bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhanced Gastrointestinal Excretion of Phenytoin in a Patient with Crohn's Disease
Authors: Lesser Ronald P. , Irace P. , Kutt H. , Pippenger C. E. , Winkelman E. L. , Terrentine S. , Gardner M.
Published: November 2007

Summary: : A patient with Crohn's disease and generalized seizures who lacked the distal small bowel and ascending colon required 600 mg of intravenous phenytoin daily (11 mg/kg/24 h) to maintain her plasma phenytoin levels in the 12–24 μg/ml range. She received no oral phenytoin. Stool volumes ranged from 1,125 to 1,875 ml/ 24 h, and stool fraction phenytoin levels from 15 to 41 μ.g/ml. Urinary 5‐(p‐hydroxyphenyl)‐5‐phenylhydantoin and phenytoin levels in three 24‐h samples were sufficient to account for 26, 46, and 57% of the administered drug, compared with the expected 70–90%. This was most likely due to an alteration of the normal cycle of absorption and reexcretion between the intestinal lumen and the blood resulting in net excretion of phenytoin into the bowel.

Una paciente con enfermedad de Crohn y ataques generalizados a quien le faltaba el intestino delgado distal y el cólon ascendente requireó 600 mg diarios de fenitoina intravenosa (11 mg/kg/24 horas) para mantener los niveles plasmáticos de fenitoina en el rango 12–24 μg/ml. No recibió fenitoina oral. Los volúmenes de heces oscilaron entre 1125–1875 ml/24 horas y los niveles de fenitoina en fracciones de heces entre 15–41 mug/ml. Los niveles en orina de HPPH y fenitoina, en 3 muestras de 24 horas, fueron suficientes para corresponder al 26, 46 y 57% de la droga administrada comparados con el calculado de 70–90%. Esto fue, probablemente, debido a una alteración del ciclo normal de absorción y re‐excreción entre la luz del intestino y sangre que conduce a una excreción neta de fenitoina en el intestino.

Eine Patientin mit M. Crohn und generalisierten Anfällen, ohne distalen Dünndarm und Colon aszendenz benötigte täglich 600 mg Phenytoin i.v. (11 mg/kg/die) um Plasmaspiegel zwischen 12 und 24 μg/ml aufrechtzuerhalten. Sie erhielt kein Phenytoin oral. Das Stuhlvolumen schwankte zwischen 1125 bis 1875 ml/ die und die Phenytoinausscheidung im Stuhl betrug 15 bis 41 (xg/ ml. Urin HPPH und Phenytoinspiegel in drei 24‐Stundenproben erreichten 26, 46 and 57% des zugeführten Medikaments verglichen mit dem Erwartungswert von 70 bis 90%. Der Grund hierfür liegt wahrscheinlich in einer Veränderung des normalen Kreislaufs von Absorptionund Wiederausscheidung aus dem Darmlumen bzw. dem Blut, die zu einer Exkretion des Pheny‐toins in den Darminhalt führte.
Valproate: Recent Findings and Perspectives
Authors: Moire M. , Keane P. E. , Vernières J. C. , Simiand J. , Roncucci R.
Published: November 2007

Valproate is a major antiepileptic drug that is now in worldwide clinical use. Nevertheless, the mechanism of action of valproate remains obscure. A number of recent articles have discussed this subject, and we ourselves have participated in a detailed review of the known actions of valproate (Chapman et al., 1982a). The object of this article is to present the most recent advances in our knowledge of valproate's actions, in particular, the pharmacological effects of some analogues and metabolites, the newest findings concerning the γ‐aminobutyric acid (GABA) hypothesis, and the possible involvement of valproate with ionic processes related to the intrinsic mechanisms of epilepsy at the cellular level.
Non‐Dose‐Related Side Effects of Valproate
Authors: Jeavons P. M.
Published: November 2007

The clinical and histological findings in 88 patients in whom hepatotoxicity with valproate has been reported were reviewed.

The characteristic lesion is microvesicular steatosis. Hepatotoxicity appears to be an idiosyncratic reaction and is most likely to appear within 6 months from the start of therapy, especially in young patients on comedication. The condition may be reversible if the drug is immediately withdrawn in patients who show acute gastrointestinal symptoms, drowsiness or lethargy, jaundice, or change in seizure pattern. Clinical monitoring is more important than laboratory monitoring.

The outcome of pregnancies in 344 women who received valproate in the first trimester was reviewed. There were 225 normal babies and 68 abnormal babies. The role of valproate in the aetiology of neural tube defects remains uncertain, but mothers treated with valproate should receive prenatal counselling.
Sodium Valproate and Cognitive Function
Authors: Trimble Michael R. , Thompson Pamela J.
Published: November 2007

The literature concerning the effects of sodium valproate on cognitive function was reviewed, including both volunteer and patient studies. Two were reported from the National Hospital—one a double‐blind crossover investigation against placebo in volunteers, and the other in patients on monotherapy. It was concluded that sodium valproate has minimal adverse effects, although those that are seen are probably dose related. It has less of an effect on cognitive function than some of the other commonly used anticonvulsants.
The Use and Promise of Nuclear Magnetic Resonance Imaging in Epilepsy
Authors: Oldendorf William H.
Published: November 2007

Summary: The revolutionary influence of X‐ray computerized tomography (CT) on neurodiagnosis will be considerably extended by a newer imaging probe using magnetic fields. This form of imaging uses nuclear magnetic resonance (NMR) as the probe‐tissue interaction to make many regional measurements of tissue in a short time, thus allowing an image to be computer‐reconstructed. The nuclei of about 100 nuclides have significant magnetic properties, behaving like small permanent bar magnets. The most interesting of these in brain tissue are ordinary hydrogen, sodium, and phosphorus. Placed in a strong magnetic field, they partially align themselves with the field. They can then absorb energy which will subsequently be reradiated. Since the resonant frequency of each nucleus is proportional to the magnetic field in which it finds itself, producing fields which change predictably in strength with position, it becomes possible to localize the activated nuclei. Images of hydrogen density and relaxation times can be made and offer considerable tissue characterization. Bone is nearly invisible and considerable gray‐white matter contrast is seen. Factors altering water‐binding in tissues affect the image. Malignant tissue usually is seen in contrast to adjacent healthy tissue. Movement of blood is visible. By measuring energy‐rich phosphorus, energy stores can be determined. There is no tissue ionization, no injected contrast materials are needed, and there are no radioactive materials involved. NMR scanners probably will replace CT within the next decade for most brain scanning purposes and will offer considerably greater tissue characterization which surely will influence studies of human epilepsy
Amino Acid Neurotransmitters and New Approaches to Anticonvulsant Drug Action
Authors: Meldrum Brian
Published: November 2007

Summary: Amino acids provide the most universal and important inhibitory (γ‐aminobutyric acid (GABA), glycine) and excitatory (glutamate, aspartate, cysteic acid, cysteine sulphinic acid) neurotransmitters in the brain. An anticonvulsant action may be produced (1) by enhancing inhibitory (GABAergic) processes, and (2) by diminishing excitatory transmission. Possible pharmacological mechanisms for enhancing GABA‐mediated inhibition include (1) GABA agonist action, (2) GABA prodrugs, (3) drugs facilitating GABA release from terminals, (4) inhibition of GABA‐transaminase, (5) allosteric enhancement of the efficacy of GABA at the receptor complex, (6) direction action on the chloride ionophore, and (7) inhibition of GABA reuptake. Examples of these approaches include the use of irreversible GABA‐transaminase inhibitors, such as γ‐vinyl GABA, and the development of anticonvulsant β‐carbolines that interact with the “benzodiazepine receptor.” Pharmacological mechanisms for diminishing excitatory transmission include (1) enzyme inhibitors that decrease the maximal rate of synthesis of glutamate or asparate, (2) drugs that decrease the synaptic release of glutamate or aspartate, and (3) drugs that block the post‐synaptic action of excitatory amino acids. Compounds that selectively antagonise excitation due to dicarboxylic amino acids have recently been developed. Those that selectively block excitation produced by N‐methyl‐D‐aspartate (and aspartate) have proved to be potent anticonvulsants in many animal models of epilepsy. This provides a novel approach to the design of anticonvulsant drugs.

Summary: Animal studies show potent anticonvulsant actions of pharmacological agents that either specifically enhance GABAergic inhibition or decrease excitatory transmission by dicarboxylic amino acids. This evidence supports the concept that some established anticonvulsant drugs act on inhibitory and excitatory transmission. It provides a theoretical framework for the search for new anticonvulsant drugs. The optimal anticonvulsant agents are likely to possess a subtle combination of selective actions on both excitation and inhibition.
A Molecular Approach to Defining the Inherited Components in Epilepsy and Other Diseases of Uncertain Etiology
Authors: Botstein David , Donis‐Keller Helen
Published: November 2007

Summary: A general method has been developed which, in theory, will make it possible to follow the inheritance of virtually all genes in human families. This method, based on genetic linkage, envisions the use of cloned single copy human deoxyribonucleic acid probes to reveal restriction fragment length polymorphisms as genetic markers. Such markers can be assembled into a linkage map which can be applied to analysis of inherited diseases. It is speculated that such a map might help to clarify the role that heredity plays in the etiology of epilepsy.
The Relevance of Secondary Epileptogenesis to the Treatment of Epilepsy: Kindling and the Mirror Focus
Authors: Goldensohn Eli S.
Published: November 2007

Summary: Human beings with partial epilepsy and demonstrable cerebral lesions show, in addition to ipsilateral epileptiform EEG discharges, apparently independent epileptiform discharges from the opposite hemisphere. Patients with apparent unilateral focal onset of their partial seizures but without demonstrable lesions also frequently display what appear to be bilaterally independent EEG foci. When surgical treatment or medical prognosis is considered and there is no demonstrable lesion, the decision of which of the two apparent foci is primarily responsible for the seizures is often difficult.

Even with a known structural lesion the question arises whether, following its removal, the contralateral focus will persist and will be epileptogenic. Two related experimental phenomena bear directly on these questions—kindling and the mirror focus. This presentation looks critically at existing evidence and finds that it fails to support the idea that kindling and the mirror focus have roles in human epilepsy that currently should influence clinical decisions.
Bicuculline Methiodide in the Blood‐Brain Barrier‐Epileptogen Model of Epilepsy
Authors: Remler Michael P. , Marcussen William H.
Published: November 2007

Summary: Focal epilepsy can be produced by a blood‐brain barrier (BBB)‐excluded systemic convulsant (penicillin, folic acid, etc.) in the presence of a focal BBB lesion. Bicuculline methiodide, a γ‐aminobutyric acid blocking epileptogen, crosses the normal BBB of rats poorly and produces no consistent abnormality behaviorally or on EEG at 36 mg/kg. When the BBB is opened in 0.25 ml of cortex by 6,000 rad of α particles, by a pin trauma lesion, or by a heat lesion, the rats are normal clinically and on EEG. When these lesioned rats are challenged with bicuculline methiodide, 36 mg/kg, an intense, highly localized epileptiform discharge results that begins ˜ 20 min after injection and lasts 30–90 min. The plausibility and experimental utility of the BBB‐epileptogen model of epilepsy are enhanced by these observations.

On peut provoquer une épilepsie focale avec un convulsivant systémique exclu par la barrière hémo‐cérébrale (BBB) si on crée une lésion dans cette barrière. La bicuculline methiodide (Bm), 4Apileptogène bloquant l'acide gamma aminobutyrique (GABA), traverse peu la BBB des rats et n'entraîne pas d'anomalie du comportement ou de l'EEG à la dose de 36 mg/kg. Quand la BBB est ouverte sur 0,25 cc de cortex, par 6 000 r de particules alpha, par lésion traumatique ou par le chaleur, les rats sont chiniquement normaux et ont un EEG normal. Quand on administre à ces rats porteurs d'une lésion 36, mg/kg de Bmon provoque une décharge éjpileptiforme intense, très localisée, qui commence environ 20 minute ajprés l'injection et dure 30 à 90 minutes. Ces observations mettent en évidence l'intérêt du modèle d'épilepsie BBB‐épileptogène.
Spread of Epileptic Seizure Activity in Humans
Authors: Mars Nicolaas J. I. , Thompson Paul M. , Wilkus Robert J.
Published: November 2007

Summary: A computer‐augmented approach to ictal EEG analysis has been developed. A method for determining both the predictability of one signal from another and the time delay between those two signals—the average amount of mutual information (AAMI) method—has been applied to representative seizures of two patients with focal‐onset seizures and one patient with generalized seizures. High AAMI values characterized the EEG derived from the sites of the epileptic foci. AAMI values were high in all sampled brain areas in the patient with generalized seizures. Time delays were not consistent in any subject. The results indicate that the AAMI technique can differentiate focal from generalized seizures and identify the site of seizure onset.

Une analyse par ordinateur de l'activité EEG critique a été entreprise. Une technique permettant de déterminer à la fois la prédictibilité d'un signal par rapport aG l'autre et le délai de temps entre ces deux signaux (la méthode de la quantité moyenne d'information mutuelle (AAMI)) a été appliquée à des crises représentatives à 2patients ayants des crises à début focal et un patient ayant des crises généralisées. Les EEG provenant du siège des foyers épileptiques avgaient des valeurs AAMI élevées. Les valeurs AAMI étaient élevées dans tous les échantillions EEG de toutes les aires cérébrales homologues dans le cas ayant des crises généralisées. Il n'y avait de délai de temps significatif chez aucun sujet. Ces résultats indiquent que la meathode AAMI peut différencier les crises focales des crises généralisées et identifier le siège du début des crises.

RESEUMEN

Se ha desarrollado una neueva lécnica para anàlisis del EEG ictal mediante un sistema de computerización—aumentada. Un método para determinar la predictibilidad de una señal partiendo de otra y la latencia temporal entre estas dos señales—método de Cantidad de Promedio de Información Mutua (AAMI)—ha sido aplicado a lso ataques representativos de dos enfermos con ataques de comienzo focal y u paciente con cirisis generalizadas. Valores altos de AAMI caracterizaron el EEG que se derivaba de los lugares de los focos epilépticos. Los valores del AAMI estaban elevados en todas las muestras de las áreas cerabrales estudiadas en el caso de crisis generalizadas. Las latencias temporales no fueron consisentes en ningún sujeto. Estos resultados indican que la técnica de AAMI puede diferenciar los ataques focales de los generalizados en identifar el lugar de origen de origen de las crisis.
Developmental Hyperthermic Seizures Alter Adult Hippocampal Benzodiazepine Binding and Morphology
Authors: Chisholm Jane , Kellogg Carol , Franck J. E.
Published: November 2007

Summary: Experimental hyperthermic seizures in 15‐day‐old rats resulted in both an alteration in the benzodiazepine (BDZ) binding site in the hippocampal region and morphologic changes in hippocampal neurons. These alterations were not apparent until adulthood. Experimental adult animals also showed a reduced anticonvulsant response to a selective BDZ ligand when challenged with pentylenetetrazol. Developmental hyperthermic seizures may initiate dynamic changes in the hippocampus that contribute to adult functional impairment.

Des crises hyperthermiques, créées expérimentalement chez des rats âgés de 15 jours ont entrainéà la fois des altérations des sites de liaison des benzodiazepines au niveau de l'hippocampe et des modifications morphologiques des neurones hippocampiques. ces altérations n'ont étéévidentes qu'ag l'âge adulte. chez les animaux d'expérience adultes on trouvait aussi une réonse anticonvulsivante diminuée à un ligand benzodiazepinique sélectif testé avec le pentylenetetrazol. les crises hyperthermiques au cours du développement peuvent donc être le point de départ de modifications hippocampiques qui contribuent à son dysfonctionnement à l'âge adulte.

Las crisis hipertérmicas experirnentales en ratas de 15 días de edad producen una alteratión en el lugar de unión de la benzodiazepinaen la región del hipocampo y cambios morfológicos en las neuronas del hipocampo. Estas alteraciones no fueron aparentes hasta la edad adulta. Los animales adultos también mostraron una respuesta anticonvulsiva reducida a1 ligando selectivo de la carbamazepina cuando fué comparada con pentylentetrazol. El desarrollo de crisis hipertérmicas puede iniciar cambios dinámicos en el hipocampo que pueden contribuir a un deterioro funcional en el adulto.
de novo Reciprocal Translocation t(6;14)(q27;q13.3) in a Child with Infantile Spasms
Authors: Hattori Haruo , Hayashi Ken , Okuno Takehiko , Temma Shinji , Fujii Tatsuya , Ochi Junko , Mikawa Haruki
Published: November 2007

Summary: A boy with infantile spasms was found to have a balanced de novo translocation, 6q;14q. The karyotype was 46, XY, t(6;14)(q27;q13.3). He had mental retardation and microcephaly but no dysmorphic features. Whether or not there is a relationship between the translocation in our patient and his infantile spasms is unknown. If there is a connection, a gene or genes on chromosome 14 may be implicated in the seizure disorders that are common in patients with ring chromosome 14 syndrome or proximal partial trisomy 14 syndrome.

Chez un enfant ayant des spasmes infantiles on a mis en évidence une translocation équilibrée de novo 6q;14q. Le caryotype était 46, XY, t(6;14)(q27;q13.3). Il avait un retard mental et une microcéphalie mais n'avait pas de dysmorphies. Nous ne pouvons pas savoir s'il y a une relation entre la translocation et les spasmes infantiles chez notre patient. S'il y en a une, c'est un gène (ou des gènes) sur le chromosome 14 qui peut ètre impliqué dans ce type de crises, habituel chez des patients ayant un syndrome du chromosome 14 en anneau ou un syndrome de trisomie 14 proximale.

Se ha encontrado que un niño con espasmos infantiles tenía una translocación equilíbrada de “novo,” 6q;14q. El cariotipo fué 46, XY, t(6;14)(q27;q13.3). El muchacho tenía retraso mental y microcefalia pero no se observaron dismorfias. Se desconoce si existe una relación entre la translocación y los espasmos infantiles en este paciente. Si existe una conexión pueden estar implicados genes o un gene en el cromosoma 14 en la producción de trastornos convulsivos que son comunes en pacientes con un síndrome de cromosoma 14, en anillo, o en el síndrome de trisomia 14 parcial proximal.

Bei einem Jungen mit BNS‐Anfälle wurde eine balancierte neu aufgetretene Translokation 6q;14q gefunden. Der Karyotyp war 46, XY, t(6;14)(q27;q13.3). Der Junge war retardiert mit einem Mikrocephalus, jedoch ohne Dysmorphien. Ob eine Beziehung zwischen der Translokation und den Anfällen besteht ist unbekannt. Wenn eine Beziehung besteht, dürften ein Gen oder Gene des Chromosoms 14 bei dem Anfallsleiden involviert sein, die auch bei Patienten mit Ringchromosom 14 oder einem proximalen partiellen Trisomie 14 Syndrom auftreten.
Is Adenosine an Endogenous Anticonvulsant?
Authors: Dragunow Michael , Goddard Graham V. , Laverty Richard
Published: November 2007

Summary: The anticonvulsant properties of adenosine were tested pharmacologically on amygdala‐kindled seizure activity in rats. The adenosine analogue 2‐chloroadenosine and the adenosine uptake blocker papaverine both increased the latency to behavioral clonus as well as reduced the duration and severity of the clonic motor convulsion. Both drugs, however, failed to alter the postkindling afterdischarge (AD) threshold. Theophylline, an adenosine antagonist, had the opposite effects, prolonging the AD and motor seizure durations and facilitating partially kindled seizures, but again not altering the prekindling or postkindling AD thresholds of amygdala‐elicited seizures. In contrast, carbamazepine raised AD thresholds, suggesting that it does not produce its anticonvulsant effects through adenosine systems. Since endogenous adenosine can impede seizure spread and seizure continuation, but does not affect seizure initiation from the amygdala, perhaps endogenous adenosine has the special property of being brought into play as an anticonvulsant only by the seizure itself.

Die antikonvulsiven Eigenschaften von Adenosin wurden pharmakologisch an der Anfallsaktivität der Ratte nach Kindeln des Amygdalons bestimmt. Das Adenosin‐analogon 2‐Chloroadenosin und der Blocker der Adenosinaufnahme Papaverin steigerten die Latenz bis zum Auftreten eines klonischen Verhaltens und reduzierten die Dauer und Schwere der klonischen motorischen Krämpfe. Beide Medikamente waren jedoch nicht in der Lage, die Schwelle der Nachentladungen in der Nachkindlingphase zu verändern. Theophyllin, ein Adenosin Antagonist, hat gegenteilige Wirkungen; es verlängert díe Nachentladungen (AD) und die Dauer der motorischen Krämpfe und ermöglicht das Kindeln von Partialanfällen. Es änderte jedoch nicht die Schwellen für Nachentladungen vor und nach dem Kindeln von Anfällen des Amygdalon. Im Gegensatz hierzu erhöhte Carbamazepin die Schwelle der Nachentladungen; das läßt vermuten, daß es eine antikonvulsive Wirkung nicht über das Adenosin‐System entfaltet. Da Adenosin die Anfallsausbreitung und Dauer verhindert, aber nicht den Anfallsbeginn vom Amygdalon beeinflusst, besitzt das endogene Adenosin möglicherweise eine spezielle Fähigkeit, zum Antikonvulsivum erst durch den Anfall selbst gemacht zu werden.
Neuronal Firing Pattern Following Amygdaloid Kindling in Unrestrained Rats
Authors: Tsuru Noriko
Published: November 2007

Summary: Chronic recordings of amygdaloid neurons were performed on freely moving rats following kindling. Satisfactory recordings were obtained from 22 amygdaloid neurons of the contralateral amygdala before, during, and after unilateral kindling. Kindling stimulations were given once per hour. Seven cells disappeared during kindling. Seven cells were recorded during the full course of kindling. These units showed (a) an increase in spontaneous firing, (b) a development of high‐frequency bursts (the peak interval of the interval histogram decreased from 18 to 2 ms), and (c) high‐frequency firings during spontaneous activity that were similar to the firings recording during afterdischarge.

Un enregistrement chronique des neurones du noyau amygdalien a été effectué chez des rats libres de leurs mouvements soumis à l'effet d'embrasement. Un enregistrement satisfaisant a été obtenu pour 22 neurones amygdaliens de l'amygdale controlatérale, avant, pendant et après un embrasement amygdalien unilatéral. Les stimulations étaient pratiquées une fois par heure. Sept cellules ont pu étre enregistrées pendant toute la durée de l'expérience. Au niveau de ces cellules, l'on observe: (1) une augmentation des décharges spontanées, (2) l'apparition de décharges à haute fréquence, l'intervalle entre les pics diminuant de 18 msec à 2 msec, et (3) des décharges à haute fréquence pendant l'activité spontanée, décharges similaires à celles obtenues pendant une post‐décharge.

Chronische Aufzeichnungen von Neuronen des Amygdalons wurden bei frei sich bewegenden Ratten in Anschluß an das Kindeln durch‐geführt. Befriedigende neuronale Ableitungen wurden von 22 Neuronen des kontralateralen Amygdalons vor, während und nach einseitigem Kindeln gemacht. Die Kindlingreize wurden einmal pro Stunde gegeben. Sieben Zellen verschwanden während des Kindelns. Sieben Zellen wurden während des gesamten Kindelns abgeleitet. Die Einheiten zeigen 1. eine Zunahme der spontanen Entladungen, 2. eine Entwicklung hochfrequenter bursts; ihr peak Intervall nahm im Histogramm von 18 msec auf 2 msec ab. 3. Hochfrequente Entladungen während Spontan‐aktivität ähnelten den Aufzeichnungen während der Nachentladungen.
Primary Reading Epilepsy
Authors: Sáenz‐Lope E. , Herranz‐Tanarro F. J. , Masdeu J. C.
Published: November 2007

En seis casos de epilepsía refleja, las convulsiones fueron precipitadas por la lectura o en el proceso de la elaboración de la palabra. El electroencefalograma mostró actividad epileptiforme local o generalizada. Las convulsiones se pudieron controlar con clonazepam en cuatro enfermos y con valproato sódico en dos enfermos. Estos casos y otros en la literatura neurológica parecen indicar que este tipo de epilepsia refleja es precipitada por los mecanismos neurológicos implicados en la elaboración del lenguaje.

Dans six cas d'épilepsie‐réflexe les crises étaient déclenchées par la lecture ou l'élaboration d'une expression verbale et étaient accompagnées sur l'EEG par une activitéépileptique focale ou généralisée. Les crises ont été contrôlées par le Valproate de sodium dans deux cas et par le Clonazepam dans quatre cas. On fait l'hypothèse que ces crises ont une origine corticale et sont déclenchées par le processus impliqué dans l'élaboration du langage.

Bei 6 Fällen von Reflexepilepsie wurden die Anfälle durch Lesen oder verbale Formulierungen ausgelöst; sie wurden im EEG von fokaler oder generalisierter epileptiformer Aktivität begleitet. Die Anfälle wurden in 4 Fällen durch Clonazepam und in 2 Fällen durch Natrium‐Valproat kontrolliert. Wir vermuten, daß die Störung corticalen Ursprungs ist und durch neurale Vorgänge getriggert wird, die an der Erarbeitung der Sprache beteiligt sind.

Summary: In six cases of reflex epilepsy, the seizures were triggered by reading or elaborating a verbal utterance, and were accompanied on EEG by focal or generalized epileptiform activity. The seizures were controlled with clonazepam in four cases and by sodium valproate in two cases. We speculate that the disturbance has a cortical origin and is triggered by neural processes involved in the elaboration of language.
Acute Effects of Lithium on Hippocampal Kindled Seizures
Authors: Clifford David B. , Podolsky Ann , Zorumski Charles F.
Published: November 2007

Les effets du lithium ont étéédudiés sur l'activité critique provoquée par l'effet d'embrasement par stimulation hippocampique du rat. L'administration intrapéritonéale de 0.25, 0.50, 1.50, 3.0 et 5.0 mEq/kg entraîne pendant les quatre heures suivantes des taux sanguins allant des taux cliniquement infrathérapeutiques aux taux toxiques. Le seuil de la post‐décharge et la sévérité des crises ne sont pas modifiés par ces taux de lithium. La durée de la post‐décharge est quelque peu prolongée, mais ne l'est d'une manière significative que pour la dose de 3.0 mEq/kg. Il est conclu que le lithium a un effet proconvulsivant mineur en administration aiguë sur le modèle d'effet d'embrasement par stimulation hippocampique.

Se han estudiado los efectos del cloruro de litio sobre la actividad epiléptica generada mediante la estimulación del hipocampo en ratas previamente condicionadas (kindled). La administración aguda de 0, 0.25, 0.50, 1.5, 3.0 y 5.0 mEq/kg intraperitonealmente produjo niveles séricos que oscilaron entre dosis clinicamente subterapéuticas y niveles tóxicos durante las 4 horas subsiguientes. El umbral de la postdescarga y la severidad del ataque no se modificaron con estos niveles de litio. La duración de la post‐descarga fue ligeramente más prolongada alcanzando un nivel significativo solamente para la dosis de 3.0 mEq/kg. Se concluye que el litio muestra un efecto proconvulsivo menor después de la administración aguda en el modelo animal de ataques del hipocampo previamente condicionado (kindled).

Untersuchungen über die Wirkung von Lithium‐Chlorid auf die Anfallsaktivität nach hippokampalem Kindling von Ratten. Die akute Verabfolgung von 0, 0,25, 0,50, 1,5, 3,0 und 5,0 mEq/kg i.p. führte zu Serumspiegeln, die in den folgenden 4 Stunden vom klinisch subtherapeutischen bis in den toxischen Bereich sich erstreckten. Das Schwellen der Nachentladungen und die Anfallsschwere wurden durch die Lithium‐Spiegel nicht beeinflusst. Die Dauer der Nachentladungen war etwas verlängert; ein signifikanter Spiegel wurde nur für die Dosis von 3,0 mEq/kg erreicht. Es ist zu folgern, daß Lithium eine geringe konvulsive Wirkung bei akuter Anwendung auf gekindelte hippokampale Anfälle besitzt.

Summary: The effects of lithium chloride on seizure activity generated by stimulation of hippocampal kindled rats were studied. Acute administration of 0, 0.25, 0.50, 1.5, 3.0, and 5.0 mEq/kg i.p. resulted in serum levels ranging from clinically subtherapeutic to toxic during the subsequent 4 h. Afterdischarge threshold and seizure severity were unchanged by these levels of lithium. Afterdischarge duration was somewhat prolonged, reaching a significant level only for the 3.0‐mEq/kg dose. It is concluded that lithium shows a minor proconvulsant effect after acute administration in the kindled hippocampal seizure model.
Aminophylline and CGS 8216 Reverse the Protective Action of Diazepam Against Electroconvulsions in Mice
Authors: Czuczwar Stanislaw J. , Turski Waldemar A. , Ikonomidou Chrysanthy , Turski Lechoslaw
Published: November 2007

L'aminophylline (50 et 100 mg/kg) et le CGS 8216 (20 et 40 mg/kg) diminuaient le pouvoir anticonvulsif du diazepam (5 et 10 mg/kg) contre les crises induites par électrochoc. On doit souligner que l'aminophylline affectait peu l'action protectrice de 5 mg/kg de benzodiazépine alors qu'elle avait le même effet que le CGS 8216 sur une dose de 10 mg/kg de diazépam. Ceci suggère la participation d'une composante purinergique dans l'action anticonvulsive du diazépam. D'autre part l'utilisation de l'aminophylline chez les patients épileptiques souffrant d'asthme ne paraît pas justifiée.

La aminofilina (50 y 100 mg/kg) y la CGS 8216 (20 y 40 mg/kg) disminuyeron la potencia anticonvulsiva del diazepán (5 y 10 mg/kg) contra los ataques inducidos por electroshock. Se debe hacer énfasis en el hecho de que la aminofilina afectó moderadamente la acción protectora de la benzodiazepina en la dosis de 5 mg/kg mientras que su potencia era equivalente a la CGS 8216 con respecto al diazepán en dosis de 10 mg/kg. Consecuentemente se sugiere la participación de un componente purinérgico en la acción anticonvulsiva del diazepán. Por otro lado, la utilización de aminofilina en pacientes epilépticos que sufren de asma no está justificada.

Aminophyllin (50 und 100 mg/kg) und CGS 8216 (20 und 40 mg/kg) vernindern die antikonvulsive Wirkung von Diazepam (5 und 10 mg/kg) gegenüber durch Elektroschock ausgelöste Krämpfe. Es sollte betont werden, daß Aminophyllin die Schutzwirkung von Benzodiazepin in einer Dosis von 5 mg/kg nur mäßig beeinflußt, während es gleichermaßen wirksam mit CGS 8216 hinsichtlich einer Diazepam‐Dosierung von 10 mg/kg Körpergewicht war. Somit wird eine Beteiligung purinergischer Komponenten bei der antikonvulsiven Wirkung des Diazepam vermutet. Andererseits scheînt die Verwendung von Aminophyllin bei epileptischen Patienten, die an Asthma leiden, nicht gerechtfertigt.

Summary: Aminophylline (50 and 100 mg/kg) and CGS 8216 (20 and 40 mg/kg) decreased the anticonvulsant potency of diazepam (5 and 10 mg/kg) against electroshock‐induced seizures. It should be emphasized that aminophylline moderately affected the protective action of the benzodiazepine at a dose of 5 mg/kg, whereas it was equipotent with CGS 8216 with regard to diazepam at a dose of 10 mg/kg. Consequently, participation of a purinergic component in the anticonvulsant action of diazepam is suggested. On the other hand, the use of aminophylline in epileptic patients suffering from asthma seems unjustified.
Autonomic Nervous System and Epilepsy
Authors: Wannamaker Braxton B.
Published: November 2007

Summary: Seizures frequently manifest autonomic dysfunction clinically, and seizure discharges commonly spread into and involve autonomic pathways. These associations are direct and simple in some instances, and the result of multiple indirect and complex relationships in others. Effects of epileptic discharge on the autonomic nervous system are mediated through the cortical, limbic, and hypothalamic systems. Some significant consequences of altered autonomic function include convulsive apnea, abnormal sexual function, and potentially fatal effects on the cardiovascular system.
Association Between Regularly Occurring Complex Partial Seizures and Thyroid Function Parameters
Authors: Taubøll Erik , Stokke Kjell Torgeir , Gjerstad Leif , Løyning Yngve , Johannessen Svein I.
Published: November 2007

Summary: A 28‐year‐old man with regularly occurring clusters of complex partial seizures was studied over a total of 224 days. His seizure periods lasted 2–4 days and occurred at intervals of 5–6 weeks. Several parameters were studied. The most striking finding was an increase in the serum concentration of thyroxine prior to and during the seizure periods. The concentrations of urine catecholamines and serum cortisol also varied with the seizure periods, but these hormones increased after the seizure periods had begun. To determine if there is a general 4–6‐week rhythm in thyroid hormone concentrations, 12 weekly blood samples from 10 healthy male students were analyzed. No rhythmicity was found.

Una mujer de 28 años con brotes de crisis parciales complejas de aparición regular fue estudiada durante un total de 224 días. Sus períodos de crisis duraban 2–4 días y ocurrían con intervalos de 5–6 semanas. Se estudiaron diferentes parámetros. El hallazgo más llamativo fue un incremento en la concentración de tiroxina antes y durante los períodos de crisis. Las concentraciones de catecolaminas urinarias y cortisol sérico también variaron con los períodos de crisis, pero estas hormonas se incrementaron una vez los períodos de crisis habían empezado. Para investigar si hay un ritmo general de 4–6 semanas en las concentraciones de hormonas tiroideas, se analizaron 12 muestras semanales de 10 estudiantes varones sanos. No se encontró ritmicidad.

Ein 28‐jähriger Mann mit regelmäßig wiederkehrenden Serien komplexer Partialanfälle wurde insgesamt 224 Tage lang untersucht. Seine Anfallsperioden dauerten 2 bis 4 Tage und traten in Intervallen von 5 bis 6 Wochen auf. Verschiedene Parameter wurden geprüft. Der wesentliche Befund war eine Zunahme der Serumkonzentration von Thyroxin vor und während der Anfallsperioden. Die Konzentrationen der Katecholamine im Urin und des Serumcortisols variierten ebenfalls mit den Anfallsperioden aber diese Hormone erhöhten sich erst, nachdem die Anfallsperiode begonnen hatte. Um zu untersuchen, ob es einen generellen 4 bis 6 Wochen‐Rhythmus der Schilddrüsenhormonkonzentration gibt, wurden aile 12 Wochen Blutproben von 10 gesunden männlichen Studenten analysiert, jedoch keine Rhythmizität gefunden.
Seizures Induced or Aggravated by Anticonvulsants
Authors: Lerman Pinchas
Published: November 2007

Summary: Six cases of epileptic children are reported, in whom anticonvulsant therapy, aggravated rather than controlled the seizures or induced minor seizures. This was caused by excessive polytherapy in one case and by the use of the inappropriate drug (for that type of epilepsy) in four other cases. In the sixth case, the appropriate anticonvulsant was used, but it induced multiple astaticmyoclonic seizures. This phenomenon of drug‐induced seizures is apt to occur particularly in certain types of childhood epilepsy that are refractory to therapy and are accompanied by slow spike‐wave discharges in the EEG, such as the Lennox‐Gastaut syndrome.

Nous rapportons les observations de 6 enfants épileptiques chez lesquels le traitement anti‐épileptique a plutôt aggravé que contrôlé les crises, ou a induit des crises mineures. Ceci était la conséquence d'une polythérapie excessive dans 1 cas, ou de l'utilisation d'une médication inadaptée au type de l'épilepsie dans 4 cas. Chez le 6ëme patient, le médicament adaptéétait prescrit, mais a entraîné l'apparition de nombreuses crises astato‐myocloniques. Ce phénomène des crises induites par le traitement est susceptible de se produire avant tout dans certains types d'épilepsie infantile réfractaires aux traitements et accompagnées de décharges de Pointes‐Ondes Lentes à l'EEG, comme le syndrome de Lennox‐Gastaut.

Bei 6 Kindern unter antikonvulsiver Therapie wurden die An‐fälle verstärkt statt unterdrückt, bzw. wurden kleine Anfälle hervorgerufen. Das geschah in einem Fall durch exzessive Polytherapie und in 4 anderen Fällen durch Gabe eines für den Anfallstyp nicht adäquaten Mittels. Im 6. Fall wurde ein adäquates Antikonvulsivum gegeben, welches jedoch multiple myoklonischastatische Anfälle hervorrief. Medikamenten‐indu‐zierte Anfälle kommen in speziellen Formen von kindlichen Epilepsien vor, die therapierefraktär und von langsamen spike wave Entladungen im EEG begleitet sind, wie das Lennox‐Gastaut‐Syndrom.
Effect of Interictal Epileptiform Discharges on Nocturnal Plasma Prolactin Concentrations in Epileptic Patients with Complex Partial Seizures
Authors: Molaie Majid , Culebras Antonio , Miller Myron
Published: November 2007

Summary: To investigate the effect of interictal epileptiform discharges (IEDs) on plasma prolactin (PRL) level, we studied 18 epileptic patients with complex partial seizures (CPS) who did not experience clinical or subclinical ictal events during all‐night monitoring with polygraphic recording and video imaging. The density of IEDs peaked during non‐REM stages and was significantly reduced during REM stage. Mean plasma PRL concentrations in epileptic patients, when sampled at 30‐min intervals, showed a moderate but significant elevation during non‐REM (p < 0.001) and awake stages (p < 0.005), but not during REM stage, when compared with 10 nonepileptic control subjects studied in a similar fashion. The data obtained in this physiologically controlled environment indicate that the cumulative effect of IEDs may modify PRL regulatory mechanisms, resulting in a modest elevation of plasma concentrations independent of ictal discharges.

Pour déterminer l'influence des décharges épileptiques intercritiques (DIC) sur la sécrétion de prolactine, nous avons étudié 18 patients présentant des crises partielles complexes sans manifestation critique clinique ou infra‐clinique pendant une nuit complète d'enregistrement polygraphique et vidéo. La densité des DIC était maximale pendant le sommeil lent et se trouvait significativement réduite pendant le sommeil paradoxal. Par comparaison avec 10 patients non épileptiques soumis à la mëme étude, la prolactine dosée sur des échantillons sanguins recueillis à des intervalles de 30 mn, était, chez les patients épileptiques, discrètement, mais significativement élevée pendant le sommeil lent (p < 0.001) et la veille (p < 0.005), mais non pendant le sommeil paradoxal. Ces résultats, obtenus dans un environnement contrölé sur le plan physiologique, montrent que l'effet cumulatif des DIC peut modifier les mécanismes régulateurs de la prolactine, et entrainer une élévation modérée des concentrations plasmatiques indépendante des décharges critiques.

Um die Wirkung von interiktalen epileptiformen Entladungen (IED) auf die Plasma‐Prolactin‐Konzentration (PRL) zu unter‐suchen, wurden 18 Patienten mit komplex‐fokalen Anfällen un‐tersucht, die während einer mit Polygraphie und Video über‐wachten Nacht keine klinischen oder subklinischen iktalen Ereignisse zeigten. Die IED‐Dichte war während der Non‐REM‐Phasen am höchsten und während der REM‐Phase signifi‐kant vermindert. Die mittleren iiber 30 Min. Intervalle gewon‐nenen Plasma‐PRL‐Konzentrationen zeigten eine mäßige, je‐doch signifikante Erhöhung während des non‐REM‐Schlafes (p < 0,001) und im Wachen (p < 0,005), nicht jedoch in den REM‐Phasen, im Vergleich zu 10 nicht epileptischen, in gleichem Maße untersuchten Probanden. Die in dieser kontrollierten Un‐tersuchung begonnenen Ergebnisse zeigen, daß eine Häufung von IED die PRL‐Regulation in Form einer mäßigen Erhöhung der Plasma‐Konzentration, unabhängig von iktalen Entladungen beeinflussen.
Ictal Tinnitus
Authors: Hurst Robert W. , Lee Soo Ik
Published: November 2007

Summary: Unilateral high pitched tinnitus was the sole epileptic ictal manifestation of a 45‐year‐old woman. Electrographic seizures originated from the contralateral midtemporal area and consistently correlated with tinnitus. Computed tomography (CT) demonstrated a lesion involving the superior temporal gyrus and inferior portion of the supramarginal gyrus. The case illustrates a cortical origin of tinnitus.

Un acouphène unilatéral de tonalité aiguëétait la seule symptomatologie critique épileptique chez une femme de 45 ans. Des crises électriques ont été enregistrées sur la région temporale moyenne controlatérale, elles ont été en relation constante avec l'acouphène. La scannographie cérébrale a mis en évidence une lésion intéressant la circonvolution temporale supérieure et la partie inférieure du gyrus supramarginal. Ce cas illustre l'existence d'un acouphène d'origine corticale.

Un acúfeno de aita frecuencia unilateral ha sido la única manifestatión epiléptica en una mujer de 45 arños. Los ataques electrográficos se originaron en la zona temporal media contralateral y mostraron una consistente correlatión con el acúfeno. La To‐mografía Computarizada mostró una lésion que afectaba a la circunvolución temporal superior y a la portión inferior del giro de la circunvolucion supramarginal. Este caso ilustra el origen cortical de los acúfenos.

Einseitiger Hochton‐Tinnitus war die einzige epileptische An‐fallsmanifestation bei einer 45 Jahre alten Frau. Elektrogra‐phisch nahmen die Anfällen ihren Ursprung von der kontralate‐ralen mittleren temporalen Region und waren mit dem Tinnitus eng korreliert. Das CT zeigte eine Läsion im oberen temporalen Gyrus und in dem unteren Anteil des supramarginalen Gyrus. Dieser Fall illustriert den corticalen Ursprung des Tinnitus.
Psychogenic Seizures
Authors: Gumnit Robert J. , Gates John R.
Published: November 2007

Summary: Psychogenic seizures occur in a heterogeneous population and are varied in their expression and etiology. Patients with psychogenic seizures form a significant percentage of patients presenting with “epilepsy”‐especially the group intractable to treatment. Intensive neurodiagnostic monitoring of ictal events and the classification of patients into clinically useful subgroups are important tools in approaching this disorder.
Clinical and EEG Features of Complex Partial Seizures of Temporal Lobe Origin
Authors: Quesney L. F.
Published: November 2007

Summary: The electrographic and clinical behavioural manifestations of 96 temporal lobe seizures are reviewed from recordings in 19 patients who were submitted to stereotaxic depth electrode implantation in temporal and frontal lobes. Focal onset in hippocampus was recorded in 40% of the seizures. Sixty percent of temporal lobe seizures exhibited a regional seizure onset but in two‐thirds of these ictal changes were restricted to amygdaloid and hippocampal structures. Thus, in approximately 80% of seizures, the onset of ictal EEG changes resided in the mesial temporal structures. The main behavioral manifestations observed during seizure discharge restricted to one temporal lobe included warning (67%), motionless stare (24%), automatism (22%), and head‐body turning (24%). The predominant ictal behavioural manifestations observed during seizure spread to contralateral temporal and extratemporal structures included warning (3%), motionless stare (36%), automatism (77%), and head‐body turning (81%). The direction of head turning did not provide reliable lateralization as to the side of seizure onset.
Epilepsy and Violence: Medical and Legal Issues
Authors: Treiman David M.
Published: November 2007

Summary: A possible relationship between epilepsy and violence has been debated for over a century. The debate has taken on new importance because of the increasing use of the “epilepsy defense” in criminal cases. In this review the following issues are addressed: (1) Is epilepsy more common among violent criminals and patients? (2) Is violence more common among epileptics? (3) Can directed violence or aggression occur as part of an epileptic seizure? (4) What medical and legal criteria should be used to determine whether a specific violent crime was the result of an epileptic seizure? Answers to these questions may be summarized as follows. (1) There is a two‐to fourfold greater prevalence of epilepsy in prisoners than in control populations, but the prevalence is similar to the prevalence in other lower socioeconomic populations from which most prisoners come. There is no greater prevalence of epilepsy in persons convicted of violent crimes than in other prisoners matched as controls. (2) There is no evidence that violence is more common among epileptics than among non‐epileptics, and no evidence that violence is more common in patients with temporal lobe epilepsy than in those with other types of epilepsy. (3) Ictal violence is rare, and when it does occur usually takes the form of “resistive violence” as the result of physical restraint at the end of a seizure, while the patient is still confused. Violence early in a seizure is extremely rare, stereotyped, and never supported by consecutive series of purposeful movements. (4) Five criteria should be used to determine if a specific violent act was the result of an epileptic seizure: a. the diagnosis of epilepsy should be established by a neurologist with special competence in epilepsy; b. the presence of epileptic automatisms should be documented by the case history and closed‐circuit TV‐EEG; c. aggression during epileptic automatisms should be documented on closed‐circuit TV‐EEG; d. the aggressive act should be characteristic of the patient's habitual seizures; and e. a clinical judgment should be made by the neurologist as to the possibility that the violent act was part of a seizure.
Epilepsy and Verbosity
Authors: Hoeppner JoAnn B. , Garron David C. , Wilson Robert S. , Koch‐Weser Margaret P.
Published: November 2007

Summary: Stories were elicited from 29 epileptic patients with generalized, simple partial, and complex partial seizures with bilateral, right, or left foci, and from 32 persons in two control groups. Four older epileptic patients with long histories of left complex partial seizures were verbose. Their stories involved trivial and subjective details, consistent with circumstantiality and suggesting the substrate for a hallucinatory syndrome.

Nous avons 0interrogé 30 patients épileptiques présentant des crises généralisées, partielles simples ou partielles complexes avec foyers bilatéraux, droits ou gauches, et 32 sujets témoins répartis en deux groupes. 4 patients épileptiques anciens, avec un long passé de crises partielles complexes gauches, se sonl montrés verbeux. Leurs discours contenaient des détails triviaux et subjectifs, témoignant ď;une adhésion non critique aux circonstances et suggérant ľexistence ď;un terrain de syndrome hallucinatoire.

Se han extraído los relatos de 30 epilépticos con ataques gen‐eralizados, simples parciales y ataques parciales complejos con focos bilaterales derechos o izquierdos y también los relatos de 32 personas en 2 grupos control. Cuatro epilépticos ancianos con historias prolongadas de ataques parciales complejos resultaron poseer importante verbosidad. Los relatos siempre contenían detalles triviales y subjetivos de caracter circunstancial que par‐ecian ser el sustrato de un sìndrome alucinatorio.

Die Berichte von 30 Anfallskranken mit generalisierten, einfa‐chen Partial‐ und komplexen Partialanfällen mit bilateralen, rechts‐ und linksseitigen Foci und von 32 Kontrollpersonen wurden analysiert. 4 ältere Patienten mit langer Anamnese von linksseitigen, komplexen Partialanfällen waren weitschweifig. Ihre Berichte enthielten triviale und subjektive Details, die mit Umstandlichkeit vereinbar waren und auf ein halluzinatorisches Syndrom schließen ließen.