bluuebunny/crossref_metadata_2025 huggingface dataset:
Problematika Implementasi Peraturan Bupati Nomor 22 Tahun 2018 tentang Penataan Stand dan Penempatan Pedagang (Studi Kasus Pasar Waru Kabupaten Sidoarjo)
Authors: Ardila Eris Marantika
Published: March 2024

Tujuan dari penelitian ini adalah untuk mengetahui secara aktual dan faktual mengenai regulasi tentang penataan stand dan penempatan pedagang di Pasar Waru Kabupaten Sidoarjo serta untuk mengetahui faktor penghambat serta pendukung kegiatan tersebut. Peneliti mengambil tema ini dikarenakan Kabupaten Sidoarjo terkenal sebagai kota perdagangan dan industri yang salah satunya memicu tumbuhnya kelompok kecil yang mempertemukan penjual dan pembeli, salah satunya adalah pasar. Dengan munculnya peluang ini maka Pemerintahan Daerah mengeluarkan Peraturan Daerah Nomor 22 Tahun 2018 tentang Penataan Stand dan Penempatan Pedagang Pasar. Penelitian ini menggunakan metode analisis kualitatif dengan jenis penelitian deskriptif. Penelitian ini didasarkan pada teori Merille S. Grindle tentang Kriteria Pengukuran Implementasi serta teori yang digagas oleh Van Meter dan Van Horn mengenai Model Implementasi Kebijakan (A model of the policy implementation). Hasil penelitian menunjukkan dalam implementasi penataan stand dan penempatan pedagang di Pasar Waru masih kurang maksimal karena adanya ketidaksesuaian implementator dalam menjalankan kebijakan tersebut terhadap peraturan yang ada. Dari problematika dan konflik tersebut para pedagang membentuk sebuah paguyuban yang bernama “Maju Bersama” sebagai bentuk penolakan terhadap penataan stand dan penempatan pedagang serta kembalinya pedagang untuk berjualan di Pasar Waru lama. Faktor penghambat dalam penerapan Perda ini adalah tidak adanya pemerataan dalam pembagian stand oleh Dinas Perindustrian dan Perdagangan; sepinya lokasi pasar yang baru sehingga memicu kembalinya pedagang pasar ke Pasar Waru lama serta; adanya biaya parkir yang membebani pembeli dan penjual.
Implementasi Bantuan Sosial Tunai pada Masa Pandemi Covid-19 di Kecamatan Semampir Kota Surabaya
Authors: Diana permatasari oktaviani
Published: March 2024

Kebijakan bantuan sosial ada beberapa bentuk ada bantuan sosial tunai, bantuanr berupa sembako dan program keluarga harapan bantuan- bantuan ini pasti memiliki tujuanb yaitu membantu mensejahterahkan masyarakatnya dan focus utama pada skripsi ini yaitu kebijakan bantuan sosial tunai dan bantuan itu berupa uang tunai sebesar Rp. 300.000 yang diberikan secara langsung di kantorp pos yang terpiih dimasing- masing kelurahan. Lalu Penelitian tentang Implementasi Bantuan Sosial Tunai pada masa pandemic covid-19 di kecamatan Semampir Kota Surabaya bertujuan untuk mendeskripsikan implementasi   bantuan social tunai dan menganalisis factor- factor pendukung dan penghambat pada pelaksanaan bantuan social tunai di kecamatan Semampir.
Penelitian menggunakan metode kualitatif kerena pengumpulan datanya menggunakan wawancara dan dokumentasi. Teori yang digunakan dalam melihat fenomena yang terjadi pada implementasi kebijakan public menurut Van Metter dan Carl Van Horn.
Implementasi dari bantuan social tunai ini berupa sosialisasi program, verifikasi data, pembagian data, pembagian kartu, pencairan dana dan pembuatan laporan. Factor pendukung dari keberhasilan terdapat pada pencairan dana dengan sumber daya manusia yang cukup menjadikan penyaluran dana terlaksana sesuai dengan jadwal yang sudah ditetapkan dan factor penghambat dari implementasi tersebut pada terletak pada sosialisasi yang tidak merata jadi ada warga yang tidak mendapat bantuan sosial tersebut .
Peran KPU Kota Surabaya Melalui Rumah Pintar Pemilu Bung Tomo dalam Pengembangan Pendidikan Politik Masyarakat
Authors: Moch Indra Kurniawan
Published: March 2024

Penelitian ini mengkaji tentang “Peran KPU Kota Surabaya Melalui Rumah Pintar Pemilu (RPP) Bung Tomo Dalam Pengembangan Pendidikan Politik Masyarakat”. Penulis menggunakan dua rumusan masalah yaitu Bagaimana upaya KPU Kota Surabaya dalam membentuk Rumah Pintar Pemilu (RPP) Bung Tomo dan Bagaimana efektivitas Rumah Pintar Pemilu (RPP) Bung Tomo dalam pengembangan pendidikan politik bagi masyarakat Kota Surabaya. Tujuan dari penelitian ini untuk mengetahui bagaimana upaya KPU Kota Surabaya dalam membentuk Rumah Pintar (RPP) Pemilu Bung Tomo dan mengembangkan pendidikan politik masyarakat. Dalam hal ini peneliti menggunakan metode deskriptif kualitatif. Teknik pengumpulan data menggunakan observasi, wawancara dan dokumentasi. Teori yang digunakan dalam penelitian ini yaitu Teori Efektivitas, Teori Partisipasi Politik, dan Teori Demokrasida sebagai program Prioritas Nasional KPU RI yaitu di setiap Komisi Pemilihan Umum (KPU) Provinsi dari tingkat Nasional dan Provinsi, maupun Kota untuk mendirikan Rumah Pintar Pemilu (RPP). Tujuan dari adanya Rumah Pintar Pemilu (RPP) adalah sebagai pusat informasi masyarakat tentang pemilu dan demokrasi. Rumah Pintar Pemilu (RPP) disepakati dengan nama Rumah Pintar Pemilu (RPP) Bung Tomo karena dari semangat juang membara dari Bung Tomo. Rumah Pintar Pemilu (RPP) Bung Tomo diresmikan pada 18 April 2017, Masyarakat dapat berkunjung ke RPP setiap hari di jam kerja untuk mengetahui tentang informasi yang diberikan RPP. Hal ini dilakukan agar masyarakat mendapatkan informasi terkait pendidikan politik dan wadah edukasi bagi masyarakat maupun kelompok komunitas untuk belajar tentang pemilu dan demokrasi. KPU Kota Surabaya telah melakukan efektivitas Rumah Pintar Pemilu dengan bekerja sama dengan beberapa sekolah di Surabaya dan Universitas di Surabaya untuk mengembangkan efektivitas adanya Rumah Pintar Pemilu Bung Tomo.
Analisis Politik Ruang Terbuka Hijau Studi Kasus pada Kecamatan Lamongan, Kabupaten Lamongan
Authors: Abdillah Qomaru Zaman  , M. Zimamul Khaq
Published: March 2024

This study seeks to explain: (1) How is environmental politics in the form of green open space development in Lamongan distict, Lamongan Regency (2) How is the dynamics of interests between actors in the practice of green open space development. The results that can be conveyed are (1) Development of green open space in Lamongan district until now is still not optimal; the ability of the community to actively participate in environmental management programs is very small. This condition has an impact on the function of green open space that has not been felt by the community and has an impact on aspects of maintenance that are not given attention. From the research results, the development of Green open space in Lamongan district is still dominated by private green open space which is more than 90%. Meanwhile, the allocation for green belt land use, parks and recreation areas is still not maximal. If we connect with the Minister of Public Works Regulation No. 5 of 2008, this is very far from expected because the ratio of green open space is 30 percent of the total area of ??Lamongan which reaches 1,782 km2 (2) District Government. Lamongan is currently still focusing on economic issues and putting aside environmental issues, especially green open space, therefore sustainable development is very difficult to carry out optimally in Lamongan district. The government in making spatial planning only prioritizes capitalist interests, and or more provides space andonly for investors.
Analisis Framing Pemberitaan Gender dalam Pembahasan Omnibus Law Cipta Kerja pada Kompas.com dan Tempo.co
Authors: Wibisono Devi Jihadillah
Published: March 2024

Artikel ini fokus pada pemberitaan gender dalam pembahasan Omnibus Law Cipta Kerja yang dimuat di Kompas.com dan Tempo.co dengan menggunakan analisis framing. 2 media online ini dipilih karena perkembangan teknologi informasi dan komunikasi menjadikan media online lebih disukai dibandingkan dengan media konversional disebabkan karena kemudahan penggunaannya. Di sisi lain, dalam setiap pemberitaan, media selalu dipengaruhi oleh ideologi, kekuasaan dan kepentingan pemilik media. Artikel ini merupakan hasil penelitian dengan menggunakan analisis framing yang mengikuti konsep Zhong Dang Pan dan Gerald M. Kosicki. Aspek yang dilihat adalah aspek sintaksis, Skrip, tematik dan retoris dalam menganalisa berita. Hasil penelusuran menunjukkan, bahwa Kompas.com dan tempo.co memiliki kesamaan yakni keduanya memenuhi 5W + 1H dalam analisisnya. Bedanya, pemberitaan Kompas.com memberikan ruang dua pihak, yakni buruh dan juga pemerintah serta pemilihan kata yang dipakai lebih halus dan moderat. Sedangkan pada Tempo.co hanya memberikan ruang pada buruh untuk menyampaikan aspirasinya dan kata yang dipakai lebih terksan negatif serta lebih ekspresif. Secara umum, pemberitaan yang ada berisikan kerugian buruh perempuan dan tuntutannya terhadap peraturan yang dianggap sangat tidak ramah terhadap perempuan serta melanggengkan kemiskinan dan kekerasan terhadap perempuan.
Neuroplasticity: Pathophysiology and Role in Major Depressive Disorder
Authors: Kadiyala Sreeharshini , Bhamidipati Priyamvada , Malla Rama Rao
Published: March 2024

Neuroplasticity is characterized by the brain's ability to change its activity in response to extrinsic and intrinsic factors and is thought to be the mechanism behind all brain functions. Neuroplasticity causes structural and functional changes on a molecular level, specifically the growth of different regions in the brain and changes in synaptic and post-synaptic activities. The four types of neuroplasticity are homologous area adaption, compensatory masquerade, cross-modal reassignment, and map expansion. All of these help the brain work around injuries or new information inputs. In addition to baseline physical functions, neuroplasticity is thought to be the basis of emotional and mental regulations and the impairment of it can cause various mental illnesses. Concurrently, these mental illnesses further the damage of synaptic plasticity in the brain. Major depressive disorder (MDD) is one of the most common mental illnesses. It is affected by and accelerates the impairment of neuroplasticity. It is characterized by a chronically depressed state of mind that can impact the patient's daily life, including work life and interests. This review will focus on highlighting the physiological aspects of the disease and the role of neuroplasticity in the pathogenesis and pathology of the disorder. Moreover, the role of monoamine regulation and ketamine uptake will be discussed in terms of their antidepressant effects on the outcomes of MDD.
Asystole induced by electrical stimulation of the left cingulate gyrus
Authors: Leung Howan , Schindler Kasper , Kwan Patrick , Elger Christian
Published: March 2024

The cortical control of the autonomic system may account for the clinical phenomenon of ictal asystole which, in turn, has been speculated to be a potential mechanism for sudden unexpected death in epilepsy (SUDEP). We report an 18‐year‐old patient with frontal lobe epilepsy who had intracranial electrode placement showing bifrontal seizure‐onset. This patient received electrical stimulation to the left cingulate gyrus and developed cardiac asystole within 3 seconds of electrical stimulation. Intracranial monitoring showed epileptiform discharges in the left frontal polar, frontal lateral and interhemispheric electrodes. We suggest that the left cingulate gyrus, as part of the central autonomic network, may mediate bradyarrhythmia through the vagal pathway. There remains the possibility that other brain regions were also involved due to the time lag between asystole and epileptiform discharges, and the lack of intracranial exploration in the mesial temporal and insular regions.[Published with video sequences]
Screen sensitivity in photosensitive children and adolescents: patient‐dependant and stimulus‐dependant factors
Authors: Bruhn Katia , Kronisch Saskia , Waltz Stephan , Stephani Ulrich
Published: March 2024

Television viewing is the most frequent cause of photogenic attacks in daily life. In the present study, we examined 48 photosensitive children and adolescents to find out: 1) whether hypersynchronous activity is induced less often by viewing a PC monitor than a television screen and 2) whether certain images are more likely to cause hypersynchronous activity than others. All subjects were tested for sensitivity to intermittent photic stimulation (IPS) and to a black and white striped pattern on cards. Additionally, all were subjected to stimuli from four different images (vertical black and white striped pattern, geometric figures, text, and a painting by Max Pechstein – 1913, Italian church), presented on a television screen (with an image regeneration frequency of 50 Hz) and on PC screens (with regeneration frequencies of 48 and 100 Hz). A total of 21 non‐photosensitive, healthy children and adolescents served as controls. Of the 48 photosensitive subjects 13% were also pattern sensitive (cards), and 33% exhibited screen sensitivity. No differences were found between the three monitor types. However, the hypersynchronous reactivity to the four images presented was significantly different, with high contrast vertical striped pattern being the most provocative. Non‐photosensitive subjects did not react to any of the stimuli. The results of the present study show that screen‐dependant factors are less important than image‐dependant factors.
Successful epilepsy surgery with a resection contralateral to a suspected epileptogenic lesion
Authors: Krsek Pavel , Tichy Michal , Hajek Milan , Dezortova Monika , Zamecnik Josef , Zedka Milan , Stibitzova Radana , Komarek Vladimir
Published: March 2024

We report on a case of frontal lobe epilepsy in an eight‐year‐old girl. Seizure semiology and EEG indicated an epileptogenic zone localized in the mesial frontal structures, without clear‐cut lateralization. MRI showed a lesion in the right cingulate gyrus, initially regarded as a hamartoma. Ictal SPECT did not have a localization value. MR spectroscopy revealed two metabolic abnormalities: one in the area of the MRI lesion and a second contra‐laterally. Invasive monitoring using subdural electrodes covering the convexity and mesial part of the right frontal lobe including mesial strips with bilateral contacts was used. The invasive monitoring failed to localize ictal onset in the right hemisphere; however, electric stimulation induced seizures from electrodes facing the left supplementary sensorimotor area (“through” thefalx cerebri). We re‐implanted the electrodes over the left frontal lobe and the second invasive monitoring clearly localized the ictal onset zone in the left supplementary sensorimotor area, which was subsequently resected. Histopathology found MRI‐negative focal cortical dysplasia. The contralateral lesion was reassessed as nonspecific enlargement of perivascular spaces. The patient has been seizure‐free for more than two years.

[Published with video sequences]
Epilepsy in a rural elderly population
Authors: Baran Mona , Stecker Mark M.
Published: March 2024

Purpose

The first goal of this study was to describe the characteristics of elderly patients with epilepsy and the antiepileptic drugs used to treat them. Next, the factors (such as epilepsy type, seizure frequency, medical comorbidities, etc.) influencing antiepileptic drug choice and living situation were explored.

Methods

Retrospective chart review of patients older than 70 with epilepsy seen in a rural health care system. This yielded 449 patients with epilepsy, 54 patients with isolated seizures and 38 patients with syncope as the primary diagnosis.

Results

The most commonly used antiepileptic drug was phenytoin. New generation AED's which had fewer side effects were used much less frequently than old generation AED's but the probability of using new generation AED's was increased in patients with renal failure and congestive heart failure as well as in patients that had seen a neurologist. Patients with acute symptomatic seizures, dementia, chronic obstructive pulmonary disease, frequent seizures and advanced age were less likely to be independent. Patients that had seen a neurologist as an outpatient were more likely to live independently.

Conclusions

The elderly are a vulnerable population because of difficulty communicating their symptoms and their needs. This leads to the suboptimal use of AED's as well as poor outcomes. Careful attention to seizure control and medication side effects is critical in promoting good outcomes in this patient group. This retrospective study suggests that access of elderly patients with epilepsy to specialty care improves outcomes in terms of living status. This important information needs to be confirmed by prospective studies.
Oligoastrocytoma presenting with intractable epilepsy
Authors: Hiremath Girish K. , Bingaman William E. , Prayson Richard A. , Nair Dileep
Published: March 2024

Objective

Oligoastrocytomas (OA) are mixed gliomas with distinct oligodendroglial and astrocytic neoplastic components. Very little about OA has been reported in the intractable epilepsy population.

Methods

We undertook a retrospective review of 923 patients who underwent resective surgery for intractable epilepsy between 1996 and 2004.

Results

6/923 (0.7%) patients were diagnosed with OA. Five patients were female, one was male. Median age at diagnosis was 25 years (range 19‐44 years). Tumors arose from the left side in all patients and from the temporal lobe in five patients. Three patients had complex partial seizures. Median length of refractory epilepsy prior to surgery was 10.5 years (range 1‐28 years), and the median number of antiepileptic drugs used was 2 (range 1‐10). Preoperative WADA testing for language and memory localization was done for three patients; preoperative stereotactical localization was done for three patients. Surgical pathology revealed low‐grade OA (WHO II) in five patients, and anaplastic OA in one. There were no surgical complications, clinical or radiographic tumor recurrence at a mean follow up period of 3.2 years (range 2‐8). Excellent seizure freedom was achieved in 5/6 patients.

Conclusion

As a result of our small sample size, general conclusions may be imprecise, but this review suggests that OA behave similar to other tumors related to intractable epilepsy: they usually have a preoperative seizure course of many years, an excellent rate of seizure‐freedom following surgery, and are in general, low‐grade tumors with an indolent course for which serial imaging is sufficient follow‐up.
Seizures induced by the sight of moving water
Authors: Bauer Sebastian , Knake Susanne , Haag Anja , Hermsen Anke , Strzelczyk Adam , Hamer Hajo M. , Rosenow Felix
Published: March 2024

The most frequent precipitants of photic‐ or pattern‐induced seizures are television and discotheque lighting effects. Seizure induction by reflection of bright sunlight on water surfaces has also been reported. We report a patient with seizures induced by the sight of moving water in the absence of bright sunlight.[Published with video sequences]
Monoamine metabolism study in severe, early‐onset epilepsy in childhood
Authors: Echenne Bernard , Roubertie Agathe , Leydet Julie , Rivier François , Hoffmann Georg Friedrich
Published: March 2024

Purpose

To investigate the possible dysfunction of monoamine metabolism in patients with early‐onset, epileptic encephalopathies.

Methods

The CSF dopamine, serotonin and biopterin metabolites were studied in 37 patients with severe, mostly drug‐resistant epilepsy.

Results

No significant abnormality was found, whatever the type of epilepsy, cryptogenic or symptomatic.

Conclusions

The present study failed to demonstrate that dysfunction of the main neurotransmitters pathways is a common phenomenon in children with early‐onset, severe epileptic encephalopathy.
Identifying seizure‐onset zone and visualizing seizure spread by fMRI: a case report
Authors: Auer Tibor , Vető Katalin , Dóczi Tamás , Komoly Sámuel , Juhos Vera , Janszky József , Schwarcz Attila
Published: March 2024

Aim

To visualize by ictal, functional MRI, the initial haemodynamic change (i.e.putative seizure‐onset zone) and subsequent seizure spread during an epileptic seizure.

Methods

A 20‐year‐old woman was investigated during a simple partial seizure consisting of right‐sided mouth clonus. An internal reference curve, correlated with signal change pixelwise, was applied to obtain correlation coefficient maps. The reference curve was shifted scan by scan to examine the correlation at each time point. To demonstrate seizure onset and propagation, a lag time map was produced showing the temporal sequence of activation in various brain regions.

Results

fMRI analysis showed that the lower part of the insular cortex was activated first, and its signal alteration preceded the clinical beginning of the seizure (i.e.mouth clonus) by more than one minute. Most of the activations started before clinical seizure onset. The activation corresponding to the motor area of the right face showed only a 7.5 second‐long, pre‐ictal phase. BOLD signal alterations were also observed in the left caudate nucleus, left thalamus, along with various areas of the left cerebral and cerebellum hemispheres.

Conclusions

The present study demonstrates a whole‐brain activity simultaneously in time and space, during an epileptic seizure. Our results also support the existence of the pre‐ictal state in epilepsy. Replication of our results would be of major interest for presurgical evaluation of patients with drug‐resistant epilepsy.
Unilateral mydriasis during temporal lobe seizures
Authors: García‐Martín Ana M. , Molina‐Martínez Francisco J. , Amer‐Ferrer Guiem , Sureda‐Ramis Bernat , Moreno‐Rojas Antonio J. , Barceló‐Artigues Inés
Published: March 2024

Autonomic signs and symptoms are a common feature of epileptic seizures. Although sympathetic activation responses are predominant, we can also find sympathetic inhibition and even an activation of the parasympathetic division of the autonomic nervous system, especially in partial seizures. These autonomic symptoms during seizures are thought to be the result of neuronal discharges arising from or spreading to cortical areas of the central autonomic network. Mydriasis, most commonly bilateral, is one of the most frequent findings. The patient described, a middle‐aged man with a focal lesion in the right temporal lobe extended to the adjacent hypothalamus, presented with episodes of autonomic symptoms including prominent unilateral mydriasis, finally evolving into a state of decreased alertness. An ictal electroencephalogram and a simultaneous video recording supported the clinical impression of an epileptic aetiology. Unilateral mydriasis is a rare condition during epileptic seizures and very few cases have been reported in the past.

[Published with video sequences]
Familial Creutzfeldt‐Jakob disease presenting as epilepsia partialis continua
Authors: Lowden Max R. , Scott Kevin , Kothari Milind J.
Published: March 2024

Creutzfeldt‐Jakob disease (CJD) is a rare disorder caused by prions that can affect any part of the central nervous system. It is characterized by a long incubation period, but once symptoms start there is a progressive neurological decline. Clinical features include dementia, ataxia and myoclonus (startle), among others. We report a biopsy‐proven case of familial CJD (fCJD) presenting with continuous focal seizures, epilepsia partialis continua (EPC), as the initial presentation. CJD is an unusual neurological disorder with an incidence of approximately one case per million population (Prusiner 2001). The disorder is due to neuronal degeneration resulting from the accumulation of a pathological isoform (PrP) of the prion protein (PrPc). Patients with fCJD have mutations in the gene encoding PrPc (PRNP) (Vercueil 2006, Collins
et al.
2004). This fCJD represents 10‐15% of CJD cases making the sporadic form more common 85‐95% (Parry
et al.
2001). During the course of the disease myoclonus has been reported in 88% of cases, and epileptic seizures (partial seizures, generalized status epilepticus) in 8% (Vercueil 2006). Periodic sharp wave complexes (PSWC) are uncommon in fCJD and occur in about 10% of patients (Wieser
et al.
2006).
Absence of increased blood decanoic acid levels in children with epilepsy treated with classic ketogenic diet
Authors: Enderlin Julie , Loussouarn Anna , Benoist Jean‐François , Dozières‐Puyravel Blandine , Auvin Stéphane
Published: March 2024

Aim
. Recently, decanoic acid (C10), a medium‐chain fatty acid, was shown to be a direct inhibitor of the AMPA receptor. Accordingly, C10 has been suggested as a potential anticonvulsant factor in the ketogenic diet (KD) or the medium‐chain triglyceride KD. Here, we tested whether C10 serum levels correlate with the response to KD in five children (1.5 ± 0.6 years of age) with epilepsy.

Methods
. The serum levels of C10 were measured before and after KD initiation (
n
=2 at one month,
n
=3 at three months, and
n
=1 at six months after initiation) by gas chromatography‐mass spectrometry.

Results
. After three months on KD, two patients were found to be responders. The mean serum level before KD initiation was 63.2 μM. Only one patient, who was a non‐responder, showed an increase (5%) in C10 serum level after a month of KD. The remaining four patients (two responders) showed a decrease in the C10 level from −5.3% to −75.5%.

Conclusion
. Our preliminary data show that KD does not lead to an increase in C10 serum levels, suggesting that increased concentration of C10 might not be directly involved in the anticonvulsant effects of classic KD.
Hemifacial spasm or subcortical epilepsy?
Authors: Arzimanoglou Alexis A. , Salefranque Françoise , Goutières Françoise , Aicardi Jean
Published: March 2024

A child with Goldenhar's syndrome presented at about one week of age with stereotyped, repetitive paroxysmal episodes of hemifacial contraction, suggestive of partial seizures or hemifacial spasm. Later in life he also developed independent, permanent abnormal eye and chin movements identical in rhythm to those seen in myorhythmias, suggesting involvement of the dentato‐olivary pathway. MRI demonstrated a hamartomatous lesion at the level of the pontomedullary junction. We speculate that the nature of the lesion could be responsible for the partial seizures mimicking hemifacial spasm and that because of its location, this same lesion could also be implicated in the genesis of myorhythmias. The presence of a hamartomatous lesion in a region affected by the abnormal development of the first and second branchial arches is not fortuitous.
When is imaging enough?
Authors: Engel Jerome
Published: March 2024

Despite tremendous recent advances in both structural and functional neuroimaging, these tests alone are not enough to recommend surgery for medically refractory epilepsy. A detailed history, careful description of the ictal events, and the neurological examination will always be necessary. Interictal EEG and neuropsychological testing also add important information. In many situations, however, video‐EEG monitoring of habitual seizures now plays a confirmatory, rather than a primary, role in the presurgical evaluation, and can occasionally contribute confounding data that delay or prevent surgical intervention. In the present climate of cost‐containment, it is reasonable to ask if this expensive diagnostic tool is
always
needed when it is clear by other means that seizures are not psychogenic, particularly in certain pediatric surgically remediably syndromes such as those catastrophic epilepsys of infants and young children amenable to hemispherectomy, and drop attack that can be treated with corpus callosotomy, as well as mesial temporal lobe epilepsy and seizures due to discrete resectable lesions that often become medically intractable in adolescence. Retrospective studies should be carried out to determine when long‐term, in‐patient, video‐EEG monitoring in these conditions add information that appropriately changes the therapeutic approach.
Encephalopathy with epileptic spasms resolved with corticoids in a 69 year‐old patient
Authors: Maton Bruno , Picard Fabienne , Njamshi Alfred , Roth Serge , Slosman Daniel , Sztajzel Roman , Jallon Pierre , Landis Theodor
Published: March 2024

A 69 year‐old man with a history of recent temporal lobe seizures, presented with progressive coma and frequent epileptic spasms. Ictal EEG, PET and SPECT alterations were strikingly similar to those described in infantile spasms. Conventional antiepileptic drugs were ineffective but the introduction of corticoids induced a dramatic improvement with disappearance of the spasms. The etiology remains unknown. Epileptic spasms may occur in the elderly. If conventional antiepileptic drugs are ineffective, corticoids should be tried immediately.
Tonic reflex seizures of early infancy: an age‐related non‐epileptic paroxysmal disorder
Authors: Vigevano Federico , Lispi Maria Luisa
Published: March 2024

Non‐epileptic paroxysmal disorders (NEPD) include a heterogeneous group of disorders that can be confused with epileptic manifestations. They occur very frequently in the first year of life and are expressed predominantly as unusual movements.

We report the clinical and EEG‐polygraphic characteristics of 13 patients (nine male, four female) that we observed between 1988 and 1999, who presented non‐epileptic tonic reflex seizures in the first months of life.

All children had normal psychomotor development with no neurological antecedents. Onset of manifestations occurred between the first and third month of life. The seizure was characterized by diffuse tonic contraction with extension of four limbs, apnoea and cyanosis, and lasted 3‐10 sec without loss of consciousness. Seizures occurred only while the child was awake and being held in a vertical position by an adult, and were triggered by movement or tactile stimulation.

Ictal and interictal EEG were normal. Prognosis was benign with spontaneous remission within 2 months of onset.

In our experience, this paroxysmal manifestation has not been described previously by other authors and represents a new NEPD which, in accordance with our first report of this entity, we suggest calling tonic reflex seizure of early infancy (TRSEI). (Published with videosequences.)
Analyse dipolaire des paroxysmes intercritiques et critiques en EEG et MEG
Authors: Merlet Isabelle
Published: March 2024

Les méthodes de modélisation dipolaire permettent d'estimer statistiquement la localisation et l'orientation des sources des signaux électroencéphalographiques (EEG) ou magnétoencéphalographiques (MEG). Ces méthodes ont été appliquées aux paroxysmes intercritiques depuis plus de 20 ans et suggèrent que la genèse des paroxysmes intercritiques repose plus sur l'expression d'un réseau de structures anatomiques que sur l'activation d'une région très focale. Nous examinons dans cette revue: (1) l'étendue de ce réseau selon différents types d'épilepsies, (2) les rapports entre ce réseau et les anomalies structurelles identifiées grâce à l'imagerie par résonance magnétique (IRM) ou les anomalies fonctionnelles observées en tomographie par émission de positons (TEP), et (3) la concordance spatiale et temporelle des sources dipolaires des paroxysmes intercritiques et critiques avec les enregistrements intracrâniens simultanés. Les informations issues des données de la modélisation dipolaire des pointes intercritiques sont généralement insuffisantes pour planifier une chirurgie sélective sans enregistrements invasifs. Cependant, les résultats des études examinées dans cette revue montrent que, confrontés aux données des autres techniques non invasives, les résultats de la modélisation dipolaire peuvent s'avérer utiles pour mieux définir la limite de la zone épileptogène ou l'étendue de l'implantation stéréo‐électroencéphalographique (SEEG).
Modélisation des signaux SEEG et interprétation des mesures de relation dans les crises temporales: une approche de l'étude des réseaux épileptogènes
Authors: Wendling Fabrice , Bartolomei Fabrice
Published: March 2024

Ce travail s'inscrit dans le contexte de l'analyse des signaux stéréoélectroencéphalographiques (SEEG, électrodes intra‐cérébrales) enregistrés chez des patients épileptiques. Notre objectif est de progresser sur l'identification de la zone cérébrale responsable du déclenchement des crises d'épilepsie et sur la compréhension de son organisation. Des méthodes de traitement du signal peuvent être mises en œuvre dans cette démarche. Cependant, les quantités calculées doivent être: i) bien comprises dans le cadre des signaux SEEG qui possèdent des propriétés non linéaires et ii) reliées, dans la mesure du possible, à l'organisation sous‐jacente des populations neuronales appartenant aux structures cérébrales impliquées dans la génération des signaux. Dans ce travail, nous montrons comment la modélisation (description macroscopique) permet d'établir une telle relation. Elle part d'un modèle des populations nuronales physiologiquement pertinent capable de simuler des signaux épileptiformes réalistes. Le modèle est utilisé pour évaluer les performances d'une méthode de régression non linéaire pour la caractérisation des couplages inter‐structures à partir des signaux SEEG qu'elles produisent [2, 3]. Deux quantités, respectivement reliées aux paramètres de couplage inter‐populations dans le modèle (degré/direction), sont présentées. Elles ont été mesurées sur des signaux SEEG réels, enregistrés chez des patients souffrant d'épilepsie temporale, candidats à un traitement chirurgical. Les résultats montrent que la caractérisation des couplages fonctionnels permet d'identifier des réseaux, dits «épileptogènes», qui pourraient être responsables du déclenchement des crises. Ils permettent également d'affiner notre classification des épilepsies temporales [4, 5] en confirmant l'existence de patterns critiques récurrents, classés à partir de la caractérisation des interactions entre structures médiales et structures latérales néocorticales. A partir des réseaux épileptogènes initiaux, il est possible de décrire des réseaux de propagation dont l'organisation est différente et qui jouent un rôle majeur dans l'expression clinique des crises.
Epilepsies et troubles de l'apprentissage chez l'enfant. Situation du problème
Authors: Motte Jacques
Published: March 2024

Les épilepsies sont particulièrement fréquentes chez l'enfant. Le retentissement de ces épilepsies sur les apprentissages est très mal connu. Un certain nombre d'études ont étudié le retard mental dans l'épilepsie. Cependant très peu d'études s'intéressent aux fonctions cognitives de l'enfant qui présente une épilepsie. Seuls certains syndromes épileptiques, comme le syndrome de West ou le syndrome de Lennox‐Gastaut ont fait l'objet d'études neuropsychologiques. Il paraît cependant important de s'intéresser au profil neuropsychologique des différents types d'épilepsie (épilepsie généralisée, épilepsie partielle, idiopathique ou non idiopathique). Ceci est d'autant plus important que certains outils de dépistage des troubles cognitifs font leur apparition et peuvent permettre de dépister les enfants suspects d'un déficit des fonctions cognitives et de préciser le profil de ces déficits. La batterie BREV (batterie rapide d'évaluation des fonctions cognitives) permet de préciser ce diagnostic devant un enfant porteur de certaines épilepsies à haut risque de conséquences cognitives.
Fonctions neuropsychologiques et acquisitions scolaires des enfants épileptiques: quelques tests d'évaluation et réflexions méthodologiques
Authors: Gillet Patrice , Sauvage Dominique , Billard Catherine
Published: March 2024

Les enfants épileptiques sont exposés aux difficultés d'acquisition scolaire. Chez les jeunes enfants qui ne sont pas encore confrontés aux apprentissages de la lecture, de l'orthographe et des mathématiques, l'évaluation psychométrique standardisée peut contribuer à identifier les troubles instrumentaux qui vont retentir sur ces capacités d'acquisition. Chez l'enfant épileptique d'âge scolaire, les troubles des acquisitions scolaires méritent d'être abordés en référence aux troubles spécifiques d'acquisition (DSM IV) et dans un cadre neuropsychologique, avec un intérêt plus particulier aux fonctions exécutives.
Impact topographique des anomalies EEG sur les fonctions cognitives dans les épilepsies de l'enfant
Authors: Jambaqué Isabelle
Published: March 2024

L'épilepsie chez l'enfant représente un risque pour le développement cognitif et l'adaptation comportementale. Il paraît crucial de ne pas réduire les problèmes d'apprentissage de l'enfant épileptique à la conception d'un simple retard mental. En effet, il est possible de mettre en évidence différents types de déficits cognitifs en rapport avec la classification actuelle des syndromes épileptiques chez l'enfant. Parmi les nombreux facteurs devant être pris en compte dans l'analyse neuropsychologique, l'impact topographique des anomalies électroencéphalographiques mérite toute notre attention. En effet, des études de plus en plus nombreuses semblent mettre en évidence l'influence du siège du foyer épileptique sur le profil cognitif chez l'enfant.
Troubles de l'apprentissage chez l'enfant épileptique: impact des médicaments
Authors: Tich Sylvie Nguyen The , Péréon Yann
Published: March 2024

Les troubles cognitifs font une grande partie de la gravité de la maladie épileptique de l'enfant. La responsabilité respective des crises, d'une éventuelle lésion sous‐jacente et des médicaments est difficile à déterminer d'autant plus que l'épilepsie est sévère et nécessite une polythérapie. Le rôle potentiel des traitements antiépileptiques ne doit pas pour autant être négligé et c'est une préoccupation constante des parents.

Dans l'hypothèse d'un effet délétère des traitements antiépileptiques sur le fonctionnement cognitif et le comportement, plusieurs mécanismes d'action peuvent être envisagés en fonction de l'âge: un effet toxique sur les neurones en développement lors d'une imprégnation anténatale ou périnatale, des effets cognitifs pharmacologiques ou indésirables chez l'enfant plus grand.

Malgré l'abondante littérature médicale consacrée à ce sujet iI est difficile de dégager des réponses précises à cette question. Divers problèmes méthodologiques peuvent en partie expliquer des résultats souvent contradictoires pour un même produit. Néanmoins les données les plus récentes montrent qu'en dehors du phénobarbital, les antiépileptiques classiques en monothérapie ne sont pas responsables de troubles cognitifs et comportementaux majeurs à l'échelle d'un groupe. Ceci n'exclut pas une sensibilité individuelle constatée en pratique clinique. L'identification de facteurs de risque de survenue de troubles cognitifs devrait permettre d'affiner les modalités de prescription. Les nouveaux antiépileptiques restent encore peu étudiés en monothérapie chez l'enfant. L'évaluation des effets neuropsychologiques est une étape indispensable dans le développement de ces produits.
Epileptic Nystagmus: electroclinical study of a case
Authors: Gire Catherine , Somma‐Mauvais Hélène , Niçaise Claire , Roussel Michel , Garnier Jean‐Marc , Farnarier Guy
Published: March 2024

Epileptic nystagmus (EN) is a rare form of nystagmus that occurs only during epileptic seizures. We report a case in which EN was first noted in an 8 year‐old boy. Neuro‐imaging was normal. Sharp waves from the left occipital lobe characterised the interictal EEG. Ictal video‐EEG showed the aspects of electric seizures during clinical manifestations
e.g.
nystagmus. Ambulatory EEG displayed numerous diurnal and nocturnal seizures, but exclusively in REM sleep.

After two weeks of sodium valproate treatment, the seizures, EEG focus spikes and nystagmus, as well as the squint, disappeared. During a two‐year follow‐up the child had no further seizures, EEG was normal and the school performance was unaffected.

This case has the main features of benign epilepsy, although there are unusual features such as epileptic nystagmus, permanent squint, reduction of EEG paroxysmal abnormalities during NREM, and the presence of seizures during REM sleep. The observation and the significance of EN are discussed with reference to the literature.
Epilepsy‐related ambiguity in rating the child behavior checklist and the teacher's report form
Authors: Oostrom K.J. , Schouten A. , Kruitwagen C.L.J.J. , Peters A.C.B. , Jennekens‐Schinkel A. ,   for the Dutch Study Group of Epilepsy in Childhood (DuSECh)
Published: March 2024

Although the child behavior checklist (CBCL) and the teacher's report form (TRF) were not designed for diagnosing psychopathology in children with chronic illnesses, they have become extensively used research tools to assess behavioural problems in paediatric populations, including children with epilepsy. When applied to children with epilepsy, items like “staring blankly” or “twitching” can be rated on the basis of seizure features rather than behaviour and, hence, render behavioural scores ambiguous.

The aims were detection, and evaluation of the impact, of CBCL and TRF items eliciting ambiguity when applied to children with “epilepsy only” (idiopathic or cryptogenic epilepsy, attending normal schools).

Experts identified items that give rise to interpretational ambiguity of the ratings in epilepsy. By treating ratings on these items as missing values, their effect was evaluated in CBCL and TRF scores of 59 schoolchildren with “epilepsy only” and age and gender matched healthy classmates.

Seven items of the CBCL gave rise to ambiguity of which items 5 co‐occur on the TRF. Rescoring reduced psychopathology scores in children with “epilepsy only”, but not in those of healthy children: the percentage of patients trespassing the clinical cut off score, on at least one of the subscales, reduced from 46 to 23% on the CBCL and from 18 to 15% on the TRF.

Parents and teachers run the risk of confusing behaviour and seizure features when filling out the CBCL and TRF. In “epilepsy only”, prevalence estimates of psychopathology based on the CBCL and TRF, should be considered with some reserve.
Reflex Epileptic Seizures: The Videoteque Commission of the Italian League Against Epilepsy (LICE)*
Authors: Tinuper P. , Canevini M.P. , Fusco L. , Giallonardo M.T. , Guerrini R. , Munari C. , Plazzi G. , Rubboli G. , Vigevano F.
Published: March 2024

Content available: Video
Partial epilepsy with prominent auditory symptoms not linked to chromosome 10q
Authors: Bisulli Francesca , Tinuper Paolo , Marini Carla , Avoni Patrizia , Carraro Gianni , Nobile Carlo
Published: March 2024

Autosomal dominant partial epilepsy with auditory features (ADPEAF) has been identified as a distinct genetic syndrome. Several families have been described linked to chromosome 10q24, which carries mutations in the LGI1 gene. We report a small new pedigree with partial epilepsy with auditory symptoms. We performed a detailed clinical study of the family, constructed an extended pedigree comprising 106 individuals, and obtained blood samples for genetic analysis. Individuals with seizures also underwent neurophysiological and neuroradiological investigations. Genetic analysis was performed with six microsatellite markers spanning to the critical region of chromosome 10q24. Mutation analysis of the coding sequence of LGI1 was performed in two patients. Five members of the family in generation IV had seizures. Three individuals had auditory auras, followed by generalised seizures in two and brief loss of contact in one, one had nocturnal tonic‐clonic seizures with an EEG suggestive of right temporal lobe onset, and one only had febrile seizures. In addition, a deceased woman was said to have had seizures. Haplotype analysis of this region of chromosome 10q24 failed to disclose a common haplotype in affected family members and no disease‐associated mutations were detected in the LGI1 gene, suggesting that this locus is not associated with the disease in our family. Our small sample with partial epilepsy with auditory symptoms, clinically resembles previously described ADPEAF families. However, the low number of patients is compatible with either autosomal dominant or other inheritance patterns. In the case of the former, the lack of segregation with 10q24 suggests that a second locus is involved in the aetiology of ADPEAF; in the latter, an epileptic syndrome also characterized by auditory features, but distinct from ADPEAF, could be transmitted in this family.
Life‐saving epilepsy surgery for status epilepticus caused by cortical dysplasia
Authors: Kršek Pavel , Tichý Michal , Belšan Tomás , Zámečník Josef , Paulas Lukáš , Faladová Ludvika , Jiruška Přemysl , Maulisová Alice , Komárek Vladimír
Published: March 2024

A uniquely successful neurosurgical intervention in a four‐ month‐old child suffering from status epilepticus (SE) caused by focal cortical dysplasia is reported. Seizures appeared at postnatal day 10 and culminated as medically intractable focal motor SE three months later. The first MRI scan at postnatal week 2 was inconclusive; electroclinical features typical of malformations of cortical development led to the repetition of MRI at the age of 3 months that confirmed the correct diagnosis. Since all medical trials including thiopental anaesthesia have been unsuccessful in treatment of SE, urgent resection of the right frontal and parietal lobes was performed at 4 months of age. One month later, the child had become seizure‐free and her psychomotor development is proceeding well. Histopathological analysis of the resected brain tissue revealed abnormalities typical of the Taylor's type of focal cortical dysplasia. The aim of the report is to encourage considering surgery in selected patients suffering from medically intractable SE early in life.
Tolerability of tiagabine: a prospective open‐label study
Authors: Bauer Jürgen , Bergmann Arnfin , Reuber Markus , Stodieck Stefan Rudolf Günther , Genton Pierre
Published: March 2024

Tiagabine was used as add‐on therapy in the treatment of epilepsy with partial and/or secondarily generalised seizures to evaluate tolerability and efficacy. Five hundred and seventy‐four patients (299 men and 275 women, mean age 38.1 years), with refractory partial seizures, were enrolled in this prospective, open‐label study. Tiagabine was added to one (44.1%) or more (up to nine) antiepileptic drugs. The median daily dose of tiagabine was 30 mg (mean 29.1, SD 12.0). The mean duration of follow‐up was 94.9 ± 42.7 days. 12.3% of patients were completely seizure‐free at the end of the observation period. Median total seizure frequency decreased from 4.5 to 2.0 seizures/4 weeks. Adverse events occurred in 78 patients (13.6%). Tiagabine proved to be a well‐tolerated AED.