low orexin levels in CSF. These cases demonstrate that children with narcolepsy may have attacks of cataplexy that resemble clonic or myoclonic seizures. Copyright © 2018 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  1. Extracellular metabolites in the cortex and hippocampus of epileptic patients.

    Science.gov (United States)

    Cavus, Idil; Kasoff, Willard S; Cassaday, Michael P; Jacob, Ralph; Gueorguieva, Ralitza; Sherwin, Robert S; Krystal, John H; Spencer, Dennis D; Abi-Saab, Walid M

    2005-02-01

    Interictal brain energy metabolism and glutamate-glutamine cycling are impaired in epilepsy and may contribute to seizure generation. We used the zero-flow microdialysis method to measure the extracellular levels of glutamate, glutamine, and the major energy substrates glucose and lactate in the epileptogenic and the nonepileptogenic cortex and hippocampus of 38 awake epileptic patients during the interictal period. Depth electrodes attached to microdialysis probes were used to identify the epileptogenic and the nonepileptogenic sites. The epileptogenic hippocampus had surprisingly high basal glutamate levels, low glutamine/glutamate ratio, high lactate levels, and indication for poor glucose utilization. The epileptogenic cortex had only marginally increased glutamate levels. We propose that interictal energetic deficiency in the epileptogenic hippocampus could contribute to impaired glutamate reuptake and glutamate-glutamine cycling, resulting in persistently increased extracellular glutamate, glial and neuronal toxicity, increased lactate production together with poor lactate and glucose utilization, and ultimately worsening energy metabolism. Our data suggest that a different neurometabolic process underlies the neocortical epilepsies.

  2. Oxcabazepine (®Trileptal in Anti-Epileptic Polytherapy

    Directory of Open Access Journals (Sweden)

    Peder Klosterskov Jensen

    1990-01-01

    Full Text Available The anti-epileptic activity of oxcarbazepine (OXC was compared with that of carbamazepine (CBZ and the primary active metabolite of OXC, a monohydroxy derivative (MHD. Altogether 255 patients receiving either OXC or MHD (192 and 63 patients respectively were included in the analysis of efficacy. Out of these 255 patients a total of 40 were children. The duration of treatment varied between 8 and 24weeks. The daily dose of OXC or MHD varied between 600 and 5400 mg (in children 600–2400 mg. Out of five studies two were double-blind controlled studies (including a total of 105 patients whereas the remaining three were open studies. The results of these studies indicate that, in adults with epilepsy, there is no statistically significant difference in overall seizure frequency between CBZ and OXC. In one double-blind study the number of generalized tonic-clonic seizures was significantly less frequent during treatment with OXC than with CBZ. No statistically significant difference with regard to side-effects was observed between OXC and CBZ. The results in children with epilepsy show a statistically significant difference in seizure frequency in favour of OXC, in comparison with CBZ. Overall, the polytherapy studies in adults and children support the effectiveness and safety of oxcarbazepine.

  3. Anti Epileptic Activity of Morinda citrifolia Linn Fruit Extract

    Directory of Open Access Journals (Sweden)

    P. Muralidharan

    2010-01-01

    Full Text Available Fruit extract of Morinda citrifolia (Noni, a medicinal plant used in many neuro protective ayurvedic preparations was evaluated for its protective effect against seizures induced by Maximal Electro Shock (MES method in rats. A daily dose of 200 and 400 mg/kg of the extract was administered to the animals for 15 days, after which seizures were induced by maximum electro shock method and the duration of various phases of epileptic attacks were recorded and compared with the control animals. A significant (P<0.01 and P<0.001 reduction in the time taken for righting reflex (recovery was noted in the experimental animals. The levels of biogenic amines such as dopamine, serotonin and nor-adrenaline in the forebrain region were also estimated and a significant level of restoration was opserved in the extract treated animals. Significant results were opserved in the estimated parameters thereby justifying the use of this medicinal plant in the treatment of epilepsy.

  4. [Epileptic encephalopathy associated with forced normalization after administration of levetiracetam].

    Science.gov (United States)

    Kikuchi, Takahiro; Kato, Mitsuhiro; Takahashi, Nobuya; Nakamura, Kazuyuki; Hayasaka, Kiyoshi

    2013-09-01

    Here we report a case of a 10-year-old female with unclassified epileptic encephalopathy who showed forced normalization after administration of levetiracetam (LEV). She initially presented with intractable tonic and myoclonic seizures that were observed about 10 times a day along with frequent multifocal sharp and slow wave complexes on electroencephalography (EEG). We were forced to decrease the topiramate dose because of the appearance of nystagmus, and her myoclonic seizures became worse. We added LEV (250 mg/day) and her tonic and myoclonic seizures disappeared one day after initiation of LEV administration. However, she showed hyporesponsiveness and akinesia. The disappearance of paroxysmal discharges on EEG confirmed the diagnosis of forced normalization. Despite continuous administration of LEV, tonic and myoclonic seizures relapsed within a month but her psychotic symptoms resolved simultaneously. To the best of our knowledge, this is the first reported case of forced normalization after LEV administration. It should be noted that LEV may cause forced normalization although it can be started at an adequate dosage.

  5. Modeling of intracerebral interictal epileptic discharges: Evidence for network interactions.

    Science.gov (United States)

    Meesters, Stephan; Ossenblok, Pauly; Colon, Albert; Wagner, Louis; Schijns, Olaf; Boon, Paul; Florack, Luc; Fuster, Andrea

    2018-06-01

    The interictal epileptic discharges (IEDs) occurring in stereotactic EEG (SEEG) recordings are in general abundant compared to ictal discharges, but difficult to interpret due to complex underlying network interactions. A framework is developed to model these network interactions. To identify the synchronized neuronal activity underlying the IEDs, the variation in correlation over time of the SEEG signals is related to the occurrence of IEDs using the general linear model. The interdependency is assessed of the brain areas that reflect highly synchronized neural activity by applying independent component analysis, followed by cluster analysis of the spatial distributions of the independent components. The spatiotemporal interactions of the spike clusters reveal the leading or lagging of brain areas. The analysis framework was evaluated for five successfully operated patients, showing that the spike cluster that was related to the MRI-visible brain lesions coincided with the seizure onset zone. The additional value of the framework was demonstrated for two more patients, who were MRI-negative and for whom surgery was not successful. A network approach is promising in case of complex epilepsies. Analysis of IEDs is considered a valuable addition to routine review of SEEG recordings, with the potential to increase the success rate of epilepsy surgery. Copyright © 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  6. Unsupervised EEG analysis for automated epileptic seizure detection

    Science.gov (United States)

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

    2016-07-01

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

  7. Significance of MDR1 and multiple drug resistance in refractory human epileptic brain

    Directory of Open Access Journals (Sweden)

    Dini Gabriele

    2004-10-01

    Full Text Available Abstract Background The multiple drug resistance protein (MDR1/P-glycoprotein is overexpressed in glia and blood-brain barrier (BBB endothelium in drug refractory human epileptic tissue. Since various antiepileptic drugs (AEDs can act as substrates for MDR1, the enhanced expression/function of this protein may increase their active extrusion from the brain, resulting in decreased responsiveness to AEDs. Methods Human drug resistant epileptic brain tissues were collected after surgical resection. Astrocyte cell cultures were established from these tissues, and commercially available normal human astrocytes were used as controls. Uptake of fluorescent doxorubicin and radioactive-labeled Phenytoin was measured in the two cell populations, and the effect of MDR1 blockers was evaluated. Frozen human epileptic brain tissue slices were double immunostained to locate MDR1 in neurons and glia. Other slices were exposed to toxic concentrations of Phenytoin to study cell viability in the presence or absence of a specific MDR1 blocker. Results MDR1 was overexpressed in blood vessels, astrocytes and neurons in human epileptic drug-resistant brain. In addition, MDR1-mediated cellular drug extrusion was increased in human 'epileptic' astrocytes compared to 'normal' ones. Concomitantly, cell viability in the presence of cytotoxic compounds was increased. Conclusions Overexpression of MDR1 in different cell types in drug-resistant epileptic human brain leads to functional alterations, not all of which are linked to drug pharmacokinetics. In particular, the modulation of glioneuronal MDR1 function in epileptic brain in the presence of toxic concentrations of xenobiotics may constitute a novel cytoprotective mechanism.

  8. Altered Expression of CXCL13 and CXCR5 in Intractable Temporal Lobe Epilepsy Patients and Pilocarpine-Induced Epileptic Rats.

    Science.gov (United States)

    Li, Ruohan; Ma, Limin; Huang, Hao; Ou, Shu; Yuan, Jinxian; Xu, Tao; Yu, Xinyuan; Liu, Xi; Yang, Juan; Chen, Yangmei; Peng, Xi

    2017-02-01

    The mechanisms that underlie the pathogenesis of epilepsy are still unclear. Recent studies have indicated that inflammatory processes occurring in the brain are involved in a common and crucial mechanism in epileptogenesis. C-X-C motif chemokine ligand 13 (CXCL13) and its only receptor, C-X-C motif chemokine receptor 5 (CXCR5), are highly expressed in the central nervous system (CNS) and participate in inflammatory responses. The present study aimed to assess the expression of CXCL13 and CXCR5 in the brain tissues of both patients with intractable epilepsy (IE) and a rat model (lithium-pilocarpine) of temporal lobe epilepsy (TLE) to identify possible roles of the CXCL13-CXCR5 signaling pathway in epileptogenesis. Real-time quantitative polymerase chain reaction (RT-qPCR), immunohistochemical, double-labeled immunofluorescence and Western blot analyses were performed in this study. CXCL13 and CXCR5 mRNA expression and protein levels were found to be significantly up-regulated in the TLE patients and TLE rats. Further, CXCL13 and CXCR5 protein levels were altered during the different epileptic phases after onset of status epilepticus (SE) in the pilocarpine model rats, including the acute phase (6, 24, and 72 h), latent phase (7 and 14 days) and chronic phase (30 and 60 days groups). Moreover, double-labeled immunofluorescence analysis revealed that CXCL13 was mainly expressed in the cytomembranes and cytoplasm of neurons and astrocytes, while CXCR5 was mainly expressed in the cytomembranes and cytoplasm of neurons. Thus, the CXCL13-CXCR5 signaling pathway may play a possible pathogenic role in IE. CXCL13 and CXCR5 may represent potential biomarkers of brain inflammation in epileptic patients.

  9. " Blaming, shaming, humiliation": Stigmatising medical interactions among people with non-epileptic seizures.

    Science.gov (United States)

    Robson, Catherine; Lian, Olaug S

    2017-01-01

    Background : People with non-epileptic seizures (NES) describe challenging relationships with health professionals, and explain negative interactions as common and expected. Despite these difficulties, little is known about how people with NES experience difficult healthcare encounters. Methods : Using a thematic discourse analysis approach, we analysed the free-text survey responses of 135 people with NES and asked: what kind of challenges do people living with this condition encounter when interacting with health professionals, and how do they experience the consequences of difficult interactions? We explore their experiences by interpreting the latent meaning of participants' texts from a social-constructionist perspective on health and illness. Results : The overarching narrative depicts a fundamental breakdown in patient-provider relationships. According to our data, the negative experiences of study participants emerge from more than practitioners' lack of awareness of NES and access to information about the condition - to the extent that it is available. In examining the challenges people with NES encounter when interacting with health professionals, their main experiences centre on blame and humiliation. When exploring their experiences, theories of stigma serve as a useful theoretical framework. Conclusions : Normative judgements arising from psychogenic understandings of NES are stigmatising and restrict professional displays of respectful (patient-centred) care. Those with the condition depict being negatively stereotyped, illegitimated and held morally culpable by health professionals. Perceived to lack medical, moral and credible status, participants describe practitioners who treat them with disrespect, and some recount conduct that defies all ethical and professional obligations and standards. These encounters can have wide-ranging adverse consequences for patients: emotionally, physically, and for their future healthcare. The quality of healthcare

  10. “ Blaming, shaming, humiliation”: Stigmatising medical interactions among people with non-epileptic seizures

    Science.gov (United States)

    Robson, Catherine; Lian, Olaug S.

    2017-01-01

    Background: People with non-epileptic seizures (NES) describe challenging relationships with health professionals, and explain negative interactions as common and expected. Despite these difficulties, little is known about how people with NES experience difficult healthcare encounters. Methods: Using a thematic discourse analysis approach, we analysed the free-text survey responses of 135 people with NES and asked: what kind of challenges do people living with this condition encounter when interacting with health professionals, and how do they experience the consequences of difficult interactions? We explore their experiences by interpreting the latent meaning of participants’ texts from a social-constructionist perspective on health and illness. Results: The overarching narrative depicts a fundamental breakdown in patient-provider relationships. According to our data, the negative experiences of study participants emerge from more than practitioners’ lack of awareness of NES and access to information about the condition - to the extent that it is available. In examining the challenges people with NES encounter when interacting with health professionals, their main experiences centre on blame and humiliation. When exploring their experiences, theories of stigma serve as a useful theoretical framework. Conclusions: Normative judgements arising from psychogenic understandings of NES are stigmatising and restrict professional displays of respectful (patient-centred) care. Those with the condition depict being negatively stereotyped, illegitimated and held morally culpable by health professionals. Perceived to lack medical, moral and credible status, participants describe practitioners who treat them with disrespect, and some recount conduct that defies all ethical and professional obligations and standards. These encounters can have wide-ranging adverse consequences for patients: emotionally, physically, and for their future healthcare. The quality of healthcare

  11. Clinical outcomes and immune benefits of anti-epileptic drug therapy in HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Krentz Hartmut B

    2010-06-01

    Full Text Available Abstract Background Anti-epileptic drugs (AEDs are frequently prescribed to persons with HIV/AIDS receiving combination antiretroviral therapy (cART although the extent of AED use and their interactions with cART are uncertain. Herein, AED usage, associated toxicities and immune consequences were investigated. Methods HIV replication was analysed in proliferating human T cells during AED exposure. Patients receiving AEDs in a geographically-based HIV care program were assessed using clinical and laboratory variables in addition to assessing AED indication, type, and cumulative exposures. Results Valproate suppressed proliferation in vitro of both HIV-infected and uninfected T cells (p 0.05 but AED exposures did not affect HIV production in vitro. Among 1345 HIV/AIDS persons in active care between 2001 and 2007, 169 individuals were exposed to AEDs for the following indications: peripheral neuropathy/neuropathic pain (60%, seizure/epilepsy (24%, mood disorder (13% and movement disorder (2%. The most frequently prescribed AEDs were calcium channel blockers (gabapentin/pregabalin, followed by sodium channel blockers (phenytoin, carbamazepine, lamotrigine and valproate. In a nested cohort of 55 AED-treated patients receiving cART and aviremic, chronic exposure to sodium and calcium channel blocking AEDs was associated with increased CD4+ T cell levels (p 0.05 with no change in CD8+ T cell levels over 12 months from the beginning of AED therapy. Conclusions AEDs were prescribed for multiple indications without major adverse effects in this population but immune status in patients receiving sodium or calcium channel blocking drugs was improved.

  12. Knowledge and attitude of Iranian community pharmacists about the pharmaceutical care for epileptic females

    International Nuclear Information System (INIS)

    Sabzghabaee, A.M.; Zolfaghari, B.; Ebrahimabadi, M.H.

    2012-01-01

    This study was designed to evaluate the knowledge and attitude of a cohort of Iranian community pharmacists about the pharmaceutical care indexes and drug therapy in female epileptic patients. Methodology: This cross-sectional study was conducted in Iran (2011) and one hundred and twenty two community pharmacists were randomly selected using clustering method for sampling. A self-administered questionnaire which was originally made by a clinical pharmacy focus group was used. This questionnaire had 10 true/false questions for knowledge assessing (Spearman-Brown coefficient, 0.65) and 19 attitude statements (with Likert scale) about the intention of pharmacists for providing pharmaceutical care for epileptic females (Croanbach's alpha, 0.802). Face and content validity for both parts of the questionnaire were performed before the study. Results: There was a significant inverse relationship between pharmacists' knowledge on pharmaceutical care for epileptic females and the time elapsed from their graduation date. Considering the minimum passing score of 5, 85% of pharmacists did not have enough knowledge. The range of pharmacists' attitude scores was 35 to 64 and its mean was 46.09. Regarding the minimum passing score of 45, 63.3% of pharmacists had positive attitude to AEDs in epileptic females. Conclusion: It seems that the pharmaceutical care for epileptic females is a missing part of Pharmacy education. It is highly recommended to pay special attention to this topic in continuing education programs for Iranian pharmacists. (author)

  13. High-Definition transcranial direct current stimulation in early onset epileptic encephalopathy: a case study.

    Science.gov (United States)

    Meiron, Oded; Gale, Rena; Namestnic, Julia; Bennet-Back, Odeya; David, Jonathan; Gebodh, Nigel; Adair, Devin; Esmaeilpour, Zeinab; Bikson, Marom

    2018-01-01

    Early onset epileptic encephalopathy is characterized by high daily seizure-frequency, multifocal epileptic discharges, severe psychomotor retardation, and death at infancy. Currently, there are no effective treatments to alleviate seizure frequency and high-voltage epileptic discharges in these catastrophic epilepsy cases. The current study examined the safety and feasibility of High-Definition transcranial direct current stimulation (HD-tDCS) in reducing epileptiform activity in a 30-month-old child suffering from early onset epileptic encephalopathy. HD-tDCS was administered over 10 intervention days spanning two weeks including pre- and post-intervention video-EEG monitoring. There were no serious adverse events or side effects related to the HD-tDCS intervention. Frequency of clinical seizures was not significantly reduced. However, interictal sharp wave amplitudes were significantly lower during the post-intervention period versus baseline. Vital signs and blood biochemistry remained stable throughout the entire study. These exploratory findings support the safety and feasibility of 4 × 1 HD-tDCS in early onset epileptic encephalopathy and provide the first evidence of HD-tDCS effects on paroxysmal EEG features in electroclinical cases under the age of 36 months. Extending HD-tDCS treatment may enhance electrographic findings and clinical effects.

  14. Does rapid and physiological astrocyte–neuron signalling amplify epileptic activity?

    Science.gov (United States)

    2016-01-01

    Abstract The hippocampus is a key brain region in the pathophysiology of mesial temporal lobe epilepsy. Long‐term changes of its architecture and function on the network and cellular level are well documented in epilepsy. Astrocytes can control many aspects of neuronal function and their long‐term alterations over weeks, months and years play an important role in epilepsy. However, a pathophysiological transformation of astrocytes does not seem to be required for astrocytes to contribute to epileptic activity. Some of the properties of physiological astrocyte–neuron communication could allow these cells to exacerbate or synchronize neuronal firing on shorter time scales of milliseconds to minutes. Therefore, these astrocyte–neuron interactions are increasingly recognized as potential contributors to epileptic activity. Fast and reciprocal communication between astrocytes and neurons is enabled by a diverse set of mechanisms that could both amplify and counteract epileptic activity. They may thus promote or cause development of epileptic activity or inhibit it. Mechanisms of astrocyte–neuron interactions that can quickly increase network excitability involve, for example, astrocyte Ca2+ and Na+ signalling, K+ buffering, gap junction coupling and metabolism. However, rapid changes of astrocyte neurotransmitter uptake and morphology may also underlie or support development of network hyperexcitability. The temporal characteristics of these interactions, their ability to synchronize neuronal activity and their net effect on network activity will determine their contribution to the emergence or maintenance of epileptic activity. PMID:27106234

  15. Does rapid and physiological astrocyte-neuron signalling amplify epileptic activity?

    Science.gov (United States)

    Henneberger, Christian

    2017-03-15

    The hippocampus is a key brain region in the pathophysiology of mesial temporal lobe epilepsy. Long-term changes of its architecture and function on the network and cellular level are well documented in epilepsy. Astrocytes can control many aspects of neuronal function and their long-term alterations over weeks, months and years play an important role in epilepsy. However, a pathophysiological transformation of astrocytes does not seem to be required for astrocytes to contribute to epileptic activity. Some of the properties of physiological astrocyte-neuron communication could allow these cells to exacerbate or synchronize neuronal firing on shorter time scales of milliseconds to minutes. Therefore, these astrocyte-neuron interactions are increasingly recognized as potential contributors to epileptic activity. Fast and reciprocal communication between astrocytes and neurons is enabled by a diverse set of mechanisms that could both amplify and counteract epileptic activity. They may thus promote or cause development of epileptic activity or inhibit it. Mechanisms of astrocyte-neuron interactions that can quickly increase network excitability involve, for example, astrocyte Ca 2+ and Na + signalling, K + buffering, gap junction coupling and metabolism. However, rapid changes of astrocyte neurotransmitter uptake and morphology may also underlie or support development of network hyperexcitability. The temporal characteristics of these interactions, their ability to synchronize neuronal activity and their net effect on network activity will determine their contribution to the emergence or maintenance of epileptic activity. © 2016 The Authors. The Journal of Physiology © 2016 The Physiological Society.

  16. Mozart's music in children with drug-refractory epileptic encephalopathies.

    Science.gov (United States)

    Coppola, Giangennaro; Toro, Annacarmela; Operto, Francesca Felicia; Ferrarioli, Giuseppe; Pisano, Simone; Viggiano, Andrea; Verrotti, Alberto

    2015-09-01

    Mozart's sonata for two pianos in D major, K448, has been shown to decrease interictal EEG discharges and recurrence of clinical seizures in both adults and young patients. In this prospective, open-label study, we evaluated the effect of listening to a set of Mozart's compositions, according to the Tomatis method, on sleep quality and behavioral disorders, including auto-/hetero-aggression, irritability, and hyperactivity, in a group of children and adolescents with drug-resistant epilepsy. The study group was composed of 11 outpatients (7 males and 4 females), between 1.5years and 21years of age (mean age: 11.9years), all suffering from drug-resistant epileptic encephalopathy (n=11). All of them had a severe/profound intellectual disability associated with cerebral palsy. During the study period, each patient had to listen to a set of Mozart's compositions 2h per day for fifteen days for a total of 30h, which could be distributed over the day depending on the habits and compliance of each patient. The music was filtered by a device preferably delivering higher sound frequencies (>3000Hz) according to the Tomatis principles. The antiepileptic drug therapy remained unchanged throughout the study period. During the 15-day music therapy, 2 out of 11 patients had a reduction of 50-75% in seizure recurrence, and 3 out of 12 patients had a reduction of 75-89%. Overall, 5 (45.4%) out of 11 patients had a ≥50% reduction in the total number of seizures, while the percentage decrease of the total seizure number (11/11) compared with baseline was -51.5% during the 15-day music therapy and -20.7% in the two weeks after the end of treatment. All responders also had an improvement in nighttime sleep and daytime behavior. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Behavioral state classification in epileptic brain using intracranial electrophysiology

    Science.gov (United States)

    Kremen, Vaclav; Duque, Juliano J.; Brinkmann, Benjamin H.; Berry, Brent M.; Kucewicz, Michal T.; Khadjevand, Fatemeh; Van Gompel, Jamie; Stead, Matt; St. Louis, Erik K.; Worrell, Gregory A.

    2017-04-01

    Objective. Automated behavioral state classification can benefit next generation implantable epilepsy devices. In this study we explored the feasibility of automated awake (AW) and slow wave sleep (SWS) classification using wide bandwidth intracranial EEG (iEEG) in patients undergoing evaluation for epilepsy surgery. Approach. Data from seven patients (age 34+/- 12 , 4 women) who underwent intracranial depth electrode implantation for iEEG monitoring were included. Spectral power features (0.1-600 Hz) spanning several frequency bands from a single electrode were used to train and test a support vector machine classifier. Main results. Classification accuracy of 97.8  ±  0.3% (normal tissue) and 89.4  ±  0.8% (epileptic tissue) across seven subjects using multiple spectral power features from a single electrode was achieved. Spectral power features from electrodes placed in normal temporal neocortex were found to be more useful (accuracy 90.8  ±  0.8%) for sleep-wake state classification than electrodes located in normal hippocampus (87.1  ±  1.6%). Spectral power in high frequency band features (Ripple (80-250 Hz), Fast Ripple (250-600 Hz)) showed comparable performance for AW and SWS classification as the best performing Berger bands (Alpha, Beta, low Gamma) with accuracy  ⩾90% using a single electrode contact and single spectral feature. Significance. Automated classification of wake and SWS should prove useful for future implantable epilepsy devices with limited computational power, memory, and number of electrodes. Applications include quantifying patient sleep patterns and behavioral state dependent detection, prediction, and electrical stimulation therapies.

  18. Effects of deficit irrigation and partial root-zone drying on soil and plant water status, stomatal conductance, plant growth and water use efficiency in tomato during early fruiting stage

    DEFF Research Database (Denmark)

    Liu, Fulai; Shahnazari, Ali; Jacobsen, S.-E.

    2008-01-01

    The effects of 'partial root-zone drying' (PRD), compared with full irrigation (FI) and deficit irrigation (DI), on soil and plant water status, plant growth and water use efficiency (WUE) were investigated in potted tomatoes (Lycopersicon esculentum L., var. Cedrico) at the early fruiting stage...... system, and the irrigated side of the plants was reversed when volumetric soil water content ( ) of the dry side had decreased to 6%. of FI was about 14%. of DI decreased during the first 4-5 days after the onset of treatment (DAT) and was about 7% and 6% thereafter for DI-70 and DI-50, respectively....... of the wet side in PRD-70 declined during 3-6 DAT and was lower than that of FI by 4-6% thereafter. in both wet and dry sides of PRD-50 was slightly lower than that for PRD-70. After 5 DAT, midday leaf water potential was significantly lower in DI and PRD than in FI plants. FI plants had the highest leaf...

  19. Magnetic resonance imaging in relation to EEG epileptic foci in tuberous sclerosis

    International Nuclear Information System (INIS)

    Tamaki, Kyoko; Okuno, Takehiko; Ito, Masatoshi; Asato, Reinin; Konishi, Junji; Mikawa, Haruki

    1990-01-01

    In 20 patients with tuberous sclerosis (TS), who were sequentially treated for epilepsy at our clinic, the high signal lesions in the cerebral cortex and subcortex detected on T2 weighted magnetic resonance imaging (MRI) were compared with the interictal EEG findings. In four cases who showed a unilateral distribution of the MRI lesions, there was a good correlation between the laterality of the affected lobes and the localization of the EEG epileptic foci. Thirteen cases with more than four affected lobes in both hemispheres also showed bilateral epileptic foci on EEG. The MRI lesions in the occipital lobes showed the best correlation with the EEG epileptic foci, while the worst correlation was seen in the frontal lobes. In addition, the cases with four or more affected lobes without laterality on MRI are more likely to show bilateral synchronization on EEG. The prognosis of epilepsy in these cases was found to be rather poor. (author)

  20. Application of rare variant transmission disequilibrium tests to epileptic encephalopathy trio sequence data

    DEFF Research Database (Denmark)

    2017-01-01

    The classic epileptic encephalopathies, including infantile spasms (IS) and Lennox-Gastaut syndrome (LGS), are severe seizure disorders that usually arise sporadically. De novo variants in genes mainly encoding ion channel and synaptic proteins have been found to account for over 15% of patients...... with IS or LGS. The contribution of autosomal recessive genetic variation, however, is less well understood. We implemented a rare variant transmission disequilibrium test (TDT) to search for autosomal recessive epileptic encephalopathy genes in a cohort of 320 outbred patient-parent trios that were generally...... not find evidence of a role for individual autosomal recessive genes, our current sample is insufficiently powered to assess the overall role of autosomal recessive genotypes in an outbred epileptic encephalopathy population....

  1. An epileptic seizures detection algorithm based on the empirical mode decomposition of EEG.

    Science.gov (United States)

    Orosco, Lorena; Laciar, Eric; Correa, Agustina Garces; Torres, Abel; Graffigna, Juan P

    2009-01-01

    Epilepsy is a neurological disorder that affects around 50 million people worldwide. The seizure detection is an important component in the diagnosis of epilepsy. In this study, the Empirical Mode Decomposition (EMD) method was proposed on the development of an automatic epileptic seizure detection algorithm. The algorithm first computes the Intrinsic Mode Functions (IMFs) of EEG records, then calculates the energy of each IMF and performs the detection based on an energy threshold and a minimum duration decision. The algorithm was tested in 9 invasive EEG records provided and validated by the Epilepsy Center of the University Hospital of Freiburg. In 90 segments analyzed (39 with epileptic seizures) the sensitivity and specificity obtained with the method were of 56.41% and 75.86% respectively. It could be concluded that EMD is a promissory method for epileptic seizure detection in EEG records.

  2. CDKL5 gene-related epileptic encephalopathy: electroclinical findings in the first year of life.

    Science.gov (United States)

    Melani, Federico; Mei, Davide; Pisano, Tiziana; Savasta, Salvatore; Franzoni, Emilio; Ferrari, Anna Rita; Marini, Carla; Guerrini, Renzo

    2011-04-01

    Cyclin-dependent kinase-like 5 (CDKL5) gene abnormalities cause an early-onset epileptic encephalopathy. We performed video-electroencephalography (video-EEG) monitoring early in the course of CDKL5-related epileptic encephalopathy in order to examine the early electroclinical characteristics of the condition. We used video-EEG to monitor six infants (five females, one male) with CDKL5-related epileptic encephalopathy (five mutations; one deletion), at ages 45 days to 12 months and followed them up to the ages of 14 months to 5 years (mean age 23 mo). We focused our analysis on the first year of life. The results were evaluated against those of a comparison group of nine infants (aged below 1y) with epileptic encephalography who had tested negative for CDKL5 mutations and deletions. One infant exhibited normal background activity, three exhibited moderate slowing, and two exhibited a suppression burst pattern. Two participants had epileptic spasms and four had a stereotyped complex seizure pattern, which we defined as a 'prolonged' generalized tonic-clonic event consisting of a tonic-tonic/vibratory contraction, followed by a clonic phase with series of spasms, gradually translating into repetitive distal myoclonic jerks. Seizure duration ranged from 2 to 4 minutes. The EEG correlate of each clinical phase included an initial electrodecremental event (tonic vibratory phase), irregular series of sharp waves and spike slow waves (clonic phase with series of spasms), and bilateral rhythmic sharp waves (time locked with myoclonus). Infants with CDKL5-related early epileptic encephalopathy can present in the first year of life with an unusual electroclinical pattern of 'prolonged' generalized tonic-clonic seizures. © The Authors. Journal compilation © Mac Keith Press 2011.

  3. Adult epileptic patients’ perception of social support during rational antiepileptic therapy

    Directory of Open Access Journals (Sweden)

    P. N. Vlasov

    2012-01-01

    Full Text Available The problem of stigmatization of a patient with epilepsy is frequently essential in restricting the capacities of his social performance. Society is often unready to recognize an epileptic patient as its equal member. The authors consider the main sources of social support (SS to patients with epilepsy: the patient’s family takes first place; friends and other important persons also play a major role. The perception of SS has been found to be related to the number of used antiepileptic drugs and the hemispheric lateralization of a leading epileptic focus.

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

    Science.gov (United States)

    Hughes, John R

    2003-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Ahmed Anwer Attia Khattab

    2014-09-01

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

  6. Epileptic Negative Myoclonus as the First and Only Symptom in a Challenging Diagnosis of Benign Epilepsy With Centrotemporal Spikes

    Directory of Open Access Journals (Sweden)

    Jing Chen MD

    2017-07-01

    Full Text Available Objective: To investigate the clinical and neurophysiological characteristics of epileptic negative myoclonus as the first and only ictal symptom of benign epilepsy with centrotemporal spikes. Methods: Electrophysiological evaluations included polygraphic recordings with simultaneous video electroencephalogram monitoring and tests performed with patient’s upper limb outstretched in standing posture. Epileptic negative myoclonus manifestations, electrophysiological features, and responses to antiepileptic drugs were analyzed. Results: The authors report 2 patients with benign epilepsy with centrotemporal spikes, who had epileptic negative myoclonus as the first and only seizure type. Video electroencephalogram monitoring results showed that their negative myoclonus seizures were emanating from the contralateral central and the parietal regions. Epileptic negative myoclonus was controlled by administration of valproate and levetiracetam. Conclusion: Epileptic negative myoclonus can be the first and only seizure type of benign epilepsy with centrotemporal spikes, and long-term follow-up monitoring should be the care for the recurrence and/or presence of other types of seizures.

  7. Medical management of epileptic seizures: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Sarma AK

    2016-02-01

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

  8. 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)

  9. A Penalized Semialgebraic Deflation ICA Algorithm for the Efficient Extraction of Interictal Epileptic Signals.

    Science.gov (United States)

    Becker, Hanna; Albera, Laurent; Comon, Pierre; Kachenoura, Amar; Merlet, Isabelle

    2017-01-01

    As a noninvasive technique, electroencephalography (EEG) is commonly used to monitor the brain signals of patients with epilepsy such as the interictal epileptic spikes. However, the recorded data are often corrupted by artifacts originating, for example, from muscle activities, which may have much higher amplitudes than the interictal epileptic signals of interest. To remove these artifacts, a number of independent component analysis (ICA) techniques were successfully applied. In this paper, we propose a new deflation ICA algorithm, called penalized semialgebraic unitary deflation (P-SAUD) algorithm, that improves upon classical ICA methods by leading to a considerably reduced computational complexity at equivalent performance. This is achieved by employing a penalized semialgebraic extraction scheme, which permits us to identify the epileptic components of interest (interictal spikes) first and obviates the need of extracting subsequent components. The proposed method is evaluated on physiologically plausible simulated EEG data and actual measurements of three patients. The results are compared to those of several popular ICA algorithms as well as second-order blind source separation methods, demonstrating that P-SAUD extracts the epileptic spikes with the same accuracy as the best ICA methods, but reduces the computational complexity by a factor of 10 for 32-channel recordings. This superior computational efficiency is of particular interest considering the increasing use of high-resolution EEG recordings, whose analysis requires algorithms with low computational cost.

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

    DEFF Research Database (Denmark)

    Conradsen, Isa; Wolf, Peter; Sams, Thomas

    2011-01-01

    Purpose: Tonic seizures and the tonic phase of tonic–clonic epileptic seizures are defined as “sustained tonic” muscle contraction lasting a few seconds to minutes. Visual inspection of the surface electromyogram (EMG) during seizures contributed considerably to a better understanding and accurat...

  11. Cognitive-Behavioral Treatment of Depressed Affect among Epileptics: Preliminary Findings.

    Science.gov (United States)

    Davis, Gay R.; And Others

    1984-01-01

    Evaluated a program where cognitive-behavioral methods were utilized in a structured learning format with clinically depressed epileptics (N=13). Results indicated that cognitive behavioral interventions result in significant decreases in depression and increases in related areas of psychosocial functioning that are maintained over time. (LLL)

  12. Psychosocial Functioning of Adult Epileptic and MS Patients and Adult Normal Controls on the WPSI.

    Science.gov (United States)

    Tan, Siang-Yang

    1986-01-01

    Psychosocial functioning of adult epileptic outpatients as assessed by the Washington Psychosocial Seizure Inventory (WPSI) was compared to that of adult multiple sclerosis (MS) outpatients and normal subjects. When only valid WPSI profiles were considered, the only significant finding was that the epilepsy group and the MS group had more…

  13. False Negatives, Canter's Background Interference Procedure, the Trail Making Test, and Epileptics.

    Science.gov (United States)

    McKinzey, Ronald K.; And Others

    1985-01-01

    Results of correlation studies of 141 adult epileptics' scores on the Background Interference Procedure (BIP) indicated that the BIP often does not agree with abnormal neurological diagnoses but often does agree with psychiatric diagnoses of Organic Brain Syndrome (OBS). Suggests that future BIP validity studies include a behavioral measure of OBS…

  14. CDKL5 alterations lead to early epileptic encephalopathy in both genders.

    Science.gov (United States)

    Liang, Jao-Shwann; Shimojima, Keiko; Takayama, Rumiko; Natsume, Jun; Shichiji, Minobu; Hirasawa, Kyoko; Imai, Kaoru; Okanishi, Tohru; Mizuno, Seiji; Okumura, Akihisa; Sugawara, Midori; Ito, Tomoshiro; Ikeda, Hiroko; Takahashi, Yukitoshi; Oguni, Hirokazu; Imai, Katsumi; Osawa, Makiko; Yamamoto, Toshiyuki

    2011-10-01

    Genetic mutations of the cyclin-dependent kinase-like 5 gene (CDKL5) have been reported in patients with epileptic encephalopathy, which is characterized by intractable seizures and severe-to-profound developmental delay. We investigated the clinical relevance of CDKL5 alterations in both genders. A total of 125 patients with epileptic encephalopathy were examined for genomic copy number aberrations, and 119 patients with no such aberrations were further examined for CDKL5 mutations. Five patients with Rett syndrome, who did not show methyl CpG-binding protein 2 gene (MECP2) mutations, were also examined for CDKL5 mutations. One male and three female patients showed submicroscopic deletions including CDKL5, and two male and six female patients showed CDKL5 nucleotide alterations. Development of early onset seizure was a characteristic clinical feature for the patients with CDKL5 alterations in both genders despite polymorphous seizure types, including myoclonic seizures, tonic seizures, and spasms. Severe developmental delays and mild frontal lobe atrophies revealed by brain magnetic resonance imaging (MRI) were observed in almost all patients, and there was no gender difference in phenotypic features. We observed that 5% of the male patients and 14% of the female patients with epileptic encephalopathy had CDKL5 alterations. These findings indicate that alterations in CDKL5 are associated with early epileptic encephalopathy in both female and male patients. Wiley Periodicals, Inc. © 2011 International League Against Epilepsy.

  15. Limits of 2D-TCA in detecting BOLD responses to epileptic activity.

    Science.gov (United States)

    Khatamian, Yasha Borna; Fahoum, Firas; Gotman, Jean

    2011-05-01

    Two-dimensional temporal clustering analysis (2D-TCA) is a relatively new functional MRI (fMRI) based technique that breaks blood oxygen level dependent activity into separate components based on timing and has shown potential for localizing epileptic activity independently of electroencephalography (EEG). 2D-TCA has only been applied to detect epileptic activity in a few studies and its limits in detecting activity of various forms (i.e. activation size, amplitude, and frequency) have not been investigated. This study evaluated 2D-TCA's ability to detect various forms of both simulated epileptic activity and EEG-fMRI activity detected in patients. When applied to simulated data, 2D-TCA consistently detected activity in 6min runs containing 5 spikes/run, 10 spikes/run, and one 5s long event with hemodynamic response function amplitudes of at least 1.5%, 1.25%, and 1% above baseline respectively. When applied to patient data, while detection of interictal spikes was inconsistent, 2D-TCA consistently produced results similar to those obtained by EEG-fMRI when at least 2 prolonged interictal events (a few seconds each) occurred during the run. However, even for such cases it was determined that 2D-TCA can only be used to validate localization by other means or to create hypotheses as to where activity may occur, as it also detects changes not caused by epileptic activity. Copyright © 2011 Elsevier B.V. All rights reserved.

  16. Homocysteine, folic acid and vitamin B12 levels in serum of epileptic ...

    African Journals Online (AJOL)

    The mechanism of this association with epileptogenesis has not been clearly understood, although there is emerging evidence to support the unfavorable effects of some anti-epileptic drugs (AEDs) on the plasma homocysteine (Hcy) concentrations. The aim of this study was to uncover the relationship between the levels of ...

  17. Cortical epileptic afterdischarges in immature rats are differently influenced by NMDA receptor antagonists

    Czech Academy of Sciences Publication Activity Database

    Šlamberová, Romana; Mareš, Pavel

    2005-01-01

    Roč. 516, č. 1 (2005), s. 10-17 ISSN 0014-2999 R&D Projects: GA MŠk(CZ) LN00B122 Institutional research plan: CEZ:AV0Z5011922 Keywords : epileptic seizure * cerebral cortex * NMDA receptor antagonist Subject RIV: FH - Neuro logy Impact factor: 2.477, year: 2005

  18. Changes of cortical epileptic afterdischarges under the influence of convulsant drugs

    Czech Academy of Sciences Publication Activity Database

    Koryntová, Hana; Kubová, Hana; Tutka, P.; Mareš, Pavel

    2002-01-01

    Roč. 58, č. 1 (2002), s. 49-54 ISSN 0361-9230 R&D Projects: GA ČR GA309/00/1643 Institutional research plan: CEZ:AV0Z5011922 Keywords : epileptic afterdischarges * cerebral cortex * rat Subject RIV: FH - Neurology Impact factor: 2.283, year: 2002

  19. Pharmacological analysis of postictal refractoriness after cortical epileptic seizures in rats

    Czech Academy of Sciences Publication Activity Database

    Mareš, Pavel; Kubová, Hana

    2007-01-01

    Roč. 59, Suppl.1 (2007), s. 12-13 ISSN 1734-1140. [Day of neuropsychopharmacology /16./. 06.09.2007-08.09.2007, Wroclaw] Institutional research plan: CEZ:AV0Z50110509 Keywords : postictal refractoriness * epileptic afterdischarges * rat Subject RIV: ED - Physiology

  20. Vulnerability to psychogenic non-epileptic seizures is linked to low neuropeptide Y levels

    DEFF Research Database (Denmark)

    Winterdahl, Michael; Miani, Alessandro; Vercoe, Moana

    2017-01-01

    Psychogenic non-epileptic seizures (PNES) is a conversion disorder that reflects underlying psychological distress. Female patients with PNES often present with a history of prolonged stressors, especially sexual abuse. In the current study, we studied the relationship between neuropeptide Y (NPY...

  1. Mozart K.545 Mimics Mozart K.448 in Reducing Epileptiform Discharges in Epileptic Children

    Directory of Open Access Journals (Sweden)

    Lung-Chang Lin

    2012-01-01

    Full Text Available Mozart K.448 has been shown to improve cognitive function, leading to what is known as the Mozart Effect. Our previous work reveals positive effects of Mozart K.448 in reducing epileptiform discharges in epileptic children. In this study, we evaluated the effect of Mozart K.545 and compared the effects with those of Mozart K.448 on epileptiform discharges in children with epilepsy. Thirty-nine epileptic children with epileptiform discharges were included in the study. They received electroencephalogram examinations before, during, and after listening to Mozart K.448 and K.545, one week apart, respectively. The frequencies of epileptiform discharges were compared. There was a significant decrease in the frequency of epileptiform discharges during and right after listening to Mozart K.448 and K.545 (reduced by 35.7±32.7% during Mozart K.448 and 30.3±44.4% after Mozart K.448; and 34.0±39.5% during Mozart K.545 and 31.8±39.2% after Mozart K.545. Spectrogrammatic analysis of the two pieces of music demonstrated that both share similar spectrogrammatic characteristics. Listening to Mozart K.448 and K.545 decreased the epileptiform discharges in epileptic children. This suggests that Mozart K.448 is not the only piece of music to have beneficial effects on children with epilepsy. Other music with lower harmonics may also decrease epileptiform discharges in epileptic children.

  2. [Epileptic seizures during childbirth in a patient with idiopathic generalised epilepsy

    NARCIS (Netherlands)

    Voermans, N.C.; Zwarts, M.J.; Renier, W.O.; Bloem, B.R.

    2005-01-01

    During her first pregnancy, a 37-year-old woman with idiopathic generalised epilepsy that was adequately controlled with lamotrigine experienced a series of epileptic seizures following an elective caesarean section. The attacks were terminated with diazepam. The following day, she developed

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    and closely resemble features of human epileptic tissue. Studies suggest that chemically induced epileptiform activity in rat OHSCs is pharmacoresistant to most of AEDs. However, high-frequency electric stimulus train-induced bursting (STIB) in OHSCs is responsive to carbamazepine and phenytoin. We...

  4. Modeling epileptic brain states using EEG spectral analysis and topographic mapping.

    Science.gov (United States)

    Direito, Bruno; Teixeira, César; Ribeiro, Bernardete; Castelo-Branco, Miguel; Sales, Francisco; Dourado, António

    2012-09-30

    Changes in the spatio-temporal behavior of the brain electrical activity are believed to be associated to epileptic brain states. We propose a novel methodology to identify the different states of the epileptic brain, based on the topographic mapping of the time varying relative power of delta, theta, alpha, beta and gamma frequency sub-bands, estimated from EEG. Using normalized-cuts segmentation algorithm, points of interest are identified in the topographic mappings and their trajectories over time are used for finding out relations with epileptogenic propagations in the brain. These trajectories are used to train a Hidden Markov Model (HMM), which models the different epileptic brain states and the transition among them. Applied to 10 patients suffering from focal seizures, with a total of 30 seizures over 497.3h of data, the methodology shows good results (an average point-by-point accuracy of 89.31%) for the identification of the four brain states--interictal, preictal, ictal and postictal. The results suggest that the spatio-temporal dynamics captured by the proposed methodology are related to the epileptic brain states and transitions involved in focal seizures. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. Application of rare variant transmission disequilibrium tests to epileptic encephalopathy trio sequence data

    NARCIS (Netherlands)

    Allen, Andrew S.; Berkovic, Samuel F.; Bridgers, Joshua; Cossette, Patrick; Dlugos, Dennis; Epstein, Michael P.; Glauser, Tracy; Goldstein, David B.; Heinzen, Erin L.; Jiang, Yu; Johnson, Michael R.; Kuzniecky, Ruben; Lowenstein, Daniel H.; Marson, Anthony G.; Mefford, Heather C.; O'Brien, Terence J.; Ottman, Ruth; Petrou, Steven; Petrovski, Slavé; Poduri, Annapurna; Ren, Zhong; Scheffer, Ingrid E.; Sherr, Elliott; Wang, Quanli; Balling, Rudi; Barisic, Nina; Baulac, Stéphanie; Caglayan, Hande; Craiu, Dana; De Jonghe, Peter; Depienne, Christel; Guerrini, Renzo; Helbig, Ingo; Hjalgrim, Helle; Hoffman-Zacharska, Dorota; Jähn, Johanna A.; Klein, Karl Martin; Koeleman, Bobby; Komarek, Vladimir; Krause, Roland; Leguern, Eric; Lehesjoki, Anna-Elina; Lemke, Johannes R.; Lerche, Holger; Linnankivi, Tarja; Marini, Carla; May, Patrick; Møller, Rikke S.; Muhle, Hiltrud; Pal, Deb; Palotie, Aarno; Rosenow, Felix; Selmer, Kaja; Serratosa, Jose M.; Sisodiya, Sanjay M.; Stephani, Ulrich; Sterbova, Katalin; Striano, Pasquale; Suls, Arvid; Talvik, Tiina; von Spiczak, Sarah; Weber, Yvonne G.; Weckhuysen, Sarah; Zara, Federico; Abou-Khalil, Bassel; Alldredge, Brian K.; Amrom, Dina; Andermann, Eva; Andermann, Frederick; Bautista, Jocelyn F.; Bluvstein, Judith; Cascino, Gregory D.; Consalvo, Damian; Crumrine, Patricia; Devinsky, Orrin; Fiol, Miguel E.; Fountain, Nathan B.; French, Jacqueline; Friedman, Daniel; Haas, Kevin; Haut, Sheryl R.; Hayward, Jean; Joshi, Sucheta; Kanner, Andres; Kirsch, Heidi E.; Kossoff, Eric H.; Kuperman, Rachel; McGuire, Shannon M.; Motika, Paul V.; Novotny, Edward J.; Paolicchi, Juliann M.; Parent, Jack; Park, Kristen; Shellhaas, Renée A; Sirven, Joseph; Smith, Michael C.; Sullivan, Joseph; Thio, Liu Lin; Venkat, Anu; Vining, Eileen P. G.; Von Allmen, Gretchen K.; Weisenberg, Judith L.; Widdess-Walsh, Peter; Winawer, Melodie R.

    2017-01-01

    The classic epileptic encephalopathies, including infantile spasms (IS) and Lennox-Gastaut syndrome (LGS), are severe seizure disorders that usually arise sporadically. De novo variants in genes mainly encoding ion channel and synaptic proteins have been found to account for over 15% of patients

  6. Targeted sequencing of 351 candidate genes for epileptic encephalopathy in a large cohort of patients

    DEFF Research Database (Denmark)

    de Kovel, Carolien G F; Brilstra, Eva H; van Kempen, Marjan J A

    2016-01-01

    BACKGROUND: Many genes are candidates for involvement in epileptic encephalopathy (EE) because one or a few possibly pathogenic variants have been found in patients, but insufficient genetic or functional evidence exists for a definite annotation. METHODS: To increase the number of validated EE...

  7. The Anticonvulsant Effects of Ketogenic Diet on Epileptic Seizures and Potential Mechanisms.

    Science.gov (United States)

    Zhang, Yifan; Xu, Jingwei; Zhang, Kun; Yang, Wei; Li, Bingjin

    2018-01-01

    Epilepsy is a syndrome of brain dysfunction induced by the aberrant excitability of certain neurons. Despite advances in surgical technique and anti-epileptic drug in recent years, recurrent epileptic seizures remain intractable and lead to a serious morbidity in the world. The ketogenic diet refers to a high-fat, low-carbohydrate and adequate-protein diet. Currently, its beneficial effects on epileptic seizure reduction have been well established. However, the detailed mechanisms underlying the anti-epileptic effects of ketogenic diet are still poorly understood. In this article, the possible roles of ketogenic diet on epilepsy were discussed. Data was obtained from the websites including Web of Science, Medline, Pubmed, Scopus, based on these keywords: "Ketogenic diet" and "epilepsy". As shown in both clinical and basic studies, the therapeutic effects of ketogenic diet might involve neuronal metabolism, neurotransmitter function, neuronal membrane potential and neuron protection against ROS. In this review, we systematically reviewed the effects and possible mechanisms of ketogenic diet on epilepsy, which may optimize the therapeutic strategies against epilepsy. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  8. Mozart k.545 mimics mozart k.448 in reducing epileptiform discharges in epileptic children.

    Science.gov (United States)

    Lin, Lung-Chang; Lee, Mei-Wen; Wei, Ruey-Chang; Mok, Hin-Kiu; Wu, Hui-Chuan; Tsai, Chin-Lin; Yang, Rei-Cheng

    2012-01-01

    Mozart K.448 has been shown to improve cognitive function, leading to what is known as the Mozart Effect. Our previous work reveals positive effects of Mozart K.448 in reducing epileptiform discharges in epileptic children. In this study, we evaluated the effect of Mozart K.545 and compared the effects with those of Mozart K.448 on epileptiform discharges in children with epilepsy. Thirty-nine epileptic children with epileptiform discharges were included in the study. They received electroencephalogram examinations before, during, and after listening to Mozart K.448 and K.545, one week apart, respectively. The frequencies of epileptiform discharges were compared. There was a significant decrease in the frequency of epileptiform discharges during and right after listening to Mozart K.448 and K.545 (reduced by 35.7 ± 32.7% during Mozart K.448 and 30.3 ± 44.4% after Mozart K.448; and 34.0 ± 39.5% during Mozart K.545 and 31.8 ± 39.2% after Mozart K.545). Spectrogrammatic analysis of the two pieces of music demonstrated that both share similar spectrogrammatic characteristics. Listening to Mozart K.448 and K.545 decreased the epileptiform discharges in epileptic children. This suggests that Mozart K.448 is not the only piece of music to have beneficial effects on children with epilepsy. Other music with lower harmonics may also decrease epileptiform discharges in epileptic children.

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

    Science.gov (United States)

    Niknazar, Hamid; Nasrabadi, Ali Motie

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

  10. Glial adenosine kinase--a neuropathological marker of the epileptic brain

    NARCIS (Netherlands)

    Aronica, Eleonora; Sandau, Ursula S.; Iyer, Anand; Boison, Detlev

    2013-01-01

    Experimental research over the past decade has supported the critical role of astrocytes activated by different types of injury and the pathophysiological processes that underlie the development of epilepsy. In both experimental and human epileptic tissues astrocytes undergo complex changes in their

  11. Restriction of the spread of epileptic discharges in cats by means of Bragg peak, intracranial irradiation

    International Nuclear Information System (INIS)

    Gaffey, C.T.; Montoya, V.J.; Lyman, J.T.; Howard, J.

    1981-01-01

    Adult male cats with a single epileptic focus receive neon ion Bragg peak radiation at the Bevalac at Lawrence Berkeley Laboratory. Bragg peak radiation is deposited in a thin disc of brain tissue beneath an epileptogenic focus produced with alumina cream. Paroxysmal electroencephalograms (EEGs) from the occipital cortex of cats confirm the biolectric changes in the pathogenesis of epilepsy. Distant spread of seizure activity occurs when the cells in the cortical focus fire a series of relatively simultaneous spikes at high frequency with sufficient intensity to develop self-sustained discharges in remote brain areas. The development of a 'mirror focus' in the EEG records in the contralateral cortex gives a measure of the distances paroxysmal discharges spread. Interhemispheric responses (IHR) that travel from the alumina-treated cortex via the corpus callosum to the contralateral cortex are a second measure of pathways over which paroxysmal discharges spread. In cat studies Bragg peak radiation is positioned beneath the epileptic cortical focus. Various heavy ion doses are employed to test whether an absorbed dose per cat is sufficient to block the transmission of epileptic activity as a function of the post-irradiation time. The relationship between neon ion dose and the post-irradiation time for the loss of IHR is a measure of the physiological dissociation of the epileptic brain tissue from the remainder of the brain. The loss of the 'mirror focus' in EEG records agrees with the IHR findings. (author)

  12. 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.

  13. Compare Of the West Syndrome with Other Syndromes in the Epileptic Encephalopathy - Kosovo Experience

    Science.gov (United States)

    Zeka, Naim; Gërguri, Abdurrahim; Bejiqi, Ramush; Retkoceri, Ragip; Vuciterna, Armend

    2017-01-01

    BACKGROUND: West Syndrome (WS) represents as a specific epileptic encephalopathy characterised with a unique type of attacks, called infantile spasms, severe forms of abnormalities in electroencephalographic (EEG) records as a hypsarythmias and delays in the psychomotoric development. The characteristics of the disease, mostly affecting male gender, are infantile spasms and typical findings in EEG as a hypsarythmia. Infantile spasms are a consequence of many factors in the undeveloped brain. AIM: We aimed: (1) to see the incidence of the illness and the spreading out because of gender in rapport with other syndromes in the epileptic encephalopathies group; (2) to show principles of the treatment for the illness; and (3) to present the effects of the disease in the psycho-motoric development of affected children. METHODS: The study was designed as a cross-sectional study of the patients with epileptic encephalopathies, treated in Paediatric Clinic in Prishtina, from 1st of January 2013 until the 31st of December 2015. RESULTS: From the cohort group of 97 children diagnosed with epileptic encephalopathies, in 14 of them clinical and EEG signs of WS were noted. The earliest age of disease manifestation was 74 days (± 63.8 days). On the group of children with WS, 13 of them with Natrium Valpropat were treated, with the doses of 301.9 mg (± 64.1). From the cohort group, in 89 children (91.8%) psychomotoric retardation was documented, within the higher reoccurrence in the undifferentiated epileptic encephalopathies (96%) and the WS (78.6%). CONCLUSION: WS is a frequent disease of the encephalopathies with the epileptogenic framework. The resistance in anticonvulsive therapy is huge, and psychomotoric retardation follows a big percentage of children with this syndrome. PMID:29362620

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

    Science.gov (United States)

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

    2017-07-01

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

  15. Using bivariate signal analysis to characterize the epileptic focus: the benefit of surrogates.

    Science.gov (United States)

    Andrzejak, R G; Chicharro, D; Lehnertz, K; Mormann, F

    2011-04-01

    The disease epilepsy is related to hypersynchronous activity of networks of neurons. While acute epileptic seizures are the most extreme manifestation of this hypersynchronous activity, an elevated level of interdependence of neuronal dynamics is thought to persist also during the seizure-free interval. In multichannel recordings from brain areas involved in the epileptic process, this interdependence can be reflected in an increased linear cross correlation but also in signal properties of higher order. Bivariate time series analysis comprises a variety of approaches, each with different degrees of sensitivity and specificity for interdependencies reflected in lower- or higher-order properties of pairs of simultaneously recorded signals. Here we investigate which approach is best suited to detect putatively elevated interdependence levels in signals recorded from brain areas involved in the epileptic process. For this purpose, we use the linear cross correlation that is sensitive to lower-order signatures of interdependence, a nonlinear interdependence measure that integrates both lower- and higher-order properties, and a surrogate-corrected nonlinear interdependence measure that aims to specifically characterize higher-order properties. We analyze intracranial electroencephalographic recordings of the seizure-free interval from 29 patients with an epileptic focus located in the medial temporal lobe. Our results show that all three approaches detect higher levels of interdependence for signals recorded from the brain hemisphere containing the epileptic focus as compared to signals recorded from the opposite hemisphere. For the linear cross correlation, however, these differences are not significant. For the nonlinear interdependence measure, results are significant but only of moderate accuracy with regard to the discriminative power for the focal and nonfocal hemispheres. The highest significance and accuracy is obtained for the surrogate-corrected nonlinear

  16. METALS IN THE METABOLISM OF HIPPOCAMPUS AND ROLE OF ZINC IN THE PATHOGENESIS OF EPILEPTIC SEIZURES

    Directory of Open Access Journals (Sweden)

    O. M. Kuchkovsky

    2016-05-01

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

  17. HMPAO-SPECT during epileptic seizures: Early and late images

    International Nuclear Information System (INIS)

    Overbeck, B.; Gruenwald, F.; Bockisch, A.; Biersack, H.J.; Reinke, U.; Gratz, K.F.

    1990-01-01

    For presurgical evaluation of epilepsy a 44-year old patient with complex-partial seizures underwent HMPAO-SPECT. The morphology of the seizures, the MRI-scan, psychometry and ictal as well as interictal EEGs showed a left temporal origin of the seizures. Early images were obtained 20 min and late images 24 h following injection. On both scans a marked hyperperfusion was observed in the left temporal area. A crossed cerebellar diaschisis was also seen on both SPECTs. It could be shown that during ictal examinations there is no bloodflow-dependent wash-out from brain tissue. (orig.) [de

  18. Unstandardized treatment of electroencephalographic status epilepticus does not improve outcome of comatose patients after cardiac arrest

    NARCIS (Netherlands)

    Hofmeijer, Jeannette; Cloostermans, M.C.; Beishuizen, A.; van Putten, Michel Johannes Antonius Maria

    2014-01-01

    Objective: Electroencephalographic status epilepticus occurs in 9–35% of comatose patients after cardiac arrest. Mortality is 90–100%. It is unclear whether (some) seizure patterns represent a condition in which anti-epileptic treatment may improve outcome, or severe ischemic damage, in which

  19. Landau-Kleffner Syndrome, Electrical Status Epilepticus in Slow Wave Sleep, and Language Regression in Children

    Science.gov (United States)

    McVicar, Kathryn A.; Shinnar, Shlomo

    2004-01-01

    The Landau-Kleffner syndrome (LKS) and electrical status epilepticus in slow wave sleep (ESES) are rare childhood-onset epileptic encephalopathies in which loss of language skills occurs in the context of an epileptiform EEG activated in sleep. Although in LKS the loss of function is limited to language, in ESES there is a wider spectrum of…

  20. Chlorpromazine-induced status epilepticus: A case report

    Directory of Open Access Journals (Sweden)

    Momčilović-Kostadinović Dragana

    2013-01-01

    Full Text Available Introduction. It is largely known that some antipsychotic agents could have proconvulsive and proepileptogenic effects in some patients and could induce EEG abnormalities as well. However, the association of status epilepticus with certain antipsychotic drugs has been very rarely reported. Case Report. A case of an 18-year-old adolescent girl, with chlorpromazine therapy started for anxiety-phobic disorder was reported. Her personal history disclosed delayed psychomotor development. Shortly after the introduction of the neuroleptic chlorpromazine therapy in minimal daily dose (37.5 mg, she developed myoclonic status epilepticus, confirmed by the EEG records. Frequent, symmetrical bilateral myoclonic jerks and altered behavior were associated with bilateral epileptiform discharges of polyspikes and spike-wave complexes. This epileptic event lasted 3.5 hours and it was stopped by the parenteral administration of valproate and lorazepam; she was EEG monitored until stable remission. Status epilepticus as initial epileptic event induced by neuroleptic agent was not previously reported in our national literature. Conclusion. Introduction of chlorpromazine to a patient without history of seizures is associated with the evolution of an epileptic activity, including the occurrence of status epilepticus. Clinical evaluation of the risk factors possibly related to chlorpromazine-induced seizure is recommended in individual patients before administering this drug.

  1. [Analysis of gene mutation of early onset epileptic spasm with unknown reason].

    Science.gov (United States)

    Yang, X; Pan, G; Li, W H; Zhang, L M; Wu, B B; Wang, H J; Zhang, P; Zhou, S Z

    2017-11-02

    Objective: To summarize the gene mutation of early onset epileptic spasm with unknown reason. Method: In this prospective study, data of patients with early onset epileptic spasm with unknown reason were collected from neurological department of Children's Hospital of Fudan University between March 2016 and December 2016. Patients with known disorders such as infection, metabolic, structural, immunological problems and known genetic mutations were excluded. Patients with genetic disease that can be diagnosed by clinical manifestations and phenotypic characteristics were also excluded. Genetic research methods included nervous system panel containing 1 427 epilepsy genes, whole exome sequencing (WES), analysis of copy number variation (CNV) and karyotype analysis of chromosome. The basic information, phenotypes, genetic results and the antiepileptic treatment of patients were analyzed. Result: Nine of the 17 cases with early onset epileptic spasm were boys and eight were girls. Patients' age at first seizure onset ranged from 1 day after birth to 8 months (median age of 3 months). The first hospital visit age ranged from 1 month to 2 years (median age of 4.5 months). The time of following-up ranged from 8 months to 3 years and 10 months. All the 17 patients had early onset epileptic spasm. Video electroencephalogram was used to monitor the spasm seizure. Five patients had Ohtahara syndrome, 10 had West syndrome, two had unclear classification. In 17 cases, 10 of them had detected pathogenic genes. Nine cases had point mutations, involving SCN2A, ARX, UNC80, KCNQ2, and GABRB3. Except one case of mutations in GABRB3 gene have been reported, all the other cases had new mutations. One patient had deletion mutation in CDKL5 gene. One CNV case had 6q 22.31 5.5MB repeats. Ten cases out of 17 were using 2-3 antiepileptic drugs (AEDs) and the drugs had no effect. Seven cases used adrenocorticotropic hormone (ACTH) and prednisone besides AEDs (a total course for 8 weeks

  2. Magnetoencephalographic localization of peritumoral temporal epileptic focus previous surgical resection.

    Science.gov (United States)

    Amo, Carlos; Saldaña, Cristóbal; Hidalgo, Mercedes González; Maestú, Fernando; Fernández, Alberto; Arrazola, Juan; Ortiz, Tomás

    2003-01-01

    Magnetoencephalography (MEG) is suggested as a localizing technique of epileptogenic areas in drug-resistant seizure patients due to intracraneal lesions. A male 42-year-old patient who begins at 26 with partial complex drug-resistant seizures is put forward. MRI shows a 9 mm diameter lesion located in left superior temporal gyrus which seems compatible with cavernoma. Both conventional and sleep deprivation EEGs have proved normal. Sleep EEG shows sharp waves in left temporal region. MEG helps to localize interictal spike and spike-wave activity, as well as wide slow wave (2-7 Hz) activity areas. Craniotomy under analgesia and aware sedation conditions is carried out. Intrasurgery cortical electric stimulation assisted by neuronavigator causes a limited partial complex seizure which the patient recognizes to be exactly like his. Thus, MEG localization of the epileptogenic area is confirmed. Surgical resection of both the lesion and the epileptogenic area is carried out. The patient remains free from seizures 9 months after surgery. A control MEG study reveals no epileptogenic nor slow wave activity. in this particular case, MEG has proven to be a useful presurgical evaluation technique to localize epileptogenic activity, validated by intrasurgical cortical stimulation.

  3. [Epilepsy from a metaphysical perspective: an interpretation of the biblical story of the epileptic boy and Raphael's Transfiguration].

    Science.gov (United States)

    Janz, D

    1994-01-01

    Raphael's last painting reveals, in the upper half of the picture, Christ's transfiguration on Mount Tabor and, in the lower half, the young boy's epileptic seizure at the foot of the mountain in the presence of the other disciples. Raphael depicts both events, which are told in succession in the Gospels, as if they took place at the same time. By synchronizing both scenes, Raphael demonstrated a significant correspondence between Christ and the epileptic boy which reveals the epileptic seizure as a symbolic representation of a transcendental event. This metaphysical aspect of epilepsy depicted by Raphael can also be found in the corresponding biblical passages. In the Gospels, the metamorphosis caused by the epileptic seizure is used as a simile for Christ's transfiguration through suffering, death and resurrection.

  4. Management of periocular post burn scarring in the epileptics

    International Nuclear Information System (INIS)

    Cheema, A.M.; Saeed, M.; Ghani, A.; Akhter, S.W.

    2003-01-01

    Objective: To assess the clinical presentation and management of patients with epilepsy presenting with periocular post burn scarring. Results: There were 18 (78.26%) female and 5(21.73%) male patients. The age range was from 18 to 45 years with a mean of 28 years. In 17 (73.91%) patients, lid contracture was released to cover their eyeballs. In 6 (26.08%) patients the eyeball was lost due to late presentation. Conclusion: There should be a high index of suspicion in facial burns for ophthalmic damage and early referral to an ophthalmologist should be made to prevent complications. Early release of contracture with application of full or partial thickness skin grafts is advisable. (author)

  5. Epileptic MEG Spike Detection Using Statistical Features and Genetic Programming with KNN

    Directory of Open Access Journals (Sweden)

    Turky N. Alotaiby

    2017-01-01

    Full Text Available Epilepsy is a neurological disorder that affects millions of people worldwide. Monitoring the brain activities and identifying the seizure source which starts with spike detection are important steps for epilepsy treatment. Magnetoencephalography (MEG is an emerging epileptic diagnostic tool with high-density sensors; this makes manual analysis a challenging task due to the vast amount of MEG data. This paper explores the use of eight statistical features and genetic programing (GP with the K-nearest neighbor (KNN for interictal spike detection. The proposed method is comprised of three stages: preprocessing, genetic programming-based feature generation, and classification. The effectiveness of the proposed approach has been evaluated using real MEG data obtained from 28 epileptic patients. It has achieved a 91.75% average sensitivity and 92.99% average specificity.

  6. If the Airway Opens with Finger During Epileptics Attack: A Case Report

    Directory of Open Access Journals (Sweden)

    Seyran Kilinc

    2016-01-01

    Full Text Available The human bites generally have been came across after the situation as fighting, aggression, murder, sports competitions and child abuse. Hands and wrists are the most common areas that human bites have seen. Our case was seen first time when 65 aged woman treating for diabetes mellitus in our endocrinology service consultated us with a neglected open wound that occurred after she put on her hands second finger%u2019s proximal phalanx to her relative%u2019s mouth to keep open duration of epileptic attack before 45 days. In this case we try to explain that the wrong intervention in epileptic attack and delaying treatment of infections of human bites can be resulted with limb missing.

  7. Atypical presentation in Rasmussen encephalitis: delayed late-onset periodic epileptic spasms.

    Science.gov (United States)

    Ferrari, Taíssa P F; Hamad, Ana P A; Caboclo, Luís Otávio S F; Centeno, Ricardo S; Zaninotto, Ana Luiza; Scattolin, Monica; Carrete Junior, Henrique; Lancellotti, Carmem L P; Yacubian, Elza Márcia T

    2011-09-01

    A five-and-a-half-year-old girl started experiencing progressive left hemiparesis at age two and a half years. At age five years and four months she started presenting clusters of asymmetric periodic epileptic spasms with no hypsarrhythmia. The ictal EEG showed periodic, constant and stereotyped complexes. Serial brain imaging revealed progressive atrophy of the right hemisphere with increased T2 signal on MRI. She underwent a right hemispherotomy, and histological examination showed signs of inflammation and features of focal cortical dysplasia (FCD). She has been seizure-free for 16 months. This case is unique in the following aspects: the presence of typical Rasmussen encephalitis features of progressive unilateral brain involvement without seizures, a delay of almost three years prior to seizure onset; an atypical seizure type presentation with periodic epileptic spasms and the presence of FCD associated with inflammatory changes. [Published with video sequences].

  8. Effect of enzyme inducing anticonvulsants on ethosuximide pharmacokinetics in epileptic patients

    Science.gov (United States)

    GIACCONE, M.; BARTOLI, A.; GATTI, G.; MARCHISELLI, R.; PISANI, F.; LATELLA, M.A.; PERUCCA, E.

    1996-01-01

    1To assess the effect of enzyme inducing anticonvulsants on ethosuximide pharmacokinetics, plasma ethosuximide concentrations after a single oral dose (500 mg) of the drug were compared in 12 healthy control subjects and 10 epileptic patients receiving chronic therapy with phenobarbitone, phenytoin and/or carbamazepine. 2Compared with controls, epileptic patients showed markedly shorter ethosuximide half-lives (29.0±7.8 vs 53.7±14.3 h, means±s.d., Panticonvulsants, the effect probably being mediated by stimulation of cytochrome CYP3A activity. 4The enhancement of ethosuximide clearance in patients comedicated with enzyme inducing anticonvulsants is likely to be clinically relevant. Higher ethosuximide dosages will be required to achieve therapeutic drug concentrations in these patients. PMID:8799524

  9. A method for detecting nonlinear determinism in normal and epileptic brain EEG signals.

    Science.gov (United States)

    Meghdadi, Amir H; Fazel-Rezai, Reza; Aghakhani, Yahya

    2007-01-01

    A robust method of detecting determinism for short time series is proposed and applied to both healthy and epileptic EEG signals. The method provides a robust measure of determinism through characterizing the trajectories of the signal components which are obtained through singular value decomposition. Robustness of the method is shown by calculating proposed index of determinism at different levels of white and colored noise added to a simulated chaotic signal. The method is shown to be able to detect determinism at considerably high levels of additive noise. The method is then applied to both intracranial and scalp EEG recordings collected in different data sets for healthy and epileptic brain signals. The results show that for all of the studied EEG data sets there is enough evidence of determinism. The determinism is more significant for intracranial EEG recordings particularly during seizure activity.

  10. Plasticity of Hippocampal Excitatory-Inhibitory Balance: Missing the Synaptic Control in the Epileptic Brain

    Directory of Open Access Journals (Sweden)

    Christian Bonansco

    2016-01-01

    Full Text Available Synaptic plasticity is the capacity generated by experience to modify the neural function and, thereby, adapt our behaviour. Long-term plasticity of glutamatergic and GABAergic transmission occurs in a concerted manner, finely adjusting the excitatory-inhibitory (E/I balance. Imbalances of E/I function are related to several neurological diseases including epilepsy. Several evidences have demonstrated that astrocytes are able to control the synaptic plasticity, with astrocytes being active partners in synaptic physiology and E/I balance. Here, we revise molecular evidences showing the epileptic stage as an abnormal form of long-term brain plasticity and propose the possible participation of astrocytes to the abnormal increase of glutamatergic and decrease of GABAergic neurotransmission in epileptic networks.

  11. The epileptic seizure and the mystery of death in Christian painting.

    Science.gov (United States)

    Mann, Michael W

    2010-02-01

    The epileptic seizure is in many cultures associated with death. Indo-European tradition perceives death not necessarily as the end but as a step, as a point the life cycle is passing through. The epileptic seizure may be seen as a transient form of death, which offers some symmetry with the biblical story of the death and resurrection of Christ. This article, originating from a case report, shows how some Christian painting alludes to renaissance after a seizure and to the parallelism between the patient with epilepsy and the destiny of Christ. Special attention is paid to Raphael's, in this respect particularly complex work, The Transfiguration. (c) 2009 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2016-02-01

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

  13. Topiramate-induced paresthesia is more frequently reported by migraine than epileptic patients.

    Science.gov (United States)

    Sedighi, Behnaz; Shafiei, Kaveh; Azizpour, Iman

    2016-04-01

    Topiramate is an approved and effective drug in migraine prophylaxis. Paresthesia is the most commonly reported side effect. The primary objective of this study was to compare the frequency of topiramate-induced paresthesia in migraine headache to epileptic patients. Patients with migraine without aura and epilepsy were enrolled in this observational study. All cases were interviewed by telephone about their history of paresthesia. Confounding factors were controlled through logistic regression. The odds ratio of developing topiramate-induced paresthesia in migraine compared to epilepsy patients was 3.4. Three factors were independent contributors to developing topiramate-induced paresthesia: female sex (odds ratio 2.1), topiramate dosage (odds ratio 0.3) and duration of therapy. Our findings indicate an independent association between migraine and development of paresthesia. Migraineurs were more likely than epileptic patients to report paresthesia as topiramate adverse effects. Female sex, treatment duration and topiramate dosage contribute significantly to subsequent development of paresthesia.

  14. Partial tooth gear bearings

    Science.gov (United States)

    Vranish, John M. (Inventor)

    2010-01-01

    A partial gear bearing including an upper half, comprising peak partial teeth, and a lower, or bottom, half, comprising valley partial teeth. The upper half also has an integrated roller section between each of the peak partial teeth with a radius equal to the gear pitch radius of the radially outwardly extending peak partial teeth. Conversely, the lower half has an integrated roller section between each of the valley half teeth with a radius also equal to the gear pitch radius of the peak partial teeth. The valley partial teeth extend radially inwardly from its roller section. The peak and valley partial teeth are exactly out of phase with each other, as are the roller sections of the upper and lower halves. Essentially, the end roller bearing of the typical gear bearing has been integrated into the normal gear tooth pattern.

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

    Science.gov (United States)

    Jaiswal, Abeg Kumar; Banka, Haider

    2017-01-01

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

  16. Age-dependent suppression of hippocampal epileptic afterdischarges by metabotropic glutamate receptor 5 antagonist MTEP

    Czech Academy of Sciences Publication Activity Database

    Zavala-Tecuapetla, Cecília; Kubová, Hana; Otáhal, Jakub; Tsenov, Grygoriy; Mareš, Pavel

    2014-01-01

    Roč. 66, č. 5 (2014), s. 927-930 ISSN 1734-1140 R&D Projects: GA ČR(CZ) GA305/09/0846; GA ČR(CZ) GBP304/12/G069 Institutional support: RVO:67985823 Keywords : epileptic afterdischarge * hippocampus * rat * ontogeny * metabotropic glutamate receptor 5 Subject RIV: FH - Neurology Impact factor: 1.928, year: 2014

  17. Biphasic effect of chronic postnatal caffeine treatment on cortical epileptic afterdischarges during ontogeny in rats

    Czech Academy of Sciences Publication Activity Database

    Tchekalarova, Jana; Kubová, Hana; Mareš, Pavel

    2006-01-01

    Roč. 1082, č. 1 (2006), s. 43-49 ISSN 0006-8993 R&D Projects: GA ČR(CZ) GA304/04/0464 Grant - others:CZ-BG(CZ) Research project 2002-2004 Institutional research plan: CEZ:AV0Z5011922 Keywords : caffeine * epileptic afterdischarges * sensorimotor cortex Subject RIV: ED - Physiology Impact factor: 2.341, year: 2006

  18. Effects of caffeine on cortical epileptic afterdischarges in adult rats are modulated by postnatal treatment

    Czech Academy of Sciences Publication Activity Database

    Tchekalarova, Jana; Kubová, Hana; Mareš, Pavel

    2013-01-01

    Roč. 113, č. 4 (2013), s. 493-500 ISSN 0300-9009 R&D Projects: GA MZd(CZ) NR9184; GA MŠk(CZ) LH11015 Institutional research plan: CEZ:AV0Z50110509 Institutional support: RVO:67985823 Keywords : caffeine * perinatal administration * cortical epileptic afterdischarges * adult rats Subject RIV: FH - Neurology Impact factor: 0.598, year: 2013

  19. Compare Of the West Syndrome with Other Syndromes in the Epileptic Encephalopathy - Kosovo Experience

    OpenAIRE

    Zeka, Naim; Gërguri, Abdurrahim; Bejiqi, Ramush; Retkoceri, Ragip; Vuciterna, Armend

    2017-01-01

    BACKGROUND: West Syndrome (WS) represents as a specific epileptic encephalopathy characterised with a unique type of attacks, called infantile spasms, severe forms of abnormalities in electroencephalographic (EEG) records as a hypsarythmias and delays in the psychomotoric development. The characteristics of the disease, mostly affecting male gender, are infantile spasms and typical findings in EEG as a hypsarythmia. Infantile spasms are a consequence of many factors in the undeveloped brain. ...

  20. Large-scale structural alteration of brain in epileptic children with SCN1A mutation

    OpenAIRE

    Lee, Yun-Jeong; Yum, Mi-Sun; Kim, Min-Jee; Shim, Woo-Hyun; Yoon, Hee Mang; Yoo, Il Han; Lee, Jiwon; Lim, Byung Chan; Kim, Ki Joong; Ko, Tae-Sung

    2017-01-01

    Objective: Mutations in SCN1A gene encoding the alpha 1 subunit of the voltage gated sodium channel are associated with several epilepsy syndromes including genetic epilepsy with febrile seizures plus (GEFS+) and severe myoclonic epilepsy of infancy (SMEI). However, in most patients with SCN1A mutation, brain imaging has reported normal or non-specific findings including cerebral or cerebellar atrophy. The aim of this study was to investigate differences in brain morphometry in epileptic chil...

  1. Motor correlates of models of secondary bilateral synchrony and multiple epileptic foci

    Czech Academy of Sciences Publication Activity Database

    Jiruška, Přemysl; Prokš, J.; Otáhal, Jakub; Mareš, Pavel

    2007-01-01

    Roč. 16, č. 7 (2007), s. 627-635 ISSN 1059-1311 R&D Projects: GA ČR(CZ) GA309/03/0770; GA ČR GA304/05/2582 Institutional research plan: CEZ:AV0Z5011922 Keywords : epileptic foci * secondary bilateral synchrony * neocortex Subject RIV: ED - Physiology Impact factor: 1.815, year: 2007

  2. A novel, non-invasive diagnostic clinical procedure for the determination of an oxygenation status of chronic lower leg ulcers using peri-ulceral transcutaneous oxygen partial pressure measurements: results of its application in chronic venous insufficiency (CVI).

    Science.gov (United States)

    Barnikol, Wolfgang K R; Pötzschke, Harald

    2012-01-01

    The basis for the new procedure is the simultaneous transcutaneous measurement of the peri-ulceral oxygen partial pressure (tcPO(2)), using a minimum of 4 electrodes which are placed as close to the wound margin as possible, additionally, as a challenge the patient inhales pure oxygen for approximately 15 minutes. In order to evaluate the measurement data and to characterise the wounds, two new oxygen parameters were defined: (1) the oxygen characteristic (K-PO(2)), and (2) the oxygen inhomogeneity (I-PO(2)) of a chronic wound. The first of these is the arithmetic mean of the two lowest tcPO(2) measurement values, and the second is the variation coefficient of the four measurement values. Using the K-PO(2) parameter, a grading of wound hypoxia can be obtained. To begin with, the physiologically regulated (and still compensated) hypoxia with K-PO(2) values of between 35 and 40 mmHg is distinguished from the pathological decompensated hypoxia with K-PO(2) values of between 0 and 35 mmHg; the first of these still stimulates self-healing (within the limits of the oxygen balance). The decompensated hypoxia can be (arbitrarily) divided into "simple" hypoxia (Grade I), intense hypoxia (Grade II) and extreme hypoxia (Grade III), with the possibility of intermediate grades (I/II and II/III).Measurements were carried out using the new procedure on the skin of the right inner ankle of 21 healthy volunteers of various ages, and in 17 CVI (chronic venous insufficiency) wounds. Sixteen of the 17 CVI wounds (i.e., 94%) were found to be pathologically hypoxic, a state which was not found in any of the healthy volunteers. The oxygen inhomogeneity (I-PO(2)) of the individual chronic wounds increased exponentially as a function of the hypoxia grading (K-PO(2)), with a 10-fold increase with extreme hypoxia in contrast to a constant value of approximately 14% in the healthy volunteers. This pronounced oxygen inhomogeneity explains inhomogeneous wound healing, resulting in the so

  3. Essays on partial retirement

    NARCIS (Netherlands)

    Kantarci, T.

    2012-01-01

    The five essays in this dissertation address a range of topics in the micro-economic literature on partial retirement. The focus is on the labor market behavior of older age groups. The essays examine the economic and non-economic determinants of partial retirement behavior, the effect of partial

  4. Ictal but not interictal epileptic discharges activate astrocyte endfeet and elicit cerebral arteriole responses.

    Directory of Open Access Journals (Sweden)

    Marta eGomez-Gonzalo

    2011-06-01

    Full Text Available Activation of astrocytes by neuronal signals plays a central role in the control of neuronal activity-dependent blood flow changes in the normal brain. The cellular pathways that mediate neurovascular coupling in the epileptic brain remain, however, poorly defined. In a cortical slice model of epilepsy, we found that the ictal, seizure-like discharge, and only to a minor extent the interictal discharge, evokes both a Ca2+ increase in astrocyte endfeet and a vasomotor response. We also observed that rapid ictal discharge-induced arteriole responses were regularly preceded by Ca2+ elevations in endfeet and were abolished by pharmacological inhibition of Ca2+ signals in these astrocyte processes. Under these latter conditions, arterioles exhibited after the ictal discharge only slowly developing vasodilations. The poor efficacy of interictal discharges, compared with ictal discharges, to activate endfeet was confirmed also in the intact in vitro isolated guinea pig brain. Although the possibility of a direct contribution of neurons, in particular in the late response of cerebral blood vessels to epileptic discharges, should be taken into account, our study supports the view that astrocytes are central for neurovascular coupling also in the epileptic brain. The massive endfeet Ca2+ elevations evoked by ictal discharges and the poor response to interictal events represent new information potentially relevant to interpret data from diagnostic brain imaging techniques, such as functional magnetic resonance, utilized in the clinic to localize neural activity and to optimize neurosurgery of untreatable epilepsies.

  5. Evaluation of SPECT with N-isopropyl[I-123]-p-iodoamphetamine (IMP) in epileptic patients

    International Nuclear Information System (INIS)

    Nambu, Toshikazu; Itoh, Kazuo; Sumi, Tetsuo; Furudate, Masayori; Irie, Goro

    1988-01-01

    Brain SPECT scintigrams with N-Isopropyl[I-123]-p-Iodoamphetamine (IMP) were reviewed and compared with the EEG findings in 21 epileptic patients (22 SPECT images) with normal CT. Thirteen of 22 SPECT images showed abnormal low uptake and 7 of them corresponded to the EEG focus. In order to obtain the quantitative analysis, the count ratio of the focus side to the opposite I-123 content in fixed ROI was measured for each case, but no statistically significant correlation for the frequency or the duration of epilepsy was found. EEG is not considered to be favorite standard for localizing epileptic foci, especially in deep cerebral region, and that may be one of the main reason for the incomplete correlation. In the qualitative study, however, the cases with frequent epileptic attack were more likely to show abnormal findings. I-123 IMP SPECT can now be considered as having a significant clinical role for the diagnosis and management of patients with epilepsy. (author)

  6. The Classical Pathways of Occipital Lobe Epileptic Propagation Revised in the Light of White Matter Dissection.

    Science.gov (United States)

    Latini, Francesco; Hjortberg, Mats; Aldskogius, Håkan; Ryttlefors, Mats

    2015-01-01

    The clinical evidences of variable epileptic propagation in occipital lobe epilepsy (OLE) have been demonstrated by several studies. However the exact localization of the epileptic focus sometimes represents a problem because of the rapid propagation to frontal, parietal, or temporal regions. Each white matter pathway close to the supposed initial focus can lead the propagation towards a specific direction, explaining the variable semiology of these rare epilepsy syndromes. Some new insights in occipital white matter anatomy are herein described by means of white matter dissection and compared to the classical epileptic patterns, mostly based on the central position of the primary visual cortex. The dissections showed a complex white matter architecture composed by vertical and longitudinal bundles, which are closely interconnected and segregated and are able to support specific high order functions with parallel bidirectional propagation of the electric signal. The same sublobar lesions may hyperactivate different white matter bundles reemphasizing the importance of the ictal semiology as a specific clinical demonstration of the subcortical networks recruited. Merging semiology, white matter anatomy, and electrophysiology may lead us to a better understanding of these complex syndromes and tailored therapeutic options based on individual white matter connectivity.

  7. Brain Graph Topology Changes Associated with Anti-Epileptic Drug Use

    Science.gov (United States)

    Levin, Harvey S.; Chiang, Sharon

    2015-01-01

    Abstract Neuroimaging studies of functional connectivity using graph theory have furthered our understanding of the network structure in temporal lobe epilepsy (TLE). Brain network effects of anti-epileptic drugs could influence such studies, but have not been systematically studied. Resting-state functional MRI was analyzed in 25 patients with TLE using graph theory analysis. Patients were divided into two groups based on anti-epileptic medication use: those taking carbamazepine/oxcarbazepine (CBZ/OXC) (n=9) and those not taking CBZ/OXC (n=16) as a part of their medication regimen. The following graph topology metrics were analyzed: global efficiency, betweenness centrality (BC), clustering coefficient, and small-world index. Multiple linear regression was used to examine the association of CBZ/OXC with graph topology. The two groups did not differ from each other based on epilepsy characteristics. Use of CBZ/OXC was associated with a lower BC. Longer epilepsy duration was also associated with a lower BC. These findings can inform graph theory-based studies in patients with TLE. The changes observed are discussed in relation to the anti-epileptic mechanism of action and adverse effects of CBZ/OXC. PMID:25492633

  8. Serum levels of zinc and copper in epileptic children during long-term therapy with anticonvulsants.

    Science.gov (United States)

    Talat, Mohamed A; Ahmed, Anwar; Mohammed, Lamia

    2015-10-01

    To evaluate the serum levels of zinc and copper in epileptic children during the long-term treatment of anticonvulsant drugs and correlate this with healthy subjects. A hospital-based group matched case-control study was conducted in the Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt between November 2013 and October 2014. Ninety patients aged 7.1 ± 3.6 years were diagnosed with epilepsy by a neurologist. The control group was selected from healthy individuals and matched to the case group. Serum zinc and copper were measured by the calorimetric method using a colorimetric method kit. The mean zinc level was 60.1 ± 22.6 ug/dl in the cases, and 102.1 ± 18 ug/dl in the controls (p<0.001). The mean copper level was 180.1 ± 32.4 ug/dl in cases compared with 114.5 ± 18.5 ug/dl in controls (p<0.001). Serum zinc levels in epileptic children under drug treatment are lower compared with healthy children. Also, serum copper levels in these patients are significantly higher than in healthy people. No significant difference in the levels of serum copper and zinc was observed in using one drug or multiple drugs in the treatment of epileptic patients.

  9. Classifying epileptic EEG signals with delay permutation entropy and Multi-Scale K-means.

    Science.gov (United States)

    Zhu, Guohun; Li, Yan; Wen, Peng Paul; Wang, Shuaifang

    2015-01-01

    Most epileptic EEG classification algorithms are supervised and require large training datasets, that hinder their use in real time applications. This chapter proposes an unsupervised Multi-Scale K-means (MSK-means) MSK-means algorithm to distinguish epileptic EEG signals and identify epileptic zones. The random initialization of the K-means algorithm can lead to wrong clusters. Based on the characteristics of EEGs, the MSK-means MSK-means algorithm initializes the coarse-scale centroid of a cluster with a suitable scale factor. In this chapter, the MSK-means algorithm is proved theoretically superior to the K-means algorithm on efficiency. In addition, three classifiers: the K-means, MSK-means MSK-means and support vector machine (SVM), are used to identify seizure and localize epileptogenic zone using delay permutation entropy features. The experimental results demonstrate that identifying seizure with the MSK-means algorithm and delay permutation entropy achieves 4. 7 % higher accuracy than that of K-means, and 0. 7 % higher accuracy than that of the SVM.

  10. The Classical Pathways of Occipital Lobe Epileptic Propagation Revised in the Light of White Matter Dissection

    Science.gov (United States)

    Latini, Francesco; Hjortberg, Mats; Aldskogius, Håkan; Ryttlefors, Mats

    2015-01-01

    The clinical evidences of variable epileptic propagation in occipital lobe epilepsy (OLE) have been demonstrated by several studies. However the exact localization of the epileptic focus sometimes represents a problem because of the rapid propagation to frontal, parietal, or temporal regions. Each white matter pathway close to the supposed initial focus can lead the propagation towards a specific direction, explaining the variable semiology of these rare epilepsy syndromes. Some new insights in occipital white matter anatomy are herein described by means of white matter dissection and compared to the classical epileptic patterns, mostly based on the central position of the primary visual cortex. The dissections showed a complex white matter architecture composed by vertical and longitudinal bundles, which are closely interconnected and segregated and are able to support specific high order functions with parallel bidirectional propagation of the electric signal. The same sublobar lesions may hyperactivate different white matter bundles reemphasizing the importance of the ictal semiology as a specific clinical demonstration of the subcortical networks recruited. Merging semiology, white matter anatomy, and electrophysiology may lead us to a better understanding of these complex syndromes and tailored therapeutic options based on individual white matter connectivity. PMID:26063964

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

    International Nuclear Information System (INIS)

    Hosokawa, Chisa; Ochi, Hironobu; Yamagami, Sakae; Kawabe, Joji; Kobashi, Toshiko; Okamura, Terue; Yamada, Ryusaku

    1995-01-01

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

  12. Personality and Psychopathology of Patients with Grandmal and Complex Partial Seizures

    Directory of Open Access Journals (Sweden)

    Najafi

    2010-06-01

    Full Text Available Introduction: Epileptic patients have special mental profile and experience emotional and psychopathological problems. Some studies have reported that epilepsy and psychopathology occur together. The aim of this study was to evaluate the mental profile of Complex partial seizure (CPS and Grandmal seizure (GMS patients and compare them with the control group. Methods: This descriptive-analytical study was carried out in 2008 at the neurological clinics of Isfahan and included 40 Patients with CPS and GMS epilepsy selected conveniently and control group included relatives of the patients. Psychological and personality profile was measured with MMPI inventory. The obtained data was analyzed with SPSS software, mainly through the analysis of Chi Square and ANOVA. Results: The findings of this research showed that although the scores of clinical scales in MMPI are higher than control group, this psychopathology isn’t abnormal. Epileptic patients in hypochondria, depression and hysteria had more elevated levels in comparison with the control group, but this difference was significant only in CPS patients. Conclusion: The results showed that epileptic patients tend to have more psychological disorders than normal people. These findings emphasize the necessity for psychological treatment along with drug therapy.

  13. Aliocha Dostoevski’s death during an epileptic seizure

    Directory of Open Access Journals (Sweden)

    Edson José Amâncio

    Full Text Available ABSTRACT Mortality due to epilepsy is of great concern worldwide. Individuals with epilepsy have a two- or three-fold risk of death when compared to the general population. Based on biographical data and Anna Grigoriévna Dostoevskaia’s memories, the authors concluded that a prolonged episode of status epilepticus was the culprit in the death of young Aliocha, youngest son of Fyodor Mikhailovich and Anna Dostoevski. At the time of Aliocha’s death, very limited knowledge about epilepsy or therapeutic resources was available. Despite all the progress, epilepsies remain potentially fatal conditions. The suffering generated by Aliocha’s death and other similar cases remains as a challenge for epileptologists who assemble efforts to fight against such conditions.

  14. Cerebrospinal Fluid Levels of Monoamine Metabolites in the Epileptic Baboon

    Science.gov (United States)

    Szabó, C. Ákos; Patel, Mayuri; Uteshev, Victor V.

    2016-01-01

    The baboon represents a natural model for genetic generalized epilepsy and sudden unexpected death in epilepsy (SUDEP). In this retrospective study, cerebrospinal fluid (CSF) monoamine metabolites and scalp electroencephalography (EEG) were evaluated in 263 baboons of a pedigreed colony. CSF monoamine abnormalities have been linked to reduced seizure thresholds, behavioral abnormalities and SUDEP in various animal models of epilepsy. The levels of 3-hydroxy-4-methoxyphenylglycol, 5-hydroxyindolacetic acid and homovanillic acid in CSF samples drawn from the cisterna magna were analyzed using high-performance liquid chromatography. These levels were compared between baboons with seizures (SZ), craniofacial trauma (CFT) and asymptomatic, control (CTL) baboons, between baboons with abnormal and normal EEG studies. We hypothesized that the CSF levels of major monoaminergic metabolites (i.e., dopamine, serotonin and norepinephrine) associate with the baboons’ electroclinical status and thus can be used as clinical biomarkers applicable to seizures/epilepsy. However, despite apparent differences in metabolite levels between the groups, usually lower in SZ and CFT baboons and in baboons with abnormal EEG studies, we did not find any statistically significant differences using a logistic regression analysis. Significant correlations between the metabolite levels, especially between 5-HIAA and HVA, were preserved in all electroclinical groups. While we were not able to demonstrate significant differences in monoamine metabolites in relation to seizures or EEG markers of epilepsy, we cannot exclude the monoaminergic system as a potential source of pathogenesis in epilepsy and SUDEP. A prospective study evaluating serial CSF monoamine levels in baboons with recently witnessed seizures, and evaluation of abnormal expression and function of monoaminergic receptors and transporters within epilepsy-related brain regions, may impact the electroclinical status. PMID:26924854

  15. Advancements in the critical care management of status epilepticus.

    Science.gov (United States)

    Bauerschmidt, Andrew; Martin, Andrew; Claassen, Jan

    2017-04-01

    Status epilepticus has a high morbidity and mortality. There are little definitive data to guide management; however, new recent data continue to improve understanding of management options of status epilepticus. This review examines recent advancements regarding the critical care management of status epilepticus. Recent studies support the initial treatment of status epilepticus with early and aggressive benzodiazepine dosing. There remains a lack of prospective randomized controlled trials comparing different treatment regimens. Recent data support further study of intravenous lacosamide as an urgent-control therapy, and ketamine and clobazam for refractory status epilepticus. Recent data support the use of continuous EEG to help guide treatment for all patients with refractory status epilepticus and to better understand epileptic activity that falls on the ictal-interictal continuum. Recent data also improve our understanding of the relationship between periodic epileptic activity and brain injury. Many treatments are available for status epilepticus and there are much new data guiding the use of specific agents. However, there continues to be a lack of prospective data supporting specific regimens, particularly in cases of refractory status epilepticus.

  16. Paradoxical Seizure Response to Phenytoin in an Epileptic Heroin Addict.

    Science.gov (United States)

    Vasagar, Brintha; Verma, Beni R; Dewberry, Robert G; Pula, Thaddeus

    2015-06-01

    Phenytoin has a narrow therapeutic window and seizures can occur at both ends of the spectrum. A 41-year-old man with a history of a seizure disorder and heroin addiction presented with dizziness following 2 generalized tonic-clonic seizures that occurred earlier that day. The patient had received a loading dose of phenytoin for seizures associated with a subtherapeutic level 5 days previously. Initial evaluation revealed an elevated phenytoin level of 32.6 mcg/mL and an opiate-positive toxicology screen. Levetiracetam was started on the day of presentation and phenytoin was held until the level returned to the therapeutic range. The patient's dizziness resolved and he had no additional seizures. Evaluation for reversible causes of seizure activity along with anticonvulsant administration is generally the standard of care for breakthrough seizures. Phenytoin blood levels, if supratherapeutic, may be at least partially responsible for breakthrough seizure activity; in this circumstance, holding phenytoin and temporarily adding another anticonvulsant may be indicated.

  17. Recurrent Partial Words

    Directory of Open Access Journals (Sweden)

    Francine Blanchet-Sadri

    2011-08-01

    Full Text Available Partial words are sequences over a finite alphabet that may contain wildcard symbols, called holes, which match or are compatible with all letters; partial words without holes are said to be full words (or simply words. Given an infinite partial word w, the number of distinct full words over the alphabet that are compatible with factors of w of length n, called subwords of w, refers to a measure of complexity of infinite partial words so-called subword complexity. This measure is of particular interest because we can construct partial words with subword complexities not achievable by full words. In this paper, we consider the notion of recurrence over infinite partial words, that is, we study whether all of the finite subwords of a given infinite partial word appear infinitely often, and we establish connections between subword complexity and recurrence in this more general framework.

  18. Endogenous sulfur dioxide regulates hippocampal neuron apoptosis in developing epileptic rats and is associated with the PERK signaling pathway.

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    Niu, Manman; Han, Ying; Li, Qinrui; Zhang, Jing

    2018-02-05

    Epilepsy is among the most common neurological diseases in children. Recurrent seizures can result in hippocampal damage and seriously impair learning and memory functions in children. However, the mechanisms underlying epilepsy-related brain injury are unclear. Neuronal apoptosis is among the most common neuropathological manifestations of brain injury. Endogenous sulfur dioxide (SO 2 ) has been shown to be involved in seizures and related neuron apoptosis. However, the role of endogenous SO 2 in epilepsy remains unclear. This study assessed whether endogenous SO 2 is involved in epilepsy and its underlying mechanisms. Using a rat epilepsy model induced by an intraperitoneal injection of kainic acid (KA), we found that hippocampal neuron apoptosis was induced in epileptic rats, and the SO 2 content and aspartate aminotransferase (AAT) activity in the plasma were increased compared to those in the control group. However, the inhibition of SO 2 production by l-aspartate-β-hydroxamate (HDX) can subvert this response 72h after an epileptic seizure. No difference in apoptosis was observed 7 d after the epileptic seizure in the KA and KA+HDX groups. The protein expression levels of AAT2, glucose-regulated protein 78 (GRP78), pancreatic eIF2 kinase-like ER kinase (PERK) and phospho-PERK (p-PERK) were remarkably elevated in the hippocampi of the epileptic rats, while the HDX treatment was capable of reversing this process 7 d after the epileptic seizure. These results indicate that the inhibition of endogenous SO 2 production can alleviate neuronal apoptosis and is associated with the PERK signaling pathway during the initial stages after epileptic seizure, but inhibiting SO 2 production only delayed the occurrence of apoptosis and did not prevent neuronal apoptosis in the epileptic rats. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Severe neonatal epileptic encephalopathy and KCNQ2 mutation: neuropathological substrate?

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    Charlotte eDalen Meurs-Van Der Schoor

    2014-12-01

    Full Text Available Background:Neonatal convulsions are clinical manifestations in a heterogeneous group of disorders with different etiology and outcome. They are attributed to several genetic causes. Methods:We describe a patient with intractable neonatal seizures who died from respiratory compromise during a status epilepticus. Results:This case report provides EEG, MRI, genetic analysis and neuropathological data. Genetic analysis revealed a de novo heterozygous missense mutation in the KCNQ2 gene, which encodes a subunit of a voltage-gated potassium channel. KCNQ2 gene mutation is associated with intractable neonatal seizures. EEG, MRI data as well as mutation analysis have been described in other KCNQ2 cases. Postmortem neuropathologic investigation revealed mild malformation of cortical development with increased heterotopic neurons in the deep white matter compared to an age-matched control subject. The new finding of this study is the combination of a KCNQ2 mutation and the cortical abnormalities. Conclusions:KCNQ2 mutations should be considered in neonates with refractory epilepsy of unknown cause. The mild cortical malformation is an important new finding, though it remains unknown whether these cortical abnormalities are due to the KCNQ2 mutation or are secondary to the refractory seizures.

  20. Seizure characteristics and the use of anti-epileptic drugs in children and young people with brain tumours and epileptic seizures: Analysis of regional paediatric cancer service population.

    Science.gov (United States)

    Pilotto, Chiara; Liu, Jo-Fen; Walker, David A; Whitehouse, William P

    2018-03-21

    Epileptic seizures complicate the management of childhood brain tumours. There are no published standards for clinical practice concerning risk factors, treatment selection or strategies to withdraw treatment with antiepileptic drugs (AED). we undertook a case note review of 120 patients with newly diagnosed brain tumours, referred to a regional paediatric cancer service. data was available on 117/120 (98%) children seizures. A cortical tumour location was associated with the highest risk of seizures (OR: 7.1; CI 95% 2.9-17.3). At a median follow up of 24 months (IQR 25°-75° : 15-48), 22/35 (63%) with seizures, had a single seizure episode, 15/35 (43%) were seizure free (SF) on AEDs, 13/35 (37%) were SF off AEDs, and 7/35 (20%) experienced continuing epileptic seizures. Overall 34/35 (97%) were treated with AEDs after a seizure, of whom 12/35 (35%) withdrew from AED medication, and although 4/35 (12%) had seizure relapse, all were after further acute events. The median duration of AED before withdrawal was 11 months (IQR 25°-75° 5-14 months), and the median follow up after withdrawal was 15 months (IQR 25°-75° 5-34 months). Seizures affect about 1/3rd of children and young people presenting with and being treated for brain tumours particularly when the tumour is in the cerebral cortex. The low risk of recurrent seizures after AED treatment justifies consideration of early withdrawal of AED after seizure control. Copyright © 2018. Published by Elsevier Ltd.

  1. Bilateral adrenal hemorrhage due to heparin-induced thrombocytopenia following partial nephrectomy – a case report [v1; ref status: indexed, http://f1000r.es/2pn

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    Ashley G. Winter

    2014-01-01

    Full Text Available Heparin-induced thrombocytopenia (HIT can cause severe life-threatening events such as bilateral adrenal hemorrhage (BAH. A 48-year-old female developed a pulmonary embolus (PE following partial nephrectomy. The anticoagulation treatment for her PE was complicated by HIT and subsequent BAH. To the author’s knowledge, this is the first reported case of HIT-associated BAH following renal surgery.

  2. Brain spect in the pre-surgical evaluation of epileptic patients preliminary results

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    Carlos A. Buchpiguel

    1992-03-01

    Full Text Available Pre-surgical evaluation of epileptic patients consists of neurological examination, intensive electroencephalographic (EEG monitoring and anatomical studies (CT and MRI. Functional methods such as PET and SPECT imaging are now used more frequently. We have studied pre-operatively 15 adult epileptic patients (8 female, 7 male using a rotational scintillation camera interfaced to a dedicated computer. The tomographic images were obtained 15 minutes after intravenous injection of 99mTc_HMPAO. All had MRI scanning and intensive EEG monitoring which generally included seizure recording. Five patients had progressive lesions (3 meningiomas, 2 astrocytomas. In 10 patients, neuroradiological studies did not show the presence of progressive lesions (2 normal scans and 8 cases with inactive lesions. Two patients with meningioma showed hypoperfusion at the lesion site while the third patient had a marked hyperperfusion which might correlate with the clinical diagnosis of epilepsia partialis continua. In the astrocytoma patients SPECT scans showed hypoperfusion at the lesion site. Data obtained from the 10 patients without progressive CNS lesions showed: (a in 4, SPECT findings correlated well with the anatomical findings; (b in 5 instances, SPECT was able to disclose additional functional deficits; (c in one case, there was no SPECT correlate of a discrete anatomical lesion. In 5 of these cases with no progressive lesions (n=10 SPECT findings were useful as a complementary tool in determining the clinical or surgical management of these patients. Despite the small number and hete-rogenicity of the present sample, SPECT seems to be an useful tool as part of the clinical workup of epileptic patients who are candidates for epilepsy surgery.

  3. MEG source localization of spatially extended generators of epileptic activity: comparing entropic and hierarchical bayesian approaches.

    Science.gov (United States)

    Chowdhury, Rasheda Arman; Lina, Jean Marc; Kobayashi, Eliane; Grova, Christophe

    2013-01-01

    Localizing the generators of epileptic activity in the brain using Electro-EncephaloGraphy (EEG) or Magneto-EncephaloGraphy (MEG) signals is of particular interest during the pre-surgical investigation of epilepsy. Epileptic discharges can be detectable from background brain activity, provided they are associated with spatially extended generators. Using realistic simulations of epileptic activity, this study evaluates the ability of distributed source localization methods to accurately estimate the location of the generators and their sensitivity to the spatial extent of such generators when using MEG data. Source localization methods based on two types of realistic models have been investigated: (i) brain activity may be modeled using cortical parcels and (ii) brain activity is assumed to be locally smooth within each parcel. A Data Driven Parcellization (DDP) method was used to segment the cortical surface into non-overlapping parcels and diffusion-based spatial priors were used to model local spatial smoothness within parcels. These models were implemented within the Maximum Entropy on the Mean (MEM) and the Hierarchical Bayesian (HB) source localization frameworks. We proposed new methods in this context and compared them with other standard ones using Monte Carlo simulations of realistic MEG data involving sources of several spatial extents and depths. Detection accuracy of each method was quantified using Receiver Operating Characteristic (ROC) analysis and localization error metrics. Our results showed that methods implemented within the MEM framework were sensitive to all spatial extents of the sources ranging from 3 cm(2) to 30 cm(2), whatever were the number and size of the parcels defining the model. To reach a similar level of accuracy within the HB framework, a model using parcels larger than the size of the sources should be considered.

  4. MEG source localization of spatially extended generators of epileptic activity: comparing entropic and hierarchical bayesian approaches.

    Directory of Open Access Journals (Sweden)

    Rasheda Arman Chowdhury

    Full Text Available Localizing the generators of epileptic activity in the brain using Electro-EncephaloGraphy (EEG or Magneto-EncephaloGraphy (MEG signals is of particular interest during the pre-surgical investigation of epilepsy. Epileptic discharges can be detectable from background brain activity, provided they are associated with spatially extended generators. Using realistic simulations of epileptic activity, this study evaluates the ability of distributed source localization methods to accurately estimate the location of the generators and their sensitivity to the spatial extent of such generators when using MEG data. Source localization methods based on two types of realistic models have been investigated: (i brain activity may be modeled using cortical parcels and (ii brain activity is assumed to be locally smooth within each parcel. A Data Driven Parcellization (DDP method was used to segment the cortical surface into non-overlapping parcels and diffusion-based spatial priors were used to model local spatial smoothness within parcels. These models were implemented within the Maximum Entropy on the Mean (MEM and the Hierarchical Bayesian (HB source localization frameworks. We proposed new methods in this context and compared them with other standard ones using Monte Carlo simulations of realistic MEG data involving sources of several spatial extents and depths. Detection accuracy of each method was quantified using Receiver Operating Characteristic (ROC analysis and localization error metrics. Our results showed that methods implemented within the MEM framework were sensitive to all spatial extents of the sources ranging from 3 cm(2 to 30 cm(2, whatever were the number and size of the parcels defining the model. To reach a similar level of accuracy within the HB framework, a model using parcels larger than the size of the sources should be considered.

  5. Preictal dynamics of EEG complexity in intracranially recorded epileptic seizure: a case report.

    Science.gov (United States)

    Bob, Petr; Roman, Robert; Svetlak, Miroslav; Kukleta, Miloslav; Chladek, Jan; Brazdil, Milan

    2014-11-01

    Recent findings suggest that neural complexity reflecting a number of independent processes in the brain may characterize typical changes during epileptic seizures and may enable to describe preictal dynamics. With respect to previously reported findings suggesting specific changes in neural complexity during preictal period, we have used measure of pointwise correlation dimension (PD2) as a sensitive indicator of nonstationary changes in complexity of the electroencephalogram (EEG) signal. Although this measure of complexity in epileptic patients was previously reported by Feucht et al (Applications of correlation dimension and pointwise dimension for non-linear topographical analysis of focal onset seizures. Med Biol Comput. 1999;37:208-217), it was not used to study changes in preictal dynamics. With this aim to study preictal changes of EEG complexity, we have examined signals from 11 multicontact depth (intracerebral) EEG electrodes located in 108 cortical and subcortical brain sites, and from 3 scalp EEG electrodes in a patient with intractable epilepsy, who underwent preoperative evaluation before epilepsy surgery. From those 108 EEG contacts, records related to 44 electrode contacts implanted into lesional structures and white matter were not included into the experimental analysis.The results show that in comparison to interictal period (at about 8-6 minutes before seizure onset), there was a statistically significant decrease in PD2 complexity in the preictal period at about 2 minutes before seizure onset in all 64 intracranial channels localized in various brain sites that were included into the analysis and in 3 scalp EEG channels as well. Presented results suggest that using PD2 in EEG analysis may have significant implications for research of preictal dynamics and prediction of epileptic seizures.

  6. Interictal functional connectivity of human epileptic networks assessed by intracerebral EEG and BOLD signal fluctuations.

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    Gaelle Bettus

    Full Text Available In this study, we aimed to demonstrate whether spontaneous fluctuations in the blood oxygen level dependent (BOLD signal derived from resting state functional magnetic resonance imaging (fMRI reflect spontaneous neuronal activity in pathological brain regions as well as in regions spared by epileptiform discharges. This is a crucial issue as coherent fluctuations of fMRI signals between remote brain areas are now widely used to define functional connectivity in physiology and in pathophysiology. We quantified functional connectivity using non-linear measures of cross-correlation between signals obtained from intracerebral EEG (iEEG and resting-state functional MRI (fMRI in 5 patients suffering from intractable temporal lobe epilepsy (TLE. Functional connectivity was quantified with both modalities in areas exhibiting different electrophysiological states (epileptic and non affected regions during the interictal period. Functional connectivity as measured from the iEEG signal was higher in regions affected by electrical epileptiform abnormalities relative to non-affected areas, whereas an opposite pattern was found for functional connectivity measured from the BOLD signal. Significant negative correlations were found between the functional connectivities of iEEG and BOLD signal when considering all pairs of signals (theta, alpha, beta and broadband and when considering pairs of signals in regions spared by epileptiform discharges (in broadband signal. This suggests differential effects of epileptic phenomena on electrophysiological and hemodynamic signals and/or an alteration of the neurovascular coupling secondary to pathological plasticity in TLE even in regions spared by epileptiform discharges. In addition, indices of directionality calculated from both modalities were consistent showing that the epileptogenic regions exert a significant influence onto the non epileptic areas during the interictal period. This study shows that functional

  7. Automated Detection of Epileptic Biomarkers in Resting-State Interictal MEG Data

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    Miguel C. Soriano

    2017-06-01

    Full Text Available Certain differences between brain networks of healthy and epilectic subjects have been reported even during the interictal activity, in which no epileptic seizures occur. Here, magnetoencephalography (MEG data recorded in the resting state is used to discriminate between healthy subjects and patients with either idiopathic generalized epilepsy or frontal focal epilepsy. Signal features extracted from interictal periods without any epileptiform activity are used to train a machine learning algorithm to draw a diagnosis. This is potentially relevant to patients without frequent or easily detectable spikes. To analyze the data, we use an up-to-date machine learning algorithm and explore the benefits of including different features obtained from the MEG data as inputs to the algorithm. We find that the relative power spectral density of the MEG time-series is sufficient to distinguish between healthy and epileptic subjects with a high prediction accuracy. We also find that a combination of features such as the phase-locked value and the relative power spectral density allow to discriminate generalized and focal epilepsy, when these features are calculated over a filtered version of the signals in certain frequency bands. Machine learning algorithms are currently being applied to the analysis and classification of brain signals. It is, however, less evident to identify the proper features of these signals that are prone to be used in such machine learning algorithms. Here, we evaluate the influence of the input feature selection on a clinical scenario to distinguish between healthy and epileptic subjects. Our results indicate that such distinction is possible with a high accuracy (86%, allowing the discrimination between idiopathic generalized and frontal focal epilepsy types.

  8. Molecular and genetic insights into an infantile epileptic encephalopathy – CDKL5 disorder

    Science.gov (United States)

    Zhou, Ailing; Han, Song

    2017-01-01

    Background The discovery that mutations in cyclin-dependent kinase-like 5 (CDKL5) gene are associated with infantile epileptic encephalopathy has stimulated world-wide research effort to understand the molecular and genetic basis of CDKL5 disorder. Given the large number of literature published thus far, this review aims to summarize current genetic studies, draw a consensus on proposed molecular functions, and point to gaps of knowledge in CDKL5 research. Methods A systematic review process was conducted using the PubMed search engine focusing on CDKL5 studies in the recent ten years. We analyzed these publications and summarized the findings into four sections: genetic studies, CDKL5 expression patterns, molecular functions, and animal models. We also discussed challenges and future directions in each section. Results On the clinical side, CDKL5 disorder is characterized by early onset epileptic seizures, intellectual disability, and stereotypical behaviors. On the research side, a series of molecular and genetic studies in human patients, cell cultures and animal models have established the causality of CDKL5 to the infantile epileptic encephalopathy, and pointed to a key role for CDKL5 in regulating neuronal function in the brain. Mouse models of CDKL5 disorder have also been developed, and notably, manifest behavioral phenotypes, mimicking numerous clinical symptoms of CDKL5 disorder and advancing CDKL5 research to the preclinical stage. Conclusions Given what we have learned thus far, future identification of robust, quantitative, and sensitive outcome measures would be the key in animal model studies, particularly in heterozygous females. In the meantime, molecular and cellular studies of CDKL5 should focus on mechanism-based investigation and aim to uncover druggable targets that offer the potential to rescue or ameliorate CDKL5 disorder-related phenotypes. PMID:28580010

  9. Molecular and genetic insights into an infantile epileptic encephalopathy - CDKL5 disorder.

    Science.gov (United States)

    Zhou, Ailing; Han, Song; Zhou, Zhaolan Joe

    2017-02-01

    The discovery that mutations in cyclin-dependent kinase-like 5 ( CDKL5 ) gene are associated with infantile epileptic encephalopathy has stimulated world-wide research effort to understand the molecular and genetic basis of CDKL5 disorder. Given the large number of literature published thus far, this review aims to summarize current genetic studies, draw a consensus on proposed molecular functions, and point to gaps of knowledge in CDKL5 research. A systematic review process was conducted using the PubMed search engine focusing on CDKL5 studies in the recent ten years. We analyzed these publications and summarized the findings into four sections: genetic studies, CDKL5 expression patterns, molecular functions, and animal models. We also discussed challenges and future directions in each section. On the clinical side, CDKL5 disorder is characterized by early onset epileptic seizures, intellectual disability, and stereotypical behaviors. On the research side, a series of molecular and genetic studies in human patients, cell cultures and animal models have established the causality of CDKL5 to the infantile epileptic encephalopathy, and pointed to a key role for CDKL5 in regulating neuronal function in the brain. Mouse models of CDKL5 disorder have also been developed, and notably, manifest behavioral phenotypes, mimicking numerous clinical symptoms of CDKL5 disorder and advancing CDKL5 research to the preclinical stage. Given what we have learned thus far, future identification of robust, quantitative, and sensitive outcome measures would be the key in animal model studies, particularly in heterozygous females. In the meantime, molecular and cellular studies of CDKL5 should focus on mechanism-based investigation and aim to uncover druggable targets that offer the potential to rescue or ameliorate CDKL5 disorder-related phenotypes.

  10. Molecular and genetic insights into an infantile epileptic encephalopathy-CDKL5 disorder

    Institute of Scientific and Technical Information of China (English)

    Ailing Zhou; Song Han; Zhaolan Joe Zhou

    2017-01-01

    BACKGROUND:The discovery that mutations in cyclin-dependent kinase-like 5 (CDKL5) gene are associated with infantile epileptic encephalopathy has stimulated world-wide research effort to understand the molecular and genetic basis of CDKL5 disorder.Given the large number of literature published thus far,this review aims to summarize current genetic studies,draw a consensus on proposed molecular functions,and point to gaps of knowledge in CDKL5 research.METHODS:A systematic review process was conducted using the PubMed search engine focusing on CDKL5 studies in the recent ten years.We analyzed these publications and summarized the findings into four sections:genetic studies,CDKL5 expression pattems,molecular functions,and animal models.We also discussed challenges and future directions in each section.RESULTS:On the clinical side,CDKL5 disorder is characterized by early onset epileptic seizures,intellectual disability,and stereotypical behaviors.On the research side,a series of molecular and genetic studies in human patients,cell cultures and animal models have established the causality of CDKL5 to the infantile epileptic encephalopathy,and pointed to a key role for CDKL5 in regulating neuronal function in the brain.Mouse models of CDKL5 disorder have also been developed,and notably,manifest behavioral phenotypes,mimicking numerous clinical symptoms of CDKL5 disorder and advancing CDKL5 research to the preclinical stage.CONCLUSIONS:Given what we have leamed thus far,future identification of robust,quantitative,and sensitive outcome measures would be the key in animal model studies,particularly in heterozygous females.In the meantime,molecular and cellular studies of CDKL5 should focus on mechanism-based investigation and aim to uncover druggable targets that offer the potential to rescue or ameliorate CDKL5 disorder-related phenotypes.

  11. Agmatine for combined treatment of epilepsy, depression and cognitive impairment in chronic epileptic animals.

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    Singh, Tanveer; Bagga, Neetu; Kaur, Anureet; Kaur, Navjot; Gawande, Dinesh Yugraj; Goel, Rajesh Kumar

    2017-08-01

    Epilepsy is fourth most common neurological disorders associated with depression and cognitive deficits. As per present scenario, none of the antiseizure drugs have been reported successful to have ameliorative effect on epilepsy associated depression and cognitive deficits. Thus, the study was envisioned to assess an ameliorative potential of agmatine on epilepsy and its efficacy and safety for management of associated depression and cognitive deficits. The animals were made epileptic employing pentylenetetrazole (35mg/kg i.p. every 48±2h) kindling model of epilepsy and subsequently were treated with vehicle, valproic acid (300mg/kg/day i.p.) and agmatine (2.5, 5, and 10mg/kg)/day/i.p. for 15days. Except naïve, all the groups were challenged with same pentylenetetrazole dose as employed during kindling on days 5, 10, and 15 to evaluate seizure severity. Two hours after seizure severity test, tail suspension test and passive shock avoidance paradigm was employed to evaluate depression and cognitive behavior respectively. Results suggested that epileptic animals were significantly associated with depression and cognitive impairment. Chronic valproate treatment significantly reduced seizure severity, but was found unable to mitigate depression and cognitive deficits. However, agmatine treatment dose dependently ameliorated seizure severity as well as associated depression and cognitive deficits. On 15th day, animals were euthanized and pertinent neurochemical estimations were carried out in cortical and hippocampal areas of the mice brain. Thus, study concluded that agmatine ameliorated seizure severity, depression and cognitive impairment in epileptic animals, possibly via restoring glutamate-GABA neurotransmission and serotonin synthesis with decreased nitrosative stress. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. Magnetic resonance imaging of the brain in epileptic adult patients: experience in Ramathibodi Hospital.

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    Solosrungruang, Anusorn; Laothamatas, Jiraporn; Chinwarun, Yotin

    2007-04-01

    The purpose of the present study was to classify the imaging structural abnormalities of epileptic adult patients referred for magnetic resonance imaging (MR imaging) of the brain at Ramathibodi Hospital and to correlate with the clinical data and EEG. MR imaging of 91 adult epileptic patients (age ranging from 15-85 years old with an average of 36.90 years old) were retrospectively reviewed and classified into eight groups according to etiologies. Then clinical data and EEG correlations were analyzed using the Kappa analysis. All of the MR imaging of the brain were performed at Ramathibodi Hospital from January 2001 to December 2002. Secondary generalized tonic clonic seizure was the most common clinical presenting seizure type. Extra temporal lobe epilepsy was the most common clinical diagnosis. Of the thirty-three patients who underwent EEG before performing MR imaging, 17 had normal EEG From MR imaging, temporal lobe lesion was the main affected location and mesial temporal sclerosis (MTS) was the most common cause of the epilepsy in patients. For age group classification, young adult (15-34 years old) and adult (35-64 years old) age groups, MTS was the most common etiology of epilepsy with cortical dysplasia being the second most common cause for the first group and vascular disease for the latter group. For the older age group (> 64 years old), vascular disease and idiopathic cause were equally common etiologies. MRI, EEG findings, and clinical data were all concordant with statistical significance. MRI is the non-invasive modality of choice for evaluation of the epileptic patients. The result is concordant with the clinical and EEG findings. It can detect and localize the structural abnormality accurately and is useful in the treatment planning.

  13. The Parameters Related to Polycystic Ovarian Syndrome in Epileptic Patients Under Valproate Treatment

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    Nilgün CENGIZ

    2005-09-01

    Full Text Available OBJECTIVE: To investigate the parameters related to polycystic ovarian syndrome (PCOS in epileptic patients under valproate (VPA treatment. Design: Cross-sectional clinical study. Setting: Ondokuz Mayis University Teaching Hospital. Patients: 16 patients using VPA for epileptic disorders. Intervensions: Reproductive history, measurement of height and weight, hormone analyses, pelvic ultrasonography. Main outcome measures: Menstrual regularity, body mass index (BMI, early follicular phase serum total testosterone level and LH/FSH ratio, fasting insulin level, polycystic ovaries (PCO’s at ultrasonography. RESULTS: Thirteen patients used VPA for generalized tonic-clonic seizures (81.2% and 3 patients for focal seizures (18.8%. Mean duration of treatment was 4.9±2.9 (2-13 years. 37.5% of the patients had irregular menses in the pattern of oligomenorrhea. Mean BMI was 22.4±3.0 (17.4-27.3 kg/m2 in the group. Only 2 patients had an LH/FSH ratio of ≥ 2 (12.5%, and hyperandrogenemia was detected at a ratio of 37.5%. Insulin levels of all the patients were within the normal range. PCO’s were observed at ultrasonography at a ratio of 62.5%. Seven out of our 16 patients were diagnosed as PCOS (43.8%. Correlation analyses didn’t reveal any significant relation between the BMI, LH/FSH ratios, total testosteron and insulin levels of the patients (p>0,05. CONCLUSIONS: The relationship of epilepsy – VPA treatment – and PCOS is a controversial issue. PCOS is diagnosed at quite a high ratio in our patient group, which mostly consisted of the ones with generalized tonic-clonic seizures. Besides the epileptic disorder itself, this high ratio appears to be related to the VPA treatment as well

  14. Uric acid and allopurinol aggravate absence epileptic activity in Wistar Albino Glaxo Rijswijk rats.

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    Lakatos, Renáta Krisztina; Dobolyi, Árpád; Kovács, Zsolt

    2018-05-01

    Uric acid has a role in several physiological and pathophysiological processes. For example, uric acid may facilitate seizure generalization while reducing uric acid level may evoke anticonvulsant/antiepileptic effects. Allopurinol blocks the activity of xanthine oxidase, by which allopurinol inhibits catabolism of hypoxanthine to xanthine and uric acid and, as a consequence, decreases the level of uric acid. Although the modulation of serum uric acid level is a widely used strategy in the treatment of certain diseases, our knowledge regarding the effects of uric acid on epileptic activity is far from complete. Thus, the main aim of this study was the investigation of the effect of uric acid on absence epileptic seizures (spike-wave discharges: SWDs) in a model of human absence epilepsy, the Wistar Albino Glaxo/Rijswijk (WAG/Rij) rat. We investigated the influence of intraperitoneally (i.p.) injected uric acid (100 mg/kg and 200 mg/kg), allopurinol (50 mg/kg and 100 mg/kg), a cyclooxygenase 1 and 2 (COX-1 and COX-2) inhibitor indomethacin (10 mg/kg) and inosine (500 mg/kg) alone and the combined application of allopurinol (50 mg/kg) with uric acid (100 mg/kg) or inosine (500 mg/kg) as well as indomethacin (10 mg/kg) with uric acid (100 mg/kg) and inosine (500 mg/kg) with uric acid (100 mg/kg) on absence epileptic activity. We demonstrated that both uric acid and allopurinol alone significantly increased the number of SWDs whereas indomethacin abolished the uric acid-evoked increase in SWD number. Our results suggest that uric acid and allopurinol have proepileptic effects in WAG/Rij rats. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. Differential Effect of Neuropeptides on Excitatory Synaptic Transmission in Human Epileptic Hippocampus

    DEFF Research Database (Denmark)

    Ledri, Marco; Sorensen, Andreas T.; Madsen, Marita G.

    2015-01-01

    therapy is an evolving innovative approach that may prove useful for clinical applications. In animal models of temporal lobe epilepsy (TLE), gene therapy treatments based on viral vectors encoding NPY or galanin have been shown to effectively suppress seizures. However, how this translates to human TLE...... remains unknown. A unique possibility to validate these animal studies is provided by a surgical therapeutic approach, whereby resected epileptic tissue from temporal lobes of pharmacoresistant patients are available for neurophysiological studies in vitro. To test whether NPY and galanin have...

  16. Causes of mortality in early infantile epileptic encephalopathy: A systematic review.

    Science.gov (United States)

    Radaelli, Graciane; de Souza Santos, Francisco; Borelli, Wyllians Vendramini; Pisani, Leonardo; Nunes, Magda Lahorgue; Scorza, Fulvio Alexandre; da Costa, Jaderson Costa

    2018-06-12

    Early infantile epileptic encephalopathy syndrome (EIEE), also known as Ohtahara syndrome, is an age-dependent epileptic encephalopathy syndrome defined by clinical features and electroencephalographic findings. Epileptic disorders with refractory seizures beginning in the neonatal period and/or early infancy have a potential risk of premature mortality, including sudden death. We aimed to identify the causes of death in EIEE and conducted a literature survey of fatal outcomes. We performed a literature search in MEDLINE, EMBASE, and Web of Science for data from inception until September 2017. The terms "death sudden," "unexplained death," "SUDEP," "lethal," and "fatal" and the medical subject heading terms "epileptic encephalopathy," "mortality," "death," "sudden infant death syndrome," and "human" were used in the search strategy. The EIEE case report studies reporting mortality were included. The search yielded 1360 articles. After screening for titles and abstracts and removing duplicate entries, full texts of 15 articles were reviewed. After reading full texts, 11 articles met the inclusion criteria (9 articles in English and 2 in Japanese, dated from 1976 to 2015). The review comprised 38 unique cases of EIEE, 17 of which had death as an outcome. In all cases, the suppression-burst pattern on electroencephalographies (EEGs) was common. Most cases (55%) involved male infants. The mean (standard deviation [SD]) age at onset of seizure was 19.6 ± 33 days. The mean (SD) age at death was 12.9 ± 14.1 months. Most infants (58.8%) survived less than one year. The cause of death was described only in eight (47%) patients; the cause was pneumonia/respiratory illness or sudden unexpected death in epilepsy (SUDEP). The results show EIEE as a severe disease associated with a premature mortality, evidenced by a very young age at death. Increasing interest in the detection of new molecular bases of EIEE is leading us to a better understanding of this severe

  17. Prevalence and correlates of epileptic seizure in substance-abusing subjects.

    Science.gov (United States)

    Mattoo, Surendra K; Singh, Shubh M; Bhardwaj, Rahul; Kumar, Suresh; Basu, Debasish; Kulhara, Parmanand

    2009-08-01

    Life-time prevalence of epileptic seizures was assessed in 626 consecutive patients treated for substance abuse. Seizures were reported in 8.63% (9.2% in alcohol abusers, 12.5% in opioid abusers). A total of 64.8% of the seizures were associated with substance use. These occurred during withdrawal in the alcohol cohort and during intoxication with dextropropoxyphene and withdrawal from heroin or poppy husk in the opioid cohort. Results indicate that seizures may be more common in older patients with longer duration of dependence among those abusing alcohol.

  18. De novo loss- or gain-of-function mutations in KCNA2 cause epileptic encephalopathy

    DEFF Research Database (Denmark)

    Syrbe, Steffen; Hedrich, Ulrike B S; Riesch, Erik

    2015-01-01

    disability, delayed speech development and sometimes ataxia. Functional studies of the two mutations associated with this phenotype showed almost complete loss of function with a dominant-negative effect. Two further individuals presented with a different and more severe epileptic encephalopathy phenotype....... They carried mutations inducing a drastic gain-of-function effect leading to permanently open channels. These results establish KCNA2 as a new gene involved in human neurodevelopmental disorders through two different mechanisms, predicting either hyperexcitability or electrical silencing of KV1.2-expressing...

  19. Transient epileptic amnesia differentiated from psychogenic "fugue": neuropsychological, EEG, and PET findings.

    Science.gov (United States)

    Kopelman, M D; Panayiotopoulos, C P; Lewis, P

    1994-08-01

    A patient had repeated episodes of transient loss of memory, which had been attributed to psychogenic causes. Preservation of his sense of personal identity and the presence of repetitive questioning indicated an organic basis, however, and the multiplicity of the attacks and their brief duration suggested an epileptic aetiology. Although three standard EEGs, CT and MRI were all normal, two sleep EEGs confirmed bilateral foci in the temporal lobes. The attacks responded to an anticonvulsant. A fluoro-deoxyglucose PET scan, performed a few months after the most recent attack, was normal. The patient also had impaired anterograde memory that persisted six months after recovery from the acute attacks.

  20. Pediatric intensive care treatment of uncontrolled status epilepticus.

    Science.gov (United States)

    Wilkes, Ryan; Tasker, Robert C

    2013-04-01

    The critically ill mechanically ventilated child with ongoing seizures that are refractory to any treatment presents a distinct challenge in pediatric neurocritical care. The evidence base from randomized controlled trials on which anti-epileptic drug (AED) strategy should be used is inadequate. This review of refractory and super-refractory status epilepticus summarizes recent pediatric case series regarding definitions, the second-tier AED therapies once initial anticonvulsants have failed, and the experience of high-dose midazolam, barbiturate anesthesia, and volatile anesthetics for uncontrolled status epilepticus. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. The evaluation of 25-hydroxy vitamin D, calcium, phosphate and alkaline phosphatase levels in epileptic children under antiepileptic medication

    Directory of Open Access Journals (Sweden)

    Keyhani doost Z

    2011-01-01

    Full Text Available "n 800x600 Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Background: Epilepsy is a common disease in the pediatric neurology. There are frequent anti-epileptic drugs which are used in management of epilepsy. Anti-epileptic drugs may have some complications on bone and vitamin-D metabolism. In this study we aimed to evaluate vitamin-D metabolism in epileptic children."n"nMethods: The study was a prospective and cross sectional one. A total 89 epileptic children who were taking anti-epileptic drugs for longer than six months with no underlying disorder in Imam Khomeini and Bahrami Hospitals in Tehran, Iran were enrolled in our study"n"nResults: Forty nine boys and 40 girls were enrolled in this study; mean age of the patients was 7.8±2.1 years. Mean duration of anti-epileptic drug therapy was 2.3 years (SD=0.4, 70 of patients were under monotherapy and 19 were under polytherapy. None of the patients had signs of rickets. Serum calcium and phosphor levels were within normal ranges. Serum alkaline phosphates levels were increased more than two times in 43%. 42% had vitamin-D deficiency (25-OH Vit D<10 ng/ml and another 33% had vitamin-D insufficiency (10<25-oh Vit D<20 ng/ml. 29 patients (32% were taking prophylactic supplemental Vit D (200-400 IU/day. There was significant difference between patients taking supplemental vitamin-D as prophylaxis and patients who did not (p=0.04. There was no significant difference in vitamin-D levels between patients according to age, gender or different drugs."n"nConclusion: Periodic

  2. Epilepsy is associated with ventricular alterations following convulsive status epilepticus in children.

    Science.gov (United States)

    Ali, Wail; Bubolz, Beth A; Nguyen, Linh; Castro, Danny; Coss-Bu, Jorge; Quach, Michael M; Kennedy, Curtis E; Anderson, Anne E; Lai, Yi-Chen

    2017-12-01

    Convulsive status epilepticus can exert profound cardiovascular effects in adults including ventricular depolarization-repolarization abnormalities. Whether status epilepticus adversely affects ventricular electrical properties in children is less understood. Therefore, we sought to characterize ventricular alterations and the associated clinical factors in children following convulsive status epilepticus. We conducted a 2-year retrospective, case-control study. Children between 1 month and 21 years of age were included if they were admitted to the pediatric intensive care unit with primary diagnosis of convulsive status epilepticus and had 12-lead electrocardiogram (ECG) within 24 hours of admission. Children with heart disease, ion channelopathy, or on vasoactive medications were excluded. Age-matched control subjects had no history of seizures or epilepsy. The primary outcome was ventricular abnormalities represented by ST segment changes, abnormal T wave, QRS axis deviation, and corrected QT (QTc) interval prolongation. The secondary outcomes included QT/RR relationship, beat-to-beat QTc interval variability, ECG interval measurement between groups, and clinical factors associated with ECG abnormalities. Of 317 eligible children, 59 met the inclusion criteria. History of epilepsy was present in 31 children (epileptic) and absent in 28 children (non-epileptic). Compared with the control subjects (n = 31), the status epilepticus groups were more likely to have an abnormal ECG with overall odds ratio of 3.8 and 7.0 for the non-epileptic and the epileptic groups respectively. Simple linear regression analysis demonstrated that children with epilepsy exhibited impaired dependence and adaptation of the QT interval on heart rate. Beat-to-beat QTc interval variability, a marker of ventricular repolarization instability, was increased in children with epilepsy. Convulsive status epilepticus can adversely affect ventricular electrical properties and stability in children

  3. Hyperbolic partial differential equations

    CERN Document Server

    Witten, Matthew

    1986-01-01

    Hyperbolic Partial Differential Equations III is a refereed journal issue that explores the applications, theory, and/or applied methods related to hyperbolic partial differential equations, or problems arising out of hyperbolic partial differential equations, in any area of research. This journal issue is interested in all types of articles in terms of review, mini-monograph, standard study, or short communication. Some studies presented in this journal include discretization of ideal fluid dynamics in the Eulerian representation; a Riemann problem in gas dynamics with bifurcation; periodic M

  4. Successful removable partial dentures.

    Science.gov (United States)

    Lynch, Christopher D

    2012-03-01

    Removable partial dentures (RPDs) remain a mainstay of prosthodontic care for partially dentate patients. Appropriately designed, they can restore masticatory efficiency, improve aesthetics and speech, and help secure overall oral health. However, challenges remain in providing such treatments, including maintaining adequate plaque control, achieving adequate retention, and facilitating patient tolerance. The aim of this paper is to review the successful provision of RPDs. Removable partial dentures are a successful form of treatment for replacing missing teeth, and can be successfully provided with appropriate design and fabrication concepts in mind.

  5. Beginning partial differential equations

    CERN Document Server

    O'Neil, Peter V

    2011-01-01

    A rigorous, yet accessible, introduction to partial differential equations-updated in a valuable new edition Beginning Partial Differential Equations, Second Edition provides a comprehensive introduction to partial differential equations (PDEs) with a special focus on the significance of characteristics, solutions by Fourier series, integrals and transforms, properties and physical interpretations of solutions, and a transition to the modern function space approach to PDEs. With its breadth of coverage, this new edition continues to present a broad introduction to the field, while also addres

  6. 3D stereotaxis for epileptic foci through integrating MR imaging with neurological electrophysiology data

    International Nuclear Information System (INIS)

    Luo Min; Peng Chenglin; Wang Kang; Lei Wenyong; Luo Song; Wang Xiaolin; Wang Xuejian; Wu Ruoqiu; Wu Guofeng

    2005-01-01

    Objective: To improve the accuracy of the epilepsy diagnoses by integrating MR image from PACS with data from neurological electrophysiology. The integration is also very important for transmiting diagnostic information to 3D TPS of radiotherapy. Methods: The electroencephalogram was redisplayed by EEG workstation, while MR image was reconstructed by Brainvoyager software. 3D model of patient brain was built up by combining reconstructed images with electroencephalogram data in Base 2000. 30 epileptic patients (18 males and 12 females) with their age ranged from 12 to 54 years were confirmed by using the integrated MR images and the data from neurological electrophysiology and their 3D stereolocating. Results: The corresponding data in 3D model could show the real situation of patients' brain and visually locate the precise position of the focus. The suddessful rate of 3D guided operation was greatly improved, and the number of epileptic onset was markedly decreased. The epilepsy was stopped for 6 months in 8 of the 30 patients. Conclusion: The integration of MR image and information of neurological electrophysiology can improve the diagnostic level for epilepsy, and it is crucial for imp roving the successful rate of manipulations and the epilepsy analysis. (authors)

  7. Generalized Hurst exponent estimates differentiate EEG signals of healthy and epileptic patients

    Science.gov (United States)

    Lahmiri, Salim

    2018-01-01

    The aim of our current study is to check whether multifractal patterns of the electroencephalographic (EEG) signals of normal and epileptic patients are statistically similar or different. In this regard, the generalized Hurst exponent (GHE) method is used for robust estimation of the multifractals in each type of EEG signals, and three powerful statistical tests are performed to check existence of differences between estimated GHEs from healthy control subjects and epileptic patients. The obtained results show that multifractals exist in both types of EEG signals. Particularly, it was found that the degree of fractal is more pronounced in short variations of normal EEG signals than in short variations of EEG signals with seizure free intervals. In contrary, it is more pronounced in long variations of EEG signals with seizure free intervals than in normal EEG signals. Importantly, both parametric and nonparametric statistical tests show strong evidence that estimated GHEs of normal EEG signals are statistically and significantly different from those with seizure free intervals. Therefore, GHEs can be efficiently used to distinguish between healthy and patients suffering from epilepsy.

  8. Detection of focal epileptic activity using combined simultaneous electroencephalogram-functional MRI

    International Nuclear Information System (INIS)

    Zhang Zhiqiang; Lu Guangming; Tian Lei; Sun Kanjian; Tan Qifu; Zhu Jianguo; Nie Cong; Hao Shaowei; Jiang Li; Liu Yijun

    2007-01-01

    Objective: To observe the brain activation of interictal epiletiform discharges (IEDs) and to localize the epileptogenic foci of epilepsy. Methods: The electroencephalogram (EEG) and functional MRI data of 12 focal epileptic patients were acquired using a combination of EEG and functional MRI simultaneously. The IEDs onset time detected with EEG were set as the time parameters in an event- related paradigm of functional MRI analysis. The spatial and temporal characters of IEDs activation were analyzed in detail. In order to confirm the consistency of this method, all patients were scanned repeatedly and the results were correlated with clinical evaluation. Results: Of the 12 patients, valid data from EEG- fMRI were obtained from 10 patients in a total of 18 sessions. Compared with the structural foci, the epileptic foci localization results of eleven sessions were good, five sessions were fairly good, and two sessions were poor. The results obtained from six patients in two separate sessions were concordant, respectively. Moreover, thalamic activation was detected in ten sessions, cerebellar activation was detected in all sessions, and the deactivation was found in the default mode loci in nine sessions. Conclusion: The method of performing EEG and fMRI simultaneously can potentially be a useful tool in epilepsy research. (authors)

  9. Volumetric localization of epileptic activities in tuberous sclerosis using synthetic aperture magnetometry

    Energy Technology Data Exchange (ETDEWEB)

    Xiao, Zheng [Hospital for Sick Children, Research Institute, Toronto (Canada); Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Xiang, Jing [Hospital for Sick Children, Research Institute, Toronto (Canada); Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Holowka, Stephanie; Chuang, Sylvester [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Hunjan, Amrita; Sharma, Rohit; Otsubo, Hiroshi [Hospital for Sick Children, Division of Neurology, Toronto (Canada)

    2006-01-01

    Magnetoencephalography (MEG) is a novel noninvasive technique for localizing epileptic zones. Tuberous sclerosis complex (TSC) is often associated with medically refractory epilepsy with multiple epileptic zones. Surgical treatment of TSC requires accurate localization of epileptogenic tubers. The objective of this study was to introduce a new MEG technique, synthetic aperture magnetometry (SAM), to volumetrically localize irritable zones and clarify the correlations between SAM, dipole modeling and anatomical tubers. Eight pediatric patients with TSC confirmed by clinical and neuroimaging findings were retrospectively studied. MEG data were recorded using a whole-cortex CTF OMEGA system. Sleep deprivation was employed to provoke epileptiform activity. Irritable zones were localized using both dipole modeling and SAM. MRI detected 42 tubers in the eight patients. Dipole modeling localized 28 irritable zones, and 19 out of the 28 zones were near tubers (19/42, 45%). SAM found 51 irritable zones, and 31 out of the 51 zones were near tubers (31/42, 74%). Among the 51 irritable zones determined by SAM, thirty-five zones were in 1-35 Hz, nine zones were in 35-60 Hz, and seven zones were in 60-120 Hz. The new method, SAM, yielded very plausible equivalent sources for patients who showed anatomical tubers on MRI. Compared to conventional dipole modeling, SAM appeared to offer increased detection of irritable zones and beneficial volumetric and frequency descriptions. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Markus eGschwind

    2016-02-01

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

  11. Control of epileptic seizures in WAG/Rij rats by means of brain-computer interface

    Science.gov (United States)

    Makarov, Vladimir V.; Maksimenko, Vladimir A.; van Luijtelaar, Gilles; Lüttjohann, Annika; Hramov, Alexander E.

    2018-02-01

    The main issue of epileptology is the elimination of epileptic events. This can be achieved by a system that predicts the emergence of seizures in conjunction with a system that interferes with the process that leads to the onset of seizure. The prediction of seizures remains, for the present, unresolved in the absence epilepsy, due to the sudden onset of seizures. We developed an algorithm for predicting seizures in real time, evaluated it and implemented it into an online closed-loop brain stimulation system designed to prevent typical for the absence of epilepsy of spike waves (SWD) in the genetic rat model. The algorithm correctly predicts more than 85% of the seizures and the rest were successfully detected. Unlike the old beliefs that SWDs are unpredictable, current results show that they can be predicted and that the development of systems for predicting and preventing closed-loop capture is a feasible step on the way to intervention to achieve control and freedom from epileptic seizures.

  12. Brain SPECT in the pre-surgical evaluation of epileptic patients

    International Nuclear Information System (INIS)

    Buchpiguel, C.A.; Cukiert, A.; Hironaka, F.H.; Cerri, G.G.; Magalhaes, A.E.A.; Marino Junior, R.

    1992-01-01

    Fifteen adult epileptic patients were studied pre-operatively using a rotational scintillation camera interfaced to a dedicated computer. The tomographic images were obtained 15 minutes after intravenous injection of 99 m Tc-HMPAO. All had MRI scanning and intensive EEG monitoring which generally included seizure recording. Five patients had progressive lesions (3 meningiomas, 2 astrocytomas). In 10 patients, neuroradiological studies did not show the presence of progressive lesions (2 normal scans and 8 cases with inactive lesions). Two patients with meningioma showed hypoperfusion at the lesion site while the third patient had a marked hypoperfusion which might correlate with the clinical diagnosis of epilepsia partialis continua. In the astrocytoma patients SPECT scans showed hypoperfusion at the lesion site. Data obtained from the 10 patients without progressive CNS lesions showed: in 4, SPECT findings correlated well with the anatomical findings; in 5 instances, SPECT was able to disclose additional functional deficits; in one case, there was no SPECT correlate of a discrete anatomical lesion. In 5 of these cases with no progressive lesions (n=10) SPECT findings were useful as a complementary tool in determining the clinical or surgical management of these patients. Despite the small number and heterogeneity of the present sample, SPECT seems to be an useful tool as part of the clinical workup of epileptic who are candidates for epilepsy surgery. (author)

  13. Dynamic modulation of epileptic high frequency oscillations by the phase of slower cortical rhythms.

    Science.gov (United States)

    Ibrahim, George M; Wong, Simeon M; Anderson, Ryan A; Singh-Cadieux, Gabrielle; Akiyama, Tomoyuki; Ochi, Ayako; Otsubo, Hiroshi; Okanishi, Tohru; Valiante, Taufik A; Donner, Elizabeth; Rutka, James T; Snead, O Carter; Doesburg, Sam M

    2014-01-01

    Pathological high frequency oscillations (pHFOs) have been proposed to be robust markers of epileptic cortex. Oscillatory activity below this frequency range has been shown to be modulated by phase of lower frequency oscillations. Here, we tested the hypothesis that dynamic cross-frequency interactions involving pHFOs are concentrated within the epileptogenic cortex. Intracranial electroencephalographic recordings from 17 children with medically-intractable epilepsy secondary to focal cortical dysplasia were obtained. A time-resolved analysis was performed to determine topographic concentrations and dynamic changes in cross-frequency amplitude-to-phase coupling (CFC). CFC between pHFOs and the phase of theta and alpha rhythms was found to be significantly elevated in the seizure-onset zone compared to non-epileptic regions (pfrequency oscillations at which pHFO amplitudes were maximal was inconsistent at seizure initiation, yet consistently at the trough of the low frequency rhythm at seizure termination. Amplitudes of pHFOs were most significantly modulated by the phase of alpha-band oscillations (p<0.01). These results suggest that increased CFC between pHFO amplitude and alpha phase may constitute a marker of epileptogenic brain areas and may be relevant for understanding seizure dynamics. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. A girl with early-onset epileptic encephalopathy associated with microdeletion involving CDKL5.

    Science.gov (United States)

    Saitsu, Hirotomo; Osaka, Hitoshi; Nishiyama, Kiyomi; Tsurusaki, Yoshinori; Doi, Hiroshi; Miyake, Noriko; Matsumoto, Naomichi

    2012-05-01

    Recent studies have shown that aberrations of CDKL5 in female patients cause early-onset intractable seizures, severe developmental delay or regression, and Rett syndrome-like features. We report on a Japanese girl with early-onset epileptic encephalopathy, hypotonia, developmental regression, and Rett syndrome-like features. The patient showed generalized tonic seizures, and later, massive myoclonus induced by phone and light stimuli. Brain magnetic resonance imaging showed no structural brain anomalies but cerebral atrophy. Electroencephalogram showed frontal dominant diffuse poly spikes and waves. Through copy number analysis by genomic microarray, we found a microdeletion at Xp22.13. A de novo 137-kb deletion, involving exons 5-21 of CDKL5, RS1, and part of PPEF1 gene, was confirmed by quantitative PCR and breakpoint specific PCR analyses. Our report suggests that the clinical features associated with CDKL5 deletions could be implicated in Japanese patients, and that genetic testing of CDKL5, including both sequencing and deletion analyses, should be considered in girls with early-onset epileptic encephalopathy and RTT-like features. Copyright © 2011 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  15. Changes of serum cytokines levels after drug therapy in epileptic patients

    International Nuclear Information System (INIS)

    Xie Jianping; Li Suping; Xiong Gang

    2004-01-01

    Objective: To explore the role of the cytokines interleukin-2 (IL-2), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the neuroimmune modulation of epilepsy through measurement of the changes of the serum levels of the these cytokines after drug therapy in epileptic patients. Methods: Serum IL-2, IL-6, TNF-α levels were measured with RIA in 43 patients with epilepsy both before and after drug therapy for 3-6 months as well as 32 controls. Results: Before treatment, serum levels of these cytokines in the patients were significantly higher than those in the controls (p<0.001). After treatment, 18 of the 43 patients were regarded as treatment very successful, with attack numbers decreased more than 75%. Some of this group of patient had their serum cytokines levels significantly dropped down, but the mean level for the group as a whole did not change much. In the rest 25 patients with less successful result, changes were not significant with the levels increased in a few cases. Among the cytokines, levels of IL-2 were significantly positively correlated to those of IL-6 and TNF-α (r=0.47, p<0.01, r=0.55, p<0.01). Conclusion: Increased levels of the cytokines in the epileptic patients suggest an activated immune state. However, the changes of levels after therapy are not predictable and do not necessarily drop down significantly even with very successful treatment

  16. EPILAB: a software package for studies on the prediction of epileptic seizures.

    Science.gov (United States)

    Teixeira, C A; Direito, B; Feldwisch-Drentrup, H; Valderrama, M; Costa, R P; Alvarado-Rojas, C; Nikolopoulos, S; Le Van Quyen, M; Timmer, J; Schelter, B; Dourado, A

    2011-09-15

    A Matlab®-based software package, EPILAB, was developed for supporting researchers in performing studies on the prediction of epileptic seizures. It provides an intuitive and convenient graphical user interface. Fundamental concepts that are crucial for epileptic seizure prediction studies were implemented. This includes, for example, the development and statistical validation of prediction methodologies in long-term continuous recordings. Seizure prediction is usually based on electroencephalography (EEG) and electrocardiography (ECG) signals. EPILAB is able to process both EEG and ECG data stored in different formats. More than 35 time and frequency domain measures (features) can be extracted based on univariate and multivariate data analysis. These features can be post-processed and used for prediction purposes. The predictions may be conducted based on optimized thresholds or by applying classifications methods such as artificial neural networks, cellular neuronal networks, and support vector machines. EPILAB proved to be an efficient tool for seizure prediction, and aims to be a way to communicate, evaluate, and compare results and data among the seizure prediction community. Copyright © 2011 Elsevier B.V. All rights reserved.

  17. Depression and anxiety disorder among epileptic people at Amanuel Specialized Mental Hospital, Addis Ababa, Ethiopia.

    Science.gov (United States)

    Tegegne, Minale Tareke; Mossie, Tilahun Belete; Awoke, Andargie Abate; Assaye, Ashagre Molla; Gebrie, Belete Temitm; Eshetu, Desalegn Asmare

    2015-09-02

    Although depression and anxiety disorders are very common in people with epilepsy; there are no studies that assessed the magnitude and associated factors among epileptic people in Ethiopia. Therefore, this study determined prevalence and associated factors of depression and anxiety disorders in people with epilepsy. An institution based cross-sectional study was conducted from April to May, 2013, among 423 people with epilepsy from the outpatient department of Amanuel Mental Specialized Hospital. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale. Logistic regression analysis was used to assess predictors of depression and anxiety. The prevalence of anxiety and depression among epileptic people were 33.5 and 32.8%, respectively. Monthly income, frequency of seizure and side effects of anti convulsants were found to be significantly associated with both depression and anxiety. Being divorced/widowed was associated with anxiety while using poly-therapy of anti convulsants, perceived stigma, and inability to read or write were associated with depression. The prevalence of co-morbid anxiety and depression was found to be high among people with epilepsy. Early identification of co-morbid depression and anxiety in people with epilepsy and managing epilepsy to become seizure free should be of great concern for health care providers.

  18. The ketogenic diet is effective for refractory epilepsy associated with acquired structural epileptic encephalopathy.

    Science.gov (United States)

    Villaluz, Mel Michel; Lomax, Lysa Boissé; Jadhav, Trupti; Cross, J Helen; Scheffer, Ingrid E

    2018-07-01

    Ketogenic diet therapies have proven efficacy for refractory epilepsy. There are many reports of their use in the genetic developmental and epileptic encephalopathies; however, little attention has been paid as to whether the diet is also effective in individuals with an acquired structural aetiology. We observed remarkable efficacy of the diet in two patients with hypoxic-ischaemic encephalopathy. We then analysed our cases with refractory structural epilepsies of acquired origin to characterize their response to the ketogenic diet. The classical ketogenic diet was implemented with dietary ratios of 3:1 to 4.4:1. Seizure frequency at 1 month, 3 months, 6 months, 1 year, and 2 years was ascertained. A responder was defined as greater than 50% seizure reduction compared to baseline. Seven of the nine patients were responders at 3 months. Somewhat surprisingly we found that the ketogenic diet was effective in patients with a developmental and epileptic encephalopathy due to an acquired structural aetiology. This cohort may not be routinely considered for the ketogenic diet because of their structural and acquired, rather than genetic, basis. The ketogenic diet should be considered early in the management of patients with acquired structural encephalopathies as it can improve seizure control with the potential to improve developmental outcome. The ketogenic diet was effective in children with epilepsy associated with an acquired structural aetiology. © 2018 Mac Keith Press.

  19. Nonlinear mixed effects modelling approach in investigating phenobarbital pharmacokinetic interactions in epileptic patients.

    Science.gov (United States)

    Vučićević, Katarina; Jovanović, Marija; Golubović, Bojana; Kovačević, Sandra Vezmar; Miljković, Branislava; Martinović, Žarko; Prostran, Milica

    2015-02-01

    The present study aimed to establish population pharmacokinetic model for phenobarbital (PB), examining and quantifying the magnitude of PB interactions with other antiepileptic drugs concomitantly used and to demonstrate its use for individualization of PB dosing regimen in adult epileptic patients. In total 205 PB concentrations were obtained during routine clinical monitoring of 136 adult epilepsy patients. PB steady state concentrations were measured by homogeneous enzyme immunoassay. Nonlinear mixed effects modelling (NONMEM) was applied for data analyses and evaluation of the final model. According to the final population model, significant determinant of apparent PB clearance (CL/F) was daily dose of concomitantly given valproic acid (VPA). Typical value of PB CL/F for final model was estimated at 0.314 l/h. Based on the final model, co-therapy with usual VPA dose of 1000 mg/day, resulted in PB CL/F average decrease of about 25 %, while 2000 mg/day leads to an average 50 % decrease in PB CL/F. Developed population PB model may be used in estimating individual CL/F for adult epileptic patients and could be applied for individualizing dosing regimen taking into account dose-dependent effect of concomitantly given VPA.

  20. Dramatic effect of levetiracetam in early-onset epileptic encephalopathy due to STXBP1 mutation.

    Science.gov (United States)

    Dilena, Robertino; Striano, Pasquale; Traverso, Monica; Viri, Maurizio; Cristofori, Gloria; Tadini, Laura; Barbieri, Sergio; Romeo, Antonino; Zara, Federico

    2016-01-01

    Syntaxin Binding Protein 1 (STXBP1) mutations determine a central neurotransmission dysfunction through impairment of the synaptic vesicle release, thus causing a spectrum of phenotypes varying from syndromic and non-syndromic epilepsy to intellectual disability of variable degree. Among the antiepileptic drugs, levetiracetam has a unique mechanism of action binding SV2A, a glycoprotein of the synaptic vesicle release machinery. We report a 1-month-old boy manifesting an epileptic encephalopathy with clonic seizures refractory to phenobarbital, pyridoxine and phenytoin that presented a dramatic response to levetiracetam with full epilepsy control and EEG normalization. Genetic analysis identified a novel de novo heterozygous mutation (c.[922A>T]p.[Lys308(∗)]) in the STXBP1 gene that severely affects the protein. The observation of a dramatic efficacy of levetiracetam in a case of STXBP1 epileptic encephalopathy refractory to other antiepileptic drugs and considerations regarding the specific mechanism of action of levetiracetam modulating the same system affected by STXBP1 mutations support the hypothesis that this drug may be able to reverse specifically the disease epileptogenic abnormalities. Further clinical observations and laboratory studies are needed to confirm this hypothesis and eventually lead to consider levetiracetam as the first choice treatment of patients with suspected or confirmed STXBP1-related epilepsies. Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  1. De novo mutations in HCN1 cause early infantile epileptic encephalopathy.

    Science.gov (United States)

    Nava, Caroline; Dalle, Carine; Rastetter, Agnès; Striano, Pasquale; de Kovel, Carolien G F; Nabbout, Rima; Cancès, Claude; Ville, Dorothée; Brilstra, Eva H; Gobbi, Giuseppe; Raffo, Emmanuel; Bouteiller, Delphine; Marie, Yannick; Trouillard, Oriane; Robbiano, Angela; Keren, Boris; Agher, Dahbia; Roze, Emmanuel; Lesage, Suzanne; Nicolas, Aude; Brice, Alexis; Baulac, Michel; Vogt, Cornelia; El Hajj, Nady; Schneider, Eberhard; Suls, Arvid; Weckhuysen, Sarah; Gormley, Padhraig; Lehesjoki, Anna-Elina; De Jonghe, Peter; Helbig, Ingo; Baulac, Stéphanie; Zara, Federico; Koeleman, Bobby P C; Haaf, Thomas; LeGuern, Eric; Depienne, Christel

    2014-06-01

    Hyperpolarization-activated, cyclic nucleotide-gated (HCN) channels contribute to cationic Ih current in neurons and regulate the excitability of neuronal networks. Studies in rat models have shown that the Hcn1 gene has a key role in epilepsy, but clinical evidence implicating HCN1 mutations in human epilepsy is lacking. We carried out exome sequencing for parent-offspring trios with fever-sensitive, intractable epileptic encephalopathy, leading to the discovery of two de novo missense HCN1 mutations. Screening of follow-up cohorts comprising 157 cases in total identified 4 additional amino acid substitutions. Patch-clamp recordings of Ih currents in cells expressing wild-type or mutant human HCN1 channels showed that the mutations had striking but divergent effects on homomeric channels. Individuals with mutations had clinical features resembling those of Dravet syndrome with progression toward atypical absences, intellectual disability and autistic traits. These findings provide clear evidence that de novo HCN1 point mutations cause a recognizable early-onset epileptic encephalopathy in humans.

  2. Effect of a Supportive Educational Program on Self-Efficacy of Mothers with Epileptic Children

    Directory of Open Access Journals (Sweden)

    Sepideh Gholami

    2016-07-01

    Full Text Available Background: In the aftermath of de-institutionalisation and the move to community management of epilepsia, mothers play an increasing role in the management of the illness. Mothers often complain of being misinformed and ill equipped to aid in the treatment. Aim: The purpose of this study was to investigate the effect of a Supportive Educational Program on self-efficacy of mothers with epileptic children. Method: This randomized controlled clinical trial was conducted on two groups of 50 mothers with epileptic children admitted to Ghaem Hospital in the city of Mashhad in 2014. Maternal self-efficacy was measured before and 6 weeks after intervention through Steffen’s Revised Scale for Caregiving Self-Efficacy as the research instrument. The Supportive Educational Program was implemented for the experimental group during five 60-minute sessions with an interval of 4 days. The control group received the routine care. Data analysis was performed using SPSS software (version 11.5. Results: The mean age of mothers in the experimental and control groups were 32.8±6.9 and 32.8±6.8 years, respectively. The findings of the independent t-test revealed significant differences between the two control (47.4±15.06 and experimental (66.5±11.5 groups following the intervention (p

  3. Regression of nodules on cranial computerized tomography (CCT) scans in 4 focal epileptic patients

    International Nuclear Information System (INIS)

    Bahk, Yong Whee; Yoon, Sei Chul; Park, Seog Hee; Huh, Choon Woong

    1983-01-01

    Epilepsy can be defined as a paroxysmal, excessive, neuronal discharge within the brain originating from either cortical or sugcortical regions. The incidence of epilepsy is increasing possibly due to the survival of persons who should have died of brain injuries or other cerebral abnormalities acquired in early life. The use of antibiotics and improvement in the medical care have saved many children who might have died of meningitis, brain abscess, encephalitis, severe head injuries, etc. CCT scan is new radiologic procedure for defining cranial and intracranial structures and also an useful procedure for evaluation and follow-up (FU) of patient with focal seizure disorder. Recently we experienced nodules which were isodense or hypodense on initial non contrasted CT (NECT) and scans became hyperdense of the enhancement in 4 cases of focal epileptic seizure. Nearly complete disappearance or regression of the epileptic foci occurred on the FU CT scans in 2 cases. Operation was performed in 2 cases. The tissue specimen obtained from the CT nodule revealed cerebral edema in one case and localized gliosis and congestion in the other. All the patients showed marked clinical improvement when the CT nodule improved. Review of literature failed to disclose any previous report on such observation

  4. Partial knee replacement - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100225.htm Partial knee replacement - series—Normal anatomy To use the sharing ... A.M. Editorial team. Related MedlinePlus Health Topics Knee Replacement A.D.A.M., Inc. is accredited ...

  5. Beginning partial differential equations

    CERN Document Server

    O'Neil, Peter V

    2014-01-01

    A broad introduction to PDEs with an emphasis on specialized topics and applications occurring in a variety of fields Featuring a thoroughly revised presentation of topics, Beginning Partial Differential Equations, Third Edition provides a challenging, yet accessible,combination of techniques, applications, and introductory theory on the subjectof partial differential equations. The new edition offers nonstandard coverageon material including Burger's equation, the telegraph equation, damped wavemotion, and the use of characteristics to solve nonhomogeneous problems. The Third Edition is or

  6. Epileptic seizure detection from EEG signals with phase-amplitude cross-frequency coupling and support vector machine

    Science.gov (United States)

    Liu, Yang; Wang, Jiang; Cai, Lihui; Chen, Yingyuan; Qin, Yingmei

    2018-03-01

    As a pattern of cross-frequency coupling (CFC), phase-amplitude coupling (PAC) depicts the interaction between the phase and amplitude of distinct frequency bands from the same signal, and has been proved to be closely related to the brain’s cognitive and memory activities. This work utilized PAC and support vector machine (SVM) classifier to identify the epileptic seizures from electroencephalogram (EEG) data. The entropy-based modulation index (MI) matrixes are used to express the strength of PAC, from which we extracted features as the input for classifier. Based on the Bonn database, which contains five datasets of EEG segments obtained from healthy volunteers and epileptic subjects, a 100% classification accuracy is achieved for identifying seizure ictal from healthy data, and an accuracy of 97.67% is reached in the classification of ictal EEG signals from inter-ictal EEGs. Based on the CHB-MIT database which is a group of continuously recorded epileptic EEGs by scalp electrodes, a 97.50% classification accuracy is obtained and a raising sign of MI value is found at 6s before seizure onset. The classification performance in this work is effective, and PAC can be considered as a useful tool for detecting and predicting the epileptic seizures and providing reference for clinical diagnosis.

  7. A1 not A2A adenosine receptors play a role in cortical epileptic afterdischarges in immature rats

    Czech Academy of Sciences Publication Activity Database

    Mareš, Pavel

    2014-01-01

    Roč. 121, č. 11 (2014), s. 1329-1336 ISSN 0300-9564 R&D Projects: GA MŠk(CZ) LH11015 Institutional support: RVO:67985823 Keywords : adenosine receptors * epileptic afterdischarges * cerebral cortex * ontogeny * rat Subject RIV: FH - Neurology Impact factor: 2.402, year: 2014

  8. Efficacy of fish liver oil and propolis as neuroprotective agents in pilocarpine epileptic rats treated with valproate.

    Science.gov (United States)

    Mannaa, Fathia; El-Shamy, Karima A; El-Shaikh, Kamal A; El-Kassaby, Mahitab

    2011-09-01

    To evaluate the action of fish liver oil and propolis in pilocarpine epileptic rats treated with the anticonvulsant drug valproate. Seven groups of rats were treated daily for six months: control; fish liver oil (0.4ml/kg b.w); propolis (50mg/kg b.w); pilocarpine-treated rats (epileptic control); epileptic rats treated with valproate (400mg/kg b.w); groups 6 and 7, epileptic rats treated with valproate plus fish liver oil or propolis. Pilocarpine administration caused a significant increase in hippocampal dopamine and serotonin levels accompanied with a significant decrease in their levels in serum. Lipid peroxidation level and LDH activity in hippocampus were significantly increased after pilocarpine treatment whereas Na(+)/K(+)-ATPase activity and total antioxidant capacity were significantly decreased compared to the controls. Animals treated with the combined treatments showed a significant improvement in tested parameters towards the normal values of the control. Fish liver oil and propolis when given in combination with valproate, neuroprotected against the neurophysiological disorders induced by pilocarpine epilepsy in rats. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  9. International veterinary epilepsy task force recommendations for systematic sampling and processing of brains from epileptic dogs and cats

    DEFF Research Database (Denmark)

    Matiasek, Kaspar; Pumarola I Batlle, Martí; Rosati, Marco

    2015-01-01

    Traditionally, histological investigations of the epileptic brain are required to identify epileptogenic brain lesions, to evaluate the impact of seizure activity, to search for mechanisms of drug-resistance and to look for comorbidities. For many instances, however, neuropathological studies fai...

  10. Mouse neuroblastoma cell based model and the effect of epileptic events on calcium oscillations and neural spikes

    Science.gov (United States)

    Kim, Suhwan; Baek, Juyeong; Jung, Unsang; Lee, Sangwon; Jung, Woonggyu; Kim, Jeehyun; Kang, Shinwon

    2013-05-01

    Recently, Mouse neuroblastoma cells are considered as an attractive model for the study of human neurological and prion diseases, and intensively used as a model system in different areas. Among those areas, differentiation of neuro2a (N2A) cells, receptor mediated ion current, and glutamate induced physiological response are actively investigated. The reason for the interest to mouse neuroblastoma N2A cells is that they have a fast growing rate than other cells in neural origin with a few another advantages. This study evaluated the calcium oscillations and neural spikes recording of mouse neuroblastoma N2A cells in an epileptic condition. Based on our observation of neural spikes in mouse N2A cell with our proposed imaging modality, we report that mouse neuroblastoma N2A cells can be an important model related to epileptic activity studies. It is concluded that the mouse neuroblastoma N2A cells produce the epileptic spikes in vitro in the same way as produced by the neurons or the astrocytes. This evidence advocates the increased and strong level of neurotransmitters release by enhancement in free calcium using the 4-aminopyridine which causes the mouse neuroblastoma N2A cells to produce the epileptic spikes and calcium oscillation.

  11. Mouse neuroblastoma cell-based model and the effect of epileptic events on calcium oscillations and neural spikes

    Science.gov (United States)

    Kim, Suhwan; Jung, Unsang; Baek, Juyoung; Lee, Sangwon; Jung, Woonggyu; Kim, Jeehyun; Kang, Shinwon

    2013-01-01

    Recently, mouse neuroblastoma cells have been considered as an attractive model for the study of human neurological and prion diseases, and they have been intensively used as a model system in different areas. For example, the differentiation of neuro2a (N2A) cells, receptor-mediated ion current, and glutamate-induced physiological responses have been actively investigated with these cells. These mouse neuroblastoma N2A cells are of interest because they grow faster than other cells of neural origin and have a number of other advantages. The calcium oscillations and neural spikes of mouse neuroblastoma N2A cells in epileptic conditions are evaluated. Based on our observations of neural spikes in these cells with our proposed imaging modality, we reported that they can be an important model in epileptic activity studies. We concluded that mouse neuroblastoma N2A cells produce epileptic spikes in vitro in the same way as those produced by neurons or astrocytes. This evidence suggests that increased levels of neurotransmitter release due to the enhancement of free calcium from 4-aminopyridine causes the mouse neuroblastoma N2A cells to produce epileptic spikes and calcium oscillations.

  12. Thyroid-stimulating hormone elevation misdiagnosed as subclinical hypothyroidism following non-convulsive status epilepticus: a case report

    Directory of Open Access Journals (Sweden)

    Kunii Yasuto

    2011-09-01

    Full Text Available Abstract Introduction Non-convulsive status epilepticus is a form of epileptic seizure that occurs without convulsions. Recent reviews suggest that the diagnosis of non-convulsive status epilepticus remains difficult. Here, we report the case of a patient with thyroid-stimulating hormone elevation misdiagnosed as subclinical hypothyroidism following non-convulsive status epilepticus. Case presentation Our patient was a 68-year-old Japanese woman. The results of endocrine testing after her first episode of non-convulsive status epilepticus suggested latent subclinical hypothyroidism: she had elevated thyroid-stimulating hormone with normal levels of free tri-iodothyronine and free thyroxine. On examination, a diagnosis of thyroid disorder was not supported by other test results and our patient remained untreated. A follow-up examination revealed that her thyroid-stimulating hormone levels had spontaneously normalized. When she consulted another doctor for confusion, the transient increase in thyroid-stimulating hormone levels following non-convulsive status epilepticus was mistaken for subclinical hypothyroidism, and unfortunately treated with levothyroxine. Our patient then experienced levothyroxine-induced non-convulsive status epilepticus. Conclusions In this report, we suggested possible mechanisms for latent hypothyroid-like hormone abnormality following epileptic seizures and the possibility of provoking epileptic seizures by administering levothyroxine for misdiagnosed subclinical hypothyroidism.

  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. Prallethrin Poisoning Presenting as Status Epilepticus

    Directory of Open Access Journals (Sweden)

    D Vijayaraju

    2014-02-01

    Full Text Available Mosquito repellents contain pyrethroid derivatives, as the active ingredient. Data regarding human toxicity following oral intake is limited. This is a case report of an individual who presented with neurotoxicity following oral ingestion of prallethrin (2.4% w/w of a higher concentration present in formulations commercially available than previously. A 22 year old male presented to the emergency Room (ER in status epilepticus. He was managed in the Intensive Care Unit (ICU. No cause for his status could be determined after all laboratory investigations. A review of history with the patient revealed that he had ingested a bottle of liquid mosquito repellent (45 ml. The patient has had no further symptoms on follow up and has been off anti epileptics. Pyrethroid containing mosquito repellents act on neuronal sodium channels causing hyperexcitiability. With no known specific antidotes, symptomatic treatment is the main stay of management.

  15. Combinations of ketamine and atropine are neuroprotective and reduce neuroinflammation after a toxic status epilepticus in mice

    International Nuclear Information System (INIS)

    Dhote, Franck; Carpentier, Pierre; Barbier, Laure; Peinnequin, André; Baille, Valérie; Pernot, Fabien; Testylier, Guy; Beaup, Claire; Foquin, Annie

    2012-01-01

    Epileptic seizures and status epilepticus (SE) induced by the poisoning with organophosphorus nerve agents (OP), like soman, are accompanied by neuroinflammation whose role in seizure-related brain damage (SRBD) is not clear. Antagonists of the NMDA glutamate ionotropic receptors are currently among the few compounds able to arrest seizures and provide neuroprotection even during refractory status epilepticus (RSE). Racemic ketamine (KET), in combination with atropine sulfate (AS), was previously shown to counteract seizures and SRBD in soman-poisoned guinea-pigs. In a mouse model of severe soman-induced SE, we assessed the potentials of KET/AS combinations as a treatment for SE/RSE-induced SRBD and neuroinflammation. When starting 30 min after soman challenge, a protocol involving six injections of a sub-anesthetic dose of KET (25 mg/kg) was evaluated on body weight loss, brain damage, and neuroinflammation whereas during RSE, anesthetic protocols were considered (KET 100 mg/kg). After confirming that during RSE, KET injection was to be repeated despite some iatrogenic deaths, we used these proof-of-concept protocols to study the changes in mRNA and related protein contents of some inflammatory cytokines, chemokines and adhesion molecules in cortex and hippocampus 48 h post-challenge. In both cases, the KET/AS combinations showed important neuroprotective effects, suppressed neutrophil granulocyte infiltration and partially suppressed glial activation. KET/AS could also reduce the increase in mRNA and related pro-inflammatory proteins provoked by the poisoning. In conclusion, the present study confirms that KET/AS treatment has a strong potential for SE/RSE management following OP poisoning. The mechanisms involved in the reduction of central neuroinflammation remain to be studied. -- Highlights: ► During soman-induced status epilepticus, ketamine-atropine limit brain damage. ► Molecular neuroinflammatory response is strongly decreased. ► Glial activation is

  16. Combinations of ketamine and atropine are neuroprotective and reduce neuroinflammation after a toxic status epilepticus in mice

    Energy Technology Data Exchange (ETDEWEB)

    Dhote, Franck [Département de Toxicologie et risques chimiques, Institut de Recherche Biomédicale des armées – Centre de recherches du Service de santé des armées IRBA-CRSSA, 24 avenue des Maquis du Grésivaudan, B.P. 87, 38702 La Tronche cedex (France); Carpentier, Pierre; Barbier, Laure [Département de Toxicologie et risques chimiques, Institut de Recherche Biomédicale des armées – Centre de recherches du Service de santé des armées IRBA-CRSSA, 24 avenue des Maquis du Grésivaudan, B.P. 87, 38702 La Tronche cedex (France); Peinnequin, André [Département Effets biologiques des rayonnements, Institut de Recherche Biomédicale des armées – Centre de recherches du Service de santé des armées IRBA-CRSSA, 24 avenue des Maquis du Grésivaudan, B.P. 87, 38702 La Tronche cedex (France); Baille, Valérie; Pernot, Fabien; Testylier, Guy; Beaup, Claire; Foquin, Annie [Département de Toxicologie et risques chimiques, Institut de Recherche Biomédicale des armées – Centre de recherches du Service de santé des armées IRBA-CRSSA, 24 avenue des Maquis du Grésivaudan, B.P. 87, 38702 La Tronche cedex (France); others, and

    2012-03-01

    Epileptic seizures and status epilepticus (SE) induced by the poisoning with organophosphorus nerve agents (OP), like soman, are accompanied by neuroinflammation whose role in seizure-related brain damage (SRBD) is not clear. Antagonists of the NMDA glutamate ionotropic receptors are currently among the few compounds able to arrest seizures and provide neuroprotection even during refractory status epilepticus (RSE). Racemic ketamine (KET), in combination with atropine sulfate (AS), was previously shown to counteract seizures and SRBD in soman-poisoned guinea-pigs. In a mouse model of severe soman-induced SE, we assessed the potentials of KET/AS combinations as a treatment for SE/RSE-induced SRBD and neuroinflammation. When starting 30 min after soman challenge, a protocol involving six injections of a sub-anesthetic dose of KET (25 mg/kg) was evaluated on body weight loss, brain damage, and neuroinflammation whereas during RSE, anesthetic protocols were considered (KET 100 mg/kg). After confirming that during RSE, KET injection was to be repeated despite some iatrogenic deaths, we used these proof-of-concept protocols to study the changes in mRNA and related protein contents of some inflammatory cytokines, chemokines and adhesion molecules in cortex and hippocampus 48 h post-challenge. In both cases, the KET/AS combinations showed important neuroprotective effects, suppressed neutrophil granulocyte infiltration and partially suppressed glial activation. KET/AS could also reduce the increase in mRNA and related pro-inflammatory proteins provoked by the poisoning. In conclusion, the present study confirms that KET/AS treatment has a strong potential for SE/RSE management following OP poisoning. The mechanisms involved in the reduction of central neuroinflammation remain to be studied. -- Highlights: ► During soman-induced status epilepticus, ketamine-atropine limit brain damage. ► Molecular neuroinflammatory response is strongly decreased. ► Glial activation is

  17. Partial differential equations

    CERN Document Server

    Evans, Lawrence C

    2010-01-01

    This text gives a comprehensive survey of modern techniques in the theoretical study of partial differential equations (PDEs) with particular emphasis on nonlinear equations. The exposition is divided into three parts: representation formulas for solutions; theory for linear partial differential equations; and theory for nonlinear partial differential equations. Included are complete treatments of the method of characteristics; energy methods within Sobolev spaces; regularity for second-order elliptic, parabolic, and hyperbolic equations; maximum principles; the multidimensional calculus of variations; viscosity solutions of Hamilton-Jacobi equations; shock waves and entropy criteria for conservation laws; and, much more.The author summarizes the relevant mathematics required to understand current research in PDEs, especially nonlinear PDEs. While he has reworked and simplified much of the classical theory (particularly the method of characteristics), he primarily emphasizes the modern interplay between funct...

  18. Classification of epileptic seizures using wavelet packet log energy and norm entropies with recurrent Elman neural network classifier.

    Science.gov (United States)

    Raghu, S; Sriraam, N; Kumar, G Pradeep

    2017-02-01

    Electroencephalogram shortly termed as EEG is considered as the fundamental segment for the assessment of the neural activities in the brain. In cognitive neuroscience domain, EEG-based assessment method is found to be superior due to its non-invasive ability to detect deep brain structure while exhibiting superior spatial resolutions. Especially for studying the neurodynamic behavior of epileptic seizures, EEG recordings reflect the neuronal activity of the brain and thus provide required clinical diagnostic information for the neurologist. This specific proposed study makes use of wavelet packet based log and norm entropies with a recurrent Elman neural network (REN) for the automated detection of epileptic seizures. Three conditions, normal, pre-ictal and epileptic EEG recordings were considered for the proposed study. An adaptive Weiner filter was initially applied to remove the power line noise of 50 Hz from raw EEG recordings. Raw EEGs were segmented into 1 s patterns to ensure stationarity of the signal. Then wavelet packet using Haar wavelet with a five level decomposition was introduced and two entropies, log and norm were estimated and were applied to REN classifier to perform binary classification. The non-linear Wilcoxon statistical test was applied to observe the variation in the features under these conditions. The effect of log energy entropy (without wavelets) was also studied. It was found from the simulation results that the wavelet packet log entropy with REN classifier yielded a classification accuracy of 99.70 % for normal-pre-ictal, 99.70 % for normal-epileptic and 99.85 % for pre-ictal-epileptic.

  19. Grey matter volume in healthy and epileptic beagles using voxel-based morphometry – a pilot study

    Directory of Open Access Journals (Sweden)

    Lisa Frank

    2018-02-01

    Full Text Available Abstract Background One of the most common chronic neurological disorders in dogs is idiopathic epilepsy (IE diagnosed as epilepsy without structural changes in the brain. In the current study the hypothesis should be proven that subtle grey matter changes occur in epileptic dogs. Therefore, magnetic resonance (MR images of one dog breed (Beagles were used to obtain an approximately uniform brain shape. Local differences in grey matter volume (GMV were compared between 5 healthy Beagles and 10 Beagles with spontaneously recurrent seizures (5 dogs with IE and 5 dogs with structural epilepsy (SE, using voxel-based morphometry (VBM. T1W images of all dogs were prepared using Amira 6.3.0 for brain extraction, FSL 4.1.8 for registration and SPM12 for realignment. After creation of tissue probability maps of cerebrospinal fluid, grey and white matter from control images to segment all extracted brains, GM templates for each group were constructed to normalize brain images for parametric statistical analysis, which was achieved using SPM12. Results Epileptic Beagles (IE and SE Beagles displayed statistically significant reduced GMV in olfactory bulb, cingulate gyrus, hippocampus and cortex, especially in temporal and occipital lobes. Beagles with IE showed statistically significant decreased GMV in olfactory bulb, cortex of parietal and temporal lobe, hippocampus and cingulate gyrus, Beagles with SE mild statistically significant GMV reduction in temporal lobe (p < 0.05; family- wise error correction. Conclusion These results suggest that, as reported in epileptic humans, focal reduction in GMV also occurs in epileptic dogs. Furthermore, the current study shows that VBM analysis represents an excellent method to detect GMV differences of the brain between a healthy dog group and dogs with epileptic syndrome, when MR images of one breed are used.

  20. Optimization of partial search

    International Nuclear Information System (INIS)

    Korepin, Vladimir E

    2005-01-01

    A quantum Grover search algorithm can find a target item in a database faster than any classical algorithm. One can trade accuracy for speed and find a part of the database (a block) containing the target item even faster; this is partial search. A partial search algorithm was recently suggested by Grover and Radhakrishnan. Here we optimize it. Efficiency of the search algorithm is measured by the number of queries to the oracle. The author suggests a new version of the Grover-Radhakrishnan algorithm which uses a minimal number of such queries. The algorithm can run on the same hardware that is used for the usual Grover algorithm. (letter to the editor)

  1. Charles Bonnet Syndrome in a Patient With Right Medial Occipital Lobe Infarction: Epileptic or Deafferentation Phenomenon?

    Science.gov (United States)

    Kumral, Emre; Uluakay, Arzu; Dönmez, İlknur

    2015-07-01

    Charles Bonnet syndrome (CBS) is an uncommon disorder characterized by complex and recurrent visual hallucinations in patients with visual pathway pathologic defects. To describe a patient who experienced complex visual hallucinations following infarction in the right occipital lobe and epileptic seizure who was diagnosed as having CBS. A 65-year-old man presented acute ischemic stroke caused by artery to artery embolism involving the right occipital lobe. Following ischemic stroke, complex visual hallucinations in the left visual field not associated with loss of consciousness or delusion developed in the patient. Hallucinations persisted for >1 month and during hallucination, no electrographic seizures were recorded through 24 hours of videoelectroencephalographic monitoring. CBS may develop in a patient with occipital lobe infarction following an embolic event. CBS associated with medial occipital lobe infarction and epilepsy may coexist and reflects the abnormal functioning of an integrated neuronal network.

  2. Brain mapping of epileptic activity in a case of idiopathic occipital lobe epilepsy (Panayiotopoulos syndrome).

    Science.gov (United States)

    Leal, Alberto J R; Nunes, Sofia; Martins, António; Secca, Mário Forjaz; Jordão, Constança

    2007-06-01

    The Panayiotopoulos type of occipital lobe epilepsy has generated great interest, but the particular brain areas involved in the peculiar seizure manifestations have not been established. We studied a patient with the syndrome, using high-resolution EEG and simultaneous EEG and functional magnetic resonance imaging (fMRI). Resolution of the scalp EEG was improved using a realistic spline Laplacian algorithm, and produced a complex distribution of current sinks and sources over the occipital lobe. The spike-related blood oxygen level dependent (BOLD) effect was multifocal, with clusters in lateral and inferior occipital lobe and lateral and anterior temporal lobe. We also performed regional dipole seeding in BOLD clusters to determine their relative contribution to generation of scalp spikes. The integrated model of the neurophysiologic and vascular data strongly suggests that the epileptic activity originates in the lateral occipital area, spreading to the occipital pole and lateral temporal lobe.

  3. Degenerate time-dependent network dynamics anticipate seizures in human epileptic brain.

    Science.gov (United States)

    Tauste Campo, Adrià; Principe, Alessandro; Ley, Miguel; Rocamora, Rodrigo; Deco, Gustavo

    2018-04-01

    Epileptic seizures are known to follow specific changes in brain dynamics. While some algorithms can nowadays robustly detect these changes, a clear understanding of the mechanism by which these alterations occur and generate seizures is still lacking. Here, we provide crossvalidated evidence that such changes are initiated by an alteration of physiological network state dynamics. Specifically, our analysis of long intracranial electroencephalography (iEEG) recordings from a group of 10 patients identifies a critical phase of a few hours in which time-dependent network states become less variable ("degenerate"), and this phase is followed by a global functional connectivity reduction before seizure onset. This critical phase is characterized by an abnormal occurrence of highly correlated network instances and is shown to be particularly associated with the activity of the resected regions in patients with validated postsurgical outcome. Our approach characterizes preseizure network dynamics as a cascade of 2 sequential events providing new insights into seizure prediction and control.

  4. Dissociative experiences and quality of life in patients with non-epileptic attack disorder.

    Science.gov (United States)

    Mitchell, James W; Ali, Fizzah; Cavanna, Andrea E

    2012-11-01

    Dissociative experiences are commonly reported by patients with non-epileptic attack disorder (NEAD). This cross-sectional study examined the prevalence and characteristics of dissociative experiences in patients with NEAD and assessed their association with health-related quality of life (HRQoL). Fifty-three patients diagnosed with NEAD were consecutively recruited (70.0% female, mean age=42 years, 22.0% with comorbid epilepsy) from a specialist neuropsychiatric clinic. Our sample reported high levels of dissociative experiences, with 36.7% of patients scoring ≥30 on the Dissociative Experiences Scale (DES). Significant negative correlations were found between total DES scores and HRQoL, as measured by the QOLIE-31 questionnaire (r=-0.64, pdissociative experiences in this patient population, highlighting the importance of routinely screening patients for dissociative symptoms and their impact on patients' lives. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Clinical evaluation and MRI findings in early infantile epileptic encephalopathy with suppression-burst

    International Nuclear Information System (INIS)

    Konishi, Hideki; Kodama, Soichi; Momota, Keiko

    1988-01-01

    The clinical courses and a follow-up study on the MRI findings in four cases with early infantile epileptic encephalopathy (EIEE) are reported. The patients consisted of one male and three females. The age at onset was before 15 days on life and the etiology was unknown in all cases. EEG improvement and a decrease in seizure frequency were seen after treatment with ACTH and anticonvulsants in three of the four patients, while no treatment was effective in the other patient who developed Lennox-Gastaut syndrome through West syndrome. Psychomotor development of all patients was severely retarded, and it was impossible for three cases to gain head control until 12 months old. MRI findings revealed dysmyelination of white matter in the cerebrum in three patients and asymmetrical myelination in the other patient. These results suggested that EIEE is based on brain immaturity combined with dysmyelination. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-04-07

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

  7. CDKL5 variant in a boy with infantile epileptic encephalopathy: case report.

    Science.gov (United States)

    Wong, Virginia Chun-Nei; Kwong, Anna Ka-Yee

    2015-04-01

    A Chinese boy presented at 18 months with intractable epilepsy, developmental delay and autistic features. He had multiple seizure types, including absence, myoclonic seizures, limb spasm and tonic seizures. His seizures were finally controlled at 3 years of age with clonazepam and a short course of chloral hydrate incidentally given for his insomnia. Subsequently, he had improvement in his communication skills. A novel hemizygous missense variant (c.1649G>A; p.R550Q) in exon 12 of CDKL5 gene was detected for him, his asymptomatic mother and elder sister. His phenotype is less severe than other male cases. We recommend screening CDKL5 for boys with pharmarco-resistant epilepsy and a trial of benzodiazepines for Infantile Epileptic Encephalopathy (IEE). Copyright © 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  8. Clinical evaluation and MRI findings in early infantile epileptic encephalopathy with suppression-burst

    Energy Technology Data Exchange (ETDEWEB)

    Konishi, Hideki; Kodama, Soichi; Momota, Keiko and others

    1988-02-01

    The clinical courses and a follow-up study on the MRI findings in four cases with early infantile epileptic encephalopathy (EIEE) are reported. The patients consisted of one male and three females. The age at onset was before 15 days on life and the etiology was unknown in all cases. EEG improvement and a decrease in seizure frequency were seen after treatment with ACTH and anticonvulsants in three of the four patients, while no treatment was effective in the other patient who developed Lennox-Gastaut syndrome through West syndrome. Psychomotor development of all patients was severely retarded, and it was impossible for three cases to gain head control until 12 months old. MRI findings revealed dysmyelination of white matter in the cerebrum in three patients and asymmetrical myelination in the other patient. These results suggested that EIEE is based on brain immaturity combined with dysmyelination.

  9. Coexistence of intermittencies in the neuronal network of the epileptic brain.

    Science.gov (United States)

    Koronovskii, Alexey A; Hramov, Alexander E; Grubov, Vadim V; Moskalenko, Olga I; Sitnikova, Evgenia; Pavlov, Alexey N

    2016-03-01

    Intermittent behavior occurs widely in nature. At present, several types of intermittencies are known and well-studied. However, consideration of intermittency has usually been limited to the analysis of cases when only one certain type of intermittency takes place. In this paper, we report on the temporal behavior of the complex neuronal network in the epileptic brain, when two types of intermittent behavior coexist and alternate with each other. We prove the presence of this phenomenon in physiological experiments with WAG/Rij rats being the model living system of absence epilepsy. In our paper, the deduced theoretical law for distributions of the lengths of laminar phases prescribing the power law with a degree of -2 agrees well with the experimental neurophysiological data.

  10. A Quantitative Analysis of an EEG Epileptic Record Based on MultiresolutionWavelet Coefficients

    Directory of Open Access Journals (Sweden)

    Mariel Rosenblatt

    2014-11-01

    Full Text Available The characterization of the dynamics associated with electroencephalogram (EEG signal combining an orthogonal discrete wavelet transform analysis with quantifiers originated from information theory is reviewed. In addition, an extension of this methodology based on multiresolution quantities, called wavelet leaders, is presented. In particular, the temporal evolution of Shannon entropy and the statistical complexity evaluated with different sets of multiresolution wavelet coefficients are considered. Both methodologies are applied to the quantitative EEG time series analysis of a tonic-clonic epileptic seizure, and comparative results are presented. In particular, even when both methods describe the dynamical changes of the EEG time series, the one based on wavelet leaders presents a better time resolution.

  11. Space time frequency (STF) code tensor for the characterization of the epileptic preictal stage.

    Science.gov (United States)

    Direito, Bruno; Teixeira, César; Ribeiro, Bernardete; Castelo-Branco, Miguel; Dourado, António

    2012-01-01

    We evaluate the ability of multiway models to characterize the epileptic preictal period. The understanding of the characteristics of the period prior to the seizure onset is a decisive step towards the development of seizure prediction frameworks. Multiway models of EEG segments already demonstrated that hidden structures may be unveiled using tensor decomposition techniques. We propose a novel approach using a multiway model, Parallel Factor Analysis (PARAFAC), to identify spatial, temporal and spectral signatures of the preictal period. The results obtained, from a dataset of 4 patients, with a total of 30 seizures, suggest that a common structure may be involved in seizure generation. Furthermore, the spatial signature may be related to the ictal onset region and that determined frequency sub-bands may be more relevant in preictal stages.

  12. Development Enamel Defects in Children Prenatally Exposed to Anti-Epileptic Drugs

    DEFF Research Database (Denmark)

    Jacobsen, Pernille Endrup; Henriksen, Tine Brink; Haubek, Dorte

    2013-01-01

    Objective Some anti-epileptic drugs (AED) have well-known teratogenic effects. The aim of the present study was to elucidate the effect of prenatal exposure to AED and the risk of enamel defects in the primary and permanent dentition. Methods A total of 38 exposed and 129 non-exposed children, 6......–10 years of age, were recruited from the Aarhus Birth Cohort and the Department of Neurology, Viborg Regional Hospital, Denmark. Medication during pregnancy was confirmed by the Danish Prescription Database. All children had their teeth examined and outcomes in terms of enamel opacities and enamel...... hypoplasia were recorded. Results Children prenatally exposed to AED have an increased prevalence of enamel hypoplasia (11% vs. 4%, odds ratio (OR) = 3.6 [95% confidence interval (CI): 0.9 to 15.4]), diffuse opacities (18% vs. 7%, OR = 3.0; [95% CI: 1.0 to 8.7, p3) white opacities (18...

  13. 99mTc-HM-PAO SPECT of epileptic patients showing focal paroxysm on electroencephalography

    International Nuclear Information System (INIS)

    Takaishi, Yasuko; Hashimoto, Kiyoshi; Fujino, Osamu; Kamayachi, Satoshi; Fujita, Takehisa; Enokido, Hisashi; Komatsuzaki, Hideki; Kawakami, Yasuhiko; Hirayama, Tsunenori

    1995-01-01

    The usefulness of 99m Tc-HM-PAO SPECT in diagnosing epilepsy was studied. The subjects were 33 epileptic patients, ranging in age from 5 years and 5 months to 28 years and 3 months, who showed focal paroxysm on electroencephalograms. Lowered accumulation site was found on SPECT in 19 patients. Four patients with abnormal findings on X-ray CT or MRI showed lowered accumulation and focal paroxysm at the same site. Of 29 patients with normal X-ray CT or MRI findings, 15 (52%) showed lowered accumulation. Five patients showed a focal paroxysm at the site of lowered accumulation. In 8 patients the focal paroxysm site was partly coincided with the accumulation site. In some patients the focal site predicted by the findings of clinical symptoms and the lowered accumulation site coincided. SPECT is therefore a useful method in diagnosing a focal site in epilepsy and considered to reflect the severity of disease. (Y.S.)

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

    Science.gov (United States)

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

    2017-05-01

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

  15. Fragility in dynamic networks: application to neural networks in the epileptic cortex.

    Science.gov (United States)

    Sritharan, Duluxan; Sarma, Sridevi V

    2014-10-01

    Epilepsy is a network phenomenon characterized by atypical activity at the neuronal and population levels during seizures, including tonic spiking, increased heterogeneity in spiking rates, and synchronization. The etiology of epilepsy is unclear, but a common theme among proposed mechanisms is that structural connectivity between neurons is altered. It is hypothesized that epilepsy arises not from random changes in connectivity, but from specific structural changes to the most fragile nodes or neurons in the network. In this letter, the minimum energy perturbation on functional connectivity required to destabilize linear networks is derived. Perturbation results are then applied to a probabilistic nonlinear neural network model that operates at a stable fixed point. That is, if a small stimulus is applied to the network, the activation probabilities of each neuron respond transiently but eventually recover to their baseline values. When the perturbed network is destabilized, the activation probabilities shift to larger or smaller values or oscillate when a small stimulus is applied. Finally, the structural modifications to the neural network that achieve the functional perturbation are derived. Simulations of the unperturbed and perturbed networks qualitatively reflect neuronal activity observed in epilepsy patients, suggesting that the changes in network dynamics due to destabilizing perturbations, including the emergence of an unstable manifold or a stable limit cycle, may be indicative of neuronal or population dynamics during seizure. That is, the epileptic cortex is always on the brink of instability and minute changes in the synaptic weights associated with the most fragile node can suddenly destabilize the network to cause seizures. Finally, the theory developed here and its interpretation of epileptic networks enables the design of a straightforward feedback controller that first detects when the network has destabilized and then applies linear state

  16. Gap junctions and epileptic seizures--two sides of the same coin?

    Directory of Open Access Journals (Sweden)

    Vladislav Volman

    Full Text Available Electrical synapses (gap junctions play a pivotal role in the synchronization of neuronal ensembles which also makes them likely agonists of pathological brain activity. Although large body of experimental data and theoretical considerations indicate that coupling neurons by electrical synapses promotes synchronous activity (and thus is potentially epileptogenic, some recent evidence questions the hypothesis of gap junctions being among purely epileptogenic factors. In particular, an expression of inter-neuronal gap junctions is often found to be higher after the experimentally induced seizures than before. Here we used a computational modeling approach to address the role of neuronal gap junctions in shaping the stability of a network to perturbations that are often associated with the onset of epileptic seizures. We show that under some circumstances, the addition of gap junctions can increase the dynamical stability of a network and thus suppress the collective electrical activity associated with seizures. This implies that the experimentally observed post-seizure additions of gap junctions could serve to prevent further escalations, suggesting furthermore that they are a consequence of an adaptive response of the neuronal network to the pathological activity. However, if the seizures are strong and persistent, our model predicts the existence of a critical tipping point after which additional gap junctions no longer suppress but strongly facilitate the escalation of epileptic seizures. Our results thus reveal a complex role of electrical coupling in relation to epileptiform events. Which dynamic scenario (seizure suppression or seizure escalation is ultimately adopted by the network depends critically on the strength and duration of seizures, in turn emphasizing the importance of temporal and causal aspects when linking gap junctions with epilepsy.

  17. Etomidate accurately localizes the epileptic area in patients with temporal lobe epilepsy.

    Science.gov (United States)

    Pastor, Jesús; Wix, Rybel; Meilán, María Luisa; Martínez-Chacón, José Luís; de Dios, Eva; Domínguez-Gadea, Luis; Herrera-Peco, Iván; Sola, Rafael G

    2010-04-01

    A variety of drugs have been used to activate and identify the epileptogenic area in patients during presurgical evaluation. We have evaluated the safety and usefulness of etomidate in identifying the epileptic zone by measuring bioelectrical brain activity and cerebral blood flow (CBF). We studied 13 men and 9 women under presurgical evaluation for temporal lobe epilepsy. We applied etomidate (0.1 mg/kg) while patients were monitored by video-electroencephalography (VEEG) with foramen ovale electrodes. In a subset of 15 patients, we also measured CBF with single photon emission computed tomography (SPECT). (1) Etomidate induced seizures in 2 of 22 patients. (2) The main side-effects observed were myoclonus (14 of 20) and moderate pain (3 of 20). (3) No changes in capillary oxygen saturation, respiration, or heart rate were observed. (4) Irritative activity specifically increased in the temporal mesial and lateral areas. No spikes were observed in other areas, aside from those observed under baseline conditions. (5) Irritative activity induced by etomidate correctly lateralized the ictal onset zone in 19 of 20 patients. In addition, the two etomidate-induced seizures appeared in the same regions as spontaneous ones. (6) The kinetics of pharmacologically induced activity was higher in the region of the ictal-onset zone. (7) Etomidate increased the CBF in the basal ganglia and especially in the posterior hippocampus of the temporal mesial region contralateral to the ictal-onset zone. Etomidate activation is a safe, specific, and quick test that can be used to identify the epileptic region in patients evaluated as candidates for temporal lobe epilepsy surgery.

  18. Two Novel Variants Affecting CDKL5 Transcript Associated with Epileptic Encephalopathy.

    Science.gov (United States)

    Neupauerová, Jana; Štěrbová, Katalin; Vlčková, Markéta; Sebroňová, Věra; Maříková, Tat'ána; Krůtová, Marcela; David, Staněk; Kršek, Pavel; Žaliová, Markéta; Seeman, Pavel; Laššuthová, Petra

    2017-10-01

    Variants in the human X-linked cyclin-dependent kinase-like 5 (CDKL5) gene have been reported as being etiologically associated with early infantile epileptic encephalopathy type 2 (EIEE2). We report on two patients, a boy and a girl, with EIEE2 that present with early onset epilepsy, hypotonia, severe intellectual disability, and poor eye contact. Massively parallel sequencing (MPS) of a custom-designed gene panel for epilepsy and epileptic encephalopathy containing 112 epilepsy-related genes was performed. Sanger sequencing was used to confirm the novel variants. For confirmation of the functional consequence of an intronic CDKL5 variant in patient 2, an RNA study was done. DNA sequencing revealed de novo variants in CDKL5, a c.2578C>T (p. Gln860*) present in a hemizygous state in a 3-year-old boy, and a potential splice site variant c.463+5G>A in heterozygous state in a 5-year-old girl. Multiple in silico splicing algorithms predicted a highly reduced splice site score for c.463+5G>A. A subsequent mRNA study confirmed an aberrant shorter transcript lacking exon 7. Our data confirmed that variants in the CDKL5 are associated with EIEE2. There is credible evidence that the novel identified variants are pathogenic and, therefore, are likely the cause of the disease in the presented patients. In one of the patients a stop codon variant is predicted to produce a truncated protein, and in the other patient an intronic variant results in aberrant splicing.

  19. Decrement of GABAA receptor-mediated inhibitory postsynaptic currents in dentate granule cells in epileptic hippocampus.

    Science.gov (United States)

    Isokawa, M

    1996-05-01

    1. Inhibitory postsynaptic currents (IPSCs) were studied in hippocampal dentate granule cells (DGCs) in the pilocarpine model and human temporal lobe epilepsy, with the use of the whole cell patch-clamp recording technique in slice preparations. 2. In the pilocarpine model, hippocampal slices were prepared from rats that were allowed to experience spontaneous seizures for 2 mo. Human hippocampal specimens were obtained from epileptic patients who underwent surgical treatment for medically intractable seizures. 3. IPSCs were generated by single perforant path stimulation and recorded at a membrane potential (Vm) of 0 mV near the reversal potential of glutamate excitatory postsynaptic currents in the voltage-clamp recording. IPSCs were pharmacologically identified as gamma-aminobutyric acid-A (GABAA) IPSCs by 10 microM bicuculline methiodide. 4. During low-frequency stimulation, IPSCs were not different in amplitude among non-seizure-experienced rat hippocampi, human nonsclerotic hippocampi, seizure-experienced rat hippocampi, and human sclerotic hippocampi. In the last two groups of DGCs, current-clamp recordings indicated the presence of prolonged excitatory postsynaptic potentials (EPSPs) mediated by the N-methyl-D-aspartate (NMDA) receptor. 5. High-frequency stimulation, administered at Vm = -30 mV to activate NMDA currents, reduced GABAA IPSC amplitude specifically in seizure-experienced rat hippocampi (t = 2.5, P < 0.03) and human sclerotic hippocampi (t = 7.7, P < 0.01). This reduction was blocked by an NMDA receptor antagonist, 2-amino-5-phosphonovaleric acid (APV) (50 microM). The time for GABAA IPSCs to recover to their original amplitude was also shortened by the application of APV. 6. I conclude that, when intensively activated, NMDA receptor-mediated excitatory transmission may interact with GABAergic synaptic inhibition in DGCs in seizure-experienced hippocampus to transiently reduce GABA(A) receptor-channel function. Such interactions may contribute to

  20. A New Rat Model of Epileptic Spasms Based on Methylazoxymethanol-Induced Malformations of Cortical Development

    Directory of Open Access Journals (Sweden)

    Eun-Hee Kim

    2017-06-01

    Full Text Available Malformations of cortical development (MCDs can cause medically intractable epilepsies and cognitive disabilities in children. We developed a new model of MCD-associated epileptic spasms by treating rats prenatally with methylazoxymethanol acetate (MAM to induce cortical malformations and postnatally with N-methyl-d-aspartate (NMDA to induce spasms. To produce cortical malformations to infant rats, two dosages of MAM (15 mg/kg, intraperitoneally were injected to pregnant rats at gestational day 15. In prenatally MAM-exposed rats and the controls, spasms were triggered by single (6 mg/kg on postnatal day 12 (P12 or 10 mg/kg on P13 or 15 mg/kg on P15 or multiple doses (P12, P13, and P15 of NMDA. In prenatally MAM-exposed rats with single NMDA-provoked spasms at P15, we obtain the intracranial electroencephalography and examine the pretreatment response to adrenocorticotropic hormone (ACTH or vigabatrin. Rat pups prenatally exposed to MAM exhibited a significantly greater number of spasms in response to single and multiple postnatal NMDA doses than vehicle-exposed controls. Vigabatrin treatment prior to a single NMDA dose on P15 significantly suppressed spasms in MAM group rats (p < 0.05, while ACTH did not. The MAM group also showed significantly higher fast oscillation (25–100 Hz power during NMDA-induced spasms than controls (p = 0.047. This new model of MCD-based epileptic spasms with corresponding features of human spasms will be valuable for future research of the developmental epilepsy.

  1. Automatic identification of epileptic seizures from EEG signals using linear programming boosting.

    Science.gov (United States)

    Hassan, Ahnaf Rashik; Subasi, Abdulhamit

    2016-11-01

    Computerized epileptic seizure detection is essential for expediting epilepsy diagnosis and research and for assisting medical professionals. Moreover, the implementation of an epilepsy monitoring device that has low power and is portable requires a reliable and successful seizure detection scheme. In this work, the problem of automated epilepsy seizure detection using singe-channel EEG signals has been addressed. At first, segments of EEG signals are decomposed using a newly proposed signal processing scheme, namely complete ensemble empirical mode decomposition with adaptive noise (CEEMDAN). Six spectral moments are extracted from the CEEMDAN mode functions and train and test matrices are formed afterward. These matrices are fed into the classifier to identify epileptic seizures from EEG signal segments. In this work, we implement an ensemble learning based machine learning algorithm, namely linear programming boosting (LPBoost) to perform classification. The efficacy of spectral features in the CEEMDAN domain is validated by graphical and statistical analyses. The performance of CEEMDAN is compared to those of its predecessors to further inspect its suitability. The effectiveness and the appropriateness of LPBoost are demonstrated as opposed to the commonly used classification models. Resubstitution and 10 fold cross-validation error analyses confirm the superior algorithm performance of the proposed scheme. The algorithmic performance of our epilepsy seizure identification scheme is also evaluated against state-of-the-art works in the literature. Experimental outcomes manifest that the proposed seizure detection scheme performs better than the existing works in terms of accuracy, sensitivity, specificity, and Cohen's Kappa coefficient. It can be anticipated that owing to its use of only one channel of EEG signal, the proposed method will be suitable for device implementation, eliminate the onus of clinicians for analyzing a large bulk of data manually, and

  2. Effects of topiramate on language functions in newly diagnosed pediatric epileptic patients.

    Science.gov (United States)

    Kim, Sun Jun; Kim, Moon Yeon; Choi, Yoon Mi; Song, Mi Kyoung

    2014-09-01

    The aim of this study was to characterize the effects of topiramate on language functions in newly diagnosed pediatric epileptic patients. Thirty-eight newly diagnosed epileptic patients were assessed using standard language tests. Data were collected before and after beginning topiramate during which time a monotherapy treatment regimen was maintained. Language tests included the Test of Language Problem Solving Abilities, a Korean version of the Peabody Picture Vocabulary Test. We used language tests in the Korean version because all the patients were spoken Korean exclusively in their families. All the language parameters of Test of Language Problem Solving Abilities worsened after initiation of topiramate (determine cause, 13.2 ± 4.8 to 11.2 ± 4.3; problem solving, 14.8 ± 6.0 to 12.8 ± 5.0; predicting, 9.8 ± 3.6 to 8.8 ± 4.6). Patients given topiramate exhibited a shortened mean length of utterance in words during response (determine cause, 4.8 ± 0.9 to 4.3 ± 0.7; making inference, 4.5 ± 0.8 to 4.1 ± 1.1; predicting, 5.2 ± 1.0 to 4.7 ± 0.6; P language of patients after taking topiramate (95.4 ± 20.4 to 100.8 ± 19.1). Our data suggest that topiramate may have negative effects on problem-solving abilities in children. We recommend performing language tests should be considered in children being treated with topiramate. Copyright © 2014 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2017-01-01

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

  4. Inhibiting cholesterol degradation induces neuronal sclerosis and epileptic activity in mouse hippocampus

    Science.gov (United States)

    Chali, Farah; Djelti, Fathia; Eugene, Emmanuel; Valderrama, Mario; Marquer, Catherine; Aubourg, Patrick; Duykaerts, Charles; Miles, Richard; Cartier, Nathalie; Navarro, Vincent

    2015-01-01

    Elevations in neuronal cholesterol have been associated with several degenerative diseases. An enhanced excitability and synchronous firing in surviving neurons are among the sequels of neuronal death in these diseases and also in some epileptic syndromes. Here, we attempted to increase neuronal cholesterol levels, using a short hairpin RNA (shRNA) to suppress expression of the enzyme CYP46A1. This protein hydroxylates cholesterol and so facilitates trans-membrane extrusion. A sh-RNA CYP46A1construction coupled to an adeno-associated virus (AAV5) was injected focally and unilaterally into mouse hippocampus. It was selectively expressed first in neurons of the CA3a region. Cytoplasmic and membrane cholesterol increased, neuronal soma volume increased and then decreased before pyramidal cells died. As CA3a pyramidal cells died, inter-ictal EEG events occurred during exploration and non-REM sleep. With time, neuronal death spread to involve pyramidal cells and interneurons of the CA1 region. CA1 neuronal death was correlated with a delayed local expression of phosphorylated tau. Astrocytes were activated throughout the hippocampus and microglial activation was specific to regions of neuronal death. CA1 neuronal death was correlated with distinct aberrant EEG activity. During exploratory behaviour and rapid eye movement sleep, EEG oscillations at 7-10 Hz (theta) could accelerate to 14-21 Hz (beta) waves. They were accompanied by low amplitude, high-frequency oscillations of peak power at ~300Hz and a range of 250-350 Hz. While episodes of EEG acceleration were not correlated with changes in exploratory behaviour, they were followed in some animals by structured seizure-like discharges. These data strengthen links between increased cholesterol, neuronal sclerosis and epileptic behavior PMID:25847620

  5. Auxiliary partial liver transplantation

    NARCIS (Netherlands)

    C.B. Reuvers (Cornelis Bastiaan)

    1986-01-01

    textabstractIn this thesis studies on auxiliary partial liver transplantation in the dog and the pig are reported. The motive to perform this study was the fact that patients with acute hepatic failure or end-stage chronic liver disease are often considered to form too great a risk for successful

  6. Partial Remission Definition

    DEFF Research Database (Denmark)

    Andersen, Marie Louise Max; Hougaard, Philip; Pörksen, Sven

    2014-01-01

    OBJECTIVE: To validate the partial remission (PR) definition based on insulin dose-adjusted HbA1c (IDAA1c). SUBJECTS AND METHODS: The IDAA1c was developed using data in 251 children from the European Hvidoere cohort. For validation, 129 children from a Danish cohort were followed from the onset...

  7. Fundamental partial compositeness

    DEFF Research Database (Denmark)

    Sannino, Francesco; Strumia, Alessandro; Tesi, Andrea

    2016-01-01

    We construct renormalizable Standard Model extensions, valid up to the Planck scale, that give a composite Higgs from a new fundamental strong force acting on fermions and scalars. Yukawa interactions of these particles with Standard Model fermions realize the partial compositeness scenario. Unde...

  8. Partially ordered models

    NARCIS (Netherlands)

    Fernandez, R.; Deveaux, V.

    2010-01-01

    We provide a formal definition and study the basic properties of partially ordered chains (POC). These systems were proposed to model textures in image processing and to represent independence relations between random variables in statistics (in the later case they are known as Bayesian networks).

  9. Partially Hidden Markov Models

    DEFF Research Database (Denmark)

    Forchhammer, Søren Otto; Rissanen, Jorma

    1996-01-01

    Partially Hidden Markov Models (PHMM) are introduced. They differ from the ordinary HMM's in that both the transition probabilities of the hidden states and the output probabilities are conditioned on past observations. As an illustration they are applied to black and white image compression where...

  10. Honesty in partial logic

    NARCIS (Netherlands)

    W. van der Hoek (Wiebe); J.O.M. Jaspars; E. Thijsse

    1995-01-01

    textabstractWe propose an epistemic logic in which knowledge is fully introspective and implies truth, although truth need not imply epistemic possibility. The logic is presented in sequential format and is interpreted in a natural class of partial models, called balloon models. We examine the

  11. Algebraic partial Boolean algebras

    International Nuclear Information System (INIS)

    Smith, Derek

    2003-01-01

    Partial Boolean algebras, first studied by Kochen and Specker in the 1960s, provide the structure for Bell-Kochen-Specker theorems which deny the existence of non-contextual hidden variable theories. In this paper, we study partial Boolean algebras which are 'algebraic' in the sense that their elements have coordinates in an algebraic number field. Several of these algebras have been discussed recently in a debate on the validity of Bell-Kochen-Specker theorems in the context of finite precision measurements. The main result of this paper is that every algebraic finitely-generated partial Boolean algebra B(T) is finite when the underlying space H is three-dimensional, answering a question of Kochen and showing that Conway and Kochen's infinite algebraic partial Boolean algebra has minimum dimension. This result contrasts the existence of an infinite (non-algebraic) B(T) generated by eight elements in an abstract orthomodular lattice of height 3. We then initiate a study of higher-dimensional algebraic partial Boolean algebras. First, we describe a restriction on the determinants of the elements of B(T) that are generated by a given set T. We then show that when the generating set T consists of the rays spanning the minimal vectors in a real irreducible root lattice, B(T) is infinite just if that root lattice has an A 5 sublattice. Finally, we characterize the rays of B(T) when T consists of the rays spanning the minimal vectors of the root lattice E 8

  12. SU-E-T-797: Variations of Cardiac Dose at Different Respiratory Status in CyberKnife M6â„¢ Treatment Plans for Accelerated Partial Breast Irradiation (APBI)

    Energy Technology Data Exchange (ETDEWEB)

    Long, S [Florida Atlantic University, Boca Raton, FL (United States); Shang, C [Boca Raton Regional Hospital, Boca Raton, FL (United States); Evans, G [Boca Raton, FL (United States); Leventouri, T [FAU, Boca Raton, FL (United States)

    2015-06-15

    Purpose: Cyberknife robotic assisted radiation delivery has become a choice for accelerated breast RT, while a slightly increased cardiac dose has been reported. The dose dynamics throughout the respiration cycle has scarcely been explored. This study was designed to investigate the dose changes at each respiratory phase or status during respiration cycle. Methods: Six patients with 4DCT studies and six patients with a pair of free-breathing and deep breath-hold CT sets were used for dosimetry comparisons. 4DCT sets were obtained by Siemens™ CT and its respiratory gating system, comprising of 8 phases. Standard APBI plan at 340 cGy was done per fraction per NSABP B-39/RTOG 0413 and modulated with Cyberknife M6™ on MultiPlan™5.1.2. For the purpose of this study, the tumor volume was outlined in the media-lower quadrant of the left breast. Results: Except for D5cc in plans with 4DCT, cardiac doses are significantly different between respiratory phases in well inhaled breathing phases, and more significantly in plans with BH CT. Mean cardiac doses in 100% inhalation phase were often found to be 5–15% (p< 0.02) less than those in other phases. Conclusion: Although ineligible cardiac doses are noted in APBI plans using 4D free-breathing CT and instantaneous free breathing CT series, a reduction in cardiac dose was seen for the well-inhaled phases. This provides practical guidance for cardiac dose reduction applicable with CK M6 APBR.

  13. SU-E-T-797: Variations of Cardiac Dose at Different Respiratory Status in CyberKnife M6â„¢ Treatment Plans for Accelerated Partial Breast Irradiation (APBI)

    International Nuclear Information System (INIS)

    Long, S; Shang, C; Evans, G; Leventouri, T

    2015-01-01

    Purpose: Cyberknife robotic assisted radiation delivery has become a choice for accelerated breast RT, while a slightly increased cardiac dose has been reported. The dose dynamics throughout the respiration cycle has scarcely been explored. This study was designed to investigate the dose changes at each respiratory phase or status during respiration cycle. Methods: Six patients with 4DCT studies and six patients with a pair of free-breathing and deep breath-hold CT sets were used for dosimetry comparisons. 4DCT sets were obtained by Siemens™ CT and its respiratory gating system, comprising of 8 phases. Standard APBI plan at 340 cGy was done per fraction per NSABP B-39/RTOG 0413 and modulated with Cyberknife M6™ on MultiPlan™5.1.2. For the purpose of this study, the tumor volume was outlined in the media-lower quadrant of the left breast. Results: Except for D5cc in plans with 4DCT, cardiac doses are significantly different between respiratory phases in well inhaled breathing phases, and more significantly in plans with BH CT. Mean cardiac doses in 100% inhalation phase were often found to be 5–15% (p< 0.02) less than those in other phases. Conclusion: Although ineligible cardiac doses are noted in APBI plans using 4D free-breathing CT and instantaneous free breathing CT series, a reduction in cardiac dose was seen for the well-inhaled phases. This provides practical guidance for cardiac dose reduction applicable with CK M6 APBR

  14. Partially composite Higgs models

    DEFF Research Database (Denmark)

    Alanne, Tommi; Buarque Franzosi, Diogo; Frandsen, Mads T.

    2018-01-01

    We study the phenomenology of partially composite-Higgs models where electroweak symmetry breaking is dynamically induced, and the Higgs is a mixture of a composite and an elementary state. The models considered have explicit realizations in terms of gauge-Yukawa theories with new strongly...... interacting fermions coupled to elementary scalars and allow for a very SM-like Higgs state. We study constraints on their parameter spaces from vacuum stability and perturbativity as well as from LHC results and find that requiring vacuum stability up to the compositeness scale already imposes relevant...... constraints. A small part of parameter space around the classically conformal limit is stable up to the Planck scale. This is however already strongly disfavored by LHC results. in different limits, the models realize both (partially) composite-Higgs and (bosonic) technicolor models and a dynamical extension...

  15. 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.

  16. Arthroscopic partial medial meniscectomy

    Directory of Open Access Journals (Sweden)

    Dašić Žarko

    2011-01-01

    Full Text Available Background/Aim. Meniscal injuries are common in professional or recreational sports as well as in daily activities. If meniscal lesions lead to physical impairment they usually require surgical treatment. Arthroscopic treatment of meniscal injuries is one of the most often performed orthopedic operative procedures. Methods. The study analyzed the results of arthroscopic partial medial meniscectomy in 213 patients in a 24-month period, from 2006, to 2008. Results. In our series of arthroscopically treated medial meniscus tears we noted 78 (36.62% vertical complete bucket handle lesions, 19 (8.92% vertical incomplete lesions, 18 (8.45% longitudinal tears, 35 (16.43% oblique tears, 18 (8.45% complex degenerative lesions, 17 (7.98% radial lesions and 28 (13.14% horisontal lesions. Mean preoperative International Knee Documentation Committee (IKDC score was 49.81%, 1 month after the arthroscopic partial medial meniscectomy the mean IKDC score was 84.08%, and 6 months after mean IKDC score was 90.36%. Six months after the procedure 197 (92.49% of patients had good or excellent subjective postoperative clinical outcomes, while 14 (6.57% patients subjectively did not notice a significant improvement after the intervention, and 2 (0.93% patients had no subjective improvement after the partial medial meniscectomy at all. Conclusion. Arthroscopic partial medial meniscetomy is minimally invasive diagnostic and therapeutic procedure and in well selected cases is a method of choice for treatment of medial meniscus injuries when repair techniques are not a viable option. It has small rate of complications, low morbidity and fast rehabilitation.

  17. Hierarchical partial order ranking

    International Nuclear Information System (INIS)

    Carlsen, Lars

    2008-01-01

    Assessing the potential impact on environmental and human health from the production and use of chemicals or from polluted sites involves a multi-criteria evaluation scheme. A priori several parameters are to address, e.g., production tonnage, specific release scenarios, geographical and site-specific factors in addition to various substance dependent parameters. Further socio-economic factors may be taken into consideration. The number of parameters to be included may well appear to be prohibitive for developing a sensible model. The study introduces hierarchical partial order ranking (HPOR) that remedies this problem. By HPOR the original parameters are initially grouped based on their mutual connection and a set of meta-descriptors is derived representing the ranking corresponding to the single groups of descriptors, respectively. A second partial order ranking is carried out based on the meta-descriptors, the final ranking being disclosed though average ranks. An illustrative example on the prioritisation of polluted sites is given. - Hierarchical partial order ranking of polluted sites has been developed for prioritization based on a large number of parameters

  18. Electric Stimulation of Ear Reduces the Effect of Toll-Like Receptor 4 Signaling Pathway on Kainic Acid-Induced Epileptic Seizures in Rats

    Directory of Open Access Journals (Sweden)

    En-Tzu Liao

    2018-01-01

    Full Text Available Epilepsy is a common clinical syndrome with recurrent neuronal discharges in the temporal lobe, cerebral cortex, and hippocampus. Clinical antiepileptic medicines are often ineffective or of little benefit in 30% of epileptic patients and usually cause severe side effects. Emerging evidence indicates the crucial role of inflammatory mediators in epilepsy. The current study investigates the role of toll-like receptor 4 (TLR4 and its underlying mechanisms in kainic acid- (KA- induced epileptic seizures in rats. Experimental KA injection successfully initiated an epileptic seizure accompanied by increased expression of TLR4 in the prefrontal cortex, hippocampus, and somatosensory cortex. In addition, calcium-sensitive phosphorylated Ca2+/calmodulin-dependent protein kinase II (pCaMKIIα increased after the initiation of the epileptic seizure. Furthermore, downstream-phosphorylated signal-regulated kinase (ERK, c-Jun NH2-terminal protein kinase (JNK, and p38 kinase simultaneously increased in these brain areas. Moreover, the transcriptional factor phosphorylated nuclear factor-κB (pNF-κB increased, suggesting that nucleus transcription was affected. Furthermore, the aforementioned molecules decreased by an electric stimulation (ES of either 2 Hz or 15 Hz of the ear in the three brain areas. Accordingly, we suggest that ES of the ear can successfully control epileptic seizures by regulating the TLR4 signaling pathway and has a therapeutic benefit in reducing epileptic seizures.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-06-15

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

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

    Directory of Open Access Journals (Sweden)

    Boyuan Yan

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

  1. Clinical utility of N-isopropyl-p-[123I] iodoamphetamine (123I-IMP) for SPECT in epileptic children

    International Nuclear Information System (INIS)

    Taki, Kuniyasu; Seto, Hikaru; Futatsuya, Ryusuke; Kakishita, Masao; Seki, Hiroyasu.

    1989-01-01

    A regional cerebral perfusion study was performed in epileptic children using single photon emission computed tomography (SPECT) and N-isopropyl-p-[ 123 I] iodoamphetamine ( 123 I-IMP). A total of 22 patients with epilepsy underwent both a 123 I-IMP brain perfusion study and X-ray CT. Eighteen had positive and four had negative perfusion study results. Of the eighteen patients with positive perfusion study results, two were positive on X-ray CT. In these two patients, the areas of perfusion defects were larger than those of low density on X-ray CT. In only four patients did the areas of perfusion defects correspond to the sites of abnormal EEG. In conclusion, 123 I-IMP perfusion study is of great clinical value in pediatric epileptic cases. (author)

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

    International Nuclear Information System (INIS)

    Choi, Hongyoon; Seo, Minseok; Lee, Hoyoung; Kim, Youngsoo; Yun, Changho; Kim, Sangeun; Park, Sungho

    2014-01-01

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

  3. EEG-confirmed epileptic activity in a cat with VGKC-complex/LGI1 antibody-associated limbic encephalitis.

    Science.gov (United States)

    Pakozdy, Akos; Glantschnigg, Ursula; Leschnik, Michael; Hechinger, Harald; Moloney, Teresa; Lang, Bethan; Halasz, Peter; Vincent, Angela

    2014-03-01

    A 5-year-old, female client-owned cat presented with acute onset of focal epileptic seizures with orofacial twitching and behavioural changes. Magnetic resonance imaging showed bilateral temporal lobe hyperintensities and the EEG was consistent with ictal epileptic seizure activity. After antiepileptic and additional corticosteroid treatment, the cat recovered and by 10 months of follow-up was seizure-free without any problem. Retrospectively, antibodies to LGI1, a component of the voltage-gated potassium channel-complex, were identified. Feline focal seizures with orofacial involvement have been increasingly recognised in client-owned cats, and autoimmune limbic encephalitis was recently suggested as a possible aetiology. This is the first report of EEG, MRI and long-term follow-up of this condition in cats which is similar to human limbic encephalitis.

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

    Science.gov (United States)

    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.

  5. CYP3A5 Polymorphism In Serbian Paediatric Epileptic Patients On Carbamazepine Treatment

    Directory of Open Access Journals (Sweden)

    Milovanovic Dragana Dragas

    2015-06-01

    Full Text Available Carbamazepine exhibits significant inter-individual variability in its efficacy and safety, which leads to unpredictable therapy outcomes for the majority of patients. Although its complex biotransformation depends on CYP3A5 activity, evidence of association between carbamazepine treatment outcomes and CYP3A5 functional variations remains inconclusive. The aim of the present study was to investigate the distribution of two of the functionally important CYP3A5 variants *2 and *3 as well as their effects on carbamazepine dose requirements, plasma concentrations and clearance in a Serbian population. The study involved 40 paediatric epileptic patients on steady-state carbamazepine treatment. Genotyping was conducted using the PCR-RFLP method, and carbamazepine plasma concentrations were determined using the HPLC method. CYP3A5*2 and *3 polymorphisms were found at frequencies of 0.0% and 97.5%, respectively, which corresponds well to previously published data for Caucasians. No differences in CYP3A5*3 allele frequencies were detected among epileptic patients in comparison to healthy volunteers within similar ethnic populations (p>0.08, indicating that CYP3A5 polymorphism does not represent a risk factor for epilepsy development. There was an observed tendency towards lower dosage requirements (mean±SD: 15.06±4.45 mg/kg vs. 18.74±5.55 mg/kg; p=0.26, higher plasma concentrations (mean±SD: 0.45±0.13 mg/kg vs. 0.38±0.03 mg/kg; p=0.47 and lower clearance (mean±SD: 0.14±0.05 mg/kg vs. 0.15±0.01 mg/kg; p=0.79 of carbamazepine in homozygous carriers of CYP3A5*3/*3 compared to heterozygous CYP3A5*1A/*3 Serbians. Because these genotype groups did not differ significantly in terms of their carbamazepine pharmacokinetics parameters, the proposed effects of CYP3A5*3 on carbamazepine metabolism could not be confirmed.

  6. Monitoring of regional cerebral blood flow by single photon emission tomography of I123-N-isopropyl-iodoamphetamine in epileptics

    International Nuclear Information System (INIS)

    Magistretti, P.L.; Uren, R.F.; Parker, J.A.; Royal, H.D.; Front, D.; Kolodny, G.M.

    1983-01-01

    In some patients with epileptic disorders it is difficult to accurately localize the seizure focus especially in the case of deep lesions. In an attempt to provide better localization of such foci we have used single photon emission tomography (SPECT) of a new radiopharmaceutical I 123 -N-isopropyl-iodoamphetamine (IMP) to measure regional cerebral blood flow (RCBF) in the ictal and interictal phases. Eight patients were studied. The location of the seizure focus was determined by intraoperative corticography operative findings and pathology in 5 patients and by neuropsychological testing and long-term EEG monitoring in the other three. The SPECT scan accurately localized the seizure focus in all patients. This modality also allowed the functional state of the seizure focus to be assessed. In five of the thirteen studies there was increased RCBF at the seizure focus. On four of these occasions the patients reported symptoms typical of their seizures. In the asymptomatic patient the focally increased RCBF corresponded with a very active superficial epileptic focus on EEG. These preliminary results suggest that SPECT scans of RCBF, will have considerable utility in the management of epileptics. This is particularly the case as the necessary instrumentation is already available in many hospitals, thus minimizing the cost of widespread application

  7. Cerebral perfusion alterations in epileptic patients during peri-ictal and post-ictal phase: PASL vs DSC-MRI.

    Science.gov (United States)

    Pizzini, Francesca B; Farace, Paolo; Manganotti, Paolo; Zoccatelli, Giada; Bongiovanni, Luigi G; Golay, Xavier; Beltramello, Alberto; Osculati, Antonio; Bertini, Giuseppe; Fabene, Paolo F

    2013-07-01

    Non-invasive pulsed arterial spin labeling (PASL) MRI is a method to study brain perfusion that does not require the administration of a contrast agent, which makes it a valuable diagnostic tool as it reduces cost and side effects. The purpose of the present study was to establish the viability of PASL as an alternative to dynamic susceptibility contrast (DSC-MRI) and other perfusion imaging methods in characterizing changes in perfusion patterns caused by seizures in epileptic patients. We evaluated 19 patients with PASL. Of these, the 9 affected by high-frequency seizures were observed during the peri-ictal period (within 5hours since the last seizure), while the 10 patients affected by low-frequency seizures were observed in the post-ictal period. For comparison, 17/19 patients were also evaluated with DSC-MRI and CBF/CBV. PASL imaging showed focal vascular changes, which allowed the classification of patients in three categories: 8 patients characterized by increased perfusion, 4 patients with normal perfusion and 7 patients with decreased perfusion. PASL perfusion imaging findings were comparable to those obtained by DSC-MRI. Since PASL is a) sensitive to vascular alterations induced by epileptic seizures, b) comparable to DSC-MRI for detecting perfusion asymmetries, c) potentially capable of detecting time-related perfusion changes, it can be recommended for repeated evaluations, to identify the epileptic focus, and in follow-up and/or therapy-response assessment. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. 18F-FDG PET Reveals Fronto-temporal Dysfunction in Children with Fever-Induced Refractory Epileptic Encephalopathy

    International Nuclear Information System (INIS)

    Mazzuca, M.; Dulac, O.; Chiron, C.; Jambaque, I.; Hertz-Pannier, L.; Bouilleret, V.; Archambaud, F.; Rodrigo, S.; Dulac, O.; Chiron, C.; Jambaque, I.; Hertz-Pannier, L.; Bouilleret, V.; Archambaud, F.; Rodrigo, S.; Chiron, C.; Hertz-Pannier, L.; Rodrigo, S.; Dulac, O.; Chiron, C.; Caviness, V.

    2011-01-01

    Fever-induced refractory epileptic encephalopathy in school-age children (FIRES) is a recently described epileptic entity whose etiology remains unknown. Brain abnormalities shown by MRI are usually limited to mesial-temporal structures and do not account for the catastrophic neuro-psychologic findings. Methods: We conducted FIRES studies in 8 patients, aged 6-13 y, using 18 F-FDG PET to disclose eventual neo-cortical dysfunction. Voxel-based analyses of cerebral glucose metabolism were performed using statistical parametric mapping and an age-matched control group. Results: Group analysis revealed a widespread inter-ictal hypo-metabolic network including the temporo-parietal and orbito-frontal cortices bilaterally. The individual analyses in patients identified hypo-metabolic areas corresponding to the predominant electroencephalograph foci and neuro-psychologic deficits involving language, behavior, and memory. Conclusion: Despite clinical heterogeneity, 18 F-FDG PET reveals a common network dysfunction in patients with sequelae due to fever-induced refractory epileptic encephalopathy. (authors)

  9. Hippocampal low-frequency stimulation inhibits afterdischarge and increases GABA (A) receptor expression in amygdala-kindled pharmacoresistant epileptic rats.

    Science.gov (United States)

    Wu, Guofeng; Wang, Likun; Hong, Zhen; Ren, Siying; Zhou, Feng

    2017-08-01

    The purpose of the present study was to observe the effects of hippocampal low-frequency stimulation (Hip-LFS) on amygdala afterdischarge and GABA (A) receptor expression in pharmacoresistant epileptic (PRE) rats. A total of 110 healthy adult male Wistar rats were used to generate a model of epilepsy by chronic stimulation of the amygdala. Sixteen PRE rats were selected from 70 amygdala-kindled rats by testing their response to Phenytoin and Phenobarbital, and they were randomly assigned to a pharmacoresistant stimulation group (PRS group, 8 rats) or a pharmacoresistant control group (PRC group, 8 rats). A stimulation electrode was implanted into the hippocampus of all of the rats. Hip-LFS was administered twice per day in the PRS group for two weeks. Simultaneously, amygdala stimulus-induced seizures and afterdischarge were recorded. After the hippocampal stimulation was terminated, the brain tissues were obtained to determine the GABA (A) receptors by a method of immumohistochemistry and a real-time polymerase chain reaction. The stages and duration of the amygdala stimulus-induced epileptic seizures were decreased in the PRS group. The afterdischarge threshold was increased and the duration as well as the afterdischarge frequency was decreased. Simultaneously, the GABA (A) expression was significantly increased in the PRS group. Hip-LFS may inhibit amygdala stimulus-induced epileptic seizures and up-regulate GABA (A) receptor expression in PRE rats. The antiepileptic effects of hippocampal stimulation may be partly achieved by increasing the GABA (A) receptor.

  10. Partially ordered algebraic systems

    CERN Document Server

    Fuchs, Laszlo

    2011-01-01

    Originally published in an important series of books on pure and applied mathematics, this monograph by a distinguished mathematician explores a high-level area in algebra. It constitutes the first systematic summary of research concerning partially ordered groups, semigroups, rings, and fields. The self-contained treatment features numerous problems, complete proofs, a detailed bibliography, and indexes. It presumes some knowledge of abstract algebra, providing necessary background and references where appropriate. This inexpensive edition of a hard-to-find systematic survey will fill a gap i

  11. Infinite partial summations

    International Nuclear Information System (INIS)

    Sprung, D.W.L.

    1975-01-01

    This paper is a brief review of those aspects of the effective interaction problem that can be grouped under the heading of infinite partial summations of the perturbation series. After a brief mention of the classic examples of infinite summations, the author turns to the effective interaction problem for two extra core particles. Their direct interaction is summed to produce the G matrix, while their indirect interaction through the core is summed in a variety of ways under the heading of core polarization. (orig./WL) [de

  12. On universal partial words

    OpenAIRE

    Chen, Herman Z. Q.; Kitaev, Sergey; Mütze, Torsten; Sun, Brian Y.

    2016-01-01

    A universal word for a finite alphabet $A$ and some integer $n\\geq 1$ is a word over $A$ such that every word in $A^n$ appears exactly once as a subword (cyclically or linearly). It is well-known and easy to prove that universal words exist for any $A$ and $n$. In this work we initiate the systematic study of universal partial words. These are words that in addition to the letters from $A$ may contain an arbitrary number of occurrences of a special `joker' symbol $\\Diamond\

  13. Partial differential equations

    CERN Document Server

    Agranovich, M S

    2002-01-01

    Mark Vishik's Partial Differential Equations seminar held at Moscow State University was one of the world's leading seminars in PDEs for over 40 years. This book celebrates Vishik's eightieth birthday. It comprises new results and survey papers written by many renowned specialists who actively participated over the years in Vishik's seminars. Contributions include original developments and methods in PDEs and related fields, such as mathematical physics, tomography, and symplectic geometry. Papers discuss linear and nonlinear equations, particularly linear elliptic problems in angles and gener

  14. Partial differential equations

    CERN Document Server

    Levine, Harold

    1997-01-01

    The subject matter, partial differential equations (PDEs), has a long history (dating from the 18th century) and an active contemporary phase. An early phase (with a separate focus on taut string vibrations and heat flow through solid bodies) stimulated developments of great importance for mathematical analysis, such as a wider concept of functions and integration and the existence of trigonometric or Fourier series representations. The direct relevance of PDEs to all manner of mathematical, physical and technical problems continues. This book presents a reasonably broad introductory account of the subject, with due regard for analytical detail, applications and historical matters.

  15. Partial differential equations

    CERN Document Server

    Sloan, D; Süli, E

    2001-01-01

    /homepage/sac/cam/na2000/index.html7-Volume Set now available at special set price ! Over the second half of the 20th century the subject area loosely referred to as numerical analysis of partial differential equations (PDEs) has undergone unprecedented development. At its practical end, the vigorous growth and steady diversification of the field were stimulated by the demand for accurate and reliable tools for computational modelling in physical sciences and engineering, and by the rapid development of computer hardware and architecture. At the more theoretical end, the analytical insight in

  16. Elliptic partial differential equations

    CERN Document Server

    Han, Qing

    2011-01-01

    Elliptic Partial Differential Equations by Qing Han and FangHua Lin is one of the best textbooks I know. It is the perfect introduction to PDE. In 150 pages or so it covers an amazing amount of wonderful and extraordinary useful material. I have used it as a textbook at both graduate and undergraduate levels which is possible since it only requires very little background material yet it covers an enormous amount of material. In my opinion it is a must read for all interested in analysis and geometry, and for all of my own PhD students it is indeed just that. I cannot say enough good things abo

  17. Generalized Partial Volume

    DEFF Research Database (Denmark)

    Darkner, Sune; Sporring, Jon

    2011-01-01

    Mutual Information (MI) and normalized mutual information (NMI) are popular choices as similarity measure for multimodal image registration. Presently, one of two approaches is often used for estimating these measures: The Parzen Window (PW) and the Generalized Partial Volume (GPV). Their theoret...... of view as well as w.r.t. computational complexity. Finally, we present algorithms for both approaches for NMI which is comparable in speed to Sum of Squared Differences (SSD), and we illustrate the differences between PW and GPV on a number of registration examples....

  18. Avaliação pelo P300 de crianças com e sem epilepsia e rendimento escolar Assessment through P300 of epileptic and non-epileptic children and school performance

    Directory of Open Access Journals (Sweden)

    JUCELEI F. VISIOLI-MELO

    2000-06-01

    Full Text Available Dificuldade de aprendizagem é situação comum em crianças com epilepsia. Distúrbios da inteligência têm sido associados com epilepsia. O potencial cognitivo (P300 é um adjunto clínico para mensurar neurofisiologicamente o processo cognitivo. Foram estudadas 99 crianças com 10 anos a 11 anos e 11 meses. Do Grupo I, sem epilepsia, faziam parte 64 crianças, das quais 32 com bom rendimento e outras 32 com mau rendimento escolar. Do Grupo II, com epilepsia, faziam parte 35 crianças, sendo 21 com bom rendimento escolar e 15 com mau rendimento escolar. Não foi encontrada diferença significativa na latência do P300 entre os dois grupos. Quando foram estratificados segundo o desempenho escolar, as crianças do Grupo I, com bom rendimento escolar, apresentaram latência do P300 de 336 ms e as com mau rendimento escolar, latência de 382 ms; as crianças do Grupo II, com bom rendimento escolar, apresentaram latência do P300 de 363 ms e as com mau rendimento escolar, latência de 400 ms, com diferença significativa. Essa diferença estava localizada entre as crianças não epilépticas com bom desempenho escolar e as com mau desempenho escolar, epilépticas ou não.Learning disability is common in epileptic children. Epilepsy has been associated with disorders of intelligence. Cognitive potential (P300 is considered to be a clinical aid in the neurophysiological measurement of the cognitive process. Ninety-nine children between the ages of 10 years and 11 years and 11 months formed our sample, with good and poor school performance. Group I, non-epileptic, had 64 children of whom 32 had good and 32 poor school performance. Group II, epileptic, had 35 children, of whom 21 had good and 15 poor school performance. No significant difference in P300 latency was found between Groups I and II. When groups were stratified based on school performance, Group I children with good school performance had P300 latency of 336 ms, while the ones with poor

  19. Current status of the New Antiepileptic drugs in chronic pain.

    Directory of Open Access Journals (Sweden)

    Harpreet Singh Sidhu

    2016-08-01

    Full Text Available Antiepileptic drugs (AEDs are extensively used worldwide to treat a wide range of disorders other than epilepsy, such as neuropathic pain, migraine and bipolar disorder. Due to this situation more than 20 new third-generation AEDs have been introduced in the market recently. The future design of new AEDs must also have potential to help in the non-epileptic disorders. The wide acceptance of second generation AEDs for the management of various Non-epileptic disorders has caused the emergence of generics in the market. The wide use of approved AEDs outside epilepsy is based on both economic and scientific reasons. Bipolar disorders, migraine prophylaxis, fibromyalgia and neuropathic pain represent the most attractive indication expansion opportunities for anticonvulsant developers, providing blockbuster revenues. Strong growth in non-epilepsy conditions will see Pfizer’s Lyrica become the market leading brand by 2018. In this review we mainly focus on the current status of new AEDs in the treatment of chronic pain and migraine prophylaxis. AEDs have a strong analgesic potential and this is demonstrated by the wide use of carbamazepine in trigeminal neuralgia and sodium valproate in migraine prophylaxis. At present, data on the new AEDs for non-epileptic conditions are inconclusive. Not all AEDs are effective in the management of neuropathic pain and migraine. Only those AEDs whose mechanisms of action are match with pathophysiology of the disease, have potential to show efficacy in non-epileptic disorder. For this better understanding of the pathophysiology of the disease and mechanisms of action of new AEDs are essential requirement before initiating pre-clinical and clinical trials. Many new AEDs show good results in the animal model and open-label studies but fail to provide strong evidence at randomized, placebo-controlled trials. The final decision regarding the clinical efficacy of the particular AEDs in a specific non-epileptic disorder

  20. Unilateral removable partial dentures.

    Science.gov (United States)

    Goodall, W A; Greer, A C; Martin, N

    2017-01-27

    Removable partial dentures (RPDs) are widely used to replace missing teeth in order to restore both function and aesthetics for the partially dentate patient. Conventional RPD design is frequently bilateral and consists of a major connector that bridges both sides of the arch. Some patients cannot and will not tolerate such an extensive appliance. For these patients, bridgework may not be a predictable option and it is not always possible to provide implant-retained restorations. This article presents unilateral RPDs as a potential treatment modality for such patients and explores indications and contraindications for their use, including factors relating to patient history, clinical presentation and patient wishes. Through case examples, design, material and fabrication considerations will be discussed. While their use is not widespread, there are a number of patients who benefit from the provision of unilateral RPDs. They are a useful treatment to have in the clinician's armamentarium, but a highly-skilled dental team and a specific patient presentation is required in order for them to be a reasonable and predictable prosthetic option.

  1. Early-onset epileptic encephalopathy caused by a reduced sensitivity of Kv7.2 potassium channels to phosphatidylinositol 4,5-bisphosphate.

    Science.gov (United States)

    Soldovieri, Maria Virginia; Ambrosino, Paolo; Mosca, Ilaria; De Maria, Michela; Moretto, Edoardo; Miceli, Francesco; Alaimo, Alessandro; Iraci, Nunzio; Manocchio, Laura; Medoro, Alessandro; Passafaro, Maria; Taglialatela, Maurizio

    2016-12-01

    Kv7.2 and Kv7.3 subunits underlie the M-current, a neuronal K + current characterized by an absolute functional requirement for phosphatidylinositol 4,5-bisphosphate (PIP 2 ). Kv7.2 gene mutations cause early-onset neonatal seizures with heterogeneous clinical outcomes, ranging from self-limiting benign familial neonatal seizures to severe early-onset epileptic encephalopathy (Kv7.2-EE). In this study, the biochemical and functional consequences prompted by a recurrent variant (R325G) found independently in four individuals with severe forms of neonatal-onset EE have been investigated. Upon heterologous expression, homomeric Kv7.2 R325G channels were non-functional, despite biotin-capture in Western blots revealed normal plasma membrane subunit expression. Mutant subunits exerted dominant-negative effects when incorporated into heteromeric channels with Kv7.2 and/or Kv7.3 subunits. Increasing cellular PIP 2 levels by co-expression of type 1γ PI(4)P5-kinase (PIP5K) partially recovered homomeric Kv7.2 R325G channel function. Currents carried by heteromeric channels incorporating Kv7.2 R325G subunits were more readily inhibited than wild-type channels upon activation of a voltage-sensitive phosphatase (VSP), and recovered more slowly upon VSP switch-off. These results reveal for the first time that a mutation-induced decrease in current sensitivity to PIP 2 is the primary molecular defect responsible for Kv7.2-EE in individuals carrying the R325G variant, further expanding the range of pathogenetic mechanisms exploitable for personalized treatment of Kv7.2-related epilepsies.

  2. Tutorial on Online Partial Evaluation

    Directory of Open Access Journals (Sweden)

    William R. Cook

    2011-09-01

    Full Text Available This paper is a short tutorial introduction to online partial evaluation. We show how to write a simple online partial evaluator for a simple, pure, first-order, functional programming language. In particular, we show that the partial evaluator can be derived as a variation on a compositionally defined interpreter. We demonstrate the use of the resulting partial evaluator for program optimization in the context of model-driven development.

  3. SozRank: A new approach for localizing the epileptic seizure onset zone.

    Science.gov (United States)

    Murin, Yonathan; Kim, Jeremy; Parvizi, Josef; Goldsmith, Andrea

    2018-01-01

    Epilepsy is one of the most common neurological disorders affecting about 1% of the world population. For patients with focal seizures that cannot be treated with antiepileptic drugs, the common treatment is a surgical procedure for removal of the seizure onset zone (SOZ). In this work we introduce an algorithm for automatic localization of the seizure onset zone (SOZ) in epileptic patients based on electrocorticography (ECoG) recordings. The proposed algorithm builds upon the hypothesis that the abnormal excessive (or synchronous) neuronal activity in the brain leading to seizures starts in the SOZ and then spreads to other areas in the brain. Thus, when this abnormal activity starts, signals recorded at electrodes close to the SOZ should have a relatively large causal influence on the rest of the recorded signals. The SOZ localization is executed in two steps. First, the algorithm represents the set of electrodes using a directed graph in which nodes correspond to recording electrodes and the edges' weights quantify the pair-wise causal influence between the recorded signals. Then, the algorithm infers the SOZ from the estimated graph using a variant of the PageRank algorithm followed by a novel post-processing phase. Inference results for 19 patients show a close match between the SOZ inferred by the proposed approach and the SOZ estimated by expert neurologists (success rate of 17 out of 19).

  4. SozRank: A new approach for localizing the epileptic seizure onset zone.

    Directory of Open Access Journals (Sweden)

    Yonathan Murin

    2018-01-01

    Full Text Available Epilepsy is one of the most common neurological disorders affecting about 1% of the world population. For patients with focal seizures that cannot be treated with antiepileptic drugs, the common treatment is a surgical procedure for removal of the seizure onset zone (SOZ. In this work we introduce an algorithm for automatic localization of the seizure onset zone (SOZ in epileptic patients based on electrocorticography (ECoG recordings. The proposed algorithm builds upon the hypothesis that the abnormal excessive (or synchronous neuronal activity in the brain leading to seizures starts in the SOZ and then spreads to other areas in the brain. Thus, when this abnormal activity starts, signals recorded at electrodes close to the SOZ should have a relatively large causal influence on the rest of the recorded signals. The SOZ localization is executed in two steps. First, the algorithm represents the set of electrodes using a directed graph in which nodes correspond to recording electrodes and the edges' weights quantify the pair-wise causal influence between the recorded signals. Then, the algorithm infers the SOZ from the estimated graph using a variant of the PageRank algorithm followed by a novel post-processing phase. Inference results for 19 patients show a close match between the SOZ inferred by the proposed approach and the SOZ estimated by expert neurologists (success rate of 17 out of 19.

  5. Recognizing of stereotypic patterns in epileptic EEG using empirical modes and wavelets

    Science.gov (United States)

    Grubov, V. V.; Sitnikova, E.; Pavlov, A. N.; Koronovskii, A. A.; Hramov, A. E.

    2017-11-01

    Epileptic activity in the form of spike-wave discharges (SWD) appears in the electroencephalogram (EEG) during absence seizures. This paper evaluates two approaches for detecting stereotypic rhythmic activities in EEG, i.e., the continuous wavelet transform (CWT) and the empirical mode decomposition (EMD). The CWT is a well-known method of time-frequency analysis of EEG, whereas EMD is a relatively novel approach for extracting signal's waveforms. A new method for pattern recognition based on combination of CWT and EMD is proposed. It was found that this combined approach resulted to the sensitivity of 86.5% and specificity of 92.9% for sleep spindles and 97.6% and 93.2% for SWD, correspondingly. Considering strong within- and between-subjects variability of sleep spindles, the obtained efficiency in their detection was high in comparison with other methods based on CWT. It is concluded that the combination of a wavelet-based approach and empirical modes increases the quality of automatic detection of stereotypic patterns in rat's EEG.

  6. The role of driver nodes in managing epileptic seizures: Application of Kuramoto model.

    Science.gov (United States)

    Mohseni, Ali; Gharibzadeh, Shahriar; Bakouie, Fatemeh

    2017-04-21

    Synchronization is an important global phenomenon which could be found in a wide range of complex systems such as brain or electronic devices. However, in some circumstances the synchronized states are not desirable for the system and should be suppressed. For example, excessively synchronized activities in the brain network could be the root of neuronal disorders like epileptic seizures. According to the controllability theory of the complex networks, a minimum set of driver nodes has the ability to control the entire system. In this study, we examine the role of driver nodes in suppressing the excessive synchronization in a generalized Kuramoto model, which consists of two types of oscillators: contrarian and regular ones. We used two different structural topologies: Barabási-Albert scale-free (BASF) network and Caenorhabditis elegans (C.elegans) neuronal network. Our results show that contrarian driver nodes have the sufficient ability to break the synchronized level of the systems. In this case, the system coherency level is not fully suppressed that is avoiding dysfunctions of normal brain functions which require the neuronal synchronized activities. Moreover, in this case, the oscillators grouped in two distinct synchronized clusters that could be an indication of chaotic behavior of the system known as resting-state activity of the brain. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Clinical spectrum of psychogenic non epileptic seizures in children; an observational study.

    Science.gov (United States)

    Madaan, Priyanka; Gulati, Sheffali; Chakrabarty, Biswaroop; Sapra, Savita; Sagar, Rajesh; Mohammad, Akbar; Pandey, R M; Tripathi, Manjari

    2018-07-01

    The current study was designed to analyze the clinical spectrum of Psychogenic non-epileptic seizures (PNES) in children. Children aged 6-16years with clinically suspected PNES, confirmed by short-term VEEG (STVEEG{video electroencephalogram}) and induction were classified as per Seneviratne classification. Stressors, associated co morbidities, Verbal IQ (Intelligence Quotient) and behavioral abnormalities were assessed using HTP(House tree person) test, DSM IV (Diagnostic and statistical manual of mental disorders) TR criteria, MISIC (Malin intelligence scale for Indian children) and CBCL (Child behaviour checklist). Eighty children with PNES {45 boys; mean age: 10.5 (±1.6) years} were enrolled. Median delay in diagnosis was 5 months {IQR(interquartile range)- 0.5 to 48 months}) and 45% patients were already on AEDs (antiepileptic drugs). Commonest semiology was dialeptic (42.5%), followed by mixed (28.8%), motor (15%) and nonepileptic aura (13.8%). Family stressors were the commonest followed by school related issues. The most common psychiatric comorbidity was adjustment disorder. Somatic complaints were observed in 50% children. Dialeptic PNES is commonest in children. In resource constrained settings, STVEEG along with induction is a reliable method to diagnose PNES. A comprehensive assessment protocol (including assessment of stressors) is needed for holistic management of pediatric PNES. Copyright © 2018 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  8. SVM-Based System for Prediction of Epileptic Seizures from iEEG Signal

    Science.gov (United States)

    Cherkassky, Vladimir; Lee, Jieun; Veber, Brandon; Patterson, Edward E.; Brinkmann, Benjamin H.; Worrell, Gregory A.

    2017-01-01

    Objective This paper describes a data-analytic modeling approach for prediction of epileptic seizures from intracranial electroencephalogram (iEEG) recording of brain activity. Even though it is widely accepted that statistical characteristics of iEEG signal change prior to seizures, robust seizure prediction remains a challenging problem due to subject-specific nature of data-analytic modeling. Methods Our work emphasizes understanding of clinical considerations important for iEEG-based seizure prediction, and proper translation of these clinical considerations into data-analytic modeling assumptions. Several design choices during pre-processing and post-processing are considered and investigated for their effect on seizure prediction accuracy. Results Our empirical results show that the proposed SVM-based seizure prediction system can achieve robust prediction of preictal and interictal iEEG segments from dogs with epilepsy. The sensitivity is about 90–100%, and the false-positive rate is about 0–0.3 times per day. The results also suggest good prediction is subject-specific (dog or human), in agreement with earlier studies. Conclusion Good prediction performance is possible only if the training data contain sufficiently many seizure episodes, i.e., at least 5–7 seizures. Significance The proposed system uses subject-specific modeling and unbalanced training data. This system also utilizes three different time scales during training and testing stages. PMID:27362758

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

    Directory of Open Access Journals (Sweden)

    Saleh LAshkari

    2016-06-01

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

  10. Long Memory Processes Are Revealed in the Dynamics of the Epileptic Brain

    Directory of Open Access Journals (Sweden)

    Mark James Cook

    2014-10-01

    Full Text Available The pattern of epileptic seizures is often considered unpredictable, and the interval between events without correlation. A number of studies have examined the possibility that seizure activity, both in terms of event magnitude and inter-event intervals, respect a power-law relationship. Such relationships are found in a variety of natural and man-made systems, such as earthquakes or Internet traffic, and describe the relationship between the magnitude of an event and the number of events. We postulated that human inter-seizure intervals would follow a power law relationship, and furthermore that evidence for the existence of a long memory process could be established in this relationship. We studied 8 patients who had long-term ambulatory EEG data recorded as part of the assessment of a novel seizure prediction device, in which data was sufficiently stationary in 6. We demonstrated that a power law relationship could be established in these patients, β=1.5. In 5/6 subjects we found evidence of long memory process, spanning time scales from 30 minutes to 40 days, using a wavelet based analysis technique. The Hurst exponent values ranged from 0.5 to 0.76. We conclude there is evidence of long memory processes in adult human epilepsy, with a heterogeneous range of time scales demonstrated between individuals. This finding may provide evidence of phase-transitions underlying the dynamics of epilepsy.

  11. Differential effects of valproic acid and enzyme-inducing anticonvulsants on nimodipine pharmacokinetics in epileptic patients

    Science.gov (United States)

    Tartara, A.; Galimberti, C.A.; Manni, R.; Parietti, L.; Zucca, C.; Baasch, H.; Caresia, L.; Mück, W.; Barzaghi, N.; Gatti, G.; Perucca, E.

    1991-01-01

    1 The single dose pharmacokinetics of orally administered nimodipine (60 mg) were investigated in normal subjects and in two groups of epileptic patients receiving chronic treatment with hepatic microsomal enzyme-inducing anticonvulsants (carbamazepine, phenobarbitone or phenytoin) and sodium valproate, respectively. 2 Compared with the values found in the control group, mean areas under the plasma nimodipine concentration curve were lowered by about seven-fold (P anticonvulsants and increased by about 50% (P < 0.05) in patients taking sodium valproate. 3 Nimodipine half-lives were shorter in enzyme-induced patients than in controls (3.9 ± 2.0 h vs 9.1 ± 3.4 h, means ± s.d., P < 0.01), but this difference could be artifactual since in the patients drug concentrations declined rapidly below the limit of assay, thus preventing identification of a possible slower terminal phase. In valproate-treated patients, half-lives (8.2 ± 1.8 h) were similar to those found in controls. PMID:1777370

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

    Directory of Open Access Journals (Sweden)

    Sandeep Kumar Satapathy

    2017-03-01

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

  13. Optimizing the molecular diagnosis of CDKL5 gene-related epileptic encephalopathy in boys.

    Science.gov (United States)

    Mei, Davide; Darra, Francesca; Barba, Carmen; Marini, Carla; Fontana, Elena; Chiti, Laura; Parrini, Elena; Dalla Bernardina, Bernardo; Guerrini, Renzo

    2014-11-01

    Mutations involving the cyclin-dependent kinase-like 5 (CDKL5) gene cause an early onset epileptic encephalopathy (EE) with severe neurologic impairment and a skewed 12:1 female-to-male ratio. To date, 18 mutations have been described in boys. We analyzed our cohort of boys with early onset EE to assess the diagnostic yield of our molecular approach. We studied 74 boys who presented early onset severe seizures, including infantile spasms and developmental delay, in the setting of EE, using Sanger sequencing, next-generation sequencing (NGS) and multiplex ligation-dependent probe amplification (MLPA). We identified alterations involving CDKL5 in four boys (5.4%) using NGS in one and MLPA in three. Three of four mutations were indicative of somatic mosaicism. CDKL5 gene mutations accounted for 5.4% of boys with early onset EE. Somatic mosaic mutations might be even more represented than germline mutations, probably because their less deleterious effect enhances viability of the male embryo. The molecular approach used for CDKL5 screening remarkably influences the diagnostic yield in boys. Diagnosis is optimized by Sanger sequencing combined with array-based methods or MLPA; alternatively, NGS targeted resequencing designed to also detect copy number alterations, may be performed. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

  14. Epileptic seizures, coma and EEG burst-suppression from suicidal bupropion intoxication.

    Science.gov (United States)

    Noda, Anna Hiro; Schu, Ulrich; Maier, Tanja; Knake, Susanne; Rosenow, Felix

    2017-03-01

    Bupropion, an amphetamine-like dual mechanism drug, is approved and increasingly used for the treatment of major depression, and its use is associated with a dose-dependent risk of epileptic seizures. Suicide attempts are frequent in major depression and often an overdose of the drugs available is ingested. Therefore, it is important to be aware of the clinical course, including EEG and neurological symptoms, as well as treatment and prognosis of bupropion intoxication. We report on the clinical and EEG course of a women who ingested 27 g of bupropion in a suicide attempt. Myoclonic seizures were followed by generalized tonic-clonic seizures and coma associated with EEG burst-suppression and brief tonic seizures. Active carbon and neuro-intensive care treatment, including respiratory support, were given. Within three days, the patient returned to a stable clinical condition with a mildly encephalopathic EEG. In conclusion, bupropion intoxication requires acute intensive care treatment and usually has a good prognosis, however, misinterpretation of the clinical and EEG presentation may lead to errors in management.

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

    Directory of Open Access Journals (Sweden)

    Lorenzo L. Pesce

    2013-01-01

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

  16. Spectral bandwidth of interictal fast epileptic activity characterizes the seizure onset zone

    Directory of Open Access Journals (Sweden)

    Marcel Heers

    2018-01-01

    Full Text Available The foremost aim of presurgical epilepsy evaluation is the delineation of the seizure onset zone (SOZ. There is increasing evidence that fast epileptic activity (FEA, 14–250 Hz occurring interictally, i.e. between seizures, is predominantly localized within the SOZ. Currently it is unknown, which frequency band of FEA performs best in identifying the SOZ, although prior studies suggest highest concordance of spectral changes with the SOZ for high frequency changes. We suspected that FEA reflects dampened oscillations in local cortical excitatory-inhibitory neural networks, and that interictal FEA in the SOZ is a consequence of reduced oscillatory damping. We therefore predict a narrowing of the spectral bandwidth alongside increased amplitudes of spectral peaks during interictal FEA events. To test this hypothesis, we evaluated spectral changes during interictal FEA in invasive EEG (iEEG recordings of 13 patients with focal epilepsy. In relative spectra of beta and gamma band changes (14–250 Hz during FEA, we found that spectral peaks within the SOZ indeed were significantly more narrow-banded and their power changes were significantly higher than outside the SOZ. In contrast, the peak frequency did not differ within and outside the SOZ. Our results show that bandwidth and power changes of spectral modulations during FEA both help localizing the SOZ. We propose the spectral bandwidth as new source of information for the evaluation of EEG data.

  17. Serum Leptin Levels in Epileptic Patients Treated with Topiramate and Valproic Acid

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    İrem Fatma Uludağ

    2011-03-01

    Full Text Available OBJECTIVE: Leptin is considered to be a signal factor that regulates body weight and energy expenditure, and there is a strong correlation between serum leptin concentrations, body mass index, and body fat mass in humans. Our aim in this study was to evaluate the role of leptin in valproic acid (VPA and topiramate (TPM related weight changes in epileptic patients. METHODS: Body mass index is calculated and serum leptin and insulin levels are measured in 56 patients with epilepsy (40 patients taking VPA and 16 patients taking VPA and TPM and in 40 healty control subjects. RESULTS: Obesity was seen in 21 patients (52.5% in VPA treated group, in 15 patients (37.5% in the control group and in only one male (6.3% in VPA and TPM treated group. Body mass index was lower in the group treated with VPA and TPM (p<0.001. Serum leptin concentrations were correlated with the body mass index (r=0.49, p<0.001 and were significantly higher in obese subjects (p<0.001 and in women (p<0.001. Serum leptin levels were significantly lower in patients treated with VPA and TPM (p<0.05. CONCLUSION: High levels of serum leptin in patients taking VPA and significantly low levels of serum leptin in patients taking VPA and TPM in our study are in agreement with the hypotheses that weight changes induced with VPA and TPM are related with the alterations in serum leptin levels

  18. Serum Leptin Levels in Epileptic Patients Treated with Topiramate and Valproic Acid

    Directory of Open Access Journals (Sweden)

    İrem Fatma Uludağ

    2011-03-01

    Full Text Available OBJECTIVE: Leptin is considered to be a signal factor that regulates body weight and energy expenditure, and there is a strong correlation between serum leptin concentrations, body mass index, and body fat mass in humans. Our aim in this study was to evaluate the role of leptin in valproic acid (VPA and topiramate (TPM related weight changes in epileptic patients. METHODS: Body mass index is calculated and serum leptin and insulin levels are measured in 56 patients with epilepsy (40 patients taking VPA and 16 patients taking VPA and TPM and in 40 healty control subjects. RESULTS: Obesity was seen in 21 patients (52.5% in VPA treated group, in 15 patients (37.5% in the control group and in only one male (6.3% in VPA and TPM treated group. Body mass index was lower in the group treated with VPA and TPM (p<0.001. Serum leptin concentrations were correlated with the body mass index (r=0.49, p<0.001 and were significantly higher in obese subjects (p<0.001 and in women (p<0.001. Serum leptin levels were significantly lower in patients treated with VPA and TPM (p<0.05. CONCLUSION: High levels of serum leptin in patients taking VPA and significantly low levels of serum leptin in patients taking VPA and TPM in our study are in agreement with the hypotheses that weight changes induced with VPA and TPM are related with the alterations in serum leptin levels.

  19. Repeat interruptions in spinocerebellar ataxia type 10 expansions are strongly associated with epileptic seizures

    Science.gov (United States)

    McFarland, Karen N.; Liu, Jilin; Landrian, Ivette; Zeng, Desmond; Raskin, Salmo; Moscovich, Mariana; Gatto, Emilia M.; Ochoa, Adriana; Teive, Hélio A. G.; Rasmussen, Astrid; Ashizawa, Tetsuo

    2014-01-01

    Spinocerebellar ataxia type 10 (SCA10), an autosomal dominant neurodegenerative disorder, is the result of a non-coding, pentanucleotide repeat expansion within intron 9 of the Ataxin 10 gene. SCA10 patients present with pure cerebellar ataxia; yet, some families also have a high incidence of epilepsy. SCA10 expansions containing penta- and heptanucleotide interruption motifs, termed “ATCCT interruptions,” experience large contractions during germline transmission, particularly in paternal lineages. At the same time, these alleles confer an earlier age at onset which contradicts traditional rules of genetic anticipation in repeat expansions. Previously, ATCCT interruptions have been associated with a higher prevalence of epileptic seizures in one Mexican-American SCA10 family. In a large cohort of SCA10 families, we analyzed whether ATCCT interruptions confers a greater risk for developing seizures in these families. Notably, we find that the presence of repeat interruptions within the SCA10 expansion confers a 6.3-fold increase in the risk of an SCA10 patient developing epilepsy (6.2-fold when considering patients of Mexican ancestry only) and a 13.7-fold increase in having a positive family history of epilepsy (10.5-fold when considering patients of Mexican ancestry only). We conclude that the presence of repeat interruptions in SCA10 repeat expansion indicates a significant risk for the epilepsy phenotype and should be considered during genetic counseling. PMID:24318420

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

    Science.gov (United States)

    Shah, Mazlina Muzafar; Wahab, Abdul Fatah

    2017-08-01

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

  1. Large-scale modeling of epileptic seizures: scaling properties of two parallel neuronal network simulation algorithms.

    Science.gov (United States)

    Pesce, Lorenzo L; Lee, Hyong C; Hereld, Mark; Visser, Sid; Stevens, Rick L; Wildeman, Albert; van Drongelen, Wim

    2013-01-01

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

  2. The Short-Term Effects of Ketogenic Diet on Cardiac Ventricular Functions in Epileptic Children.

    Science.gov (United States)

    Doksöz, Önder; Çeleğen, Kübra; Güzel, Orkide; Yılmaz, Ünsal; Uysal, Utku; İşgüder, Rana; Çeleğen, Mehmet; Meşe, Timur

    2015-09-01

    Our primary aim was to determine the short-term effects of a ketogenic diet on cardiac ventricular function in patients with refractory epilepsy. Thirty-eight drug-resistant epileptic patients who were treated with a ketogenic diet were enrolled in this prospective study. Echocardiography was performed on all patients before beginning the ketogenic diet and after the sixth month of therapy. Two-dimensional, M-mode, color flow, spectral Doppler, and pulsed-wave tissue Doppler imaging measurements were performed on all patients. The median age of the 32 patients was 45.5 months, and 22 (57.8%) of them were male. Body weight, height, and body mass index increased significantly at the sixth month of therapy when compared with baseline values (P 0.05). Doppler flow indices of mitral annulus and tricuspid annulus velocity of patients at baseline and month 6 showed no significant differences (P > 0.05). Tricuspid annular E/A ratio was lower at month 6 (P 0.05), there was a decrease in Ea velocity and Ea/Aa ratio gathered from tricuspid annulus at month 6 compared with baseline (P ketogenic diet does not impair left ventricular functions in children with refractory epilepsy; however, it may be associated with a right ventricular diastolic dysfunction. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Does arousal interfere with operant conditioning of spike-wave discharges in genetic epileptic rats?

    Science.gov (United States)

    Osterhagen, Lasse; Breteler, Marinus; van Luijtelaar, Gilles

    2010-06-01

    One of the ways in which brain computer interfaces can be used is neurofeedback (NF). Subjects use their brain activation to control an external device, and with this technique it is also possible to learn to control aspects of the brain activity by operant conditioning. Beneficial effects of NF training on seizure occurrence have been described in epileptic patients. Little research has been done about differentiating NF effectiveness by type of epilepsy, particularly, whether idiopathic generalized seizures are susceptible to NF. In this experiment, seizures that manifest themselves as spike-wave discharges (SWDs) in the EEG were reinforced during 10 sessions in 6 rats of the WAG/Rij strain, an animal model for absence epilepsy. EEG's were recorded before and after the training sessions. Reinforcing SWDs let to decreased SWD occurrences during training; however, the changes during training were not persistent in the post-training sessions. Because behavioural states are known to have an influence on the occurrence of SWDs, it is proposed that the reinforcement situation increased arousal which resulted in fewer SWDs. Additional tests supported this hypothesis. The outcomes have implications for the possibility to train SWDs with operant learning techniques. Copyright (c) 2010 Elsevier B.V. All rights reserved.

  4. Magnetic resonance volumetry of the hippocampus in familial spontaneous epileptic cats.

    Science.gov (United States)

    Mizoguchi, Shunta; Hasegawa, Daisuke; Kuwabara, Takayuki; Hamamoto, Yuji; Ogawa, Fukie; Fujiwara, Aki; Matsuki, Naoaki; Fujita, Michio

    2014-12-01

    A strain of familial spontaneous epileptic cats (FSECs) with typical limbic seizures was identified in 2010. The electroencephalographic features suggested that an epileptogenic zone is present in the mesial temporal structures (i.e., amygdala and/or hippocampus). In this study, visual evaluations and quantitative analyses were performed by using 3D MR hippocampal volumetry in comparing FSECs with age-matched controls. Visual hippocampal asymmetries were seen in 8 of 14 (57.1%) FSECs. The FSEC group showed a significantly higher asymmetric ratio (4.15%) than the control group (0.99%). The smaller side of hippocampal volume (HV) (0.206 cm(3)) in FSECs was significantly smaller than the mean HV in controls (0.227 cm(3)). However, the means of left and right HVs and total HVs in FSECs showed no differences because the laterality of hippocampal atrophy was different in each individual. Therefore, since FSECs represent a true model of spontaneous epilepsy, hippocampal volumetry should be evaluated in each individual as well as in human patients. The significant asymmetry of HV suggests the potential for hippocampal atrophy in FSECs. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Bio-Signal Complexity Analysis in Epileptic Seizure Monitoring: A Topic Review

    Directory of Open Access Journals (Sweden)

    Zhenning Mei

    2018-05-01

    Full Text Available Complexity science has provided new perspectives and opportunities for understanding a variety of complex natural or social phenomena, including brain dysfunctions like epilepsy. By delving into the complexity in electrophysiological signals and neuroimaging, new insights have emerged. These discoveries have revealed that complexity is a fundamental aspect of physiological processes. The inherent nonlinearity and non-stationarity of physiological processes limits the methods based on simpler underlying assumptions to point out the pathway to a more comprehensive understanding of their behavior and relation with certain diseases. The perspective of complexity may benefit both the research and clinical practice through providing novel data analytics tools devoted for the understanding of and the intervention about epilepsies. This review aims to provide a sketchy overview of the methods derived from different disciplines lucubrating to the complexity of bio-signals in the field of epilepsy monitoring. Although the complexity of bio-signals is still not fully understood, bundles of new insights have been already obtained. Despite the promising results about epileptic seizure detection and prediction through offline analysis, we are still lacking robust, tried-and-true real-time applications. Multidisciplinary collaborations and more high-quality data accessible to the whole community are needed for reproducible research and the development of such applications.

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

    Science.gov (United States)

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

    2016-11-01

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

  7. Treating Lennox–Gastaut syndrome in epileptic pediatric patients with third-generation rufinamide

    Directory of Open Access Journals (Sweden)

    Jessica Gresham

    2010-09-01

    Full Text Available Jessica Gresham1, Lea S Eiland2,3, Allison M Chung2,41Auburn University, Harrison School of Pharmacy (AUHSOP, 2Department of Pharmacy Practice, AUHSOP, 3University of Alabama, School of Medicine, Huntsville Regional Medical Campus, 4University of South Alabama School of Medicine, Department of Pediatrics, Mobile, Alabama, USAAbstract: Lennox–Gastaut syndrome (LGS is a rare but debilitating pediatric epileptic encephalopathy characterized by multiple intractable seizure types. Treatment of LGS is challenging because of the small number of antiepileptic drugs (AEDs which are effective for this syndrome, as well as the need for polytherapy in the majority of patients. This review focuses on the treatment of LGS with rufinamide, a recently approved third-generation AED with reported efficacy as adjunctive therapy for LGS. All relevant papers identified through a PubMed search on the treatment of LGS with rufinamide were reviewed. To date, the literature suggests improvements in seizure frequency for pediatric patients with LGS on rufinamide. Rufinamide appears to be especially effective for atonic or drop attack seizures. Rufinamide also displays a favorable adverse event profile compared with the older anticonvulsants, as well as a minimal number of drug interactions, making it a promising option for the adjunctive treatment of seizures associated with LGS.Keywords: epilepsy, Lennox-Gastaut syndrome, pediatrics, seizure, rufinamide

  8. Affective disorders and functional (non-epileptic) seizures in persons with epilepsy.

    Science.gov (United States)

    Johnson, Keith A; Macfarlane, Matthew D; Looi, Jeffrey Cl

    2016-12-01

    This paper aims to describe the prevalence, assessment and management of affective disorders as well as functional (non-epileptic) seizures in people with epilepsy. This paper comprises a selective review of the literature of the common affective manifestations of epilepsy. Affective disorders are the most common psychiatric comorbidity seen in people with epilepsy and assessment and management parallels that of the general population. Additionally, people with epilepsy may experience higher rates of mood instability, irritability and euphoria, classified together as a group, interictal dysphoric disorder and resembling an unstable bipolar Type II disorder. Functional seizures present unique challenges in terms of identification of the disorder and a lack of specific management. Given their high prevalence, it is important to be able to recognise affective disorders in people with epilepsy. Management principles parallel those in the general population with specific caution exercised regarding the potential interactions between antidepressant medications and antiepileptic drugs. Functional seizures are more complex and require a coordinated approach involving neurologists, psychiatrists, general practitioners, nursing and allied health. There is very limited evidence to guide psychological and behavioural interventions for neurotic disorders in epilepsy and much more research is needed. © The Royal Australian and New Zealand College of Psychiatrists 2016.

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

    Science.gov (United States)

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

    2016-05-01

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

  10. Interaction between valproic acid and aspirin in epileptic children: serum protein binding and metabolic effects.

    Science.gov (United States)

    Orr, J M; Abbott, F S; Farrell, K; Ferguson, S; Sheppard, I; Godolphin, W

    1982-05-01

    In five of six epileptic children who were taking 18 to 49 mg/kg/day valproic acid (VPA), the steady-state serum free fractions of VPA rose from 12% to 43% when antipyretic doses of aspirin were also taken. Mean total VPA half-life (t1/2) rose from 10.4 +/- 2.7 to 12.9 +/- 1.8 hr and mean free VPA t1/2 rose from 6.7 +/- to 2.1 to 8.9 +2- 3.0 hr when salicylate was present in the serum. The in vitro albumin binding association constant (ka) for VPA was decreased by salicylate, but the in vivo ka value was not affected. The 12-hr (trough) concentrations of both free and total VPA were higher in the presence of serum salicylate in five of six patients. Renal excretion of unchanged VPA decreased in five of six patients, but the VPA carboxyl conjugate metabolite-excretion patterns were not consistently affected. Salicylate appeared to displace VPA from serum albumin in vivo, but the increased VPA t1/2 and changes in VPA elimination patterns suggest that serum salicylate also altered VPA metabolism.

  11. Type-Directed Partial Evaluation

    DEFF Research Database (Denmark)

    Danvy, Olivier

    1998-01-01

    Type-directed partial evaluation uses a normalization function to achieve partial evaluation. These lecture notes review its background, foundations, practice, and applications. Of specific interest is the modular technique of offline and online type-directed partial evaluation in Standard ML...

  12. Type-Directed Partial Evaluation

    DEFF Research Database (Denmark)

    Danvy, Olivier

    1998-01-01

    Type-directed partial evaluation uses a normalization function to achieve partial evaluation. These lecture notes review its background, foundations, practice, and applications. Of specific interest is the modular technique of offline and online type-directed partial evaluation in Standard ML of ...

  13. Applied partial differential equations

    CERN Document Server

    Logan, J David

    2004-01-01

    This primer on elementary partial differential equations presents the standard material usually covered in a one-semester, undergraduate course on boundary value problems and PDEs. What makes this book unique is that it is a brief treatment, yet it covers all the major ideas: the wave equation, the diffusion equation, the Laplace equation, and the advection equation on bounded and unbounded domains. Methods include eigenfunction expansions, integral transforms, and characteristics. Mathematical ideas are motivated from physical problems, and the exposition is presented in a concise style accessible to science and engineering students; emphasis is on motivation, concepts, methods, and interpretation, rather than formal theory. This second edition contains new and additional exercises, and it includes a new chapter on the applications of PDEs to biology: age structured models, pattern formation; epidemic wave fronts, and advection-diffusion processes. The student who reads through this book and solves many of t...

  14. Inductance loop and partial

    CERN Document Server

    Paul, Clayton R

    2010-01-01

    "Inductance is an unprecedented text, thoroughly discussing "loop" inductance as well as the increasingly important "partial" inductance. These concepts and their proper calculation are crucial in designing modern high-speed digital systems. World-renowned leader in electromagnetics Clayton Paul provides the knowledge and tools necessary to understand and calculate inductance." "With the present and increasing emphasis on high-speed digital systems and high-frequency analog systems, it is imperative that system designers develop an intimate understanding of the concepts and methods in this book. Inductance is a much-needed textbook designed for senior and graduate-level engineering students, as well as a hands-on guide for working engineers and professionals engaged in the design of high-speed digital and high-frequency analog systems."--Jacket.

  15. Fundamental partial compositeness

    CERN Document Server

    Sannino, Francesco

    2016-11-07

    We construct renormalizable Standard Model extensions, valid up to the Planck scale, that give a composite Higgs from a new fundamental strong force acting on fermions and scalars. Yukawa interactions of these particles with Standard Model fermions realize the partial compositeness scenario. Successful models exist because gauge quantum numbers of Standard Model fermions admit a minimal enough 'square root'. Furthermore, right-handed SM fermions have an SU(2)$_R$-like structure, yielding a custodially-protected composite Higgs. Baryon and lepton numbers arise accidentally. Standard Model fermions acquire mass at tree level, while the Higgs potential and flavor violations are generated by quantum corrections. We further discuss accidental symmetries and other dynamical features stemming from the new strongly interacting scalars. If the same phenomenology can be obtained from models without our elementary scalars, they would reappear as composite states.

  16. Fundamental partial compositeness

    International Nuclear Information System (INIS)

    Sannino, Francesco; Strumia, Alessandro; Tesi, Andrea; Vigiani, Elena

    2016-01-01

    We construct renormalizable Standard Model extensions, valid up to the Planck scale, that give a composite Higgs from a new fundamental strong force acting on fermions and scalars. Yukawa interactions of these particles with Standard Model fermions realize the partial compositeness scenario. Under certain assumptions on the dynamics of the scalars, successful models exist because gauge quantum numbers of Standard Model fermions admit a minimal enough ‘square root’. Furthermore, right-handed SM fermions have an SU(2)_R-like structure, yielding a custodially-protected composite Higgs. Baryon and lepton numbers arise accidentally. Standard Model fermions acquire mass at tree level, while the Higgs potential and flavor violations are generated by quantum corrections. We further discuss accidental symmetries and other dynamical features stemming from the new strongly interacting scalars. If the same phenomenology can be obtained from models without our elementary scalars, they would reappear as composite states.

  17. Computer-aided diagnosis of interictal 18F-FDG PET images for presurgical evaluation of epileptic foci in extratemporal lobe epilepsy

    International Nuclear Information System (INIS)

    Imabayashi, Etsuko

    2003-01-01

    Interictal 18 F-FDG PET is beneficial to patients with epilepsy to define the epileptic foci before operation, especially to decide the laterality of temporal lobe epilepsy (TLE). However usefulness has not been clearly established in extra TLE. We retrospectively applied Z-score analysis to interictal preoperative 18 F-FDG PET images for detection of the epileptic foci in order to achieve better performance. Seventeen epileptic patients (women/men; 8/9, age; 11-55 yrs) underwent resection of epileptic foci with good outcome (Engel's stage of I or II) even after more than a year from operation. Presurgical 18 F-FDG PET images were spatially normalized using statistical parametric mapping 99 (SPM99) with an original Japanese template for 18 F-FDG and compared with normal database constructed from 31 healthy volunteers (women/men; 14/17, age; 19-59 yrs). A software program, easy Z-score imaging system (eZIS), for analysis of patient data was developed by calculating Z-score in each voxel and visualizing the score in a standardized stereotactic space; Z-score=(normal mean-patient's value)/a standard deviation of normal data. Detectability of epileptic foci for this computer-aided analysis was compared with visual inspection of original 18 F-FDG PET images by five radiologists without any clinical information. In all cases, there was significant reduction of glucose metabolism in the operated area. The sensitivities of the detection of epileptic foci obtained from visual inspection were 47-59%. In contrast to, computer analysis by eZIS showed 71% sensitivity when we defined the highest Z-score in the cerebrum to be the focus diagnosed by eZIS. Computer-aided diagnosis with eZIS for 18 F-FDG PET study is useful for detecting epileptic foci in extra TLE. (author)

  18. Partial oxidation process

    International Nuclear Information System (INIS)

    Najjar, M.S.

    1987-01-01

    A process is described for the production of gaseous mixtures comprising H/sub 2/+CO by the partial oxidation of a fuel feedstock comprising a heavy liquid hydrocarbonaceous fuel having a nickel, iron, and vanadium-containing ash or petroleum coke having a nickel, iron, and vanadium-containing ash, or mixtures thereof. The feedstock includes a minimum of 0.5 wt. % of sulfur and the ash includes a minimum of 5.0 wt. % vanadium, a minimum of 0.5 ppm nickel, and a minimum of 0.5 ppm iron. The process comprises: (1) mixing together a copper-containing additive with the fuel feedstock; wherein the weight ratio of copper-containing additive to ash in the fuel feedstock is in the range of about 1.0-10.0, and there is at least 10 parts by weight of copper for each part by weight of vanadium; (2) reacting the mixture from (1) at a temperature in the range of 2200 0 F to 2900 0 F and a pressure in the range of about 5 to 250 atmospheres in a free-flow refactory lined partial oxidation reaction zone with a free-oxygen containing gas in the presence of a temperature moderator and in a reducing atmosphere to produce a hot raw effluent gas stream comprising H/sub 2/+CO and entrained molten slag; and where in the reaction zone and the copper-containing additive combines with at least a portion of the nickel and iron constituents and sulfur found in the feedstock to produce a liquid phase washing agent that collects and transports at least a portion of the vanadium-containing oxide laths and spinels and other ash components and refractory out of the reaction zone; and (3) separating nongaseous materials from the hot raw effluent gas stream

  19. Blood-brain barrier leakage after status epilepticus in rapamycin-treated rats I: Magnetic resonance imaging.

    Science.gov (United States)

    van Vliet, Erwin A; Otte, Willem M; Wadman, Wytse J; Aronica, Eleonora; Kooij, Gijs; de Vries, Helga E; Dijkhuizen, Rick M; Gorter, Jan A

    2016-01-01

    The mammalian target of rapamycin (mTOR) pathway has received increasing attention as a potential antiepileptogenic target. Treatment with the mTOR inhibitor rapamycin after status epilepticus reduces the development of epilepsy in a rat model. To study whether rapamycin mediates this effect via restoration of blood-brain barrier (BBB) dysfunction, contrast-enhanced magnetic resonance imaging (CE-MRI) was used to determine BBB permeability throughout epileptogenesis. Imaging was repeatedly performed until 6 weeks after kainic acid-induced status epilepticus in rapamycin (6 mg/kg for 6 weeks starting 4 h after SE) and vehicle-treated rats, using gadobutrol as contrast agent. Seizures were detected using video monitoring in the week following the last imaging session. Gadobutrol leakage was widespread and extensive in both rapamycin and vehicle-treated epileptic rats during the acute phase, with the piriform cortex and amygdala as the most affected regions. Gadobutrol leakage was higher in rapamycin-treated rats 4 and 8 days after status epilepticus compared to vehicle-treated rats. However, during the chronic epileptic phase, gadobutrol leakage was lower in rapamycin-treated epileptic rats along with a decreased seizure frequency. This was confirmed by local fluorescein staining in the brains of the same rats. Total brain volume was reduced by this rapamycin treatment regimen. The initial slow recovery of BBB function in rapamycin-treated epileptic rats indicates that rapamycin does not reduce seizure activity by a gradual recovery of BBB integrity. The reduced BBB leakage during the chronic phase, however, could contribute to the decreased seizure frequency in post-status epilepticus rats treated with rapamycin. Furthermore, the data show that CE-MRI (using step-down infusion with gadobutrol) can be used as biomarker for monitoring the effect of drug therapy in rats. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

  20. Reduced GABAA receptor density contralateral to a potentially epileptogenic MRI abnormality in a patient with complex partial seizures

    International Nuclear Information System (INIS)

    Kuwert, T.; Stodieck, S.R.G.; Puskas, C.; Diehl, B.; Puskas, Z.; Schuierer, G.; Vollet, B.; Schober, O.

    1996-01-01

    Imaging cerebral GABA A receptor density (GRD) with single-photon emission tomography (SPET) and iodine-123 iomazenil is highly accurate in lateralizing epileptogenic foci in patients with complex partial seizures of temporal origin. Limited knowledge exists on how iomazenil SPET compares with magnetic resonance imaging (MRI) in this regard. We present a patient with complex partial seizures in whom MRI had identified an arachnoid cyst anterior to the tip of the left temporal lobe. Contralaterally to this structural abnormality, interictal electroencephalography (EEG) performed after sleep deprivation disclosed an intermittent frontotemporal dysrhythmic focus with slow and sharp waves. On iomazenil SPET images GRD was significantly reduced in the right temporal lobe and thus contralaterally to the MRI abnormality, but ipsilaterally to the pathological EEG findings. These data suggest that iomazenil SPET may significantly contribute to the presurgical evaluation of epileptic patients even when MRI identifies potentialy epileptogenic structural lesions. (orig.)

  1. “Blaming, shaming, humiliation”: Stigmatising medical interactions among people with non-epileptic seizures [version 2; referees: 1 approved, 2 approved with reservations

    Directory of Open Access Journals (Sweden)

    Catherine Robson

    2017-10-01

    Full Text Available Background: People with non-epileptic seizures (NES describe challenging relationships with health professionals, and explain negative interactions as common and expected. Despite these difficulties, little is known about how people with NES experience difficult healthcare encounters. Methods: Using a thematic discourse analysis approach, we analysed the free-text survey responses of 135 people with NES and asked: what kind of challenges do people living with this condition encounter when interacting with health professionals, and how do they experience the consequences of difficult interactions? We explore their experiences by interpreting the latent meaning of participants’ texts from a social-constructionist perspective on health and illness. Results: The overarching narrative depicts a fundamental breakdown in patient-provider relationships. According to our data, the negative experiences of study participants emerge from more than practitioners’ lack of awareness of NES and access to information about the condition - to the extent that it is available. In examining the challenges people with NES encounter when interacting with health professionals, their main experiences centre on blame and humiliation. When exploring their experiences, theories of stigma serve as a useful theoretical framework. Conclusions: Normative judgements arising from psychogenic understandings of NES are stigmatising and restrict professional displays of respectful (patient-centred care. Those with the condition depict being negatively stereotyped, illegitimated and held morally culpable by health professionals. Perceived to lack medical, moral and credible status, participants describe practitioners who treat them with disrespect, and some recount conduct that defies all ethical and professional obligations and standards. These encounters can have wide-ranging adverse consequences for patients: emotionally, physically, and for their future healthcare. The

  2. 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

  3. Experts' understanding of partial derivatives using the Partial Derivative Machine

    OpenAIRE

    Roundy, David; Dorko, Allison; Dray, Tevian; Manogue, Corinne A.; Weber, Eric

    2014-01-01

    Partial derivatives are used in a variety of different ways within physics. Most notably, thermodynamics uses partial derivatives in ways that students often find confusing. As part of a collaboration with mathematics faculty, we are at the beginning of a study of the teaching of partial derivatives, a goal of better aligning the teaching of multivariable calculus with the needs of students in STEM disciplines. As a part of this project, we have performed a pilot study of expert understanding...

  4. Reports on Polysomnograph Combined with Long-term Video Electroencephalogram for Monitoring Nocturnal Sleep-breath Events in 82 Epileptic Patients

    Directory of Open Access Journals (Sweden)

    Hongliang Li

    2013-06-01

    Full Text Available Objective: To investigate the effects of epileptic discharges in sleep of epileptic patients on sleepbreath events. Methods: Polysomnograph (PSG and long-term video electroencephalogram (LTVEEG were used to monitor 82 adult epileptic patients. The condition of paroxysmal events in nocturnal sleep was analyzed, and the epileptiform discharge and effects of antiepileptic drugs were explored. Results: In epileptic group, latency to persistent sleep (LPS and REM sleep latency increased, the proportion of light sleep increased while that of deep sleep decreased, sleep efficiency reduced, nocturnal arousal times increased and apnea hyponea indexes (AHI improved, which demonstrated significant differences by comparison to control group. Periodic leg movements (PLM had no conspicuous differences compared with control group. There were no specific effects of epileptiform discharge and antiepileptic drugs on AHI and PLM indexes. Conclusion: Epileptic patients have sleep structure disorders and sleep-disordered breathing, and arousal, respiratory and leg movement events influence mutually. Synchronous detection of PSG combined with LTVEEG is in favor of comprehensively analyzing the relationship between sleep structures and epilepsy-breath events.

  5. On the nose: Olfactory disturbances in patients with transient epileptic amnesia.

    Science.gov (United States)

    Savage, Sharon A; Butler, Christopher R; Milton, Fraser; Han, Yang; Zeman, Adam Z

    2017-01-01

    While olfactory hallucinations are relatively rare in epilepsy, a high prevalence (up to 42%) has been reported in one form - Transient Epileptic Amnesia (TEA). TEA is characterized by recurring amnestic seizures and is commonly associated with persistent interictal memory deficits. Despite reports of changes in smell, olfactory ability has not been objectively assessed in this group. The aim of this study was to measure olfactory ability in patients with TEA and explore whether olfactory symptoms relate to other clinical variables. Fifty-five participants with TEA were recruited from The Impairment of Memory in Epilepsy project database. The presence of olfactory symptoms was obtained via case notes and clinical interview. Participants completed questionnaires to evaluate their olfaction and memory function subjectively. Olfactory ability was measured using the University of Pennsylvania Smell Identification Test (UPSIT). TEA participants' performance was compared to 50 matched healthy control participants. A subset of TEA participants (n=26) also completed a battery of memory tests including standard neuropsychological measures, and assessment of accelerated long-term forgetting and autobiographical memory. Olfactory hallucinations were reported in 55% of patients with TEA. A significant reduction in smell identification (UPSIT) was found between patients with TEA and healthy controls (polfactory hallucinations, were not predictive of olfactory ability. Patients reported ongoing memory difficulties and performed below normative values on objective tests. While no correlation was found between objective measures of memory and olfactory performance, subjective complaints of route finding difficulty was associated with UPSIT score. Impairments in odor identification are common in patients with TEA and exceed changes that occur in normal aging. Olfactory hallucinations occurs in approximately half of patients with TEA, but do not always coincide with reduced sense of

  6. The effect of epileptic seizures on proton MRS visible neurochemical concentrations.

    Science.gov (United States)

    Simister, Robert J; McLean, Mary A; Salmenpera, Tuuli M; Barker, Gareth J; Duncan, John S

    2008-09-01

    To investigate post-ictal changes in cerebral metabolites. We performed a longitudinal quantitative proton magnetic resonance spectroscopy (MRS) study in 10 patients with epilepsy and 10 control subjects. The patients were studied on two occasions: immediately following a seizure, and on a second occasion at least 7h after the most recent seizure. Each study measured N-acetyl aspartate plus N-acetyl aspartyl glutamate (NAAt), Creatine plus phosphocreatine (Cr), Choline containing compounds (Cho) and glutamate plus glutamine (GLX) concentrations using a short-echo time sequence (TE=30ms), and NAAt, Cr and lactate using a second sequence with longer echo time (TE=144ms). The control group was studied on two occasions using the same sequences. No inter-scan differences were observed for the control group. NAAt and NAAt/Cr levels were lower in the patient group at both measured TEs but did not change significantly between studies. The ratio of Cr at TE 144ms to TE 30ms (Cr(144)/Cr(30)) and GLX/Cr were higher and Cho lower in the post-ictal scan compared to the inter-ictal study. Change in Cr(144)/Cr(30) and NAAt(144)/Cr(144) correlated with the post-ictal interval. Lactate measurement at longer TE was not informative. Proton MRS is sensitive to metabolite changes following epileptic seizures within the immediate post-ictal period. The ratio Cr(144)/Cr(30) is the most sensitive measure of metabolic disturbance and is highest in the post-ictal period but appears to normalise within 2h of the most recent seizure.

  7. Topography of brain glucose hypometabolism and epileptic network in glucose transporter 1 deficiency.

    Science.gov (United States)

    Akman, Cigdem Inan; Provenzano, Frank; Wang, Dong; Engelstad, Kristin; Hinton, Veronica; Yu, Julia; Tikofsky, Ronald; Ichese, Masonari; De Vivo, Darryl C

    2015-02-01

    (18)F fluorodeoxyglucose positron emission tomography ((18)F FDG-PET) facilitates examination of glucose metabolism. Previously, we described regional cerebral glucose hypometabolism using (18)F FDG-PET in patients with Glucose transporter 1 Deficiency Syndrome (Glut1 DS). We now expand this observation in Glut1 DS using quantitative image analysis to identify the epileptic network based on the regional distribution of glucose hypometabolism. (18)F FDG-PET scans of 16 Glut1 DS patients and 7 healthy participants were examined using Statistical parametric Mapping (SPM). Summed images were preprocessed for statistical analysis using MATLAB 7.1 and SPM 2 software. Region of interest (ROI) analysis was performed to validate SPM results. Visual analysis of the (18)F FDG-PET images demonstrated prominent regional glucose hypometabolism in the thalamus, neocortical regions and cerebellum bilaterally. Group comparison using SPM analysis confirmed that the regional distribution of glucose hypo-metabolism was present in thalamus, cerebellum, temporal cortex and central lobule. Two mildly affected patients without epilepsy had hypometabolism in cerebellum, inferior frontal cortex, and temporal lobe, but not thalamus. Glucose hypometabolism did not correlate with age at the time of PET imaging, head circumference, CSF glucose concentration at the time of diagnosis, RBC glucose uptake, or CNS score. Quantitative analysis of (18)F FDG-PET imaging in Glut1 DS patients confirmed that hypometabolism was present symmetrically in thalamus, cerebellum, frontal and temporal cortex. The hypometabolism in thalamus correlated with the clinical history of epilepsy. Copyright © 2014. Published by Elsevier B.V.

  8. Brain lateralization and neural plasticity for musical and cognitive abilities in an epileptic musician

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    Isabel eTrujillo-Pozo

    2013-12-01

    Full Text Available The use of intracarotid propofol procedure (IPP when assessing musical lateralization has not been reported in literature up to now. This procedure (similar to Wada Test has provided the opportunity to investigate not only lateralization of language and memory functions on epileptic patients but also offers a functional mapping approach with superior spatial and temporal resolution to analyze the lateralization of musical abilities. Findings in literature suggest that musical training modifies functional and structural brain organization. We studied hemispheric lateralization in a professional musician, a 33 years old woman with refractory left medial temporal lobe epilepsy. A longitudinal neuropsychological study was performed over a period of 21 months. Before epilepsy surgery, musical abilities, language and memory were tested during IPP by means of a novel and exhaustive neuropsychological battery focusing on the processing of music. We used a selection of stimuli to analyze listening, score reading, and tempo discrimination. Our results suggested that IPP is an excellent method to determine not only language, semantic and episodic memory, but also musical dominance in a professional musician who may be candidate for epilepsy surgery. Neuropsychological testing revealed that right hemisphere’s patient is involved in semantic and episodic musical memory processes, whereas her score reading and tempo processing require contribution from both hemispheres. At 1-year follow-up, outcome was excellent with respect to seizures and professional skills, meanwhile cognitive abilities improved. These findings indicate that IPP helps to predict who might be at risk for postoperative musical, language and memory deficits after epilepsy surgery. Our research suggests that musical expertise and epilepsy critically modifies long-term memory processes and induces brain structural and functional plasticity.

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

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    Amir Eftekhar

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

  10. Classification of Focal and Non Focal Epileptic Seizures Using Multi-Features and SVM Classifier.

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    Sriraam, N; Raghu, S

    2017-09-02

    Identifying epileptogenic zones prior to surgery is an essential and crucial step in treating patients having pharmacoresistant focal epilepsy. Electroencephalogram (EEG) is a significant measurement benchmark to assess patients suffering from epilepsy. This paper investigates the application of multi-features derived from different domains to recognize the focal and non focal epileptic seizures obtained from pharmacoresistant focal epilepsy patients from Bern Barcelona database. From the dataset, five different classification tasks were formed. Total 26 features were extracted from focal and non focal EEG. Significant features were selected using Wilcoxon rank sum test by setting p-value (p z > 1.96) at 95% significance interval. Hypothesis was made that the effect of removing outliers improves the classification accuracy. Turkey's range test was adopted for pruning outliers from feature set. Finally, 21 features were classified using optimized support vector machine (SVM) classifier with 10-fold cross validation. Bayesian optimization technique was adopted to minimize the cross-validation loss. From the simulation results, it was inferred that the highest sensitivity, specificity, and classification accuracy of 94.56%, 89.74%, and 92.15% achieved respectively and found to be better than the state-of-the-art approaches. Further, it was observed that the classification accuracy improved from 80.2% with outliers to 92.15% without outliers. The classifier performance metrics ensures the suitability of the proposed multi-features with optimized SVM classifier. It can be concluded that the proposed approach can be applied for recognition of focal EEG signals to localize epileptogenic zones.

  11. Causality within the Epileptic Network: An EEG-fMRI Study Validated by Intracranial EEG.

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    Vaudano, Anna Elisabetta; Avanzini, Pietro; Tassi, Laura; Ruggieri, Andrea; Cantalupo, Gaetano; Benuzzi, Francesca; Nichelli, Paolo; Lemieux, Louis; Meletti, Stefano

    2013-01-01

    Accurate localization of the Seizure Onset Zone (SOZ) is crucial in patients with drug-resistance focal epilepsy. EEG with fMRI recording (EEG-fMRI) has been proposed as a complementary non-invasive tool, which can give useful additional information in the pre-surgical work-up. However, fMRI maps related to interictal epileptiform activities (IED) often show multiple regions of signal change, or "networks," rather than highly focal ones. Effective connectivity approaches like Dynamic Causal Modeling (DCM) applied to fMRI data potentially offers a framework to address which brain regions drives the generation of seizures and IED within an epileptic network. Here, we present a first attempt to validate DCM on EEG-fMRI data in one patient affected by frontal lobe epilepsy. Pre-surgical EEG-fMRI demonstrated two distinct clusters of blood oxygenation level dependent (BOLD) signal increases linked to IED, one located in the left frontal pole and the other in the ipsilateral dorso-lateral frontal cortex. DCM of the IED-related BOLD signal favored a model corresponding to the left dorso-lateral frontal cortex as driver of changes in the fronto-polar region. The validity of DCM was supported by: (a) the results of two different non-invasive analysis obtained on the same dataset: EEG source imaging (ESI), and "psycho-physiological interaction" analysis; (b) the failure of a first surgical intervention limited to the fronto-polar region; (c) the results of the intracranial EEG monitoring performed after the first surgical intervention confirming a SOZ located over the dorso-lateral frontal cortex. These results add evidence that EEG-fMRI together with advanced methods of BOLD signal analysis is a promising tool that can give relevant information within the epilepsy surgery diagnostic work-up.

  12. Causality within the epileptic network: an EEG-fMRI study validated by intracranial EEG.

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    Anna Elisabetta eVaudano

    2013-11-01

    Full Text Available Accurate localization of the Seizure Onset Zone (SOZ is crucial in patients with drug-resistance focal epilepsy. EEG with fMRI recording (EEG-fMRI has been proposed as a complementary non-invasive tool, which can give useful additional information in the pre-surgical workup. However, fMRI maps related to interictal epileptiform activities (IED often show multiple regions of signal change, or networks, rather than highly focal ones. Effective connectivity approaches like Dynamic Causal Modelling (DCM applied to fMRI data potentially offers a framework to address which brain regions drives the generation of seizures and IED within an epileptic network. Here we present a first attempt to validate DCM on EEG-fMRI data in one patient affected by frontal lobe epilepsy. Pre-surgical EEG-fMRI demonstrated two distinct clusters of BOLD signal increases linked to IED, one located in the left frontal pole and the other in the ipsilateral dorso-lateral frontal cortex. DCM of the IED-related BOLD signal favoured a model corresponding to the left dorsolateral frontal cortex as driver of changes in the fronto-polar region. The validity of DCM was supported by: (a the results of two different non-invasive analysis obtained on the same dataset: EEG source imaging (ESI, and psychophysiological interaction analysis (PPI; (b the failure of a first surgical intervention limited to the fronto-polar region; (c the results of the intracranial EEG monitoring performed after the first surgical intervention confirming a SOZ located over the dorso-lateral frontal cortex. These results add evidence that EEG-fMRI together with advanced methods of BOLD signal analysis is a promising tool that can give relevant information within the epilepsy surgery diagnostic work-up.

  13. Large-scale structural alteration of brain in epileptic children with SCN1A mutation.

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    Lee, Yun-Jeong; Yum, Mi-Sun; Kim, Min-Jee; Shim, Woo-Hyun; Yoon, Hee Mang; Yoo, Il Han; Lee, Jiwon; Lim, Byung Chan; Kim, Ki Joong; Ko, Tae-Sung

    2017-01-01

    Mutations in SCN1A gene encoding the alpha 1 subunit of the voltage gated sodium channel are associated with several epilepsy syndromes including genetic epilepsy with febrile seizures plus (GEFS +) and severe myoclonic epilepsy of infancy (SMEI). However, in most patients with SCN1A mutation, brain imaging has reported normal or non-specific findings including cerebral or cerebellar atrophy. The aim of this study was to investigate differences in brain morphometry in epileptic children with SCN1A mutation compared to healthy control subjects. We obtained cortical morphology (thickness, and surface area) and brain volume (global, subcortical, and regional) measurements using FreeSurfer (version 5.3.0, https://surfer.nmr.mgh.harvard.edu) and compared measurements of children with epilepsy and SCN1A gene mutation ( n  = 21) with those of age and gender matched healthy controls ( n  = 42). Compared to the healthy control group, children with epilepsy and SCN1A gene mutation exhibited smaller total brain, total gray matter and white matter, cerebellar white matter, and subcortical volumes, as well as mean surface area and mean cortical thickness. A regional analysis revealed significantly reduced gray matter volume in the patient group in the bilateral inferior parietal, left lateral orbitofrontal, left precentral, right postcentral, right isthmus cingulate, right middle temporal area with smaller surface area and white matter volume in some of these areas. However, the regional cortical thickness was not significantly different in two groups. This study showed large-scale developmental brain changes in patients with epilepsy and SCN1A gene mutation, which may be associated with the core symptoms of the patients. Further longitudinal MRI studies with larger cohorts are required to confirm the effect of SCN1A gene mutation on structural brain development.

  14. Importance of competing risks in the analysis of anti-epileptic drug failure

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    Sander Josemir W

    2007-03-01

    Full Text Available Abstract Background Retention time (time to treatment failure is a commonly used outcome in antiepileptic drug (AED studies. Methods Two datasets are used to demonstrate the issues in a competing risks analysis of AEDs. First, data collection and follow-up considerations are discussed with reference to information from 15 monotherapy trials. Recommendations for improved data collection and cumulative incidence analysis are then illustrated using the SANAD trial dataset. The results are compared to the more common approach using standard survival analysis methods. Results A non-significant difference in overall treatment failure time between gabapentin and topiramate (logrank test statistic = 0.01, 1 degree of freedom, p-value = 0.91 masked highly significant differences in opposite directions with gabapentin resulting in fewer withdrawals due to side effects (Gray's test statistic = 11.60, 1 degree of freedom, p = 0.0007 but more due to poor seizure control (Gray's test statistic = 14.47, 1 degree of freedom, p-value = 0.0001. The significant difference in overall treatment failure time between lamotrigine and carbamazepine (logrank test statistic = 5.6, 1 degree of freedom, p-value = 0.018 was due entirely to a significant benefit of lamotrigine in terms of side effects (Gray's test statistic = 10.27, 1 degree of freedom, p = 0.001. Conclusion Treatment failure time can be measured reliably but care is needed to collect sufficient information on reasons for drug withdrawal to allow a competing risks analysis. Important differences between the profiles of AEDs may be missed unless appropriate statistical methods are used to fully investigate treatment failure time. Cumulative incidence analysis allows comparison of the probability of failure between two AEDs and is likely to be a more powerful approach than logrank analysis for most comparisons of standard and new anti-epileptic drugs.

  15. Automatic detection of epileptic seizures on the intra-cranial electroencephalogram of rats using reservoir computing.

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    Buteneers, Pieter; Verstraeten, David; van Mierlo, Pieter; Wyckhuys, Tine; Stroobandt, Dirk; Raedt, Robrecht; Hallez, Hans; Schrauwen, Benjamin

    2011-11-01

    In this paper we propose a technique based on reservoir computing (RC) to mark epileptic seizures on the intra-cranial electroencephalogram (EEG) of rats. RC is a recurrent neural networks training technique which has been shown to possess good generalization properties with limited training. The system is evaluated on data containing two different seizure types: absence seizures from genetic absence epilepsy rats from Strasbourg (GAERS) and tonic-clonic seizures from kainate-induced temporal-lobe epilepsy rats. The dataset consists of 452hours from 23 GAERS and 982hours from 15 kainate-induced temporal-lobe epilepsy rats. During the preprocessing stage, several features are extracted from the EEG. A feature selection algorithm selects the best features, which are then presented as input to the RC-based classification algorithm. To classify the output of this algorithm a two-threshold technique is used. This technique is compared with other state-of-the-art techniques. A balanced error rate (BER) of 3.7% and 3.5% was achieved on the data from GAERS and kainate rats, respectively. This resulted in a sensitivity of 96% and 94% and a specificity of 96% and 99% respectively. The state-of-the-art technique for GAERS achieved a BER of 4%, whereas the best technique to detect tonic-clonic seizures achieved a BER of 16%. Our method outperforms up-to-date techniques and only a few parameters need to be optimized on a limited training set. It is therefore suited as an automatic aid for epilepsy researchers and is able to eliminate the tedious manual review and annotation of EEG. Copyright © 2011 Elsevier B.V. All rights reserved.

  16. Controlled test for predictive power of Lyapunov exponents: their inability to predict epileptic seizures.

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    Lai, Ying-Cheng; Harrison, Mary Ann F; Frei, Mark G; Osorio, Ivan

    2004-09-01

    Lyapunov exponents are a set of fundamental dynamical invariants characterizing a system's sensitive dependence on initial conditions. For more than a decade, it has been claimed that the exponents computed from electroencephalogram (EEG) or electrocorticogram (ECoG) signals can be used for prediction of epileptic seizures minutes or even tens of minutes in advance. The purpose of this paper is to examine the predictive power of Lyapunov exponents. Three approaches are employed. (1) We present qualitative arguments suggesting that the Lyapunov exponents generally are not useful for seizure prediction. (2) We construct a two-dimensional, nonstationary chaotic map with a parameter slowly varying in a range containing a crisis, and test whether this critical event can be predicted by monitoring the evolution of finite-time Lyapunov exponents. This can thus be regarded as a "control test" for the claimed predictive power of the exponents for seizure. We find that two major obstacles arise in this application: statistical fluctuations of the Lyapunov exponents due to finite time computation and noise from the time series. We show that increasing the amount of data in a moving window will not improve the exponents' detective power for characteristic system changes, and that the presence of small noise can ruin completely the predictive power of the exponents. (3) We report negative results obtained from ECoG signals recorded from patients with epilepsy. All these indicate firmly that, the use of Lyapunov exponents for seizure prediction is practically impossible as the brain dynamical system generating the ECoG signals is more complicated than low-dimensional chaotic systems, and is noisy. Copyright 2004 American Institute of Physics

  17. De novo status epilepticus is associated with adverse outcome: An 11-year retrospective study in Hong Kong.

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    Lui, Hoi Ki Kate; Hui, Kwok Fai; Fong, Wing Chi; Ip, Chun Tak; Lui, Hiu Tung Colin

    2016-08-01

    To identify predictors of poor clinical outcome in patients presenting to the intensive care units with status epilepticus (SE), in particular for patients presenting with de novo status epileptics. A retrospective review was performed on patients admitted to the intensive care units with status epilepticus in two hospitals in Hong Kong over an 11-year period from 2003 to 2013. A total of 87 SE cases were analyzed. The mean age of patients was 49.3 years (SD 14.9 years). Eighteen subjects (20.7%) had breakthrough seizure, which was the most common etiology for the status epilepticus episodes. Seventy-eight subjects (89.7%) had convulsive status epilepticus (CSE) and 9 subjects (10.3%) had non-convulsive status epilepticus (NCSE) on presentation. The 30-day mortality rate of all subjects was 18.4%. Non-convulsive status epilepticus was more common in patients with de novo status epilepticus when compared to those with existing history of epilepsy (15.5% Vs. 0%, p=0.03). Patients with de novo status epilepticus were older (52 Vs 43, p=0.009). De novo status epilepticus was associated with longer status duration (median 2.5 days, IQR 5 days), longer ICU stay (median 7.5 days, IQR 9 days) and poorer outcome (OR 4.15, 95% CI 1.53-11.2). For patients presenting to intensive care units with status epilepticus, those with de novo status epileptics were older and were more likely to develop non-convulsive status epilepticus. De novo status epilepticus was associated with poorer outcome. Continuous EEG monitoring would help identifying NCSE and potentially help improving clinical outcomes. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  18. Effect of lateralized epileptic discharges on the thought flow Efeito de descargas epilépticas lateralizadas no fluxo do pensamento

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    Paulo Bueno de Mendonça

    2001-06-01

    Full Text Available PURPOSE: Pauses in verbal expression of thought flow in patients with partial epilepsy was studied in order to achieve a best comprehension of brain interhemispheric influences. METHOD: We studied thirty nine patients with partial epileptic seizures and twenty four volunteers (control group. Free association of ideas was used as a method to stablish the thought flow, starting with a stimulus word (subject name that must be followed by spontaneous and consecutive word-phrase. Patients were instructed to say any thought that came to their minds without any kind of censoring. Subject responses were recorded through a PC keyboard and time intervals (pauses between each word-phrase were processed by a software developed for this purpose. RESULTS: Time intervals reduction among associations in right lesional group were compared to left lesional, right non-lesional and control groups. An increase of associative time intervals was observed in the right non-lesional group compared to left non-lesional group. CONCLUSIONS: We suggest a possible inhibitory inter-hemispheric function of the right hemisphere modulating verbal expression of the thought flow. Considering the hypothesis of the inter-hemispheric inhibition by the right hemisphere on left hemisphere, we admit that in epileptic patients with right hemispheric lesion there is an attenuation of the inter-hemispheric inhibition and an increase in thought flow, whereas in patients without a lesion but a paroxysmal epileptic activity in right temporal lobe there is an exacerbation of this inhibitory function and consequent reduction in the thought flow.OBJETIVO: Foram estudadas as pausas na expressão verbal do pensamento em pacientes com epilepsia parcial a fim de estabelecer uma melhor compreensão das influências interhemisféricas cerebrais. MÉTODO: foram estudados 39 pacientes com crises epilépticas parciais e 24 voluntários (grupo controle. A associação livre de idéias foi usada como m

  19. Astroglial role in the pathophysiology of status epilepticus: an overview.

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    Vargas-Sánchez, Karina; Mogilevskaya, Maria; Rodríguez-Pérez, John; Rubiano, María G; Javela, José J; González-Reyes, Rodrigo E

    2018-06-01

    Status epilepticus is a medical emergency with elevated morbidity and mortality rates, and represents a leading cause of epilepsy-related deaths. Though status epilepticus can occur at any age, it manifests more likely in children and elderly people. Despite the common prevalence of epileptic disorders, a complete explanation for the mechanisms leading to development of self-limited or long lasting seizures (as in status epilepticus) are still lacking. Apart from neurons, research evidence suggests the involvement of immune and glial cells in epileptogenesis. Among glial cells, astrocytes represent an ideal target for the study of the pathophysiology of status epilepticus, due to their key role in homeostatic balance of the central nervous system. During status epilepticus, astroglial cells are activated by the presence of cytokines, damage associated molecular patterns and reactive oxygen species. The persistent activation of astrocytes leads to a decrease in glutamate clearance with a corresponding accumulation in the synaptic extracellular space, increasing the chance of neuronal excitotoxicity. Moreover, major alterations in astrocytic gap junction coupling, inflammation and receptor expression, facilitate the generation of seizures. Astrocytes are also involved in dysregulation of inhibitory transmission in the central nervous system and directly participate in ionic homeostatic alterations during status epilepticus. In the present review, we focus on the functional and structural changes in astrocytic activity that participate in the development and maintenance of status epilepticus, with special attention on concurrent inflammatory alterations. We also include potential astrocytic treatment targets for status epilepticus.

  20. Partial Actions and Power Sets

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    Jesús Ávila

    2013-01-01

    Full Text Available We consider a partial action (X,α with enveloping action (T,β. In this work we extend α to a partial action on the ring (P(X,Δ,∩ and find its enveloping action (E,β. Finally, we introduce the concept of partial action of finite type to investigate the relationship between (E,β and (P(T,β.