bluuebunny/crossref_metadata_2025 huggingface dataset:
Anticipation des crises d'épilepsie par l'analyse non‐linéaire de l'EEG
Authors: Le Van Quyen Michel
Published: March 2024

L'étude des changements dynamiques de l'activité neuronale précédant une crise épileptique permet une caractérisation d'un état pré‐ictal plusieurs minutes avant la crise. Ces résultats ouvrent de nouvelles perspectives pour l'étude des mécanismes de l'épileptogenèse mais aussi la possibilité de nouvelles interventions thérapeutiques avant l'occurrence de la crise. Dans cette revue, nous discutons les résultats obtenus par notre groupe dans ce domaine utilisant l'analyse non‐linéaire de l'activité électrique du cerveau et précisons les limites de ces résultats ainsi que les questions encore ouvertes.
Conduite à tenir devant une première crise d'épilepsie
Authors: Sabouraud Pascal
Published: March 2024

La prise en charge d'une première crise d'épilepsie chez un enfant n'a pas fait l'objet encore d'un consensus sur le plan médical. La fréquence de crises méconnues nécessite un interrogatoire orienté devant toute première crise. Cela permet souvent d'envisager un syndrome épileptique particulier. Celui‐ci sera confirmé par la recherche de l'âge de début et le type de crise, l'état intercritique et l'électroencéphalogramme. L'indication d'une imagerie cérébrale, essentiellement une imagerie par résonnance magnétique en dehors du contexte de l'urgence, n'est pas systématique sauf en cas de première crise partielle. L'existence d'antécédents neurologiques, d'une dysmorphie, d'anomalies cutanées, d'une modification récente du comportement ou de l'efficience scolaire, d'un retard mental, d'une anomalie à l'examen neurologique, d'un foyer à l'électroencéphalogramme, d'un âge inférieur à un an permettra de poser l'indication pour une IRM devant une première crise généralisée tonico‐clonique. Enfin, un traitement antiépileptique ne sera pas démarré devant une vraie première crise sauf dans certains syndromes épileptiques caractérisés par une rechute systématique des crises.
Les épilepsies généralisées idiopathiques de l'enfant sont‐elles bénignes?
Authors: Échenne Bernard , Cheminai Renée , Roubertie Agathe , Rivier François
Published: March 2024

Le pronostic et la réputation de bénignité des épilepsies généralisées idiopathiques de l'enfant sont analysées à partir des données publiées et, dans certains cas, d'études personnelles. Sont soulignées essentiellement les perturbations neurocognitives et les difficultés scolaires observées au cours de certains types d'épilepsie: épilepsies absence, épilepsies myocloniques, épilepsies généralisées avec des crises tonicocloniques.

Dans une étude contrôlée concernant les épilepsies absences idiopathiques typiques, nous avons mis en évidence une absence de résultats moyens forts ou supérieurs à l'échelle non verbale et aux résultats globaux du test de Wechsler; une faiblesse significative des compétences mnésiques, une lenteur de réalisation, des signes d'hyperactivité et des troubles de l'attention sont également retrouvés dans 35 à 50 % des cas. La majorité des enfants a des difficultés scolaires à des degrés divers. Ces résultats posent le problème de la réputation de bénignité de la plupart de ces épilepsies.
Anoxic seizures: self‐terminating syncopes
Authors: Stephenson John B.P.
Published: March 2024

This review focuses on anoxic seizures induced by self terminating syncopes in the young. Anoxic seizures are nonepileptic events consequent upon abrupt interruption of the energy supply to metabolically active cerebral neurones. Anoxic seizures are the most common paroxysmal events misdiagnosed as epilepsy. Neurally mediated syncopes have numerous appellations, especially in the young. This proliferation of terminology likely results from uncertainty regarding pathophysiology. The most important type of self‐limiting syncope from the point of view of diagnostic difficulty has been called neurocardiogenic or vasovagal syncope and reflex anoxic seizure, amongst other names: this review includes a video clip of such a child with prolonged asystole. It also includes a detailed case history emphasising the feelings of a patient with this type of syncope who was misdiagnosed as having epilepsy for many years. The second class of self‐terminating syncope discussed and illustrated on video is the so‐called breath‐holding spell of young children. The third example illustrated is the compulsive Valsalva manoeuvre of individuals with autistic spectrum disorder, in which anoxic seizures – as shown on the video clips – are easily misdiagnosed as epileptic seizures, with unfortunate consequences.
Epigastric sensations as an unusual manifestation of adult absence epilepsy
Authors: Wiest R. , Schindler K. , Kollar M. , Donati F.
Published: March 2024

We report the case of a 39‐year‐old woman with onset of daily epigastric sensations associated with brief episodes of unresponsive blank stare, which have been interpreted as complex partial seizures with occasional secondary generalisation. Phenytoin as monotherapy and in combination with valproate had not been effective. During video‐EEG we recorded typical absences with brief 3 second spike, and slow‐wave discharges of up to 5 seconds, which were recognized by the patient herself. All absences were preceded by epigastric sensations. There was no indication of focal epilepsy. Monotherapy with valproate substantially decreased the frequency of the absences. In conclusion, this case is peculiar for several reasons: 1) late onset of absence epilepsy, 2) epigastric sensation at onset of absence seizures, 3) recognition of brief “phantom” absences and 4) presumable adverse effects of phenytoin.
Temporoporal metabolic abnormalities in temporal lobe epilepsies
Authors: Semah Franck
Published: March 2024

Positron emission tomography (PET) may be used to map regional cerebral glucose metabolism using
18
F‐deoxyglucose‐PET in patients with partial epilepsy. An area of reduced glucose metabolism, that is commonly more extensive than the underlying anatomical abnormality, is reported in most of the patients with medically refractory partial epilepsy. These functional changes are useful in the delineation of the epileptogenic focus prior to surgery. Nevertheless, in patients with mesial temporal lobe epilepsy (MTLE) without mass lesion, the hypometabolism involves a large area of the temporal lobe, including the mesial structures, the temporal pole and part of the lateral temporal cortex. In such patients with MTLE, subcortical structures and extratemporal lobe areas are also often hypometabolic. The reasons for this large hypometabolism remain debated. In MTLE patients, the most severe hypometabolism is found in the temporo‐polar region. The clinical significance of this temporo‐polar hypometabolism is unknown. The pathophysiology of interictal hypometabolism probably involves several mechanisms, such as neuronal loss, deafferentation, postictal depression, and others epilepsy‐related phenomena. The relationship between interictal temporo‐polar hypometabolism and seizure onset or seizure spread remain speculative.
Normal functional imaging of the basal ganglia
Authors: Lehéricy Stéphane , Gerardin Emmanuel
Published: March 2024

In non‐human primates, all cortical projections into the striatum are topographically organized in discrete parallel circuits. These circuits are involved in distinct behavioral functions. In humans, functional imaging data support a similar organization of the striatum. The representation of the different elements of a motor act (such as movement learning, selection, mental representation, preparation and execution) are represented differentially along distinct cortico‐basal ganglia circuits. Saccadic eye movements are predominantly represented in the caudate nucleus. Motivational processes are represented in the ventral part of the striatum. Thus, functional imaging data suggest that the human striatum is organized in parallel motor circuits similar to those found in animal studies.

RÉSUMÉ – Imagerie fonctionnelle normale des ganglions de la base.
Chez le primate, les projections corticales vers le striatum sont organisées en circuits parallèles distincts. Ces circuits ont des fonctions différentes dans l'élaboration des comportements. Chez l'homme, les données de l'imagerie fonctionnelle suggèrent l'existence d'une organisation similaire du striatum. La représentation des différentes variables d'un acte moteur (comme l'apprentissage, la sélection, la représentation mentale, la préparation et l'exécution du mouvement) s'organise en circuits cortex‐ganglion de la base distincts. Les saccades oculaires sont principalement représentées dans le noyau caudé. Les processus de motivation sont représentés dans la partie ventrale du striatum. Les données de l'imagerie fonctionelle suggèrent donc que le striatum humain est organisé en circuits parallèles semblables à ceux décrits chez l'animal.
Long‐term experience with levetiracetam
Authors: Abou‐Khalil Bassel , Lazenby Barry
Published: March 2024

Although short‐term clinical trials provide important data regarding efficacy and tolerability, long‐term studies are needed to address important aspects of clinical practice, such as long‐term efficacy and safety. Long‐term studies and post‐marketing data show that the efficacy of levetiracetam is sustained over the long term and that this antiepileptic drug continues to be well tolerated, with low withdrawal rates and high retention rates. Patients continue to achieve significant reductions in seizure frequency and may achieve seizure freedom. Levetiracetam may allow patients to decrease the number of concomitant antiepileptic medications or withdraw to monotherapy. Add‐on therapy with levetiracetam should be considered when additional control of seizures is needed.
Levetiracetam: preliminary efficacy in generalized seizures
Authors: Trenité Dorothée G.A. Kasteleijn‐Nolst , Hirsch Edouard
Published: March 2024

Levetiracetam is a novel antiepileptic drug (AED) with proven efficacy against partial seizures, but there is limited information about its effectiveness against generalized seizures. In animal models, levetiracetam protects against seizures in audiogenic susceptible rodents, and it is effective in the Genetic Absence Epilepsy Rat from Strasbourg, a model of absence seizures. In these models, levetiracetam has a therapeutic index that is higher than those of other AEDs. A number of small open‐label studies suggest that levetiracetam reduces seizure frequency in patients with generalized seizures, including primarily generalized seizures and myoclonic seizures. Case reports provide additional information regarding the potential efficacy of levetiracetam in postanoxic, post‐encephalitic and progressive myoclonus. Although randomized controlled studies of patients with generalized seizures have not yet been conducted, on the basis of available information, levetiracetam may be promising in the treatment of generalized seizures.
Preliminary efficacy of levetiracetam in monotherapy
Authors: Ben‐Menachem Elinor
Published: March 2024

The standard of care for prescribing antiepileptic drugs (AEDs) has come to favor the use of monotherapy when possible; i.e., when comparable efficacy can be achieved with fewer risks of adverse events and drug interactions. Most patients with epilepsy are started on one of the classic AEDs and, if it proves ineffective, another drug is tried, usually as monotherapy. While most of the newer AEDs that have come into clinical use in recent years are initially used as add‐on therapy, their success at improving seizure control in combination treatments has led to their cautious use as monotherapy even before they have been approved for this indication. As a first study to determine the potential efficacy of levetiracetam in monotherapy, a withdrawal trial model was used. Patients who achieved adequate seizure control with levetiracetam as add‐on therapy in a double‐blind, placebo‐controlled study entered a monotherapy phase of the trial in which the baseline AED was gradually withdrawn. Also, long‐term data of 505 patients who received levetiracetam for refractory partial seizures were reviewed and found to include 49 patients still treated with levetiracetam monotherapy at the end of the study for a duration between 3 months and 5.5 years. Data from patients in the two trials lend supportive evidence that levetiracetam monotherapy is safe and effective for partial seizures.
Disconnective hemispherectomy for hemispheric dysplasia
Authors: Villemure Jean Guy , Meagher‐Villemure Kathleen , Montes Jose Luis , Farmer Jean‐Pierre , Broggi Giovanni
Published: March 2024

Twelve patients suffering from intractable epilepsy and presenting with radiological evidence of diffuse hemispheric involvement of a dysplastic process, were treated by disconnective hemispherectomy, either functional hemispherectomy or peri‐insular hemispherotomy. The median age at surgery was 4.5 years old and the interval between seizure onset and surgery, 3 years. All patients underwent a presurgical evaluation that led to the suggestion of disconnective hemispherectomy. Over 70% of patients have remained in Engel's seizure outcome class I since surgery and another 18% have had a satisfactory seizure outcome. There was one unexplained death and one case of early hydrocephalus. Hemispherectomy offers the possibility to improve seizure control in the majority of patients undergoing surgery for extensive dysplastic pathology of the hemisphere. Disconnective techniques reduce the rate of complications in this specific pathology.
MR imaging of epilepsy: State of the art at 1.5 T and potential of 3 T
Authors: Briellmann Regula S. , Pell Gaby S. , Wellard R. Mark , Mitchell L. Anne , Abbott David F , Jackson Graeme D.
Published: March 2024

Shortly after being introduced in the nineteen eighties, magnetic resonance imaging (MRI) became a key tool for the investigation of patients with epilepsy, due to its ability to acquire high quality images. The strength of the magnetic field of a scanner is measured in tesla (T). This review addresses the clinical and research potential in epilepsy of MR imaging at 1.5 T and 3 T. A typical clinical scanning protocol at 1.5 T for a patient with refractory epilepsy may include T1‐ and T2‐weighted imaging, fluid‐attenuated inversion recovery (FLAIR) imaging, and a 3D volume acquisition sequence. A research protocol may add quantification of structural imaging, such as volumetric assessment and T2‐relaxometry, together with functional measures, such as MR‐spectroscopy, functional MRI and diffusion weighted sequences. MR‐spectroscopy assesses the metabolites of the seizure focus and other brain areas. Functional MRI allows localisation of cognitive and sensori‐motor function and the ability to assess the spatial relationship of these functions to the seizure focus. Whereas these techniques can be performed at 1.5 T, particularly MR‐spectroscopy and functional MRI benefit from increased magnetic field‐strength. Higher magnetic field‐strength is associated with a higher signal‐to‐noise ratio (SNR). The increased SNR can allow shorter imaging times for a given resolution, higher resolution for a given imaging time, or combination of both. The use of higher magnetic field‐strengths is therefore indicated for the (fast) imaging of ill subjects, for long protocols, including structural, metabolic and functional imaging, and for novel applications, such as continuous EEG recording and functional MRI for the detection of the seizure focus. Disadvantages of MR imaging in epilepsy at a high field‐strength of 3 T and above are, apart from engineering and technical challenges, the greater energy deposition into tissue and increased susceptibility to artefacts. So far, magnets of 3 T and above have been used mainly for research applications, however the benefits of high field‐strength for MR spectroscopy and functional MRI, and the usefulness of these techniques for the investigation of epilepsy patients are obvious incentives for the use of 3 T systems in routine clinical investigations. [Published with neuroimaging sequences.]
Mesial temporal lobe epilepsy with focal photoparoxysmal response
Authors: Fiore Lia A. , Valente Kette , Gronich Gary , Ono Carla R , Buchpiguel Carlos A.
Published: March 2024

Intermittent photic stimulation (IPS) may produce epileptiform discharges and seizures, most of which are generalized. There are several cases of focal seizures of occipital origin induced by IPS and only five reported cases originating from the temporal lobe (TL). We report an unusual case of TL epilepsy, supported by electroclinical and neuroimaging data, with rhythmic focal TL discharges precipitated by photic stimulus. Case report: A 37 year old male with refractory epilepsy due to a right mesial temporal sclerosis presented a focal right TL photoparoxysmal response during IPS. A routine, interictal SPECT study obtained with injection of HMPAO, carried out during continuous pulses of the photic stimulus at 16 Hz, disclosed hyperperfusion over the right TL. Presurgical ictal studies demonstrated seizures arising from the same region. A temporal lobectomy rendered the patient seizure‐free and further EEGs with IPS were normal. Conclusion: To our knowledge, this is the sixth case in medical literature showing evidence of photosensitivity associated with a TL lesion and it is the first in which photic stimulation induced a focal electrographic response of the involved TL. We hypothesize that in rare cases, photosensitivity may be related to a mesial TL lesion without occipital cortex involvement.
Subdural electrodes in focal cortical dysplasia
Authors: Noachtar Soheyl
Published: March 2024

Subdural electrodes are useful in selected patients with cortical dysplasia for planning resective epilepsy surgery. Their potential risks have to be balanced against the diagnostic yield and expected benefit of epilepsy surgery for the patient. Recent advances in imaging techniques now allow more accurate placement of the subdural electrodes and also limit the number required.
Childhood epilepsy: a critical review of cost‐of‐illness studies
Authors: Argumosa Ana , Herranz José Luis
Published: March 2024

Epilepsy is an illness with multiple consequences and costs for children, families and society. There are only a few studies published on the cost of childhood epilepsy. The different methodologies used in these studies make it difficult to compare them or even to compare the cost of childhood epilepsy treatment with that of adult epilepsy. Nevertheless, studies highlight important differences in the distribution of costs associated with childhood epilepsy and epilepsy in adults. It is understandable that direct costs represent the higher percentage of the total cost associated with childhood epilepsy treatment, given the higher number of hospital admissions and investigations, as well as the complexity of therapeutic trials, while indirect costs represent the greater proportion in adult epilepsy treatment. In addition to age, the total cost associated with epilepsy also depends on other factors such as seizure frequency, the moment at which the illness cost is estimated and the local health care system. In summary, chronic illnesses not only have an influence on the physical and psychological development of children, they also impose costs on the family and society. Childhood epilepsy has greater economic costs than those generated by more prevalent, chronic illnesses.
Memory function decline over 18 months after selective amygdalohippocampectomy
Authors: Ogino Tatsuya , Ohtsuka Yoko , Ido Yumiko , Mayanagi Yoshiaki , Watanabe Eiju , Oka Eiji
Published: March 2024

We report on a 22 year‐old woman with left temporal lobe epilepsy who had suffered complex partial seizures since childhood. At 19 years 10 months of age she underwent selective amygdalohippocampectomy, which resulted in a complete cessation of seizures. Preoperatively, the Logical Memory II section of the WMS‐R revealed poor logical memory function. Postoperatively, the patient's scores on several neuropsychological tests had deteriorated, namely, the Miyake Paired‐Associate Word Learning Test (related and unrelated pairs), several sections of the WMS‐R (Figural Memory, Logical memory I, Visual Reproduction II, Visual Paired Associates I, and Verbal Paired Associates I and II), and the BVRT‐R. In particular, her scores on the Visual Paired Associates I, Verbal Paired Associates I and II sections of the WMS‐R, and the BVRT‐R not only declined at one and three months post‐surgery, but also showed progressive deterioration at 16 and 18 months post‐surgery. It should be kept in mind that selective amygdalohippocampectomy can result in progressive postoperative, deterioration in some aspects of memory function.
Adverse motor effects induced by antiepileptic drugs
Authors: Zaccara G. , Cincotta M. , Borgheresi A. , Balestrieri F.
Published: March 2024

Cognitive effects of anti‐epileptic drugs (AEDs) have been already extensively reported. In contrast, motor disturbances, frequently induced by these drugs, have not received similar attention. We review subjective and objective adverse motor effects of traditional and new AEDs. We discuss the methodological issues caused by the heterogeneous sources of information on drug adverse effects (controlled clinical studies, open studies, and case reports). We describe specific disturbances (vestibulocerebellar, dyskinesias, parkinsonism, tics, myoclonus, and tremor) as the effects of different AEDs on distinct motor circuitries. Finally, we summarize the role of sophisticated technical studies which provide a valuable insight into the specific or subtle effects of AEDs on the central nervous system.
Video‐EEG study in an adult and a child with eyelid myoclonia with absences
Authors: Burneo J.G. , Miller S. , Bebin E.M. , Prasad A.
Published: March 2024

Two patients with eyelid myoclonia with absences (EMA) are described. Videotape of the eyelid myoclonia in one patient is presented. An interesting feature in one patient was the induction of clinical seizures only with daylight, and in another the presence of rare, focal, epileptiform discharges during drowsiness. Valproic acid only partially controlled eyelid myoclonia in both cases. Lamotrigine, alone or in combination with valproate, can be used as an alternative but was ineffective in our cases. [Published with video sequences].
Infection du système nerveux central et épilepsies
Authors: Vespignani Hervé , Najjar A. Al , Kremer S. , Maillard L.
Published: March 2024

La survenue récente de crises d'épilepsie (CE) partielles, partielles secondairement généralisées ou apparemment généralisées d'emblée de type tonicocloniques représente une circonstance diagnostique fréquente d'une infection du système nerveux central (méningites, encéphalites, abcès unique ou multiples, empyhèmes sous‐duraux). Le déclenchement d'un état de mal d'origine infectieuse correspond à un facteur de gravité dans la prise en charge thérapeutique. Le diagnostic évoqué selon le contexte clinique, l'origine géographique, est confirmé par le scanner ou l'IRM encéphalique dont les aspects peuvent être caractéristiques d'une étiologie parasitaire, mycotique, bactérienne ou virale. La normalité des explorations morphologiques n'écarte pas cependant l'origine infectieuse de CE récentes, notamment d'une méningite quel que soit l'âge, mais surtout chez l'enfant. De même, la survenue de CE au cours d'une méningite doit faire rechercher un abcès cérébral. Le traitement antiépileptique à la phase aiguë est de règle. Ses indications à distance dans le but de prévenir une épilepsie séquellaire dépendent du type d'infection et des possibilités de thérapeutiques anti‐infectieuses. Le risque de récidive de CE est le plus important en cas d'encéphalite ou d'abcès cérébral. Dans un contexte traumatique, l'infection du système nerveux central majore le risque de survenue d'une CE post‐traumatique.
A semiological classification of status epilepticus
Authors: Rona Sabine , Rosenow Felix , Arnold Stephan , Carreño Mar , Diehl Beate , Ebner Alois , Fritsch Brita , Hamer Hajo M. , Holthausen Hans , Knake Susanne , Kruse Bernd , Noachtar Soheyl , Pieper Tom , Tuxhorn Ingrid , Lüders Hans O.
Published: March 2024

The classification of status epilepticus (SE) has been a subject of discussion for many years, yet no satisfactory agreement has been reached. Due to their complexity, status episodes often defy classification according to the current international classification scheme. The semiological seizure classification (SSC) has been in use in several epilepsy centers for more than a decade, and has proven to be a valid approach to the classification of epileptic seizures. Based on the detailed analysis of more than 100 episodes of SE documented with video‐EEG recordings, the authors now present a proposal for a semiological classification of status epilepticus (SCSE). The SCSE reflects the assumption implied by all modern definitions of SE that “there are as many types of status as there are types of seizures” and relies on the same principles as the SSC, focusing on the main clinical manifestations and the evolution of the status episode. The clinical manifestations of SE are subdivided into semiological components and classified along three axes: the type of brain function predominantly compromised by the seizure activity, the body part involved, and the evolution over time. Each axis contains several subcategories, so that many different levels of accuracy are possible. The SCSE, just like the SSC, is meant to be part of a comprehensive epilepsy classification which classifies as independent variables (epileptogenic zone, ictal semiology, etiology, related medical conditions) the main features of the patient's epilepsy, allowing for each variable maximum flexibility. [Published with videosequences]
Temporal lobe epilepsy: clinical semiology and age at onset
Authors: Villanueva Vicente , Serratosa José Maria
Published: March 2024

The objective of this study was to define the clinical semiology of seizures in temporal lobe epilepsy according to the age at onset. We analyzed 180 seizures from 50 patients with medial or neocortical temporal lobe epilepsy who underwent epilepsy surgery between 1997‐2002, and achieved an Engel class I or II outcome. We classified the patients into two groups according to the age at the first seizure: at or before 17 years of age and 18 years of age or older. All patients underwent intensive video‐EEG monitoring. We reviewed at least three seizures from each patient and analyzed the following clinical data: presence of aura, duration of aura, ictal and post‐ictal period, clinical semiology of aura, ictal and post‐ictal period. We also analyzed the following data from the clinical history prior to surgery: presence of isolated auras, frequency of secondary generalized seizures, and frequency of complex partial seizures. Non‐parametric, chi‐square tests and odds ratios were used for the statistical analysis.

There were 41 patients in the “early onset” group and 9 patients in the “later onset” group. A relationship was found between early onset and mesial temporal lobe epilepsy and between later onset and neocortical temporal lobe epilepsy (p = 0.04). The later onset group presented a higher incidence of blinking during seizures (p = 0.03), a longer duration of the post‐ictal period (p = 0.07) and a lower number of presurgical complex partial seizures (p = 0.03). The other parameters analyzed showed no significant differences between the two groups. We conclude that clinical and semiological differences exist between patients with temporal lobe epilepsy according to the age at onset.
[Published with video sequences]
Subjective signs in premotor epilepsy: confirmation by stereo‐electroencephalography
Authors: Beauvais Katell , Biraben Arnaud , Seigneuret Eric , Saïkali Stephan , Scarabin Jean‐Marie
Published: March 2024

Subjective manifestations inaugurating frontal seizures are less well known than those observed in temporal seizures. We report eleven consecutive patients who underwent surgery for premotor epilepsy. Six of them had focal cortical dysplasia. Ictal symptomatology was analysed to establish electroclinical correlations. The localisation of the epileptogenic zone was assessed by stereoelectroencephalographic studies. Subjective manifestations were described in all cases, more frequently in a sensory rather than an emotional or psychological fashion. Focal seizures limited to subjective features were recorded in two patients. In one, psychological illusions and visual hallucinations were related to the superior frontal sulcus. Another presented isolated paraesthesia in the left arm with the implication of the supplementary motor area. Electrical stimulation of an electrode located in the premotor area evoked isolated subjective manifestations in three other patients. One patient reported sensory manifestations and another, ideational manifestations. Cephalic sensations and emotional manifestations were associated in one case. Subjective manifestations were observed in all patients, and were proved to be related to a discharge restricted to the premotor area in five. These were non‐specific signs, but were always the same in a given patient. Spontaneous, isolated sensations and stimulation data tended to be contradictory. This illustrates the complexity of analyzing subjective signs, as well as the complexity of the neuronal networks participating in the propagation of discharges arising in the premotor frontal area.
Improving quality of life beyond seizure control
Authors: Schachter Steven C.
Published: March 2024

More than 50 years ago, Lennox and Markham urged physicians who treated patients with epilepsy to “match modern drug and surgical therapy with practical sociopsychological therapy” and to be “concerned not only with turbulent brain waves but with disturbed emotions”. Indeed, while seizure frequency and severity correlate with quality of life and psychosocial outcomes for patients with drug‐resistant epilepsy, numerous other epilepsy‐related factors may also be significant determinants. These factors include medical and psychiatric co‐morbidities, side effects of therapy, stigma, parental anxiety, employment status, seizure worry, self‐esteem and self‐mastery. Importantly, these epilepsy‐related factors may be amenable to educational or therapeutic interventions, which if successful may benefit patients even without a concomitant reduction in seizure frequency or severity. Therefore, while further research is needed, physicians and other health care providers should comprehensively attend to these factors and refer patients with treatment‐resistant seizures, when appropriate, for further evaluation and treatment to improve their quality of life beyond seizure control.
Implacable images: why epileptiform events continue to be featured in film and television
Authors: Kerson Toba Schwaber , Kerson Lawrence A.
Published: March 2024

Epileptiform events have been portrayed in film since 1900 and on television since the 1950's. Over time, portrayals have not reflected medicine's understanding of epilepsy. At present, it is unlikely that individuals who do not have a close relationship with someone with a seizure‐disorder will witness a seizure. Because fictive and often incorrect images appear increasingly, many think of them as accurate depictions. The research addresses three questions in relation to these images: How do directors use the images? Why do uses of seizures in visual media not reflect contemporary scientific knowledge? Why have they persisted and increased in use? Data consist of material from 192 films and television episodes. The general category of seizures includes seizures in characters said to have epilepsy or some other condition, seizures related to drug or alcohol use, pseudoseizures and feigned seizures, and, a category in which, for example, someone is described as “having a fit.” The research demonstrates how epileptiform events drive the narrative, support the genre, evoke specific emotional reactions, accentuate traits of characters with seizures, highlight qualities of other characters through their responses to the seizures, act as catalysts for actions, and enhance the voyeuristic experience of the audience. Twenty video sequences are included in the manuscript. The authors conclude that the visual experience of seizures remains so enthralling that its use is most likely to increase particularly on television, and that as the public has less experience with real seizures, depictions in film will continue to be more concerned with what the image can do for the show and less interested in accurate portrayals. Ways to influence depictions are suggested.

[Published with video sequences]
Intractable cryptogenic frontal lobe epilepsy in a patient with MURCS association
Authors: Dericioglu Nese , Saygi Serap
Published: March 2024

The MURCS association is a rare, nonrandom association of müllerian duct aplasia, renal aplasia and cervicothoracic somite dysplasia. The etiology is unknown. Although it is usually a sporadic disorder, familial cases with uterovaginal anomalies have been reported. Occasionally, it may be accompanied by abnormalities involving various other organs or systems. Malformations related to the central nervous system are very rare and the presence of seizures has not been reported previously. We present a 26‐year‐old female with MURCS association who had late onset, drug resistant partial seizures presumably originating in the frontal lobe.
Progressive myoclonic epilepsies: myth or reality?
Authors: Genton Pierre , Bureau Michelle
Published: March 2024

The progressive myoclonus epilepsies (PME) are rare diseases and many clinicians, who have only few opportunities to encounter such patients, may think of them as mythical. However, the category of PME has been retained by the latest classification scheme proposal of the International League Against Epilepsy. PMEs are defined by: 1) generalized epileptic seizures (focal seizures may also occur in certain etiologies), 2) a sometimes invalidating myoclonus, and 3) other neurological symptoms (ataxia, dementia, sensory deficits) that vary according to etiology. Indeed, PMEs are a heterogenous group of conditions, with diverse etiologies. Their prevalence varies according to the ethnic context, and PMEs may appear as fairly frequent in some settings, because of genetic factors (isolate and/or inbreeding, for instance, in PMEs with recessive inheritance). The genetic and biochemical mechanisms underlying PMEs are increasingly recognized. We must nowadays follow a logical diagnostic scheme that will take into account the ethnic and genetic context, the age at onset of symptoms and the respective weight of symptoms. New therapeutic approaches are under development, and the available purely symptomatic treatments can be used to best possible effect. It is thus possible to recognize PMEs as a group of conditions appearing either as epilepsy, or as a movement disorder, or still under the mask of various neurological or cognitive symptoms. It is also possible to organize a logical, comprehensive care for patients with PME.
Towards a definition of the “practical” epileptogenic zone: a case of epilepsy with dual pathology
Authors: Chassagnon Serge , Valenti Maria Paola , Sabourdy Cécile , Esposito Philippe , Kehrli Pierre , Arzimanoglou Alexis , Ryvlin Philippe , Kahane Philippe , Hirsch Edouard
Published: March 2024

Presurgical evaluation for patients with drug‐resistant epilepsy requires the definition of various zones that have a variable spatial relationship with the epileptogenic zone. All the available mehods to directly measure the actual seizure‐onset zone and to define “the minimum amount of cortical tissue that must be resected to produce seizure‐freedom” have significant limitations. We report on the case of a patient with dual pathology (hippocampal sclerosis and a post‐traumatic scar) and discuss the contribution of the various presurgical investigations that led to surgery and seizure‐freedom.
Euphoric (hedonic) theta hypersynchrony in early childhood
Authors: Koutroumanidis Michael
Published: March 2024

Euphoric or hedonic theta hypersynchrony appears to be an unusual finding in the electroencephalography of the child, and it has been rarely reported. This case report presents a 4‐year‐old child who responded to pleasurable stimulation with a robust, diffuse theta activity, and also samples some of the thoughts that such a response can generate.
[Published with video sequences]
BRICS Academies Forum 2023: InterAcademy Collaboration on the Global Polycrisis
Authors:   Chinese Academy of Sciences (CAS),   Indian National Science Academy (INSA),   Russian Academy of Sciences (RAS),   Academy of Science of South Africa (ASSAf)
Published: March 2024

The Academy of Science of South Africa (ASSAf) and the Department of Science and Innovation (DSI) jointly hosted the 2023 BRICS Academies Forum on 1-2 December 2023 in Pretoria, South Africa. The Forum is the body of science academies of the BRICS member states including the: Brazilian Academy of Sciences (ABC), Russian Academy of Sciences (RAS), Indian National Science Academy (INSA), Chinese Academy of Sciences (CAS), and ASSAf. The theme of the 2023 BRICS Academies Forum Meeting was “Inter-Academy Collaboration on Global Crises” which was aligned to the 2023 BRICS Science, Technology, and Innovation (STI) theme; “Building BRICS and Africa Partnership for Mutually Accelerated Growth, Sustainable Development and Inclusive Multilateralism.” The delegations of the BRICS Academies were welcomed by ASSAf Acting President, Prof Stephanie Burton, and DSI Deputy Director-General for International Cooperation and Resources, Mr Daan du Toit during the Opening and Welcome Dinner ceremony on the 1st of December. Day 2 of the meeting was dedicated to technical presentations by each Academy and subsequent discussions. Prof Burton directed the proceedings and Prof Himla Soodyall the ASSAf Executive Officer moderated the discussion.
Исследование возможности стабилизации напряжения питания промышленных потребителей при изменениях параметров нагрузки
Authors: Табаров Бехруз Довудходжаевич , Соловьев Вячеслав Алексеевич , Сериков Александр Владимирович
Published: March 2024

Рассмотрены возможности применения нового типа регулятора напряжения на основе реакторно-тиристорных управляемых ключей для обеспечения нормального функционирования и улучшения качества электроэнергии систем электроснабжения при номинальном напряжении питающей сети и номинальной нагрузке, а также отклонениях тока нагрузки на -40% от номинального значения. Для определения и оценки показателей использован метод компьютерного моделирования с применением программного средства MatLab, на основе которого проведено исследование возможности стабилизации напряжения у потребителей с существующим и предлагаемым регулятором напряжения. Исследование проведено в среде MatLab на компьютерной модели цехового трансформатора с предлагаемым управляемым регулятором напряжения мощностью 1МВ·А и напряжением 6 / 0,4 кВ при номинальном напряжении питающей сети и неравномерном графике активно-индуктивной нагрузки. Результаты численных экспериментов показали, что предлагаемый управляемый регулятор напряжения сохраняет уровень напряжения на шине распределительного устройства цехового трансформатора на номинальном значении и сохраняет высокое значение энергетической эффективности не только потребителей электроэнергии, но и электропередачи. Сравнительные характеристики результатов исследований подтвердили преимущество предлагаемого регулятора напряжения по быстродействию и точности регулирования, что позволяет не только достигнуть поставленных целей, но и повысить технико-экономические показатели электротехнических систем.
Сглаживание пиковых нагрузок в частотно-регулируемом электроприводе трамвая с системой хранения энергии на базе суперконденсаторов
Authors: Плотников Юрий Валерьевич , Поляков Владимир Николаевич , Савосина Алена Александровна , Щербаков Дмитрий Андреевич
Published: March 2024

Рассмотрена проблема снижения пиковых нагрузок на систему энергоснабжения в частотно-регулируемом электроприводе. Показано, что при пусковых режимах работы городского транспорта в условиях слабой контактной сети постоянного тока могут возникать значительные падения напряжения, что негативно отражается на работе других потребителей. Предложено в системе частотно-регулируемого электропривода использовать дополнительный источник питания, включающий в себя блок суперконденсаторов и двунаправленный DC-DC преобразователь с собственной системой автоматического управления. В основе построения системы автоматического управления DC-DC преобразователем для устройства хранения энергии на базе суперконденсаторов лежит теория систем подчиненного регулирования координат. При синтезе регулятора тока для одноконтурной системы использованы методы технической линеаризации нелинейностей объекта управления. Для проверки разработанных алгоритмов управления применены методы математического моделирования на основе структурных схем. Для получения переходных процессов использовано приложение Simulink программного пакета MATLAB. При моделировании системы частотно-регулируемого электропривода трамвая с накопителями электрической энергии не учитывалась дискретность DC-DC преобразователя и преобразователя частоты. В моделях использованы средние значения переменных за период дискретности преобразователя. Рассмотрены несколько вариантов алгоритмов управления для решения задачи ограничения пиковой мощности, потребляемой от контактного источника питания во время пусковых режимов электропривода городского транспорта. Предложен вариант системы накопления энергии, ограничивающий энергопотребление электропривода от контактной линии на заданном уровне, обеспечивая при этом необходимые технологические режимы работы электропривода трамвая. Приведены структурные схемы и алгоритмы управления. Представлены результаты моделирования частотно-регулируемого электропривода трамвая с системой накопления энергии, доказывающие эффективность разработанных алгоритмов управления.
Оптимизация стационарных режимов работы установок охлаждения газа с частотно-регулируемым приводом вентиляторов
Authors: Зубков Юрий Валентинович , Абакумов Олег Александрович , Абакумов Александр Михайлович
Published: March 2024

Рассмотрена задача оптимизации алгоритмов управления скоростью вентиляторов аппаратов воздушного охлаждения (АВО) природного газа с учетом индивидуальных характеристик аппаратов по критерию минимума суммарной мощности на валу вентиляторов. Для решения задачи использован метод неопределенных множителей Лагранжа. Приведены постановка и методика решения задачи оптимизации управления температурой газа на выходе установки охлаждения для аппаратов с отличающимися характеристиками. Оптимальный алгоритм управления скоростью вентиляторов АВО с учетом их индивидуальных характеристик и ограничений на максимальную скорость содержит несколько интервалов. Найдены выражения для определения оптимальной скорости вентиляторов отдельных АВО на каждом интервале управления. Для конкретного примера рассчитаны значения суммарной мощности на валу вентиляторов и обоснована возможность существенного снижения требуемой на охлаждение мощности при использовании оптимального управления. Обсуждена возможность реализации оптимальных алгоритмов управления в системе автоматического управления, замкнутой по температуре газа на выходе установки охлаждения. Использование алгоритмов оптимального управления позволяет реализовать дополнительные потенциальные возможности повышения энергоэффективности установок охлаждения природного газа с частотно-регулируемым приводом вентиляторов.
Отечественный опыт разработки, внедрения и эксплуатации, перспективы и области применения вентильных индукторных реактив-ных электродвигателей большой мощности
Authors: Птах Геннадий Константинович
Published: March 2024

Рассмотрены опыт разработки, внедрения и эксплуатации, а также текущее состояние в области регулируемых вентильных индукторных реактивных электроприводов большой мощности. На основе анализа конструктивных особенностей крупных вентильных индукторных реактивных электродвигателей (ВИРД) показано, что они имеют больше возможностей для дробления мощности с целью снижения фазных токов и токовой нагрузки на полупроводниковые ключи по сравнению с классическими асинхронными и синхронными электрическими машинами. Приведены результаты эксплуатации ВИРД большой мощности (более 1000 кВт) для привода гребного винта морского буксира-спасателя «Виктор Конецкий», 15 км магистрального ленточного конвейера КЛМ-4500, главных механизмов шагающего экскаватора ЭШ 20.90. Представлены результаты разработки ООО «НПП «МИР» опытного образца самого крупного в мире индукторного гребного электродвигателя ИГЭД-15000-107 мощностью 15 МВт и диапазоном частот вращения при постоянстве номинальной мощности 107…142 мин-1, предназначенного для прямого привода винта атомных ледоколов. Изложены результаты заводских в ООО «Электротяжмаш-Привод» и стендовых испытаний в ФГУП «Крыловский государственный научный центр». По результатам заводских испытаний ИГЭД-15000-107 аттестован Российским морским регистром судоходства. Опыт эксплуатации ВИРД большой мощности различного назначения показал их высокую энергоэффективность, особенно в повторно-кратковременных режимах, характерных для транспортной техники и экскаваторов, надёжность и отказоустойчивость, хорошую динамику управления. Обозначены перспективы и предпочтительные области применения ВИРД большой мощности.
A WIRELESS POWER TRANSFER SYSTEM DESIGN FOR CHARGING OF INTRA-BODY IMPLANT DEVICES
Authors: Büyüktuna Edanur , Dilek Elif , Yorgancılar Fatma Nur , Çetin Ramazan , Ağçal Ali
Published: March 2024

Wireless power transfer (WPT) presents numerous possibilities for recharging electronic devices in challenging environments. Charging of biomedical devices within the body is among the available opportunities. Inductively coupled WPT is a dependable and effective solution for powering these devices. Energy is transferred from the transmitter to the receiver in the inductively coupled WPT system through the use of coils and magnetic coupling. A WPT system was designed for this study, with dimensions of 4 cm by 4 cm, power output of 1 mW, and a frequency of 13.56 MHz. Series-Series (SS) topology was selected for its ease of handling and simple architecture. A square coil was selected as the receiver and transmitter coil structure due to its higher coupling factor than circular coils. ANSYS® Maxwell 3D was used to design the coils and perform magnetic analysis. In the ANSYS® HFSS program, the WPT system was placed inside the male human model and the electromagnetic exposure of the WPT on humans was examined. The magnetic scattering of the WPT system was within the safe values specified by IEEE and ICNIRP standards.
STOKASTİK TALEPLİ VE ÇOK PERİYOTLU EVDE SAĞLIK HİZMETLERİNİN PLANLANMASI PROBLEMİ
Authors: Saraç Tuğba , Tükenmez İlknur , Tutumlu Büşra
Published: March 2024

Evde Sağlık Hizmetleri (ESH), yaşlanan nüfus ve kronik hastalıkların yükselmesiyle birlikte giderek daha fazla önem kazanmaktadır. Ancak, bu hizmetlerin etkin ve verimli bir şekilde planlanması ve yönetilmesi, stokastik hasta talepleri, değişken yol koşulları ve kaynakların kapasitesi gibi birçok kısıtla karşı karşıyadır. Özellikle, hasta taleplerinin stokastik doğası, planlamada önemli bir belirsizlik faktörü oluşturmakta ve planların çoğu zaman yeniden düzenlenmesini gerektirmektedir. Ayrıca, ESH'nin çok periyotlu bir yapısı vardır, yani her hasta için farklı zaman dilimlerinde farklı türden hizmetler gerekebilmektedir. Bu çalışmanın ana amacı, stokastik hasta talepleri ve çok periyotlu planlama ihtiyaçlarını dikkate alarak, ESH hizmetlerinin sunumunu daha etkin ve verimli bir şekilde yapabilecek bir matematiksel model önermektir. Önerilen model, kaynakların daha etkin bir şekilde ayrılmasına, servis kalitesinin artırılmasına ve acil durumlarla daha etkin bir şekilde başa çıkılmasına da katkı sağlayacaktır. Bu, hem hastalara daha iyi hizmet sunumu hem de sağlık sistemi için daha düşük maliyetler anlamına gelmektedir.