bluuebunny/crossref_metadata_2025 huggingface dataset:
A New Perspective on the Problem of Borrowing: Linguistic Frustration vs Marketing Strategies
Authors:   Georgian-American University, Vardzelashvili Janetta , Prokofyeva Larisa ,   aratov State Medical University named after V.I. Razumovsky
Published: March 2024

The article reveals linguocognitive mechanisms as well as social reasons for active functioning of new borrowings in the modern public discourse and in commercial enterprises naming. The material for the analysis is a sample of the most frequent lexis in the micro synchrony that are not yet part of the host language lexicon, and comprises over one hundred and fifty lexical units, selected from the national corpus of the Russian language, public internet discourse, the author's collection of brand names (and names of businesses), radio and television programs. As a result of a comprehensive analysis, two main isomorphic types of borrowing functioning are identified. They are supposed to be motivated by multi-level linguistic, social, and pragmatic factors. Hence, the evidence of linguomental transformations of meaning is linked to the condition of linguistic frustration. This justifies considering it as a state of linguistic personality (at both the first and second levels, according to Yu.N. Karaulov), wherein the constraints of linguistic norms are lifted, and foreign-language word usage is motivated in specific speech act. A tendency of duplicate (native and foreign) naming in explicitly nominative and implicitly subjective-pragmatic functions has been established. It is suggested that the synergy of these functions conveys the speaker's subjective intentions and can be regarded as a marketing strategy of self-positioning in the act of foreign-language use in the nomination process, or as a commercial move, emphasizing the value of the product / service (i.e., commercialization of the nominative unit). Thus, the discourse becomes either status-oriented or conative. The linguistic phenomena under consideration introduce changes into the national concept sphere, as they contain features of a different language world view.
Rola Republiki Turcji w procesie mediacji między Ukrainą a Rosją
Authors:   Uniwersytet Warmińsko-Mazurski w Olsztynie, Kumelska-Koniecko Magdalena
Published: March 2024

Since the armed attack of the Russian Federation on Ukraine on February 24, 2022, the Republic of Türkiye has been to mediate between the conflicting parties as a part of extensive diplomatic activities, the primary goal of which is to induce the parties to a ceasefire, work out peace terms, and, finally, end the war. Although Ankara’s mediation has not yet led to the expected breakthrough, it has managed to reach an agreement on grain exports and exchange prisoners of war. The paper aims to analyse the role of Türkiye as a mediator in Russia’s war against Ukraine, indicating the conditions of Türkiye ‘s involvement in the mediation, and verify the effects of Turkish diplomacy in the short and long-term. Regarding the defined objectives, the following research assumptions were adopted. First, in the face of Russian aggression against Ukraine, Türkiye adopted the ‘strategic autonomy’, which allowed it to maintain its credibility in mediations between the parties and to take care of vital interests in the area of security and economy. Second, Türkiye’s involvement in the mediation has contributed to the country’s increased importance and prestige in the international arena, which is an important element of President Recep Tayyip Erdoğan’s neo-Ottoman strategy that has been implemented for two decades. Third, Ankara’s diplomatic offensive contributed to the warming of Turkish-American relations, which have been in deep crisis since 2016. The following research instruments were used in the preparation of the text: analysis, synthesis, and inference.
REVISITANDO E RECONSTRUINDO UM CONCEITO DE GESTÃO DEMOCRÁTICA DA EDUCAÇÃO
Authors: Souza Ângelo Ricardo de
Published: March 2024

Este artigo desenvolve um estudo teórico sobre a gestão democrática da escola e da educação pública, pensando-a como princípio, método e como fim educacional. Para tanto, reflete e analisa conceitualmente elementos que constituem a noção de gestão democrática na educação no Brasil, com vistas à edificação de um conceito que auxilie não só a compreensão sobre o fenômeno da gestão democrática e suas diversas faces, como também ajude na análise de casos concretos de implementação de políticas e processos de democratização da gestão da educação e da escola. Com base na teoria democrática de Norberto Bobbio, o artigo revisita um conceito de gestão democrática e o reconstrói, incrementando aspectos fundamentais com vistas a uma elaboração teórica mais efetiva.
CORRELAÇÃO DA TROPONINA SANGUÍNEA E SALIVAR EM PACIENTES COM INFARTO AGUDO DO MIOCÁRDIO: ESTUDO PRELIMINAR
Authors: Arsego Flávia Kubrusly , Kubrusly Luiz Fernando , Gewehr Douglas Mesadri , Possiedi Rafael Dib , Nassif Paulo Afonso Nunes , Tabushi Fernando Issamu , Kubrusly Fernando Bermudez , Ronkoski Maria Luiza , Cioato Priscila Panassolo
Published: March 2024

Introdução: Na ocorrência da lesão miocárdica, a identificação de biomarcadores constituintes da célula muscular cardíaca, em especial as troponinas, pode ser observada a partir de amostras de sangue e saliva. A preferência pela utilização da saliva como fluído diagnóstico é sustentada pela facilidade de obtenção a partir de método não invasivo e potencialmente pré-hospitalar.

Objetivo: Verificar a expressão de troponina I do fluído salivar no infarto agudo do miocárdio em triagens de emergências e pré-hospitalares e correlacioná-la com os níveis plasmáticos da troponina I.

Método: Estudo analítico transversal de teste diagnóstico em 27 pacientes, 9 mulheres e 18 homens, com confirmação diagnóstica de infarto agudo do miocárdio. Foram coletadas amostras de sangue e saliva armazenadas e transportadas em período de até 24 h para quantificação da troponina I.

Resultados: O estudo demonstrou que 44,4% dos pacientes apresentaram positivação de troponina I em ambas as análises, com igualdade de resultados dicotômicos em 48,1% dos casos. Assim, o teste de troponina salivar obteve 48% de sensibilidade e 50% de especificidade.

Conclusão: Foi possível identificar troponina I no fluido da saliva de pacientes em vigência de infarte agudo do miocárdio, mas a probabilidade de ela ter resultado falso positivo foi de 50% e de falso negativo de 52%.
THE QUALITY OF THIN-WALLED STRUCTURES OF AlSi10Mg PRODUCED BY SELECTIVE LASER MELTING
Authors: Tarasova T. V. , Podrabinnik Pavel A. , Babushkin N. N. , Khmyrov Roman S. , Grigoriev S. N.
Published: March 2024

The process of manufacturing thin walls using selective laser melting (SLM) from aluminum alloy powder AlSi10Mg was studied. The research aims at specifying a type of lattice structure based on skeletal-triple periodic minimal surface (TPMS) and sheet-TPMS shells. In this regard, the possibility of obtaining well-quality thin walls was studied. The accuracy of manufacturing, surface roughness and porosity of the samples were taken as quality criteria. The dependences of the influence of SLM parameters on the geometric characteristics, roughness, and porosity of thin walls were obtained. The preferential parameters for manufacturing thin-walled aluminum alloy samples have been determined. The microstructure and phase composition of the studied alloy after SLM were studied.
Preparation and characterization of expanded dickite/decanoic acid phase-change materials
Authors: Su Hao , Ma Zhonghua , Ding Mingtao , Li Ye , Dang Lianfa , Yang Kuo , Li Fangfei , Xue Bing
Published: March 2024

The leakage of phase-change materials presents a significant challenge that impedes their application. Loading porous materials onto phase-change materials is an effective approach to addressing this issue. In this study, porous expanded dickite as a carrier was utilized to load decanoic acid and create a composite phase-change material. The loading content of decanoic acid was varied to obtain different composite phase-change materials. Fourier transform infrared spectroscopy analysis confirmed the formation of hydrogen bonds between the expanded dickite carrier and decanoic acid. Scanning electron microscopy images and energy-dispersive X-ray spectroscopy mapping results demonstrated that decanoic acid was evenly dispersed on the expanded dickite carrier without any agglomeration. The expanded dickite carrier effectively immobilized decanoic acid through hydrogen bonding, thereby preventing leakage, as long as the loading content of decanoic acid did not exceed 60%. The higher thermal conductivity of the expanded dickite carrier promoted the thermal conductivity of the expanded dickite/decanoic acid composite phase-change materials, enhancing the responsiveness of the composite phase-change materials to ambient temperature. The composite phase-change material containing 60 wt% decanoic acid exhibited excellent endothermic/exothermic cycle stability, and after six cycles, its latent heat remained stable.
A non-linear stress–strain relationship for soil and rock
Authors: Norris Gary , Yang Horng-Jyh
Published: March 2024

While many employ a hyperbolic stress–strain relationship for soils, it is known that such a relationship is accurate over the small-strain range as encountered in earthquake and soil dynamics problems. For large strains, a relationship with different input parameters is needed, as is required for finite-element analyses of large-deformation behaviour. These separate characterisations do not carry over into the other application. Here, a proposed power relationship is presented that was developed to characterise the triaxial test stress–strain behaviour of cohesionless material from lubricated or ‘frictionless’ cap and base tests (144 tests) covering a range in the natural variation in particle size, particle shape and surface roughness, over low to high confining pressure. This relationship covers the strain range from 10−6 to soil failure. To date, it has been successfully used in laterally loaded pile response characterisation (the strain wedge model) and shallow-foundation load–settlement–bearing capacity response. Most recently, it has been extended to assess the behaviour of rock-like material (caliche). The relationship and its comparison with the hyperbolic relationship for large strain and the shear modulus reduction curve for seismic behaviour are presented.
Shear friction capacity of monolithic construction joints reinforced with self-prestressing reinforcing steel bars
Authors: Jung Yeon-Back , Mun Ju-Hyun , Kim Sanghee , Hwang Seung-Hyeon , Sim Jae-Il
Published: March 2024

The shear friction capacity (SFC) of a monolithic concrete interface reinforced with newly developed self-prestressing reinforcing steel bars (SPRBs) was examined. A total of 12 SPRB-reinforced push-off specimens with different concrete compressive strengths (f′c) were prepared and different compressive stresses (σx) were applied to the monolithic concrete interface. To compare the SFCs of monolithic concrete interfaces reinforced with conventional reinforcing bars, four companion specimens were prepared. The test results showed that the shear cracking and SFCs were high for specimens with high f′c and σx values, with highest values for specimens with f′c = 40 MPa and σx = 0.5fy (fy is the yield strength of the reinforcing steel bar). The test results confirmed that, at a similar reinforcement index ((ρvffy + σx)/f′c) (ρvf is the transverse reinforcement ratio), σx > 0.35fy is required for the SPRBs to achieve a SFC (λn) comparable to that of specimens reinforced with conventional reinforcing bars. Code prediction models were found to underestimate the SFC significantly. In addition, the difference between the experimental and predicted values increased with an increase in (ρvffy + σx)/f′c. However, Mattock's model produced good estimates of the measured SFCs of all the specimens tested in this study, irrespective of the values of ρvffy and σx. The mean and standard deviation of the measured-to-predicted SFC ratio were 1.07 and 0.13, respectively.
Pronounced microcephaly in a patient with malignant migrating partial seizures in infancy
Authors: Hahn Andreas , Heckel Martina , Neubauer Bernd A.
Published: March 2024

Malignant migrating partial seizures in infancy is an age‐specific epilepsy syndrome, resistant to conventional antiepileptic drugs in most cases. Since the first description of 14 infants in 1995, only 16 additional patients have been reported. We add a further case and present a video that shows a typical generalizing tonic seizure arising from the right temporo‐occipital area and slowly spreading about both hemispheres. In addition to other symptoms previously described, almost complete arrest of brain growth with onset of seizures and evolution of distinctive secondary microcephaly were striking features in this patient.

[Published with video sequences]
Neurosyphilis presenting with status epilepticus
Authors: Gürses Candan , Kürtüncü Murat , Jirsch Jeffrey , Yeşilot Nilüfer , Hanağası Haşmet , Bebek Nerses , Baykan Betül , Emre Murat , Gökyiğit Ayşen , Andermann Frederick
Published: March 2024

Three patients with neurosyphilis are reported. The first and third patients presented with convulsive status epilepticus and the second with non‐convulsive status after penicillin administration. In all cerebrospinal fluid and the serum Venereal Disease Research Laboratory Test (VDRL) and
Treponema Pallidum
hemagglutination (TPHA) or fluorescent treponemal antibody absorption test (FTA‐ABS) were positive, but HIV serology was negative. Their EEGs showed periodic, lateralized, epileptiform discharges (PLEDs) just after SE. The first and third patients had no history of epilepsy. Seizures started as focal motor attacks but then secondarily generalized. The first patient's cranial MRI showed cerebral atrophy and hyperintensity involving bilateral medial and anterior temporal regions, more prominent on the left and which disappeared after penicillin treatment. The second case, after receiving penicillin, had nonconvulsive SE, a clinical presentation suggesting a Jarisch‐Herxheimer reaction (JHR). Her cranial MR revealed moderate cortical atrophy and widespread confluent hyperintense foci mainly in both periventricular areas, corona radiata and centrum semiovale. MRI of the third case showed a large, left sylvian, arachnoid cyst without mass effect. Executive dysfunction was observed in follow‐up neuropsychological tests in all patients. When investigating status epilepticus, neurosyphilis as a cause must not be forgotten.
Video‐EEG in syncopal attack due to ocular compression in an adolescent mistreated for epilepsy
Authors: Gelisse Philippe , Serafini Anna , Davy Jean Marc , Balbe Marc , Coubes Philippe , Crespel Arielle
Published: March 2024

Vasovagal syncope can be confused with epileptic seizure. In this situation, eye compression may be performed during EEG. We present a video‐EEG of a patient in whom eye compression produced a typical syncope. Before this recording, the patient had been treated for five years with sodium valproate because of a misdiagnosis of epilepsy. The diagnosis of neurally‐mediated syncope was not difficult on the basis of the clinical history, but the reproduction of syncope reinforced the correct diagnosis. Ocular compression is now only indicated in exceptional circumstances and should be performed with precautions. The video of this episode in an adolescent should be of considerable educational value to those who are confronted to diagnostic work‐up of transient loss of consciousness.

[Published with video sequences]
Unrecognized paroxysmal ventricular standstill masquerading as epilepsy: a Stokes‐Adams attack
Authors: You Chi‐Fang , Chong Chee‐Fah , Wang Tzong‐Luen , Hung Tzu‐Yao , Chen Chien‐Chih
Published: March 2024

Recognition of cardiac syncope masquerading as epilepsy may be difficult in the Emergency Department. We report a middle‐aged man with recent onset convulsions who posed a diagnostic puzzle before it was found that he had paroxysmal ventricular standstill with complete atrioventricular block: he made a complete recovery after temporary pacemaker insertion. The main lessons from this case were (1) a convulsive seizure of only seconds duration and with an abrupt return of consciousness suggests syncope not epilepsy, (2) repeated, convulsive syncopes without provocation suggest cardiac syncope, (3) a 12‐lead ECG should be recorded as soon as possible after such a series of episodes and should not be discontinued until an event is captured, and (4) Emergency Department clinicians should be familiar with any automatic gain on their ECG machine, lest fast, atrial activity be mistaken for narrow complex tachycardia. In summary, a good clinical history is of prime importance in differentiating convulsive syncope from epilepsy, and a simple, non‐invasive cardiovascular evaluation may help to diagnose the condition as cardiac syncope.
Hippocampal sclerosis in association with neurocysticercosis
Authors: Singla Monika , Singh Parampreet , Kaushal Sandeep , Bansal Rajinder , Singh Gagandeep
Published: March 2024

Objective

To discuss the possible mechanisms underlying a dual pathology combining neurocysticercosis and hippocampal atrophy, illustrated by the observation of four patients with epilepsy.
Case reports.
The first patient presented at the age of four years with a first episode of status epilepticus, presumably due to an inflamed, calcified, parenchymal cysticercus granuloma. Thereafter, he had occasional seizures. Routine MRI undertaken several years later revealed unilateral hippocampal atrophy and sclerosis. Two other patients with initial imaging evidence of active neurocysticercosis located close to the hippocampus, and occasional seizures, developed ipsilateral hippocampal sclerosis. The seizure disorder of our fourth patient, with medically intractable epilepsy, was initially attributed to a calcified cysticercus granuloma. Clinical description, video‐EEG telemetry and imaging work‐up suggested a diagnosis of mesial temporal lobe epilepsy due to hippocampal sclerosis.

Conclusions

Definitive conclusions as to the underlying mechanisms cannot be derived from the present, retrospective series of only four patients. However, the following suggestions can be made: 1) seizures due to neurocysticercosis may constitute the initial precipitating illness for the development of hippocampal sclerosis, 2) the hippocampus may be involved in host brain inflammation and gliosis in response to a nearby, degenerating cysticercus, 3) the seizure focus formed by the degenerating cysticercus, engenders epileptogenic changes in the hippocampus through kindling, and 4) the two conditions may coexist purely by chance. Systematic and prospective, serial MRI evaluations of hippocampal structures in patients with neurocysticercosis should contribute to further clarify the underlying mechanisms.
GEFS
+
where focal seizures evolve from generalized spike wave: video‐EEG study of two children
Authors: Deng Yu Hong , Berkovic Samuel F. , Scheffer Ingrid E.
Published: March 2024

Focal seizures often secondarily generalize but the reverse is much less frequently documented. The idiopathic generalized epilepsies have the EEG signature of generalized, or bilaterally synchronous spike wave activity and although focal features can be seen, seizures are usually generalized once they commence. Although focal seizures can be seen in some syndromes, it is not well recognized that generalized seizures can become focal
during
the attack. Here we describe two cases of idiopathic epilepsy with a genetic basis; both cases falling within the spectrum of generalized epilepsy with febrile seizures plus (GEFS
+
). One patient has a family history consistent with the family epilepsy syndrome diagnosis of GEFS
+
, whilst the second has a
de novo SCN1A
mutation in the setting of “severe” Febrile Seizures. In both patients, seizures began with generalized spike wave activity and then a focal ictal rhythm emerged. This is a further example of the increasingly blurred distinction between generalized and focal categories of specific genetically determined epilepsies.

[
Published with video sequences
]
Bilateral symmetric tonic posturing suggesting propagation to the supplementary motor area in a patient with precuneate cortical dysplasia
Authors: Umeoka Shuichi , Baba Koichi , Terada Kiyohito , Matsuda Kazumi , Tottori Takayasu , Usui Naotaka , Usui Keiko , Nakamura Fumihiro , Inoue Yushi , Fujiwara Tateki , Mihara Tadahiro
Published: March 2024

We report a patient manifesting seizures with bilateral symmetric tonic posturing, which were markedly reduced after resection of the left precuneus. A 16‐year‐old man had sudden onset, complex partial seizures with bilateral symmetric tonic posturing since the age of eight years. Magnetic resonance fluid‐attenuated inversion‐recovery imaging revealed a hyperintense lesion in left precuneus. In almost all focal seizures recorded during an invasive EEG evaluation, ictal onset was detected from the inferomesial aspect of the lesion, but fast paroxysmal discharges from the ipsilateral supplementary motor area (SMA) were observed just before the clinical onset. After surgical excision of the EEG onset zone, including the lesion, seizure frequency was markedly (> 95%) reduced. By the 20
th
month after surgery, there were only brief nocturnal seizures involving slight elevation of both shoulders and slight abduction of both arms, with preservation of consciousness occurring once every few days. Invasive EEG findings and surgical outcome suggested that the epileptic activity originating from the epileptogenic zone may have propagated to the symptomatogenic zone including mainly the ipsilateral SMA. In summary, we report an interesting case of bilateral symmetric tonic posturing suggesting propagation to the SMA. MRI and invasive EEG confirmed the epileptogenic focus as a precuneate cortical dysplasia lesion.
[Published with video sequences]
Hot water epilepsy: a video case report of a Caucasian toddler
Authors: Ceulemans Berten , Koninckx Muriel , Garmyn Kristien , Wojciechowski Marek
Published: March 2024

We present the case report of a 13‐month‐old Caucasian toddler with symptoms of loss of consciousness, central cyanosis and uncontrolled movements of the upper limbs while taking a warm bath. The diagnosis of hot water epilepsy was supported by an ictal EEG. Hot water epilepsy, also known as bathing epilepsy or water‐immersion epilepsy is, in the Caucasian population, a rare form of benign epilepsy, where seizures are provoked by immersion in a hot or even just a warm bath. This is the first comprehensive video publication of a seizure provoked by water‐immersion in a Caucasian child.
[Published with video sequences].
Anatomo‐electro‐clinical correlations: the Cleveland Case Report (March 2008): Temporal lobe neoplasm and seizures: how deep does the story go?
*
Authors: Jehi Lara E. , Lμders Hans Ö. , Naugle Richard , Ruggieri Paul , Morris Harold , Foldvary Nancy , Wyllie Elaine , Kotagal Prakash , Bingaman Bill , Dinner Dudley , Prayson Richard , Diehl Beate , Alexopoulos Andreas , Bautista Jocelyn , Busch Robyn
Published: March 2024

[March 2008 ‐ Cleveland Case Report]

. There is a well‐described association between the occurrence of developmental tumors and the presence of cortical dysplasia in the neighboring brain tissue. The main surgical approaches in the treatment of medically refractory epilepsy related to such developmental tumors include a lesionectomy
versus
a tailored cortical resection, often guided by an invasive evaluation. This case report describes the surgical management of a 26‐year‐old female with olfactory auras evolving into automotor seizures and convulsions, occurring in the context of a right temporo‐parietal developmental lesion. It illustrates the pros and cons of various surgical approaches, and discusses some pathophysiological aspects of developmental tumors, dysplasia and epilepsy.
[Published with video sequences]
Recurrent alcohol‐induced seizures in a patient with chronic alcohol abuse
Authors: Hattemer Katja , Knake Susanne , Oertel Wolfgang H. , Hamer Hajo M. , Rosenow Felix
Published: March 2024

Seizures related to alcohol are a common finding, and are usually attributed to alcohol withdrawal, or to a neurotoxic effect of ethanol leading to seizures that are unrelated to acute alcohol consumption or withdrawal. However, there is also evidence for a third kind of alcohol‐related seizure: alcohol‐induced seizures. We describe a 36‐year‐old patient who, during the years from 1996–2006, was admitted 27 times with alcohol‐induced seizures that occurred during alcohol consumption. Excluding one documented withdrawal seizure, serum ethanol levels at admission were 3.24 ± 0.67%. There were no seizures that were unrelated to alcohol consumption. This case report supports the evidence of a seizure‐provoking effect of ethanol that should be considered in the diagnosis and treatment of patients with alcohol‐dependency and seizures.
Photosensitivity in epileptic syndromes of childhood and adolescence
Authors: Lu Yang , Waltz Stephan , Stenzel Katja , Muhle Hiltrud , Stephani Ulrich
Published: March 2024

Purpose

Photosensitivity, a reaction of the brain to external photic stimulation, can be graded from 1 to 4, and is most frequently seen in the first decades of life. This study investigated photosensitivity in children with epilepsy.

Methods

A retrospective study performed in the neuropaediatric department of the largest paediatric hospital in Kiel, treating patients at all medical care levels. The clinical data and EEG records of 566 patients with the most common epileptic syndromes were analyzed, in particular regarding photosensitivity. Their EEGs included application of intermittent light stimulation using standard techniques at twice the minimum.

Results

The proportion of photosensitive patients was significantly higher in the paediatric cohort than in adult patients, as published in the literature: 46% of patients with generalized epilepsies showed photosensitivity as compared to 20% with focal epilepsies. Photosensitivity was more common in idiopathic generalized epilepsy (IGE), (epilepsy with
grand mal
on awakening, 74%; juvenile absence epilepsy, 56%; juvenile myoclonic epilepsy, 50%; childhood absence epilepsy, 44%) than in focal types (idiopathic partial – Rolandic epilepsy, 23%; symptomatic/ cryptogenic type of epilepsy, 16%), while in patients who experienced occasional seizures (neonatal/febrile seizures), this ranged between 40% and 23%, respectively. The generalized photoparoxysmal response, (PPR), grades 3 and 4 were found significantly more often in patients with IGE (92%) than in patients with focal epilepsies. Finally, the female preponderance was confirmed (37% to 27% of all epilepsies).

Conclusions

Photosensitivity can be detected both in patients with IGE, with idiopathic and symptomatic/cryptogenic types of focal epilepsies, and with epileptic (occasional) seizures. PPR grades 3 and 4 are the most common in IGE.
Ocular compression pressure during EEG for the study of increased vagal reactivity
Authors: Haneef Zulfi , Khurana Divya S. , Melvin Joseph J. , Carvalho Karen S. , Legido Agustin , Valencia Ignacio
Published: March 2024

Ocular compression (OC) is a maneuver performed during EEG to demonstrate increased vagal reactivity in children with suspected syncope including breath‐holding spells. We examined the relationship between the simulated OC pressure exerted by different physicians and the cardiac slowing responses that they had historically obtained as per EEG records. Simulated OC was performed by each physician using a sphygmomanometer. EEGs were reviewed for the rate of positive cardiac slowing per physician. Among three physicians who performed a total of 73 OC, the mean ± SD of applied pressure were 29.0 ± 2.4, 60.7 ± 3.5 and 42.4 ± 2.5 mmHg, respectively. There was good intra‐physician consistency for the OC pressures exerted. The mean pressure exerted was significantly different between physicians (p < 0.001, ANOVA). The positive response rate for cardiac slowing among these physicians was 11/37 (29.7%), 10/21 (47.6%) and 8/15 (53.3%) respectively. The difference in positive OC responses between physicians was not significant (p = 0.127, chi‐square). Higher OC pressures did not translate into more positive responses. A pressure of 30 mmHg is as good as 60 mmHg in demonstrating cardiac slowing during OC.
Antiepileptic drugs and relapse after epilepsy surgery
Authors: Asadi‐Pooya Ali A. , Nei Maromi , Sharan Ashwini D. , Mintzer Scott , Zangaladze Andro , Evans James G. , Skidmore Christopher , Sperling Michael R.
Published: March 2024

Purpose

To evaluate whether the postoperative, antiepileptic drug (AED) regimen influences seizure recurrence after anterior temporal lobectomy when considering the putative mechanism of action and possible neuroprotective effects.

Methods

This was a retrospective study. Patients who had an anterior temporal lobectomy for refractory epilepsy, whose preoperative MRI indicated mesial temporal sclerosis, were included. Postoperative AED regimens were compared with regard to seizure‐outcome, considering the putative mechanism of action (sodium channel blockers, non‐sodium channel blockers, and mixed mechanisms) or possible neuroprotective effect (levetiracetam, topiramate, tiagabine and zonisamide
versus
others). Time‐to‐event (first seizure after surgery) analysis was used to produce a Kaplan‐Meier estimate of seizure recurrence, and groups were compared using Cox proportional hazard analysis.

Results

226 patients (103 males and 123 females; mean age 42 ± 11 years) were studied. The rates of postoperative seizure recurrence were not significantly different between the three groups regardless of the use of AEDs with different mechanisms of action (p = 0.23). Fifty patients were receiving possibly neuroprotective AEDs and 176 patients were not. Rates of seizure recurrence were not significantly different between these two groups either (p = 0.11). The differences between one‐year seizure‐free rates were not significant when we compared levetiracetam
versus
phenytoin or carbamazepine.

Discussion

There appeared to be no advantage or disadvantage to either prescribing drugs with different mechanisms of action or using drugs with possible neuroprotective effect after temporal lobectomy. Prospective studies with larger sample sizes may be of benefit to further explore this issue.
Massive rhythmic axial myoclonus in post‐anoxic coma
Authors: Legriel Stéphane , Tran‐Dinh Yves Roger , Bele Nicolas , Thiery Guillaume
Published: March 2024

We present the video of a patient who presented massive and impressive rhythmic axial sudden flexion of the neck and the upper part of the trunk in post anoxic coma.

[Published with video sequences]
A patient with two episodes of epilepsia partialis continua of the abdominal muscles caused by cortical dysplasia
Authors: Tezer F. Irsel , Celebi Ozlem , Ozgen Burce , Saygi Serap
Published: March 2024

Epilepsia partialis continua (EPC) is a rare form of focal motor status epilepticus. There is typically a predilection for facial and distal limb involvement, but rarely trunk or abdomen muscles may be affected. Rarely, EPC may also present in association with cortical dysplasia. In this report, we describe the clinical, neuroimaging and ictal electroencephalographic findings of a young woman presenting with persistent myoclonic twitches of the abdominal muscles that were considered to represent a rare manifestation of EPC due to cortical dysplasia. To the best of our knowledge, this is the first report of malformation of cortical development causing abdominal myoclonus.
[Published with video sequences]
Pharmacology and drug interactions of cannabinoids
Authors: Landmark Cecilie Johannessen , Brandl Ulrich
Published: March 2024

Cannabinoids include a variety of substances, of which cannabidiol (CBD) is the main substance investigated for the treatment of epilepsy, and this will be the focus in the present review. CBD preparations exist in various forms. There are significant differences in quality control regarding content and reproducibility for an approved drug versus herbal preparations. Cannabidiol has challenging pharmacological properties, and pharmaceutical and pharmacokinetic aspects will depend on the formulation or preparation of a certain product. This article will focus on the characteristics, pharmacokinetic challenges, and interactions of standardised CBD‐containing drugs based on evidence from clinical and pharmacokinetic studies.
Epileptic encephalopathy with features of rapid‐onset dystonia Parkinsonism and alternating hemiplegia of childhood: a novel combination phenotype associated with
ATP1A3
mutation
Authors: Tran Linh , Richards Jason , McDonald Marie , McConkie‐Rosell Allyn , Stong Nicholas , Jasien Joan , Shashi Vandana , Mikati Mohamad A.
Published: March 2024

Mutations in
ATP1A3
have been found to cause rapid‐onset dystonia Parkinsonism, alternating hemiplegia of childhood, epileptic encephalopathy and other syndromes. We report a four‐year, nine‐month‐old boy with episodes of frequent and recurrent status epilepticus, who first began having generalized tonic‐clonic seizures at four months of age. Development was normal until the age of four months, and markedly slowed down after the onset of seizures. Between the age of seven months and two and a half years, the patient had recurrent attacks of unilateral and bilateral hemiplegia. At the age of 21 months, after a febrile illness with status epilepticus, he regressed and developed continuous severe dystonia and bradykinesia with superimposed intermittent painful dystonic spasms. Extensive neurological and genetic workup revealed a
de novo
p.V589F
ATP1A3
mutation (NM_152296.5:c.1765G>T, NC_000019.9:g.42482344C>A). This is a novel mutation associated with a novel phenotype that shares features with epileptic encephalopathy, alternating hemiplegia of childhood, and rapid‐onset dystonia Parkinsonism.
Clinical and video‐polygraphic features of epileptic spasms in adults with cortical migration disorder
Authors: Cerullo Angelina , Marini Carla , Carcangiu Roberta , Baruzzi Agostino , Tinuper Paolo
Published: March 2024

The International Classification of Epileptic Syndromes considers epileptic spasms to be typical seizures of West syndrome. Literature reports show that spasms are present in epileptic syndromes other than West syndrome but there are few data on their characteristics in adults.

We describe ictal, clinical and video‐polygraphic findings in three patients (aged 21, 32 and 57 years) with epileptic spasms and with diffuse (case 2), focal right fronto‐parietal (case 1) and bi‐opercular (case 3) pachygyria. Spasms had been present since the ages of 1 month, 11 and 27 years respectively. Only one patient is mentally retarded. Two of our patients (cases 2 and 3) have partial seizures.

Ictal polygraphic studies showed a positive, diffuse, high amplitude slow wave activity during spasms, with superimposed fast activity, followed by a diffuse flattening in all cases with a typical muscle pattern.

Epileptic spasms, as typically described in West syndrome, can maintain the same semeiological and electroencephalographic features during adulthood in certain patients with cortical dysplasia.
Efficacy of lamotrigine in idiopathic generalized epilepsy syndromes: a video‐EEG‐controlled, open study
Authors: Gericke Christian A. , Picard Fabienne , de Saint‐Martin Anne , Strumia Sylvia , Marescaux Christian , Hirsch Edouard
Published: March 2024

Purpose

This prospective, open, video‐EEG‐controlled study examined the efficacy of lamotrigine (LTG) as add‐on and monotherapy in idiopathic generalized epilepsy (IGE).

Methods

47 patients received LTG either because of insufficient seizure control (n = 35) or serious side effects of prior antiepileptic drugs (AED). Long‐term video‐EEG recordings were performed before and after the introduction of LTG. The mean follow‐up time was 25.5 months.

Results

Of 12 patients with refractory childhood absence epilepsy, 9 became seizure free; in one child with absences with eyelid myoclonia, absence frequency was reduced > 50%; in 2 children with absences with a mild atonic component, seizure reduction was only transient. Of 12 patients with juvenile absence epilepsy, 10 became seizure‐free and, in 2, a > 50% reduction was obtained. In 15 patients with juvenile myoclonic epilepsy, complete seizure control was achieved in 7 patients, in 6 patients myoclonia persisted. In one patient generalized tonic‐clonic seizures also persisted and another patient developed a rash, LTG was therefore stopped. Of 5 patients with grand‐mal on awakening, 3 became seizure‐free, and a reduction of > 50% was obtained in one patient; LTG was stopped in one patient because of poor compliance. Three patients with pure photosensitive epilepsy became seizure‐free. At the end of the study, 11 patients were seizure‐free on LTG monotherapy, and in most other patients concomitant AED dosage could be substantially reduced.

Conclusions

Lamotrigine was effective and well tolerated in patients with various IGE syndromes, although differences were observed between individual syndromes and seizure types.
Non‐convulsive status in the ring chromosome 20 syndrome: a video illustration of 3 cases
Authors: Petit Jérôme , Roubertie Agathe , Inoue Y. , Genton Pierre
Published: March 2024

We report the clinical history and the video‐EEG recordings of three young adults with r(20), who exibited repeated episodes of non‐convulsive status epilepticus, often triggered by emotional events.

This recognizable clinical entity associates a slight mental deficiency, behavioural disorder and epilepsy, often resistant to treatment and with a particular clinical presentation.

We demonstrate with video EEG recording, atypical absence status triggered by emotional behaviour with ictal EEG characterized by bifrontal slow waves, often rhythmic, or sharp waves.

Our report highlights the characteristic features of non‐convulsive status in this electro‐clinical syndrome.
Nocturnal paroxysmal dystonia due to a subfrontal cortical dysplasia
Authors: Lombroso Cesare T.
Published: March 2024

The nature and nosology of nocturnal paroxysmal dystonia (NPD) have been controversial. Some authors consider it as a type of parasomnia, akin to night terrors and the official Classification of Sleep Disorder includes NPD within the parasomnias [1]. Others have opined for its epileptic nature, although mainly on circumstantial evidence. The location of the epileptogenic area has been so far unknown. A child with NPD was studied extensively, and in spite of normal scalp EEGs, all of his attacks were shown to originate from his right orbitofrontal cortex. Surgical ablation of an unsuspected cortical dysplastic lesion led to full control.
Ictal SPECT hyperperfusion reflects the activation of the symptomatogenic cortex in spontaneous and electrically‐induced non‐habitual focal epileptic seizures: correlation with subdural EEG recordings
Authors: Arnold Stephan , Noachtar Soheyl , Linke Rainer , Werhahn Konrad J. , Yousry Tarek A. , Winkler Peter A. , Tatsch Klaus
Published: March 2024

We report a patient with left temporal lobe epilepsy and a left parietal angioma, in whom ictal SPECT showed hyperperfusion in a spontaneous and an electrically‐induced, non‐habitual focal seizure. A SPECT investigation during an habitual seizure originating in the left temporal lobe showed a left temporal hyperperfusion. Electrical stimulation of the parietal cortex adjacent to the location of a previously resected angioma using subdural electrodes resulted in a non‐habitual seizure beginning with a unilateral somatosensory aura. Ictal SPECT of this seizure demonstrated contralateral central hyperperfusion. We conclude from our findings that ictal SPECT hyperperfusion reflects the activation of symptomatogenic cortex, which can be induced by both epileptic discharge and electrical stimulation.
Cardiac asystole in partial seizures
Authors: Scott Catherine A. , Fish David R.
Published: March 2024

Literature review shows many anecdotal case reports of cardiac asystole in ictal recordings of partial seizures. We have reviewed our data from the last five years, of patients who are being assessed for epilepsy surgery and found 2 out of more than 1,500 complex partial seizures, recorded in 589 consecutive patients, showing a significant period of asystole (13 and 15 seconds). Our previous studies of cardiac and respiratory parameters during partial seizures showed that a central apnoea occurred in 39%. It is probable that sudden death during seizures is due to the interaction of both cardiac and respiratory irregularities. Although rare (occurrence < 0.15%), the possibility of cardiac asystole occurring in an epilepsy monitoring unit highlights the need for resuscitation equipment to be readily available and for trained nursing staff. Furthermore, it is important to recognize that the semiology of seizures may be affected by the consequences of secondary cardiac asystole.
Epileptic negative myoclonus and brief asymmetric tonic seizures. A supplementary sensorimotor area involvement for both negative and positive motor phenomena
Authors: Meletti Stefano , Tinuper Paolo , Bisulli Francesca , Santucci Margherita
Published: March 2024

Epileptic negative myoclonus (ENM) is an epileptic motor dysfunction characterised by brief lapses of postural tone provoked by paroxysmal cortical discharges. We report the electrophysiological and video‐polygraphic findings in a patient presenting with the unusual association of ENM and brief asymmetric tonic‐postural seizures of cryptogenetic origin. Focal EMG silent periods in the left deltoid muscle (mean duration 81.2 ± 16.4 ms), time‐locked with vertex spikes were present. The time lag between spikes and ENM was 33.1 ± 4.6 ms. We suggest the involvement of mesial frontal areas in the genesis of both negative and positive motor phenomena.
Prognosis in nonconvulsive status epilepticus
Authors: Kaplan Peter W.
Published: March 2024

Determining the prognosis in nonconvulsive status epilepticus (NCSE) is complicated by several factors: under‐recognition of NCSE with its spontaneous resolution (thus decreasing the “denominator” of total cases that will have a poor outcome); incorrect diagnosis of NCSE based on misinterpretation of EEG “epileptiform” activity; mis‐classification of certain EEG patterns as NCSE (
e.g.
PLEDs; triphasic waves); and grouping of different populations that have markedly different co‐morbidities (ambulatory patients with NCSE together with comatose patients with electrographic seizure activity on EEG). There are almost no prospective studies with premorbid neuropsychometric studies, and retrospective studies typically include isolated cases, or case series that include conditions in which the cause of NCSE itself causes cognitive morbidity.

To summarize available data, absence status (ambulatory generalized non‐convulsive status epilepticus) would appear to carry no lasting morbidity. Complex partial status epilepticus in ambulatory patients rarely results in measurable permanent neurologic deficit, although rarely, short or longstanding deficits may clearly occur.

Because intensive treatment with intravenous anticonvulsants (
e.g.
benzodiazepines or phenytoin) can confer morbidity, the equation has not yet been made as to whether the morbidity of such intensive treatment for all cases of NCSE exceeds the morbidity of the disease itself. Larger, prospective studies will be needed to truly determine the prognosis in the different types of NCSE, stratified according to associated degrees of impairment (minimally impaired, moderately obtunded, comatose).
Clinical and EEG video‐polygraphic features of epileptic spasms in a child with dihydropteridine reductase deficiency. Efficiency of hydrocortisone
Authors: Mikaeloff Yann , Plouin Perrine , Dhondt Jean‐Louis , Ponsot Gérard , Dulac Olivier
Published: March 2024

West syndrome is an epileptic encephalopathy which includes psychomotor deterioration. In rare cases, it is due to an inherited, progressive metabolic disease. We report a 2 year‐old child with dihydropteridine reductase deficiency who developed hypsarrhythmia and infantile spasms which were documented on video‐polygraphic EEG. Despite dietary restriction of phenylalanine, and oral administration of amine precursors, the initial course was unfavorable. A beneficial effect from hydrocortisone was then observed, with control of spasms and improvement of psychomotor delay.
Cognitive function in adolescents and young adults in complete remission from benign childhood epilepsy with centro‐temporal spikes
Authors: Hommet Caroline , Billard Catherine , Motte Jacques , du Passage Grégoire , Perrier Danièle , Gillet Patrice , Prunier Caroline , de Toffol Bertrand , Autret Alain
Published: March 2024

Benign childhood epilepsy with centrotemporal spikes (BECTS) is a frequent, benign childhood epilepsy with a good prognosis. However, neuropsychological deficits have been reported during its active phase. In this study, we evaluate the long‐term neuropsychological consequences of this reputedly benign epilepsy, particularly the relation between paroxysmal abnormalities and cerebral language lateralization.

The neuropsychological outcomes concerning both overall cognitive and lateral hemispheric functions were studied in twenty‐three adolescents and young adults in total recovery from BECTS, in thirty‐three controls without any significant past neurological history and in ten adolescents and young adults with complete resolution of generalized idiopathic epilepsy (childhood absence epilepsy or CAE). Language lateralization was evaluated using classical neuropsychological procedures (dichotic listening tasks, dual‐task procedure).

No difference was seen in the three populations with respect to overall cognitive function: memory, language and the executive functions. Although the Performance IQ was lower in patients in remission from CAE, the results were within normal limits. However, qualitative analysis of the dual‐task procedure suggested a different organizational pattern for cerebral language in adolescents and young adults in remission from BECTS as compared to controls and patients in remission from CAE. The different organization in cerebral pattern in BECTS patients appeared to be related to the initial epileptic focus as determined by the EEG and/or the sleep‐recording. We discuss the relationship between the presence of paroxysmal anomalies in childhood and subtle functional lateralized hemispheric abnormalities in adulthood.