bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experiential auditory hallucinations due to chronic epileptic discharges after radiotherapy for oligoastrocytoma
Authors: Sasaki Takeshi , Kodaka Fumitoshi , Taniguchi Go , Nishikawa Toru , Watanabe Masako 
Published: August 2019

ABSTRACTExperiential auditory hallucinations have been reported in patients with epilepsy. We report the case of a 46‐year‐old woman with a history of more than three years of experiential auditory hallucinations caused by chronic epileptic discharges, which developed after radiotherapy for an oligoastrocytoma in the left temporal lobe. Electroencephalography revealed frequent spikes in the left temporal lobe. In response to clonazepam, but not antipsychotics, her auditory hallucinations almost completely disappeared and spikes were reduced. Her auditory hallucinations exhibited the characteristics of first‐rank symptoms of schizophrenia, however, the content of experiential auditory hallucinations endured by our patient suggested an epileptic origin. We believe that the persistent subictal discharges, in combination with hyperexcitability of the temporal neocortex near radiation‐induced necrotic lesions, were the cause of the auditory hallucinations.
Successful surgical resection in non‐lesional operculo‐insular epilepsy without intracranial monitoring
Authors: Chiosa Vitalie , Granziera Cristina , Spinelli Laurent , Pollo Claudio , Roulet‐Perez Eliane , Groppa Stanislav , Seeck Margitta 
Published: August 2019

ABSTRACTPre‐operative assessment and surgical management of patients with non‐lesional extratemporal epilepsy remain challenging due to a lack of precise localisation of the epileptic zone. In most cases, invasive recording with depth or subdural electrodes is required. Here, we describe the case of 6.5‐year‐old girl who underwent comprehensive non‐invasive phase I video‐EEG investigation for drug‐resistant epilepsy, including electric source and nuclear imaging. Left operculo‐insular epilepsy was diagnosed. Post‐operatively, she developed aphasia which resolved within one year, corroborating the notion of enhanced language plasticity in children. The patient remained seizure‐free for more than three years.
The clinical outcome of adjuvant therapy with black seed oil on intractable paediatric seizures: a pilot study
Authors: Shawki May , Wakeel Lamia El , Shatla Rania , EL‐Saeed Gamila , Ibrahim Samira , Badary Osama 
Published: August 2019

ABSTRACTAimTo evaluate the effect of black seed oil, as add‐on treatment to antiepileptic drugs (AEDs), on seizure frequency and severity as well as oxidative stress in intractable epilepsy patients.MethodsA prospective, randomised, single‐blinded, controlled, crossover pilot study. Five healthy children were included as controls. Thirty intractable epileptic children were randomly assigned to either Group I or II. Group I received placebo for four weeks, followed by a two‐week washout period, and subsequently black seed oil for four weeks. Group II received the same intervention but in the reverse order. All patients received AEDs throughout the study period. Prior to allocation, all patients underwent a neurological assessment and evaluation of oxidative stress markers; total antioxidant capacity (TAC) and malondialehyde (MDA). Patients were assessed at Weeks 4 and 10 for oxidative stress markers and seizure frequency and severity.ResultsAt baseline, both groups (I, II) had significantly lower serum TAC levels relative to healthy controls (p=0.007), while MDA levels were unchanged. After the 4‐week period of black seed oil administration, there was no significant difference between the two groups with regards to seizure frequency, severity, or oxidative stressmarkers (TAC and MDA; p>0.05). Eight patients had >50% reduction in seizure frequency/severity after black seed oil versus placebo.ConclusionChildren with intractable epilepsy show evidence of oxidative stress. Administration of 40‐80 mg/kg/day of black seed oil as add‐on therapy did not alter either oxidative stress markers or seizure frequency or severity in intractable epileptic patients.
The association between CCL2 polymorphisms and drug‐resistant epilepsy in Chinese children
Authors: He Xuelian , Li Ying , Liu Zhisheng , Yue Xin , Zhao Peiwei , Hu Jiasheng , Wu Gefei , Mao Bing , Sun Dan , Zhang Huanian , Song Xinwen , Wang Yang , Shao Jianbo 
Published: August 2019

ABSTRACTThe treatment of drug‐resistant epilepsy remains a major challenge, affecting approximately 30% of epilepsy patients. More recently, immunity and inflammation are considered to be key elements of epilepsy. Targeting brain inflammation may represent a novel therapeutic strategy for epilepsy and refractory epilepsy. In this study, we investigated the association of a tag SNP of the CCL2 gene, rs1024611 (originally designated as ‐2578G>A or ‐2518G>A) with drug‐resistant epilepsy in Chinese children with epilepsy. We enrolled 484 epilepsy patients, including 98 drug‐resistant patients and 386 drug‐responsive patients. The rs1024611 was genotyped by PCR‐RPLP. The rs1024611 AA genotype was associated with a greater susceptibility to drug‐resistant epilepsy (p=0.008; OR=2.51, 95% CI: 1.33‐4.72), adjusted for age, sex, and seizure type, and the association remained significant after Bonferroni correction for multiple testing (p<0.05). Our results demonstrate that the CCL2 genetic polymorphism is associated with drug‐resistant epilepsy in Chinese paediatric patients.
Hippocampal sclerosis and chronic epilepsy following posterior reversible encephalopathy syndrome
Authors: Kapina Viktoria , Vargas Maria‐Isabel , Wohlrab Gabriele , Vulliemoz Serge , Fluss Joel , Seeck Margitta 
Published: August 2019

ABSTRACTChronic epilepsy has rarely been reported after posterior reversible encephalopathy syndrome (PRES) and the association with hippocampal sclerosis has been suggested only once before. We report the case of a girl admitted at the age of 8 years with idiopathic nephrotic syndrome. On the second day of admission, she presented with focal complex seizures and cerebral MRI showed posterior encephalopathy and no hippocampal sclerosis. MRI after one month confirmed the diagnosis of PRES. The seizures recurred and the girl developed pharmacoresistant epilepsy and was admitted to our hospital for further investigation. Cerebral MRI three years after the diagnosis of PRES showed hippocampal sclerosis which was not present on the initial MRI. We conclude that there is a triggering role of PRES in the development of hippocampal sclerosis. Hippocampal sclerosis may have resulted from seizure‐associated damage, alternatively, hypertensive encephalopathy may have led to hippocampal damage via a vascular mechanism.
Training doctors in basic EEG: analysis of a learning tool relevant to resource‐limited settings
Authors: Kander Veena , Wilmshurst Jo M 
Published: August 2019

AbstractAim. Clinicians trained to interpret EEG in Africa are scarce. The region is challenged by inadequate access to healthcare professionals and a significant burden of disease, with the result that trained neurophysiologists and epileptologists may not be viewed as an immediate priority. However, approaches, specific to the African context, could be adopted to enable safe practice of basic EEG interpretation. Educational guidelines for the interpretation of paediatric studies, relevant to the region, are lacking. As a result, a handbook targeting this training need was developed and a pilot study undertaken to assess the efficacy of this tool to improve EEG‐reporting skills for clinicians at a basic level.Methods. Eleven health practitioners, who manage children with epilepsy, from various African countries, were recruited. The group analysed selected EEGs before and after reading a training manual (the handbook). A survey was conducted on how useful the participants found the handbook.Results. There was a trend (p<0.06) supporting improvement in the ability to analyse EEGs following reading of the handbook. The doctors who had one‐on‐one tutoring, in addition to access to the handbook, did significantly better in most EEG‐reporting variables (p<0.01).Conclusions. The handbook was found to be a viable tool to promote EEG interpretation in the African setting, where foundation skills are needed. However, optimal outcomes were evident with additional individual tutoring, as well as on‐going support to maintain skills. This curriculum will be adapted into a post‐graduate qualification intended to generate clinicians with key basic EEG skills, but not fully trained electrophysiologists. Currently, in the African setting, for maximum impact on patient care, this approach is considered the most likely to have the furthest reach.
Epilepsia partialis continua of the abdominal muscles due to cerebrovascular disease
Authors: Ribeiro Joana Jesus , Sousa Mário , Teotónio Rute , Bento Conceição , Sales Francisco 
Published: August 2019

AbstractTwo elderly men, with previous history of cerebrovascular disease, were admitted to the emergency department due to focal motor status epilepticus with persistent myoclonic jerks of one side of the body. In both cases, the clinical picture evolved into a unilateral and isolated arrhythmic myoclonus of the abdominal muscles with preserved consciousness. These involuntary movements resolved with antiepileptic drugs. Although cerebrovascular disease is one of the most common causes of epilepsia partialis continua, reported cases in the literature with predominant abdominal involvement have a different aetiology. The neuroimaging and electroencephalographic findings showed a wide spectrum of different localizations and aetiologies associated with this particular type of epileptic seizure. Indeed, the pathophysiology of focal motor seizures involving the abdominal muscles is still a matter of discussion. In our second case, we present a patient with epilepsia partialis continua of the abdominal wall with an occipital focus, which, to the best of our knowledge, has not been previously reported. [Published with video sequences]
Incidence, prevalence and aetiology of seizures and epilepsy in children
Authors: Camfield Peter , Camfield Carol 
Published: August 2019

AbstractAim. To (1) summarize published, peer‐reviewed literature about the incidence and prevalence of epilepsy in children from developed and developing countries around the world, and (2) discuss problems in defining aetiologies of epilepsy in children, and distinguish between seizures and epilepsy.Methods. Review of selected literature with particular attention to systematic reviews.Results. The incidence of epilepsy in children ranges from 41–187/100,000. Higher incidence is reported from underdeveloped countries, particularly from rural areas. The incidence is consistently reported to be highest in the first year of life and declines to adult levels by the end of the first decade. The prevalence of epilepsy in children is consistently higher than the incidence and ranges from 3.2–5.5/1,000 in developed countries and 3.6–44/1,000 in underdeveloped countries. Prevalence also seems highest in rural areas. The incidence and prevalence of specific seizure types and epilepsy syndromes is less well documented. In population‐based studies, there is a slight, but consistent, predominance of focal seizures compared with generalized seizures. Only about one third of children with epilepsy can be assigned to a specific epilepsy syndrome, as defined by the most recently proposed system for organization of epilepsy syndromes.Conclusions. The incidence and prevalence of epilepsy in children appears to be lower in developed countries and highest in rural areas of underdeveloped countries. The reasons for these trends are not well established. Although focal seizures predominate, the incidence and prevalence of specific epilepsy syndromes is not well documented.
Epilepsy of infancy with migrating focal seizures: three patients treated with the ketogenic diet
Authors: Caraballo Roberto , Noli Daniel , Cachia Pedro 
Published: August 2019

AbstractAim. We present three patients with epilepsy of infancy with migrating focal seizures treated with the ketogenic diet.Methods. Between February 1, 2012 and January 31, 2014, three patients who met the diagnostic criteria for migrating focal seizures in infancy at our department were placed on the ketogenic diet and followed for a minimum of seven months.Results. Two of the three children responded well to the ketogenic diet. One of these patients became seizure‐free and his neuropsychological performance also significantly improved. The other child had a seizure reduction of 75% to 99% with only weekly seizures and moderate psychomotor improvement. For these two patients who responded well to the ketogenic diet, hospital admission was not required. The remaining patient had a seizure reduction of less than 50%. Tolerability of the diet was good in all three patients.Conclusion. Early treatment with the ketogenic diet should be considered for epilepsy of infancy with migrating focal seizures to control seizures and status epilepticus, and avoid progressive cognitive impairment.
Intracranial electrographic analysis of preictal spiking and ictal onset in uni‐ and bitemporal epilepsy
Authors: Wasade Vibhangini S , Gaddam Shailaja , Burdette David E , Schultz Lonni , Spanaki‐Varelas Marianna , Constantinou Jules EC , Elisevich Kost 
Published: August 2019

AbstractAim. Ictal onset patterns in bilateral mesial temporal lobe epilepsy have not been comprehensively studied. A retrospective review of intracranial electrographic data was undertaken to establish whether it is possible to distinguish between unilateral and bilateral mesial temporal lobe epilepsy based on ictal onset patterns, including periodic preictal spiking.Methods. A total of 470 ictal onset patterns were analyzed by bitemporal extraoperative electrocorticography in 13 patients with medically intractable mesial temporal lobe epilepsy. Ictal onset patterns were categorized, by frequency, as type A (<12 Hz), type B (12–40 Hz) and type C (>40 Hz). Preictal rhythmic spiking, of at least five seconds duration, and time to contralateral propagation were also measured with each ictal event. We determined if the proportion of “ictal onset pattern frequencies” or “incidence of preictal spiking” differed between unilateral and bilateral mesial temporal lobe epilepsy.Results. Seven patients with unilateral mesial temporal lobe epilepsy received surgery and achieved Engel class I outcomes, while the remaining six did not undergo resective surgery, due to the bilateral ictal onsets in extraoperative electrocorticography. The proportion of patients experiencing any preictal spikes was higher in unitemporal than in bitemporal cases (100%vs50%;p=0.069). Of the 470 ictal onset patterns analyzed (174 unitemporal and 296 bitemporal), a significant greater percentage of preictal spikes was found in unilateral cases (78% unitemporalvs14% bitemporal;p=0.002). Low‐frequency patterns were more evident in bitemporal cases (45%) than in unitemporal (10%), although the difference was not statistically significant (p=0.129). No differences were detected between the unitemporal and bitemporal groups regarding age at onset or at presentation.Conclusion. A greater proportion of preictal spiking, based on extraoperative electrocorticography, was present in unilateral, compared to bilateral, mesial temporal lobe epilepsy. Further studies are warranted to determine the causal significance of preictal spiking in mesial temporal lobe epilepsy.
Ictal asystole mimicking seizure deterioration in temporal lobe epilepsy
Authors: Guldiken Baburhan , Hartl Elisabeth , Rémi Jan , Noachtar Soheyl 
Published: August 2019

AbstractWe report on a patient with temporal lobe epilepsy, secondary to a left lateral temporal cavernoma, in whom the change in seizure semiology suggested recurrence of secondary generalized seizures. Anticonvulsive medication previously controlled secondary generalized seizures over a period of years but focal seizures continued at a lower rate. Continuous video‐EEG monitoring revealed ictal asystole associated with myoclonic syncope and falls during focal seizures arising from the left temporal lobe. After implantation of a cardiac pacemaker, no more falls occurred during the focal seizures. In conclusion, recurrence of seizure‐associated falls is typically attributed to recurrence of secondary generalized seizures, however, ictal asystole should be considered in selected epilepsy patients as a differential diagnosis of falls. [Published with video sequence]
Brief rhythmic discharges in neonates: a marker for seizures
Authors: Alix James JP , Ponnusamy Athi , Hart Anthony R 
Published: August 2019

AbstractBrief rhythmic discharges (BRDs) are paroxysms of rhythmic electrographic activity with an amplitude of >2 μV and a duration of <10 seconds. Although BRDs are reported in neonates, this electrographic activity contrasts the accepted definition of neonatal seizures (duration of >10 seconds). BRDs are associated with background EEG abnormalities as well as increased morbidity and mortality (Oliveira et al., 2000, Nagarajan et al., 2011), and appear to be more closely related to formal neonatal seizures than post‐neonatal epilepsy (Nagarajan et al., 2011). Most neonatal units are restricted to one‐hour recordings, and if BRDs are observed without any accompanying electrographic seizures, then the neonate should be regarded as being at high risk of seizures and repeat recordings should be considered.
Vagus nerve stimulation in children with drug‐resistant epilepsy: age at implantation and shorter duration of epilepsy as predictors of better efficacy?
Authors: Lagae Lieven , Verstrepen An , Nada Ayman , Van Loon Johan , Theys Tom , Ceulemans Berten , Jansen Katrien 
Published: August 2019

AbstractAim. To study the efficacy of vagus nerve stimulation (VNS) therapy in a highly drug‐resistant childhood epilepsy patient group and to investigate the effect of age at implantation on efficacy.Methods. The efficacy of VNS treatment was analysed in a cohort of 70 patients with drug‐resistant epilepsy. Both children with focal (n=16) and generalized epilepsies (n=54) were included. Age at implantation varied between 19 months and 25 years.Results. Overall, responder rate was 54% with 5.7% children becoming seizure‐free. The only factor in our analysis that could predict good outcome was age at implantation. In the youngest group (<5 years), the responder rate was 77% and this group also included three of the four seizure‐free children. These three seizure‐free children were known to have tuberous sclerosis. There were no outcome differences between generalized and focal epilepsies.Conclusions. Our single centre study confirms previous studies on the efficacy of VNS in children. A larger study using multivariate analysis to disentangle the contribution of different factors (such as age at implantation, aetiology, and epilepsy duration) is necessary to confirm our preliminary finding that younger age at VNS implantation might result in a better outcome.
Paroxysmal eyelid movements in patients with visual‐sensitive reflex seizures
Authors: Brinciotti Mario , Matricardi Maria 
Published: August 2019

AbstractAim. Paroxysmal eyelid movements (PEM) are non‐epileptic episodes characterized by eyelid closure, upturning of the eyes, and rapid eyelid flutter. The aim of this study was to report clinical and EEG data of patients with PEM and its relationship with visual sensitivity.Methods. We studied 26 patients with epilepsy (12 males and 14 females; mean age: 14.0±6.9 years) who presented PEM. The epilepsy was idiopathic generalized (eight cases), idiopathic focal (six cases), symptomatic focal (five cases), and reflex epilepsy (seven cases). PEM and blinking were analysed by video‐EEG recordings at rest and during intermittent photic stimulation, pattern stimulation, and TV watching. Blink rate was evaluated during three different conditions: at rest, during a TV‐viewing period, and at the occurrence of PEM. Analysis of variance (ANOVA) was used for statistical comparisons.Results. Repeated episodes of PEM were recorded in all patients. The frequency of PEM ranged from 8 to 12.5 Hz (average: 9.6±1.5). PEM were accompanied by a significant increase in blinking compared to the rest condition and TV watching (blink rate: 56.5±21.1vs25.0±16.2vs11.3±11.8, respectively;p<0.0001). Photoparoxysmal EEG responses (measured as sensitivity to photic stimulation) were found in 25 cases, associated with pattern sensitivity in 22; only one patient was sensitive to pattern but not photic stimulation. Visually‐induced seizures were recorded in 20 cases, triggered by both stimuli (photic and pattern stimulation) in 11 patients; seizures were triggered by pattern stimulation (but not photic stimulation) in five, photic stimulation (but not pattern stimulation) in three, and TV watching (but not photic or pattern stimulation) in one. Epileptic eyelid myoclonia was noted in 17 patients.Conclusion. The coexistence of PEM, photoparoxysmal EEG responses, increased blinking, and epileptic eyelid myoclonia suggests an underlying dysfunction involving cortical‐subcortical neural networks, according to the recent concept of system epilepsies. [Published with video sequences]
Electroclinical and cytogenetic features of epilepsy in cri‐du‐chat syndrome
Authors: Nakagami Yukako , Terada Kiyohito , Ikeda Hitoshi , Hiyoshi Toshio , Inoue Yushi 
Published: August 2019

AbstractCri‐du‐chat syndrome (CdCs) is caused by deletion in the short arm of chromosome 5, occurring in 1:15,000 to 1:50,000 live births. Recent genotype‐phenotype correlation studies show the importance of 5p15.2 for facial dysmorphism and intellectual disability, and 5p15.3 for cat‐like cry. Numerous reports have shown the relative rarity of epilepsy in this syndrome. We identified two cases with epilepsy in CdCs, and described their electroclinical and cytogenetic features. The first case was a 25‐year‐old female who had axial tonic seizures with flexion of the neck and shoulders. Interictal EEG was characterized by generalized spike‐and‐slow‐wave complexes. Her ictal EEG started with diffuse electrodecremental pattern, followed by alpha‐range activities. High‐resolution banding analysis of chromosomes revealed a terminal deletion of 5p14.1. The second case was a 30‐year‐old female who had startle epilepsy with falling. Interictal EEG demonstrated generalized spike and slow waves. High‐resolution banding analysis revealed a terminal deletion of 5p13.3 with additional chromosomal material of unknown origin. Based on the cases presented here, as well as those previously reported, the relationship between epilepsy and CdCs is discussed. The data suggests that although CdCs patients rarely suffer from epileptic seizures, the seizures may vary in type.