bluuebunny/crossref_metadata_2025 huggingface dataset:
Intelligence Test Performance of Patients with Partial and Generalized Seizures
Authors: Giordani Bruno , Berent Stanley , Sackellares J. Chris , Rourke Daniel , Seidenberg Michael , O'Leary Daniel S. , Dreifuss Fritz E. , Boll Thomas J.
Published: November 2007

Summary: The intellectual performance of 350 patients with seizures was examined. Seizures were classified according to the revised International Classification of Epileptic Seizures as partial (simple or complex), generalized, or partial secondarily generalized. Performance on the Wechsler Intelligence subtests served to measure intellectual ability. Patients with partial seizures performed better on Digit Span, Digit Symbol, Block Design, and Object Assembly than those with either generalized or partial secondarily generalized seizures. These subtests are functionally associated with abilities such as attention, visuospatial problem‐solving, and sequencing ability.

Les performances intellectuelles de 350 patients épileptiques ont étéévaluées dans ce travail. Les crises ont été classées selon la nouvelle Classification Internationale des Crises Epileptiques en crises partielles (simples ou complexes), généralisées ou partielles secondairement généralisées. Les résultats aux subtests de l'échelle d'intelligence de Wechsler ont servi de mesure des captacités intellectuelles. Les patients ayant des crises partielles avaient de meilleurs résultats à l'empan verbal (span), au code, aux cubes et aux assemblages do'objects que les patients avec crises généralsées ou avec crises partielles secondairement généralisées. Ces subtests sont liés aux fonctions d'attention. de structuration visuospatiale et d'habileté dans les tâches séquentielles.

En este estudio se ha examinado la capacidad intelectual de 350 pacientes con ataques. Las crisis se clasificaron de acuerdo con la Clasificación Internacional de los Ataques Epilépticos revisada, como ataques parciales (simples o complejos), generalizados o paraciales con generalización secundaria. Los resultados de los subtests de la Escala de Inteligencia de Wechsler sirvieron como medida de la capacidad intelectual. Los pacientes con ataques parciales consiguieron mejores resultados en la retención de digitos, simbolos de digitos, diseño de bloques y asamablaje de objetos, que los que padecian ataques generalizados o parciales con generalización secundaria. Estos subtests estAn asociados funcionalmente con habiladades tales como atención, resolución de problemas visuo0espaciales y capacidad de elaborar secuencias.
An Electroencephalographic Demonstration of Auricular Reflex Epilepsy
Authors: Santanelli P. , Mancini J. , Gastaut H.
Published: November 2007

Summary: Through electroencephalographic recording of an experimentally induced epileptic seizure, existence of the “auricular reflex epilepsy” described in about 30 reports dating from the past century is now objectively demonstrated.

L'enregistrement électroencéphalographique d'une crise expérimentalement provoquée démontre objectivement l'existence d'une “épilepsie auriculaire réflexe” décrite depuis plus d'un siècle.

Mediante registros elecroencefalogràficos de una crisis epilléptica inducida experimentalmente se demuestra ahora, objecti‐vamente, la existencia de una “epilepséa refleja auricular” descrita en unas 30 publicationes fechadas desde el siglo pasado.
A Review of Mouse Mutants as Genetic Models of Epilepsy
Authors: Seyfried Thomas N. , Glaser Gilbert H.
Published: November 2007

Summary: Here we review the major inherited convulsive disorders found in mice and discuss their possible relationship to specific clinical seizure disorders in humans. These mouse disorders include audiogenic seizures, the epilepsy (El) mutation, spontaneous seizures, the tottering/learner syndrome, cerebellar abnormalities, myelin disorders, and alcohol withdrawal seizures. Some of these disorders are symptomatic and others are idiopathic. We find that for many major types of epilepsy in humans there exists a similar counterpart in mice. Because the genetic constitution of the mouse is better known and more easily manipulated than that of other mammalian species, the mouse may serve as an excellent animal model for genetic and biochemical studies of epilepsy.

nous faisons une revue des plus importants des troubles convulsifs héréditaires de la souris et nous discutons leurs relations possibles avec les épilepsies de l'homme. Ces maladies de la souris comprennent les crises audiogènes. la mutation épilepsie (EL), les crises spontanées, le syndrome “tottering‐learner,” les anomalies du cervelet, les désordres myéliniques et les crises par privation d'alcool. certains de ces troubles sont symptomatiques, d'autres idiopathiques. nous avons trouvé que pour beaucoup des principaux types d‘épilepsie de l'homme il existe un équivalent similaire chez la souris. comme la constitution génétique de la souris est mieux connue et peut être plus facilement manipulée que celle d'autres espèces de mammiferes, la souris peut être utilisée comme un excellent modèle animal pour les études génétiques et biochimiques de l’épilepsie

Hemos revisado los desórdenes convulsivos hereditarios más importantes encontrados en el ratón y discutimos su posible relación con determinados desórdenes comiciales en el hombre. Estos desórdenes en el ratón incluyen crisis audiogénicas, la mutación epiléptica (EL), crisis espontáneas, el síndrome de “aprendiz vacilante o titubeante”, anormalidades cerebelosas, alteraciones mielínicas y crisis de abstinencia alcohólica. Algunos de estos procesos son sintomáticas y otras son idiopáticos. Hemos encontrado que para muchos tipos de ataques mayores en el hombre existe un duplicado similar en el ratón. Dado que la constitución genética del ratón es mejor conocida y más fácilmente manipulable que otras especies de mamíferos, el ratón puede servir como un excelente modelo animal para estudios genéticos y bioquímicos de la epilepsía.
Effect of Seizures During Pregnancy on Seizure Susceptibility in Offspring
Authors: Holmes Gregory L. , Weber Donald A.
Published: November 2007

Summary: The risk of epilepsy is higher in the offspring of epileptic mothers than epileptic fathers. It has been hypothesized that seizures during pregnancy may alter subsequent seizure susceptibility in the offspring. To test this hypothesis, pregnant rats were fully kindled during the first, second, or third trimesters. In addition, another group of pregnant rats were kindled during the first trimester and then stimulated daily to induce generalized tonic‐clonic seizures until delivery. The rate of kindling in the offspring of the four groups was then compared with sham‐operated controls. No significant difference in rate of kindling was noted between the offspring of sham‐operated controls and kindled mothers. This study fails to support the hypothesis that maternal seizures during pregnancy lead to increased seizure susceptibility in the offspring.

Le risque d‐épilepsie est plus élevé chez les enfants de mère épileptique que chez ceux de père épileptique. On a émis l'hypothèse que la survenue de crises pendant la grossesse pouvait modifier la prédisposition aux crises des enfants. Pour vérifier cette hypothèse on a soumis à l'effet d'embrasement complet dans rates gravides pendant le premier, le deuxième ou le troisième trimestre. De plus, un autre groupe de rates gravides a subi l'èmbrasement pendant le premier trimestre et ensuite a reçu des stimulations induisant des crises tonicocloniques généralisées tour les jours jusqu'à la délivrance. Le taux d'embrasement dans la descendance des 4 groupes a été ensuite comparéà des animaux de contrôle chez qui l'embrasement avait été simulté. Aucune différence significative n'a été notée dans le taux d'embrasement entre la descendance des contrôles et celle des mères stimulées. Cette étude ne confirme donc pas l'hypothèse que les crises de la mère pendant la grossesse entraînent une plus grande prédisposition aux crises chez lés enfants.

Das Epilepsierisiko ist für Kinder epileptischer Mütter höher als für Kinder epileptischer Väter. Es ist vermutet worden, daß Anfälle während der Schwangerschaft die spätere Empfindlichkeit Anfällen gegenüber, beim Nachkommen verändert. Um diese Hypothese zu testen, wurden trächtige Ratten während des ersten, zweiten und dritten Trimesters vollständig gekindelt. Zusätzlich wurden andere Gruppen trächtiger Ratten während des ersten Trimesters gekindelt und dann täglich bis zum Werfen stimuliert, um generalisierte, tonisch‐klonische Krämpfe zu erzeugen. Die Kindlingrate bei den Nachkommen der 4 Gruppen wurde dann mit pro‐forma operierten Kontrollen verglichen. Es fand sich keine signifikante Differenz der Kindlingrate zwischen den Nachkommen der pro‐forma operierten Kontrollen und der gekindelten Mütter. Diese Untersuchung vermag die Hypothese, daß mütterliche Anfälle während der Schwangerschaft zu einer erhöhten Anfallsempfindlichkeit bei den Nachkommen führt, nicht zu stützen.
Relative Bioavailability of Rectally Administered Carbamazepine Suspension in Humans
Authors: Graves Nina M. , Kriel Robert L. , Jones‐Saete Carolyn , Cloyd James C.
Published: November 2007

Summary: The relative bioavailability of an investigational carbamazepine suspension was studied following rectal administration in human volunteers. Carbamazepine, in doses of ˜6 mg/kg, was given to nine men. The routes of administration were oral tablet, oral suspension, and rectal suspension. There was no significant difference (p > 0.05) in total absorption, maximum serum concentration, and time to achieve maximum serum concentration between the orally‐administered tablet and the rectally administered suspension. Orally administered suspension was absorbed more quickly and completely. All volunteers complained of a strong defecatory urge after the suspension was given rectally. The slow absorption after rectal administration precludes the use of this route in status epilepticus; however, it may be a satisfactory alternative for maintenance therapy when administration by the oral route is not possible.

La biodisponibilité relative d'une suspension de carbamazepine expérimentale, après administration rectale, a étéétudiée chez des sujets volontaires. Neuf sujets masculins ont reçu des doses d'environ 6 mg/K. Les voies d'administration étaient orale (comprimés et suspension) et rectale (suspension). On n'a pas trouvé de différence significative (p. > 0.05) dans l'absorption totale, la concentration sérique maximum et le temps pour obtenir cette concentration maximum, entre les comprimés par voie orale et la suspension par voie rectale. La suspension par voie orale était absorbée plus rapidement et plus complètement. Tous les volontaires se sont plaint d'un besoin de défécation urgente après l'administration rectale. La lenteur d'absorption par la voie rectale interdit l'utilisation de cette voie dans les états de mal. Mais elle peut constituer une alternative satisfaisante pour continuer le traitement quand l'administration orale n'est pas possible.

Die relative Bioverfügbarkeit einer untersuchten Carbamazepin Suspension wurde nach rectaler Anwendung bei menschlichen Freiwilligen untersucht. Das Carbamazepin wurde 9 Männern in Dosen von etwa 6 mg/kg gegeben und zwar als orale Tabletten, orale Suspension und rectale Suspension. Es bestanden keine signifikanten Differenzen (p > 0.05) hinsichtlich der totalen Absorption, der maximalen Ser‐umkonzentration und der Zeit bis zum Erreichen der maximalen Ser‐umkonzentration zwischen der oral verabfolgten Tablette und der rectal gegebenen Suspension. Die oral gegebene Suspension wurde schneller und vollständiger absorbiert. Alle Freiwilligen beklagten sich über starken Defäkationsdrang nach der rectalen Suspension. Die langsame Absorption nach rectaler Anwendung verbietet diese Anwendung beim Status epilepticus; sie mag jedoch eine zufriedenstellende Alternative für die Erhaltungstherapie darstellen, wenn der orale Weg unmöglich ist.
Epileptic Seizures Due to Thrombotic and Embolic Cerebrovascular Disease in Older Patients
Authors: Lesser Ronald P. , Lüders Hans , Dinner Dudley S. , Morris Harold H.
Published: November 2007

La maladie vasculaire thrombo‐embolique provoque fréquemment des crises et en représente l'étiologie la plus commune chez les patients âgés. La survenue immédiate de crises après un ictus, cependant, n'indique pas nécessairement que le patient continuera à en avoir après la guérison du premier épisode. Ceci est vrai même s'il s'agit d'un état de mal. Ceci est peut‐être dû au fait que les crises précoces et les crises tardives répondent à des mécanismes physiopathologiques différents.

Las enfermedades vasculares tromboembólicas son frecuentes precipitantes de ataques y es la etiología más común de este trastorno en ancianos. De todos modos, la presentación de ataques inmediatamente después de un ictus no indica necesariamente que el enfermo va a continuar teniendo ataques una vez que se ha establecido la recuperación inicial. Esta afirmación es real incluso en enfermos que tienen status epilepticus. Esta observación puede ser debida al hecho de que existen mecanismos fisiopatológicos distintos para la producción de ataques precoces o tardíos.

Thromboembolische vaskuläre Erkrankungen gehen den epileptischen Anfällen häufig voran und sind bei älteren Patienten ihre häufigste Ursache. Das Auftreten von epileptischen Anfällen kurz nach einem Schlafanfall jedoch deutet nicht notwendigerweise darauf hin, daß der Patient auch nach der initialen Erholung weiter Anfälle haben wird. Das gilt auch für Patienten, die im Status epilepticus sind. Die Ursache hierfür liegt sicherlich darin, daß frühe und spätere Anfälle durch unterschiedliche pathophysiologische Mechanismen hervorgerufen werden.

Summary: Thromboembolic vascular disease is a frequent precipitant of seizures, and is the most common etiology in older patients. The occurrence of seizures shortly after a stroke, however, does not necessarily indicate that the patient will continue to have seizures following initial recovery. This is true even when patients present in epileptic status. This may be because early and late seizures are produced by different pathophysiologic mechanisms.
Epilepsy, Sex Hormones, and Antiepileptic Drugs
Authors: Mattson Richard H. , Cramer Joyce A.
Published: November 2007

Summary: Many factors associated with hormone function have an impact on the course of epilepsy. Patients with epilepsy may have disturbances in sexual function such as anovulatory cycles in women and decreased libido and potency in men. Data indicate seizures, especially those arising in the limbic system, may influence the hypothalamic pituitary axis. Antiepileptic drugs also influence sexual function through direct brain effects as well as through induced changes in pharmacokinetics of the sex steroid hormones. Pregnancy has been reported to be a time of increased seizures; however, this has often been associated with low drug levels, for reasons that include inadequate drug dose, possible changes in pharmacokinetics, and noncompliance. Some evidence suggests that hormones affect seizure frequency. Changes in seizures during the menstrual cycle (catamenial epilepsy) have been found in some women: seizures were fewer during the luteal phase but increased when progesterone levels declined. Some improvement in seizure frequency has been shown in pilot studies using medroxyprogesterone acetate, a synthetic progesterone. Current concepts of the interrelationship among epilepsy, sex hormones, and antiepileptic drugs are discussed.
Extracellular (36C1) Space, Electrolyte, Protein, and DNA Content in Brain of DBA and C57 Mice: Effects of Age
Authors: Engstrom Fae L. , Kemp John W. , Chow Sien‐Yao , Woodbury Dixon M.
Published: November 2007

Summary: DBA/2J (DBA) mice are susceptible to audiogenic seizures (AGSs) in an age‐dependent manner, susceptibility being maximal at 21 days and absent at 110 days of age. Previous studies have demonstrated that there is a decrease in anion transport and an increase in carbonic anhydrase (CA) activity in brain from DBA mice as compared with C57BL/6J (C57, non‐AGS) mice at 21 days. Since these results suggest that there are alterations in cellular and electrolyte composition of brain from DBA mice, the present work was directed toward determining electrolyte content, extracellular space, and DNA content of brain from DBA and C57 mice at 21 and 110 days of age.

There was a decrease in intracellular chloride and sodium content, and an increase in intracellular potassium content in cerebral cortex, cerebellum, and brainstem from DBA mice at both 21 and 110 days. Also, extracellular space was larger in these three brain tissues from DBA mice at both ages. DNA content, not different between the strains at 21 days, was significantly lower in cerebellum from DBA mice at 110 days. These findings give further evidence of alterations in the transport of ions in brain from DBA mice. In addition, they demonstrate that there are alterations in the intracellular and extracellular space values, an indication of changes in cellular composition of brain in these mice. Such changes may contribute to AGS susceptibility by disrupting the balance that normally exists in the neuronal microenvironment of the central nervous system.
Partial Seizures in Monozygous Twins
Authors: Hurst Robert , Lenn Nicholas J.
Published: November 2007

Summary: Identical twins concordant for partial epilepsy, with onset at 8 and 11 years of age, are presented. Their course has been benign on anticonvulsant therapy. It is suggested that these cases of presumed genetic epilepsy support current concepts of cortical origin and genetic determinants in several subtypes of focal epilepsy of childhood.

Les auteurs présentent des jumeaux identiques concordant pour une épilepsie partielle, ayant débutéà 8 ans et 11 ans. Leur évolution a été bénigne sous traitement anticonvulsif. Ces cas d'épilepsie présumée génétique pourraient soutenir les concepts actuels de l'origine corticale et des déterminants génétiques dans plusieurs sous‐groupes d'épilepsie partielle de l'enfant.

Se presentan dos gemelos idénticos que coincidi'an en el pade‐cimiento de epilepsia parcial con un comienzo a los 8 y a los 11 anos respectivamente. La evolución ha sido benigna con terapia anticomicial. Se sugiere que estos casos, con presumible epilepsia genética, apoyan los conceptos corrientes de un origen cortical y déterminantes genéticos en varios grupos de epilepsia focal en la infancia.

Identische Zwillinge, konkordant für Partialepilepsie und einem Beginn im Alter von 8 und 11 Jahren, werden vorgestellt. Ihr Krankheitsverlauf unter antikonvulsiver Therapie war benigne. Es wird vermutet, daß diese Beispiele einer vermutlich genetischen Epilepsie das gegenwartige Konzept des kortikalen Ursprungs und der genetischen Determination von verschiedenen Untergruppen der fokalen Epilepsie im Kindesalter unterstützen.
Epilepsy, Viewed Metaphysically: An Interpretation of the Biblical Story of the Epileptic Boy and of Raphael's Transfiguration
Authors: Janz Dieter
Published: November 2007

Summary: 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 transcendent 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.

En la mitad superior del último cuadro de Rafael aparece la transfiguraciǒn de Cristo en el Monte Tabor y en la porciǒn inferior del mismo cuadro y en la presencia de otros discípulos, se observa la presencia de un muchacho en pleno ataque epiléptico al pie de la montaña. Rafael pinta ambos acontecimientos, que en las Sagradas Escrituras son descritos sucesivamente, como si hubieran ocurrido al mismo tiempo. Al sincronizar ambas escenas Rafael desmostró la correspondencia significativa entre Cristo y el muchacho epiléptico lo cual revela la representación simbólica del ataque epiléptico de un acontecimiento trascendental. El aspecto metafísico de la epilepsía tal como lo pinta Rafael puede también encontrarse en los correspondientes pasajes bíblicos. En las Sagradas Escrituras la metamorfosis causada por el ataque epiléptico se usa como un símil de la transfiguración de Cristo a través del sufrimiento, muerte y resurrección.

Das letzte Bild von Raphael zeigt in der oberen Hälfte die Verwandlung Christi auf dem Berg Tabor und in der unteren Hälfte die Vorstellung des epileptischen Knaben vor den am Fuß des Berges zurückgebliebenen Jüngern. Raphael stellt die beiden Geschichten, die in den Evangelien nacheinander erzählt werden, so dar, als ob sie sich gleichzeitig ereignen. Durch die Synchronisation beider Szenen wird eine bedeutsame Korrespondenz zwischen Christus und dem epileptischen Knaben sichtbar, die den epileptischen Anfall als eine symbolische Representation eines transzendenten Geschehens erkennen läßt. Dieser von Raphael dargestellte metaphysische Aspekt von Epilepsie läßt sich auch in den biblischen Texten belegen. In den Evangelien hat die im epileptischen Anfall vor sich gehende Metamorphose die Bedeutung eines Gleichnisses für die auf Leiden, Tod und Auferstehung hinweisende Transfiguration von Christus.
Effect of Systemic Estrogen on Seizure Susceptibility in the Immature Animal
Authors: Schultz‐Krohn Winifred A. , Thompson James , Holmes Gregory L.
Published: November 2007

Summary: Estrogens have previously been reported to be proconvulsants in adult animals. This study evaluated the effects of acute, high‐dose estrogen administration on rate of kindling in immature rats. No significant differences in rate of kindling between the estrogen‐treated rats and controls were noted. This study, using the kindling model, demonstrates that estradiol does not have a significant effect on the development of seizures in the immature animal.

Il a été montré que les oestrogènes ont une activité proconvulsivante chez l'animal adulte. Dans ce travail, nous avons étudié les effets de l'administration en aigu d'une forte dose d'oestrogènes sur le taux d'embrasement chez des rats immatures. Nous n'avons pas noté de différence significative des taux d'embrasement entre les animaux traités par oestrogènes et les contrǒles. Ce travail démontre que l'oestradiol n'a pas d'effet significatif sur la survenue de crises chez l'animal immature, lorsque l'on utilise le modèle de l'embrasement.

Östrogene sollen bei ausgewachsenen Tieren als Prokonvulsiva wirken. Diese Studie untersucht die Wirkungen der akuten hochdosierten Östrogenanwendung auf die Kindiingrate unreifer Ratten. Keine signifikanten Unterschiede in der Kindling‐Rate zwischen Östrogenbehandelten Ratten und Kontrollen konnten gefunden werden. Diese Untersuchung zeigt, daßÖstradiol kiene deutliche Wirkung auf die Entwicklung von Anfällen hat, wenn man bei unreifen Tieren das Kindling‐Modell verwendet.
Putnam, Merritt, and the Discovery of Dilantin®
Authors: Friedlander Walter J.
Published: November 2007

In the first part of this essay, the “common wisdom” about Putnam and Merritt's contributions to the treatment of epilepsy was summarized (Rowland, 1982). Based on the history that has been presented here, how true are these “wisdoms”? Putnam and Merritt did devise “a simple and reliable method to test drugs of anticonvulsant effect” and they did show “that anticonvulsant effects in cats accurately predicted effects in humans,” but others before them had done these same things. Dilantin, contrary to common wisdom, was not the first anticonvulsant drug to be tested in animals before it was given to human subjects; at least a year before, Cobb and his co‐workers had done the same thing using vital dyes. However, Dilantin did represent the first time an anticonvulsant tested in animals was subsequently studied in a large series of patients.

Nor were Putnam and Merritt the first to show that “anticonvulsant and sedative effects of drugs could be separated.” Potassium borotartrate, ketogenic diet, ketone bodies, and vital dyes were anticonvulsive without necessarily being sedative. However, Putnam and Merritt were probably the first to make so explicit a statement to this effect. It may well have been this particular statement—and the fact that it was so well heard by other researchers—that represented their greatest achievement. In Kuhn's theory of scientific revolutions, the great step forward may not be so much the accumulation of evidence that the existing paradigm is not a feasible one, but rather the use of this evidence to form a new model or paradigm which is then accepted by normal science in such a fashion that the results prove to be productive. This, it would seem, is what Putnam and Merritt did. From it came their own major discovery, Dilantin, which, in Rowland's words, remains “a mainstay of treatment” for epilepsy up to the present time, and which “opened the way to the development of other anticonvulsant drugs.”
Epileptic Seizures as a Cause of Unilateral Pulmonary Edema
Authors: Koppel Barbara S. , Pearl Marilyn , Perla Elliott
Published: November 2007

Summary: We report three patients with recurrent tonic‐clonic seizures associated with unilateral pulmonary edema. Each lung was involved on separate occasions in one patient. The mechanisms of seizure‐related pulmonary edema are discussed. Although accurate diagnosis of unilateral postictal pulmonary edema may be difficult because of its rarity, not all pulmonary abnormalities that follow seizures represent pneumonia.

Nous rapportons 3 observations de patients présentant des crises tonico‐cloniques répétées s'accompagnant ď;un œdème pulmonaire unilatéral. Chaque poumon était atteint à tour de röle chez un patient. Les mécanismes de ľœdème pulmonaire lié aux crises sont discutés. Bien que le diagnostic du caractère post‐critique ď;un œdème pulmonaire unilatéral soit difficile en raison de la rareté de ce phénomène, ces observations montrent que la pneumonie ne constitue pas la seule atteinte pulmonaire consécutive aux crises comitiales.

Publicamos 3 pacientes con ataques tónico‐clónicos recur‐rentes asociados a edema pulmonar unilateral. Cada pulmón es‐tuvo afectado en ocasiones diversas en un paciente. Se discuten los mecanismos de los ataques relacionados con edema pulmonar. A pesar de que el diagnóstico exacto del edema pulmonar unilateral postictal puede resultar difícil debido a su rareza no todas las anomalías pulmonares que siguen a ataques representan neumonías.

Wir berichten über 3 Patienten mit wiederholten tonischklon‐ischen Anfällen, die mit einseitigem Lungenoedem einhergingen. Jede Lungenseite konnte bei verschiedenen Anfällen betroffen sein. Die Pathophysiologic des anfallsbedingten Lungenoedems wird diskutiert. Obwohl die exakte Diagnose eines einseitigen postiktalen Lungenoedems eine Rarität darstellt, sollten nicht alle pulmonalen Auffälligkeiten nach einem Anfall als Pneumonie gedeutet werden.
Effect of Aminophylline and Enprofylline on the Protective Efficacy of Common Antiepileptic Drugs Against Electroconvulsions in Mice
Authors: Czuczwar Stanislaw J. , Kleinrok Zdzislaw , Turski Lechoslaw , Turski Waldemar A.
Published: November 2007

Summary: The anticonvulsant potency of phenobarbital (PB) (120 min before the test), phenytoin (PHT) (120 min), carbamazepine (CBZ) (60 min), valproate (VPA) (30 min), and acetazolamide (60 min) alone or in combination with either aminophylline (50 mg/kg, 30 min) or enprofylline (46.2 mg/kg, 30 min) was measured against maximal electroshock‐induced convulsions in mice. All drugs were administered intraperitoneally (i.p.), and the protective efficacy of each drug was expressed as ED50 in milligrams per kilogram. Aminophylline decreased anticonvulsant activity of PB, PHT, CBZ, and VPA, increasing the respective ED50 values from 16 to 28 mg/kg, 7.4 to 14 mg/kg, 18 to 26 mg/kg, and 260 to 335 mg/kg. On the contrary, enprofylline in the equimolar dose did not exert such effect. Furthermore, neither aminophylline nor enprofylline affected anticonvulsant action of acetazolamide. The present data favor enprofylline as a preferable drug for treatment of obstructive lung diseases in epilepsy patients. However, accurate pharmacokinetic data in mice and men for both xanthines are necessary if one attempts to compare their cerebral and pulmonary actions.

L'effet anticonvulsivant du phénobarbital (PB) (120 minutes avant l'épreuve), de la phénytoïne (PHT) (120 min), de la barbamazépine (CBZ) (60 min), du valproate (VPA) (30 min) et de l'acétazolamide (60 min) donnés seuls ou associés à soit l'aminophylline (50 mg/kg; 30 min), soit à l'enprofylline (46.2 mg/kg; 30 min) a étéétudiée vis‐à‐vis des convulsions induites par électrochoc maximal chez la souris. Tous les produits ont été injectés i.p. et l'effet protecteur de chaque médicament a été exprimé comme ED50 en mg/kg. L'aminophylline a diminué l'activite anticonvulsivante du PB, de la PHT, de la CBZ et du VPA, en augmentant leur ED50 respectivement de 16 à 28 mg/kg, de 7.4 à 14 mg/kg, de 18 à 26 mg/kg et de 260 à 335 mg/kg. En revanche, l'enprofylline, à dose équimolaire, n'a pas fait preuve de tels effets. Ni l'aminophylline, ni l'enprofylline n'ont modifié l'action anticonvulsivante de l'acétazolamide. Ces résultats suggèrent que l'emprofylline doit être préférée dans le traitement des bronchopneumopathies obstructives chez les épileptiques. Cependant, il serait souhaitable de disposer de données pharmacodynamiques précises pour ces deux xanthines, chez la souris comme chez I'homme, si l'on veut essayer de comparer leurs effets pulmonaires et cérébraux.
Effects of Anticonvulsants on Cell Growth and Enzymatic and Receptor Binding Activity in a Neuroblastoma X Glioma Hybrid Cell Culture
Authors: Slesinger Paul A. , Singer Harvey S.
Published: November 2007

Summary: : The effects of anticonvulsants on markers of growth, intracellular enzymes, and synaptic functions were evaluated using a rapidly dividing cholinergic neuroblastoma x glioma hybrid cell‐line (NG108‐15). Cell cultures were exposed for 4 days to phenobarbital, phenytoin, carbamazepine, or valproic acid. Anticonvulsant concentrations added to the media were selected to produce free levels in the cell media that were equivalent to free levels in humans ranging from therapeutic to very toxic. Free levels of anticonvulsants in the toxic range affected cell number, protein content, and neurochemical markers. However, only valproic acid and phenytoin reduced cell growth at therapeutic free drug concentrations. Valproic acid was the only medication to act as a differentiating agent, significantly increasing the activity of choline acetyl transferase, (3‐galactosidase, and muscarinic cholinergic receptor binding. These results emphasize the importance of performing drug studies at appropriate free drug concentrations and suggest that valproic acid differs from other commonly prescribed anticonvulsants by having both a growth‐suppressing and a differentiating effect.
Acute Effect of Anticonvulsants on Amygdaloid Kindled Seizures Induced with Low‐Frequency Stimulations
Authors: Minabe Yoshio , Tanii Yasuyuki , Kurachi Masayoshi
Published: November 2007

Summary: : Acute effects of several antiepileptic drugs on low‐frequency amygdaloid‐kindled seizures were assessed. The number of stimulating pulses required for the provocation of epileptic afterdischarge (pulse‐number threshold, PNT) was used as an indicator for the seizure‐generating threshold. The duration of epileptic afterdischarge (AD duration) was used as an indicator for the severity of the induced seizures. Phenytoin (PHT) and carbamazepine (CBZ) reduced AD duration more than did elevating PNT. Conversely, phenobarbital (PB) and diazepam (DZP) elevated PNT more than did reducing AD duration. Weak effects on the two indicators, valproic acid (VPA) and ethosuximide (ESM), were observed. Low‐frequency kindling may be a useful experimental model of epilepsy in drug‐assessments.
Long‐Term Increase in Striatal Thyrotropin‐Releasing Hormone Receptor Binding Caused by Amygdaloid Kindling
Authors: Kajita Saburo
Published: November 2007

Summary: : Our previous finding that intracerebroven‐tricular (i.e.v.) administration of both thyrotropin‐releasing hormone (TRH) and its analogue, γ‐butyro‐lactone‐γ‐carbonyl‐L‐histidyl‐L‐prolinamide citrate (DN‐1417), suppressed seizure development of amygdaloid (AM) kindling and kindled AM seizures leads to a new hypothesis that endogenous TRH may be an antiepi‐leptic substance in the brain. In this study, we examined postictal chronological changes in both immunoreactive TRH (IR‐TRH) and TRH receptor binding activity in discrete brain regions of AM‐kindled rats to study the relationship of the brain TRH system to kindling‐induced seizure susceptibility. AM‐kindled rats were decapitated 30 min, 24 h, 48 h, 7 days, and 21 days after the last kindled convulsion. IR‐TRH increased markedly in the AM/pyri‐form cortex and hippocampus 24 and 48 h after the last convulsion, and returned to the control (unstimulated, sham‐operated) value within 3 weeks after the convulsions ended. In contrast, a significant increase in the striatal TRH binding sites was evident 24 h after the cessation of convulsions which lasted 21 days. A lasting change in the striatal TRH neural system may be related to kindling‐induced seizure susceptibility.
Failure of Neocortical Transplants to Alter Seizure Susceptibility in Previously Kindled Rats
Authors: Holmes Gregory L. , Thompson James L.
Published: November 2007

Summary: : Transplantation of embryonic tissue into the brains of host animals has been demonstrated to totally or partially correct functional lesions and neurohormonal deficits in a variety of animals. This study evaluated the hypothesis that “naive” embryonic neural tissue implanted into previously kindled animals will alter subsequent seizure susceptibility. At age 16 days, male rats were electrically kindled in the right amygdala (AM). Following kindling (age 19 days), rats underwent either transplants of embryonic neocortical tissue into the left dorsal hippocampus or a sham procedure. At age 84 days, both groups underwent transfer kindling in the left AM. In addition, two other groups of 19‐day‐old pups that had had electrode implantation in the right AM without subsequent kindling received either embryonic neocortical implants in the left dorsal hippocampus or a sham procedure and were kindled in the left AM for the first time at age 84 days. There were no differences in rate of kindling between the animals that received successfully grafted transplants and those that underwent sham procedures. Using the kindling model, transplantation of embryonic neocortical tissue into the hippocampus does not significantly alter seizure susceptibility in the host animal.
Prevalence of the Epilepsies in Nigerian Africans: A Community‐Based Study
Authors: Osuntokun B. O. , Adeuja A. O. G. , Nottidge V. A. , Bademosi O. , Olumide A. , Ige O. , Yaria F. , Bolis C. L. , Schoenberg Bruce S.
Published: November 2007

Summary: : A door‐to‐door survey to detect commonly occurring neurologic diseases was carried out in Igbo‐Ora, a large Nigerian town with a population of ∽20,000. Effective health care facilities have been operating in the community since 1963. Primary health care workers and nondoctor personnel administered a complete census, a screening questionnaire, and a simple screening neurologic examination. The pretested screening questionnaire had been shown in a pilot study to have a sensitivity of 95% for identifying those with epilepsy. Individuals positive on the screening phase of the survey were evaluated by neurologists and neurosurgeons, who used well‐defined criteria to make the diagnosis. There were 101 (48 males and 53 females) who suffered from active epilepsy (5.3 cases/1,000) on prevalence day. The highest age‐specific prevalence ratios occurred in those below age 20. The most common of the identifiable seizure types was complex partial seizures (52 cases). The prevalence ratio of epilepsy in this Nigerian town (with an effective health care system) is similar to that reported in some developed countries and several times lower than figures derived from studies in developing countries. These data suggest that an improved health care system would probably reduce the prevalence and burden of epilepsy in developing countries.
The Effect of Chronic Felbamate Administration on Anticonvulsant Activity and Hepatic Drug‐Metabolizing Enzymes in Mice and Rats
Authors: Swinyard Ewart A. , Woodhead Jose H. , Franklin Michael R. , Sofia R. Duane , Kupferberg Harvey J.
Published: November 2007

Summary: The possibility of tolerance development from chronic administration of felbamate (FBM) was investigated in mice and rats. Chronic administration (15 days) of FBM (150 mg/kg i.p.) in mice had no significant effect on either intravenous pentylenetetrazol (PTZ) seizure threshold or hexobarbital sleep time; however, hexobarbital sleep time was significantly increased after a single dose. Chronic administration (5–7 days) of FBM (48 or 95 mg/kg orally) in rats also had no significant effect on either maximal electroshock seizure activity or hexobarbital sleep time. Chronic administration of FBM at 238 mg/kg slightly decreased anti‐subcutaneous PTZ activity in chronically treated rats (one of eight protected) as compared with those receiving only a single dose (three of eight protected), but there was no significant change in hexobarbital sleep time. Chronic treatment of rats for 7 days with 48 mg/kg had no significant effect on any hepatic parameters. However, 95 or 238 mg/kg of FBM significantly increased p‐nitroanisole O‐demethylase activity. It is concluded that the increased hexobarbital sleep time induced by an acute dose of FBM reflects the CNS‐depressant effect of the substance. The increased p‐nitroanisole O‐demethylase activity observed after chronic administration may be indicative of some liver microsomal induction. Overall, FBM in doses ranging from 48 to 238 mg/kg appears to have minimal potential for tolerance development.
A Clinical Approach to the Child with Seizures and Epilepsy
Authors: Freeman John M.
Published: November 2007

Summary: Generalized tonic‐clonic seizures in children may have different causes and a different natural history than seizures and epilepsy in adults. The effects of medication may also be of greater importance during childhood. In making decisions about whether or not to treat a child who has had only one or a few seizures, the physician must consider the chance of further seizures and the possible consequences of further seizures. Since the major consequence of seizure recurrence is psychosocial, and since the psychosocial consequences of infrequent seizure recurrence vary with age during childhood and differ from those in adults, decisions about therapy should take these differences into account. The potential effects of anticonvulsants on learning and behavior should also be considered. Seizures should not be treated just “because they are there,” but rather only when the risks and consequences outweigh the benefits of being free of medication and its effects.

In summary, why do we treat seizures? We treat seizures because of their consequences. However, when talking about the patient who has had a single seizure or even two seizures, the consequences vary with age, with the time of the seizure, and with the precipitating factors of the seizure. Clearly, these are not the same for all individuals. In view of the side effects of medications and their lack of complete efficacy, perhaps we need not treat every patient who has had one or two seizures. The decision to treat, or not to treat, should be made in conjunction with the patient and/or the family, carefully weighing the unknowns on both sides of this equation. If this is done, then, not everyone who has one seizure or even two seizures will, or should, be treated.
Neonatal Seizures: Problems in Diagnosis and Classification
Authors: Mizrahi Eli M.
Published: November 2007

Summary: The clinical identification of neonatal seizures is critical for the recognition of brain dysfunction; however, diagnosis is often difficult because of the poorly organized and varied nature of these behaviors. Current classification systems are limited in their ability to communicate motor, autonomic, and electroencephalo‐graphic features of seizures precisely and to provide a basis for uniform effective diagnosis, therapy, and determination of prognosis. Recent investigations of neonates, utilizing bedside electroencephalographic/polygraphic/ video monitoring techniques, have provided the basis for improved diagnosis and classification of seizures in the newborn. These studies have demonstrated that not all clinical phenomena currently considered to be seizures require electrocortical epileptiform activity for their initiation or elaboration. In addition, the specific clinical character of the phenomena considered to be seizures, the clinical state of the infant, and the character of the EEG indicate the probable pathophysiological mechanisms involved and suggest probable etiologies, prognosis, and therapy. Similarities between animal models that demonstrate reflex physiology and neonates with motor automatisms and tonic posturing suggest that these clinical behaviors may not be epileptic in origin but, rather, primitive movements of progression and posture mediated by brainstem mechanisms. Although not all clinical behaviors currently considered to be neonatal seizures may have similar pathophysiological mechanisms, they are clinically significant because they all indicate brain dysfunction.
Pediatric Epilepsy Surgery
Authors: Goldring Sidney
Published: November 2007

Summary: The use of implantable arrays of epidural electrodes has made it possible to carry out extraoperative electrocorticography (ECoG) and functional localization in the awake child. This has permitted cortical excisions that are determined by criteria similar to those obtained during surgical procedures performed under local anesthesia in adults. In addition, the method also permits simultaneous ECoG and video monitoring during the child's symptomatic seizures, providing additional important localizing information that is impractical to obtain in operations under local anesthesia. We report our experience with 75 children, ages 5 months to 15 years, whom we have managed with epidural electrode arrays. The method of extraoperative ECoG is described and illustrative cases are presented to demonstrate its feasibility and utility in children. In addition, we call attention to gliomas as a common cause of chronic focal seizures in children. Of 49 children undergoing resection and followed for from 1 to 14 years (mean of 5.8 years), 32 (65%) are either seizure free or have had a significant reduction in seizure frequency that has unambiguously improved their quality of life. The results are analyzed further by relating the surgical outcome to each of the pathologic entities that caused the seizures. This analysis reveals the variety of neurological conditions that commonly cause intractable focal seizure disorder in children and distinguishes those pathologic entities in which the seizure disorder is apt to respond to surgical intervention from those that will not.
Treatment Considerations in Anticonvulsant Monotherapy
Authors: Wilder B. J.
Published: November 2007

Summary: The long‐standing practice of polypharmacy in treating epilepsy is giving way to use of monotherapy. Monotherapy can improve seizure control as well as reduce the risk of serious idiosyncratic reactions, dose‐related side effects, and complex drug interactions. Monotherapy also offers improved compliance and cost‐effectiveness. The basis of monotherapy is accurate diagnosis and assessment of the patient's seizure type(s), followed by selection of a single appropriate anticonvulsant drug. Many patients currently treated with multiple anticonvulsants can be successfully converted to monotherapy with a carefully monitored program in which troublesome and redundant drugs are gradually withdrawn from the therapeutic regimen.
Monotherapy with Valproate in Primary Generalized Epilepsies
Authors: Bourgeois B. , Beaumanoir A. , Blajev B. , de la Cruz N. , Despland P.A. , Egli M. , Geudelin B. , Kaspar U. , Ketz E. , Kronauer Ch. , Meyer Ch. , Scollo‐Lavizzari G. , Tosi C. , Vassella F. , Zagury S.
Published: November 2007

Summary: Sodium valproate enteric‐coated tablets were administered as monotherapy to 118 patients (median age, 19 years) with primary generalized epilepsies. More than half (56%) of these patients were transferred from prior drug therapy, most of them because of inadequate seizure control, and some because of adverse effects. Seventy‐one percent of the patients experienced tonic‐clonic seizures, either alone or in combination with other types of seizures, principally absences. Mean duration of follow‐up was 18 months (median, 17 months; range, 1–68 months). At a mean daily dosage of <20 mg/kg, 83% of the patients became seizure‐free. Therapy was equally effective against tonic‐clonic seizures, absences, and myoclonic seizures. Tonic‐clonic seizures were suppressed in 85% of cases (89% when patient had only one seizure type), absences in 82% (95% when patient had only one seizure type), and myoclonic seizures in 82%. Paroxysmal activity was present in 88% of the electroencephalogram (EEG) records before valproate monotherapy, and in 32.4% at the study's end. These results were achieved with generally mild and mostly transient side effects; side effects were reported by 16% of patients during the first month, and 2% at the last follow‐up. No hematologic or hepatic toxicity was observed. The lag time between attaining steady‐state serum concentrations and achieving maximal clinical improvement suggests that sodium valproate monotherapy should be given an adequate trial to ensure that patients derive the greatest possible benefit before adding or switching to another drug.
Carbamazepine Efficacy in Adults With Partial and Generalized Tonic‐Clonic Seizures
Authors: Wilder B. J. , Rangel Rogelio
Published: November 2007

Summary: Carbamazepine and phenytoin are drugs of choice in initial monotherapy for adult partial and secondarily generalized tonic‐clonic seizures. These designations reflect the results of the Veterans Administration Epilepsy Cooperative Study Group of 1985. An earlier comparative study of carbamazepine and phenytoin by Ramsay and associates found both drugs equally effective in controlling new‐onset seizures. Among the advantages of carbamazepine is that it causes relatively few cognitive and dysmorphic side effects. Its disadvantages are its unavailability in parenteral formulation and its metabolic autoinduction. The latter must be compensated for by planned dosage increases to maintain therapeutic plasma steady‐state levels during the first 2 or 3 months of treatment. Carbamazepine is judged a drug of choice in the treatment of these secondarily generalized tonic‐clonic seizures, and the drug of choice in children, adolescents, and women susceptible to the dysmorphic side effects associated with other anticonvulsant agents.