bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variations de l'activité des rythmes EEG en relation à un événement. Application à la physiologie et à la pathologie du mouvement
Authors: Szurhaj William , Labyt Etienne , Bourriez Jean‐Louis , Cassini François , Defebvre Luc , Hauser Jean‐Jacques , Guieu Jean‐Daniel , Derambure Philippe 
Published: March 2024

RÉSUMÉ
La traduction la plus classique d'un événement répété sur l'électroencéphalogramme (EEG) est le potentiel évoqué dont la mise en évidence repose sur le moyennage de l'EEG. La condition nécessaire à cette technique est qu'il existe une relation de phase entre le stimulus et le potentiel évoqué par ce stimulus. La réactivité des rythmes EEG induite par un événement ne peut donc pas être mise en évidence par une simple technique de moyennage, cette réactivité ne survenant pas toujours à la même phase du signal. L'étude de cette réactivité est possible par la méthode des Désynchronisations et Synchronisations Liées à l'Événement (DLE/SLE) proposée par Pfurtscheller et Aranibar en 1977. Cette méthode consiste à mesurer l'évolution temporelle de la puissance du signal EEG dans une bande de fréquence donnée, avant, pendant, et après un événement. La DLE correspond à l'atténuation d'amplitude d'un rythme EEG en rapport avec un événement. Inversement, une augmentation d'amplitude en relation avec l'événement correspond à une SLE. Les DLE traduisent l'activation des aires corticales sous‐jacentes. Les SLE traduiraient en partie la mise au repos du cortex, et probablement également des phénomènes de réafférentation somesthésique. Cette méthode peut être appliquée à l'étude de nombreux processus: mnésiques, auditifs, attentionnels, anticipatoires et moteurs. Ainsi un mouvement volontaire auto‐commandé de la main dominante s'accompagne d'une DLE précoce des rythmes mu et bêta précédant le mouvement de respectivement 2 000 et 1 500 ms, enregistrée en regard de la région centrale contralatéral. Cette DLE devient bilatérale au début du mouvement et est maximale à la fin de celui‐ci. Elle est alors suivie d'une SLE des rythmes bêta. Nous montrons que ces phénomènes de DLE/SLE varient en fonction du type de mouvement, et permettent d'explorer les modifications de l'excitabilité corticale rencontrées au cours de la maladie de Parkinson et de l'épilepsie avec crises motrices.
Prospective study on concentration‐efficacy and concentration‐toxicity: Correlations with lamotrigine serum levels
Authors: Fröscher Walter , Keller Ferdinand , Vogt Heinrich , Krämer Günter 
Published: March 2024

ABSTRACT

Rationale:
The relationship between lamotrigine (LTG) serum concentration and clinical response in patients with epilepsy is still controversial. We therefore performed a prospective study in which LTG was added to the existing therapeutic regimen in patients with poorly controlled epilepsy. The goal of the study was to determine the serum levels of patients with seizure reduction of at least 50% after addition of LTG, and to assess a possible relationship between the occurrence of adverse effects due to LTG and its serum concentration.

Methods:
Fifteen adult patients were evaluated with respect to seizure reduction. Nine patients had focal seizures with or without generalization, six patients had generalized seizures (Group I). The correlation between the occurrence of adverse effects and LTG serum concentration was calculated in a second group of 63 young adult, and adult patients with epilepsy (Group II).

Results:

The range of the LTG serum concentration in the 15 patients with a 50% or greater reduction of seizure frequency was 1.3‐7.1 μg/ml (median = 3.6 μg/ml). In group II patients the serum concentration associated with an adverse effect was not significantly different from the serum concentration in patients without adverse effects. There was, however, a tendency for higher serum concentrations in patients with adverse effects. In the serum concentration range of 5 to 13 μg/ml, the frequency of LTG levels which were accompanied by an adverse effect increased only slowly, whereas above 13‐14 μg/ml, there was a steep increase in adverse effects. The serum concentration of four patients with tremor (mean = 14 ± 2.8 μg/ml) was significantly higher than the LTG level which were in 42 patients who did not have adverse effects at any time (mean = 4.8 ± 4.1 μg/ml),
P
= 0.003.

Conclusion:
Our results suggest a target range for LTG serum concentrations of 1‐13 μg/ml, especially, if LTG is used as an add on‐drug.
Seizure‐induced hippocampal damage in the mature and immature brain
Authors: Lado Fred A. , Laureta E.C. , Moshé Solomon L. 
Published: March 2024

ABSTRACT

Neurologists caring for patients who have experienced a first seizure or who are at increased risk of seizures are concerned with two questions. First, at what point do seizures lesion the brain and create the conditions for unprovoked, recurrent seizures,
i.e.
epilepsy. And second, seizure‐induced changes can be prevented pharmacologically following an initial prolonged seizure, or prophylactically in individuals deemed at high risk of epilepsy? The number, duration and severity of seizures each influence the likelihood that an individual will experience chronic seizure‐induced brain damage. However, the thresholds for deleterious seizure‐induced sequelae are not well understood. Will repeated brief seizures produce similar changes as a single prolonged seizure? Do permanent alterations of neuronal function result from a single brief seizure? How long can neurons resist damage caused by prolonged seizures? These are all questions of immediate clinical significance. The anatomical, synaptic and functional consequences of seizures have been most extensively studied in the hippocampus, an epileptogenic structure that plays a central role in the generation of temporal lobe seizures. In this review, we will discuss the spectrum of known hippocampal alterations in epilepsy and highlight mechanisms through which neuronal and synaptic changes accrue. In addition to discussing the effects of prolonged seizures on the hippocampus, we will also review current data regarding the effects of repeated brief seizures as well as the effect of a single brief seizure. We will also discuss the relevance of development and gender on the manifestations of seizure‐induced damage, in order to begin to stratify the risk of seizure sequelae to different human populations depending on age, and – to a lesser extent – on gender.

The decision whether to treat, and how to treat seizures, results from an understanding of the immediate and long‐term risks to the patient of either recurrent seizures, or of seizure‐induced brain damage. Paradigmatic to this type of decision is the assessment of febrile seizures, a common occurrence in childhood. Current clinical and laboratory data indicate that simple febrile seizures do not result in long‐term brain injury. However, novel laboratory findings indicate that even “benign” febrile seizures may produce subtle long‐term changes in neuronal behavior‐such as altered synaptic function. The improved understanding of the mechanism producing these long term effects is a necessary first step in the development of neuroprotective treatments that can be applied either in the acute setting at the time of an initial prolonged seizure, or prophylactically in individuals most likely to high risk of developing epilepsy.
Surgical pathology of drug‐resistant partial epilepsy: A 10‐year‐experience with a series of 327 consecutive resections
Authors: Pasquier Basile , Péoc'h Michel , Fabre‐Bocquentin Blandine , Bensaadi Lamia , Pasquier Dominique , Hoffmann Dominique , Kahane Philippe , Tassi Laura , Le Bas Jean‐François , Benabid Alim Louis 
Published: March 2024

ABSTRACT
Herein we reviewed the histopathological findings in 327 consecutive surgical specimens from patients with pharmaco‐resistant epilepsy (PRE). Three major pathological groups (78.3% of all cases) were identified: Ammon's horn sclerosis (85 cases as an isolated lesion plus 18 as one part of a dual pathology), tumors (94 cases), and malformations (77 cases). Tumors, often associated with cortical dysplasias (CDs), were all of low histological grade and included 61 dysembryoplastic neuroepithelial tumors (DNTs), 29 gangliogliomas, and 4 pleomorphic xanthoastrocytomas (PXAs). Among the malformations were observed 52 CDs, 13 cavernomas, 8 cortical tubers, and 4 cysts. The remaining findings consisted of 16 scars (mostly posttraumatic) and 4 Rasmussen's encephalitis. Fifty‐one (15.6%) specimens contained non‐specific changes, and histological samples from 215 patients with presurgical implantation of electrodes revealed iatrogenic changes. All these figures are in agreement with the most recent and comparable series, and confirm the high incidence of DNTs that appear clearly as the most common tumoral entity in PRE. Our data also support the hypothesis of a close histogenetic relationship between DNT, ganglioglioma, and PXA, with a putative common origin from pluripotential progenitor CD34 positive cells of the subpial granular layer. As for CDs, our study confirms the clinical relevance of two main subtypes: severe CD (or Taylor's type CD) with neuronal cytomegaly and balloon cells, and non‐Taylor's type CDs with a better outcome. Eventually, this series demonstrates that most patients have significant histopathological lesions, among which, aspects that are relevant to the diagnostic surgical pathologist are highlighted [published with a complete image database on CD‐Rom].
Clinical features and EEG findings differentiating mesial from neocortical temporal lobe epilepsy
Authors: Pfänder Mona , Arnold Stephan , Henkel Anja , Weil S. , Werhahn Konrad J. , Eisensehr Ilonka , Winkler Peter A. , Noachtar Soheyl 
Published: March 2024

ABSTRACT

We evaluated whether mesial temporal lobe epilepsy (MTE) and neocortical temporal lobe epilepsy (NTE) can be distinguished on electroclinical grounds. One hundred and twenty‐two consecutive MTE (
n
= 86) and NTE (
n
= 36) patients were included in this prospective study. All patients underwent prolonged EEG‐video monitoring and high resolution magnetic‐resonance imaging (MRI). MTE was defined as epilepsy with purely mesial temporal lesion in the absence of extramesial temporal pathology, based on pre‐operative MRI or post‐operative histology. NTE was defined as neocortical temporal MRI lesions, depth recorded neocortical temporal seizure onset and lack of mesial temporal lesions on MRI or histology. One thousand two hundred and fourty‐nine epileptic seizures were analyzed. Congenital malformation (NTE 19%
versus
MTE 3%,
P
< 0.01), nonspecific auras (NTE 25%
versus
MTE 8%,
P
< 0.001) and early clonic activity following automatisms (NTE 22%
versus
MTE 8%,
P
< 0.03) were more frequent in NTE. In contrast, a history of febrile seizures (MTE 29%
versus
NTE 3%,
P
< 0,001), abdominal auras (MTE 62%
versus
NTE 33%,
P
< 0.005) and contralateral hand dystonia (MTE 43%
versus
NTE 22%,
P
< 0.03) were more often documented in MTE. Interictal epileptiform discharges in MTE occurred predominantly (> 67%) over the ipsilateral mesial temporal regions (MTE 65%
versus
NTE 33%,
P
< 0.001). No MTE patient had lateral neocortical temporal spike predominance (NTE 22%,
P
< 0.001). Multiple logistic regression revealed that a history of febrile seizures, abdominal auras, contralateral dystonic posturing and predominance of ipsilateral mesial temporal spikes point to MTE, with an accuracy of 73% (PPV 81%, NPV 70%). Analyzing clinical and EEG features, particularly the distribution of interictal epileptiform discharges, helps to differentiate between MTE and NTE.
Idiopathic generalised epilepsies with 3 Hz and faster spike wave discharges: A population‐based study with evaluation and long‐term follow‐up in 71 patients
Authors: Siren Auli , Eriksson Kai , Jalava Heli , Kilpinen‐Loisa Päivi , Koivikko Matti 
Published: March 2024

ABSTRACT
For several years we have been following patients with intractable, childhood‐onset idiopathic generalised epilepsies with ≥ 3 Hz spike‐wave discharges. Our need to find explanations for their intractability was the starting point for this study. We were interested in identifying characteristics, which would predict intractability; evaluating how these patients were treated and whether polytherapy was useful. We identified patients with ≥ 3 Hz spike‐wave discharges by reviewing EEG reports recorded between 1983 and 1992. Data were collected from medical records and through personal interviews. We identified 82 patients with tentative idiopathic generalised epilepsy. Eleven were excluded. Thirty‐eight patients had childhood absence epilepsy, 18 had juvenile absence epilepsy, 13 had juvenile myoclonic epilepsy and two had eyelid myoclonia with absences: 89.5, 78, 38 and 0% of the patients in each group, respectively, had been seizure free for more than 2 years. Twenty percent of the patients had intractable seizures. All intractable patients with juvenile absence epilepsy had rhythmic, random eyelid blinking and generalised tonic‐clonic seizures. A history of more than ten generalised tonic‐clonic seizures was associated with intractability in juvenile myoclonic patients. Monotherapy with ethosuximide or valproate resulted in seizure control in 65% of patients. Seventeen patients (24%) were treated with polytherapy, six achieved remission. These six patients had childhood absence epilepsy and juvenile absence epilepsy. Positive outcome was found in childhood absence epilepsy and juvenile absence epilepsy. Intractable seizures were more frequent among patients with juvenile myoclonic epilepsy. None of them benefited from polytherapy with conventional anti‐epileptic drugs.
Treatment options in pediatric epilepsy syndromes
Authors: Arzimanoglou Alexis 
Published: March 2024

ABSTRACT
Recent evidence suggests that various epilepsy syndromes respond differently to antiepileptic drugs. It follows that a more precise diagnosis, together with a better understanding of AED mechanisms of action, enables them to be used more specifically, and therefore more effectively. Patient characteristics including age of onset, seizure frequency, EEG data and the findings of imaging studies, provide diagnostic pointers which enable the physician to reach a syndrome diagnosis and to choose the most appropriate AED for the individual patient. Home videotapes of paroxysmal events are becoming increasingly available and are often of great assistance. Parents should be encouraged to record their children's attacks. Careful history‐taking and correct interpretation of clinical data remain the cornerstones of accurate diagnosis and successful treatment.
However, the specificity of antiepileptic drugs is relatively limited and often pharmacotherapy should start using an agent with a broad spectrum of activity appropriate for the primary seizure type. It is in fact common that several antiepileptic agents have similar or identical effectiveness for one particular form of epilepsy. Therefore, the eventual side effects and the greater or lesser difficulties in handling the drug play an essential role in the choice of a therapeutic agent. Polypharmacy should be avoided and surgery should be considered early for selected patients, particularly children, who fail to respond to an appropriate drug trial. Correct diagnosis and the first drug(s) used may have a crucial impact on the evolution of given epilepsy. One major emphasis in the management of epilepsy is on information that should be complete, adapted to the level of understanding, and objective, although given in a positive manner. The understanding and cooperation of children and their families is clearly decisive for the success of therapy, and this requires a confident relationship between the physician and the patient.
Current knowledge, on antiepileptic drugs options in paediatric epilepsy syndromes, is discussed.
Fear, anger and compulsive behavior during seizure: involvement of large scale fronto‐temporal neural networks
Authors: Bartolomei Fabrice , Guye Maxime , Wendling Fabrice , Gavaret Martine , Régis Jean , Chauvel Patrick 
Published: March 2024

ABSTRACT
Seizure‐related, abnormal affective and gestural behavior may involve some of the same processes as those underlying non‐pathological behavior, but their mechanisms remain largely unknown. In this report, we studied a patient in whom seizures initially involved the medial temporal region before involving the frontal cortex. Seizure semiology of the second part of the seizure included marked emotional disturbances (dominated by intense fear and anger) and compulsive behavior to bite into something. This patient underwent pre‐surgical evaluation including intracerebral electroencephalographic recordings (SEEG, stereoelectroencephalography).

Methods

In addition to SEEG examination, we used coherence analysis of signals as a means of studying functional coupling between different regions of the brain. Two seizures were studied. Coherence values from different periods of interest were compared to identify the neural structures involved at the onset of seizure activity as well as during the emotional behavioral changes.

Results

A first network of neural structures was identified within the right anterior temporal regions (amygdala, temporal pole, hippocampus, temporal neocortex). At the time of intense affective and compulsive changes, and by comparison with the first ictal period, a second network was identified characterized by significant functional coupling between the amygdala, the orbito‐frontal structures and the frontal opercular region, while a decrease in functional coupling between these regions and the dorsolateral region and the cingulate gyrus was apparent.

Conclusion

This study show that the emergence of an intense affective and behavioral state during a temporal lobe seizure could be related to the involvement of a network of structures including the anterior temporal lobe and the orbito‐frontal cortex. The decrease of coupling between these regions and the lateral prefrontal and cingulate regions could also participate in these phenomena.
Epilepsy and women's issues: An update
Authors: Tettenborn Barbara , Genton Pierre , Poison David 
Published: March 2024

ABSTRACT
Although the fundamentals of epilepsy are similar for both males and females, the clinical management of epilepsy in women should take into consideration a variety of factors including: social and cultural issues, age, relationships, diagnosis and characterization, female specific syndromes, the influence of female hormones, hormonal contraceptives and hormonal replacement therapy, the cosmetic side effects of epilepsy treatment, fertility, pregnancy and child care. Regarding the issue of reproduction, there are several misconceptions in relation to fertility in women with epilepsy. In general, women with epilepsy do not have a markedly reduced fertility compared with those without. Standard AEDs in common use have been associated with an increased risk of foetal malformations and with newer AEDs there is very little information regarding teratogenicity. The incidence of congenital malformations is also known to increase with the number of AEDs. Before planning a pregnancy it is imperative that the best possible seizure control is achieved at the lowest possible AED dose, preferably in monotherapy. With this in mind, the importance of effective pre‐pregnancy counselling should be stressed and along with appropriate patient management and folic acid supplementation, effective patient education, most women with epilepsy can lead normal lives and deliver healthy children. This report will provide an update on these important considerations for women with epilepsy from both a social and medical perspective.
Seizures and the basal ganglia: a review of the clinical data
Authors: Vercueil Laurent , Hirsch Edouard 
Published: March 2024

ABSTRACT
This article attempts an overview of the clinical and electrophysiological evidence supporting the involvement of the basal ganglia in epileptic seizures. In contrast to animal data, evidence for a role of these structures in human epilepsies is lacking. However, from the theoretical point of view, it remains conceivable that, given their strong interconnectivity, basal ganglia could be functionally linked to the cerebral cortex during an epileptic seizure. Several clinical ictal aspects have been suggested to be compatible with the involvement of basal ganglia, namely, ictal dystonic posturing during temporal lobe seizures, rotatory seizures and paroxysmal dyskinesia‐like seizures. On the other hand, basal ganglia dysfunction may also influence some aspects of epilepsy, as suggested by pure basal ganglia pathology such as Parkinson's disease, or the described effect of an acute basal ganglia lesion in epileptic patients. The data discussed in this review may stimulate further research to link basic scientific data to human epilepsies, and lead to the development of novel therapeutical solutions.
The control of seizures by the basal ganglia? A review of experimental data
Authors: Deransart Colin , Depaulis Antoine 
Published: March 2024

ABSTRACT
Over the past few years, the role of the basal ganglia in epilepsy has been widely debated, the debate being mainly based on experimental data obtained from several animal models. In the present review, the possibility that basal ganglia circuits can generate some forms of seizure or participate to their initiation will first be addressed. In the second part of this chapter, recent data suggesting the involvement of the basal ganglia in the control of seizures will be discussed. Although it is clear that basal ganglia circuits cannot generate seizures and are unlikely to be involved in their initiation, numerous experimental data have revealed that seizures modify the activity of this system. More recently, the collection of pharmacological and electrophysiological data in animal models of epilepsy has led to the emergence of the basal ganglia as a possible control circuit for the seizures. These experimental data have already led to initial clinical trials in epileptic patients. The preliminary clinical data encourage the further development of experimental research in chronic models of epilepsy to better determine the exact output circuits involved in seizure interruption, the mechanisms participating in seizure control and whether the same circuits are involved in the control of different types of seizures. These studies may allow the identification of crucial structures and the types of epilepsy likely to benefit from this new therapeutic approach.