bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of DN‐1417 on Photosensitivity and Cortically Kindled Seizure in Senegalese Baboons, Papio papio
Authors: Sakai S. , Baba H. , Sato M. , Wada J. A. 
Published: November 2007

SUMMARY: The effect of DN‐1417, a thyrotropin‐releasing hormone (TRH) analogue, on photosensitivity and cortically kindled seizures was examined in seven Senegalese baboons (Papio papio). Intravenous (i.v.) administration of 2 mg/kg had no effect on either photosensitivity or cortically kindled seizures. When this agent was administered intracisternally, both the photomyoclonic response and cortically kindled seizures were suppressed for 4–5 days. A study of the transcallosal response also showed a long‐lasting attenuation of the early positive wave (PI) amplitude (peak latency, 5–10 ms) elicited by a single stimulus after cisternal injection of DN‐1417. These findings are consistent with the assumption that endogenous TRH is involved in suppression of epileptic seizures.RÉSUMÉL'effet du DN‐1417, un analogue de la TRH, sur la photosensibilité et les crises après kindling cortical, a étéétudié chez sept babouins sénégalais Papio papio. L'administration intraveineuse de 2 mg/kg n'a pas eu d'effet, ni sur la photosensibilité, ni sur les crises après kindling cortical. Cependant, lorsque cet agent a été administré par voie intraventriculaire, la réponse photomyoclonique et les crises induites par kindling cortical ont été supprimées pendant 4 à 5 jours. Une étude de la réponse transcalleuse a également montré une atténuation prolongée de la pointe positive précoce (Iatence du pic, 5–10 ms) provoquée par une stimulation isolée après injection intracisternale de DN‐1417. Ces constatations confirment l'hypothèse selon laquelle la TRH endogène est impliquée dans la suppression des crises épileptiques.RESUMENEn 7 babiones senegaleses Papio papio, se ha estudiado el efecto de la DN‐1417, un análogo de la hormona liberadora de tirotropina (TRH), sobre lafotosensibilidad de los ataques condi‐cionados corticalmente (kindled). La administración intravenosa de 2 mg/kg no produjo ningún efecto sobre la fotosensibilidad ni sobre los ataques condicionados corticalmente. Cuando este agente se administró intracistemalmente la respuesta fotomio‐clónica y los ataques condicionados corticalmente se suprimieron durante 4–5 días. Un estudio de la respuesta transcallosa también mostró una atenuación prolongada de la amplitud (latencia pico, 5–10 msec) producida por un estímulo único después de la inyección cisternal de DN‐1417. Estos hallazgos están de acuerdo con la presunción de que la TRH endógena participa en la supresión de ataques epilépticos.
Dreams and Epilepsy
Authors: Reami Denilce O. , Silva Délrio F. , Albuquerque Marly , Campos Carlos J. R. 
Published: November 2007

SUMMARY: The relationship between dreams and epilepsy is illustrated by two patients whose awake epileptic seizures and recurrent dreams during night sleep had similar content. In both of our cases the EEG showed right anterior temporal spike discharge, suggesting a role for the temporal lobe in the association between dreams and seizures.RÉSUMÉLa relation entre les rêves et l'épilepsie est illustrée par deux observations dans lesquelles le contenu subjectif était le même lors des crises survenant à la veille et lors des rêves répétés au cours de la nuit. Dans les deux cas rapportés l'EEG a mis en évidence des décharges de pointes‐ondes temporales antérieures droites, ce qui suggère que le lobe temporal joue un rôle dans l'association entre rêves et crises.RESUMENLa relación entre sueños y epilepsía se ilustra en dos casos en los que, durante los ataques epilépticos y los sueños recurrentes durante la noche, tenían un contenido semejante. En estos dos casos el EEG mostró un foco de descargas de puntas en la región temporal anterior derecha que sugiere la participación del lóbulo temporal como asociación entre sueños y ataques.ZUSAMMENFASSUNGDie Beziehung zwischen Träumen und Epilepsie wird an zwei Fallbeispielen dargestellt, bei welchen ahnliche Inhalte er‐schienen, entweder bei Anfällen im Wachzustand oder Träumen im Schlaf. In unseren beiden Fällen zeigte das EEG rechts temporal vorne spike‐Entladungen, so daβ eine Beteiligung des Temporallappens gleichermaβen bei Träumen und bei Anfällen vermutet wird.
Clinical Development Outlook of Oxcarbazepine
Authors: Schwabe Stefan 
Published: November 2007

Summary: Oxcarbazepine (OCBZ) has been accepted for registration as a first‐line antiepileptic drug (AED) in several countries. However, because of changing regulations, further studies confirming statistically significant proof of efficacy are necessary in accordance with new standards. Therefore, Ciba has initiated a worldwide clinical development program to achieve registration. Four different types of design to demonstrate statistically significant proof of efficacy in partial seizures will be initiated. These studies are a “classical” poly‐therapy add‐on study, a monotherapy substitution trial, a high‐dose/low‐dose active‐control monotherapy study, and a study in presurgical patients.Anticonvulsants
The Limitations of Antiepileptic Drug Monotherapy
Authors: Krämer G. 
Published: November 2007

SummaryThe success rate for antiepileptic drug (AED) monotherapy varies among seizure types and epilepsy syndromes, although monotherapy has been shown to be suitable for the majority of patients. Certain groups of patients, e.g., patients with partial seizures, with or without secondarily generalizing, are less satisfactorily controlled with monotherapy. Prospective studies have shown that 33–50% of patients with refractory partial epilepsies and symptomatic generalized epilepsies whose seizures are not satisfactorily controlled by monotherapy respond well to a combination of AEDs. Current consensus is that all patients should initially receive monotherapy [e.g., valproate (VPA) or carbamazepine (CBZ)] and, if unsuccessful, an alternative AED should be administered as monotherapy. Only if seizures are still not satisfactorily controlled should combination therapy be instituted. Studies have shown that combination therapy with VPA and CBZ brings seizures of many previously nonresponsive patients with refractory complex partial and secondary generalized epilepsies under control. However, to establish the limitations of monotherapy in an individual, the maximal tolerated dosage must have been administered. Full seizure control may occur in some patients only when the plasma concentration exceeds the therapeutic range.
Surgical Treatment for Perirolandic Lesional Epilepsy
Authors: Sandok Evan K. , Cascino Gregory D. 
Published: November 2007

Summary: Our purpose was to evaluate the safety and efficacy of surgical treatment for perirolandic lesional epilepsy. We analyzed the records of 14 consecutive patients who underwent a stereotactic lesionectomy for intractable partial epilepsy between 1985 and 1994. All patients had a neuroimaging‐identified lesion in the perirolandic cortex. The mean duration of follow‐up was 6 years (range 1–11 years). Thirteen patients (93%) had a significant improvement in seizure tendency. Eleven patients (78%) were rendered seizure‐free. Morbidity occurred in only one patient, who experienced an increased monoparesis after surgery. Stereotactic lesionectomy is an effective surgical strategy in patients with perirolandic lesional epilepsy. The recent development of functional brain imaging using subtraction ictal single‐photon emission computed tomography co‐registered with volumetric magnetic resonance imaging has been shown to be a reliable indicator of epileptic brain tissue that may significantly alter the preoperative evaluation in patients with extratemporal seizures.Summary: Stereotactic lesionectomy in a consecutive series of patients with medically refractory partial seizures related to perirolandic lesional epilepsy proved to be safe and effective. The rationale for the operative procedure was to resect the neuroimaging‐identified abnormality. The only patient who did not experience an excellent outcome, i.e., Class I or 11, was an individual who did not have a pathologically verified foreign‐tissue lesion. The advantages of this operative approach include the use of a surgical strategy that does not require extensive preoperative functional mapping and the ability to excise the pathologic lesion using a small cranial trephine. The main disadvantage of stereotactic neurosurgery for epilepsy is the inability to resect the epileptogenic zone, which may be necessary to render the patient seizure‐free. The procedure is also not “risk‐free,” as demonstrated by the patient who experienced an increased hemiparesis.
Structure‐Pharmacokinetic‐Pharmacodynamic Relationships of yV‐Alkyl Derivatives of the New Antiepileptic Drug Valproyl Glycinamide
Authors: Spiegelstein Ofer , Yagen Boris , Bialer Meir 
Published: November 2007

Summary:Purpose: The purpose of this study was to evaluate the structure‐phartnacokinetie‐pharmacodynamic relationships of a series ofN‐alkyl andN,N‐dialkyl derivatives of the new antiepileptic drug (AED), valproyl glycinamide (VGD).Methods: The following compounds were synthesized:N‐methyl VGD (M‐VGD),N,N‐dimethyl VGD,N‐ethyl VGD,N.N‐diethyl VGD (DE‐VGD), andN,N‐diisopropyl VGD. These compounds were evaluated for anticonvulsant activity, neurotoxicity, and pharmacokinetics.Results: After i.p. administration to mice in the maximal electroshock seizure test (MES), DE‐VGD had an ED50value comparable to that of VGD (145 and 152 mg/kg, respectively), whereas in the subcutaneous metrazol test (sc Met) model, M‐VGD had a slightly lower ED50than VGD (108 and 127 mg/kg, respectively). After oral administration to rats, M‐VGD had an MES‐ED50similar to that of VGD (75 and 73 mg/kg, respectively). Of theN‐alkyl VGD derivatives studied, M‐VGD had the best pharmacokinetic profile: the lowest clearance (5.4 L/h), the longest half‐life (1.8 h), and the lowest liver‐extraction ratio (14%).N,N‐dialkylated VGD derivatives underwent two consecutiveN‐dealkylations, whereasN‐alkylated derivatives underwent a singleN‐dealkylation process, yielding VGD as a major active metabolite.Conclusions: M‐VGD had the most favorable pharmacodynamic and pharmacokinetic profile of the investigatedN‐alkyl VGD derivatives. VGD was found to be a major active metabolite of M‐VGD and to be less neurotoxic than M‐VGD. Therefore VGD rather than one of the investigated /V‐alkyl VGD derivatives should be considered for development as a new AED.
Outcome of Epilepsy Surgery in the First Three Years of Life
Authors: Sugimoto Tateo , Otsubo Hiroshi , Hwang Paul A. , Hoffman Harold J. , Jay Venita , III O. Carter Snead 
Published: November 2007

Summary: Purpose: We analyzed our experience over a 6‐year period with early‐chiidhood patients who had undergone epilepsy surgery, and investigated the surgical outcomes. Method: We reviewed the medical records of 23 children, ages 0–3 years, who underwent epilepsy surgery between 1991 and 1996. Results: Twenty children had partial seizures; two had infantile spasms; and one had generalized tonic‐clonic seizures at onset. The mean age at onset of seizures was 4.7 months, and the mean age at time of surgery was 15.3 months. A total of 32 operations (21 focal cortical resections and 11 hemispherecto‐mies) was performed. Five of 12 children with seizures secondary to a neuronal migration disorder had reoperations, including three who ultimately underwent complete hemispher‐ectomy. The pathology consisted of hemimegalencephaly in three patients, focal cortical dysplasia (FCD) in eight, tuberous sclerosis in one, Sturge‐Weber syndrome (SWS) in five, infarction in two, low‐grade glioma (LGG) in three, and post‐herpes simplex virus encephalitis (HSE) in one. The follow‐up period ranged from 1 to 6.5 years (mean, 3.2 years) from patients' last operation. The seizure outcome according to Engel's criteria was class 1 in 12 patients, class II in three, class III in six and class IV in two. Conclusions: Seizure outcomes after surgery were less favorable in infants with FCD than in those with SWS and LGG. Seizure outcome for the patients with hemispherectomies was excellent, compared with those who had focal cortical resections.
Early and Late Posttraumatic Seizures in Traumatic Brain Injury Rehabilitation Patients: Brain Injury Factors Causing Late Seizures and Influence of Seizures on Long‐Term Outcome
Authors: Asikainen Ilmari , Kaste Markku , Sarna Seppo 
Published: November 2007

Summary: Purpose: To demonstrate risk factors involved in the origin of late posttraumatic seizures (LPTSs) in civilian traumatic brain injury (TBI) rehabilitation patients and the occurrence of LPTSs in this population. as well as the time of the first late seizures, and influence of these seizures o n functional and occupational long‐term outcome. Methods: A consecutive sample of 490 patients (age range, 0.8–71 years) with TBI, and with postinjury problems in their education and employment, were followed up for 5 yearsfrom the time of injury in a rehabilitation and reemployment program. The study was carried out at the outpatient neurologic clinic of the Kauniala Hospital, which specializes in brain injuries in Finland and works in close cooperation with the Department of Clinical Neurosciences at the Helsinki University Central Hospital. Main outcome measures were functional outcome, as measured o n the Clasgow Outcome Scale (GOS), and the capacity for employment at the end of follow‐up. Outcomes were studied separately among patients with late seizures and for the nonseizure group. Rescuts; Children age 7 years or younger at time of injury more often had early posttraumatic seizures (EPTSs). than did adolescents or adults. The time elapsed between brain injury and the first late seizure also was longer in older age groups. EPTSs and depressed skull fracture had a statistically significant relation to the origin of LPTSs. Permanent posttraumatic neurologic deficit, linear skull fracture, and permanent local brain lesion documented on 21 computed tomography (CT) scan appeared clinically important as risk factors. Late seizures did worsen the functional outcome but had n o significant influence on reemployment at the end of follow‐up. Conclusions: Young children are more prone to early seizures. and adolescents and adults, to late seizures. The main risk factors for LPTSs are early seizures and depressed skull fracture. Severity of brain injury, as measured by a low GCS score, prolonged unconsciousness, and posttraumatic amnesia (PTA) without local brain lesion, should not be considered risk factor for LPTSs. Thorough follow‐up of patients with TBI with seizures and adequate antiepileptic therapy may help attain rehabilitation goals and reemployment.
Lamotrigine Monotherapy in Newly Diagnosed Untreated Epilepsy: A Double‐Blind Comparison with Phenytoin
Authors: Steiner T. J. , Dellaportas C. I. , Findley L. J. , Gross M. , Gibberd F. B. , Perkin G. D. , Park D. M. , Abbott R. 
Published: November 2007

Summary: Purpose: Lamotrigine is an effective add‐on therapy against a range of epileptic seizure types. Comparative studies with carbamazepine (CBZ) as monotherapy in newly diagnosed epilepsy suggest similar efficacy. In this study, lamotrigine (LTG) and phenytoin (PHT) are compared. Methods: In a double‐blind parallel‐groups study, 181 patients with newly diagnosed untreated partial seizures or secondarily or primary generalised tonic‐clonic seizures were randomised to two treatment groups. One group (n = 86) received LTG titrated over 6 weeks from a starting dose of 100 mg/day. The other (n = 95) received PHT titrated from 200 mg/day. Treatment continued for <48 weeks. Results: The percentages of patients remaining on each treatment and seizure free during the last 24 and 40 weeks of the study, and times to first seizure after the first 6 weeks of treatment (dose‐titration period), did not differ significantly between the treatment groups. These were measures of efficacy. Time to discontinuation, a composite index of efficacy and safety, likewise did not distinguish between treatments. Adverse events led to discontinuation of 13 (15%) patients from LTG and 18 (19%) from PHT. The adverse‐event profile for LTG was dominated by skin rash [discontinuation of 10 (11.6%) patients compared with five (5.3%) from PHT] rather than central nervous system side effects: asthenia, somnolence, and ataxia were each significantly more frequent in the PHT group. The high rate of rash with LTG was probably due to the high starting dose and may be avoidable. A quality‐of‐life instrument, the SEALS inventory, favoured LTG. Patients taking PHT showed the biochemical changes expected of an enzyme‐inducing drug, whereas those taking LTG did not. Conclusions: LTG and PHT monotherapy were similarly effective against these seizure types in patients with newly diagnosed epilepsy. LTG was better tolerated, more frequently causing rash, but with a lower incidence of central nervous system side effects.
Prevalence of Epilepsy in Silivri, a Rural Area of Turkey
Authors: Karaaĝaç N. , Yeni S. N. , Şenocak M. , Bozluolgay M. , Savrun F. Karaali , Özdemir H. , Çaĝatay P. 
Published: November 2007

Summary: Purpose: To learn the prevalence of epilepsy in Silivri, a western town of Turkey, a randomized door‐to‐door survey was conducted using a standard questionnaire. The method of the study was adopted from the suggestions of the World Health Organization (WHO) for prevalence studies in developing countries, and the criteria were derived from Guidelines for Epidemiologic. Studies on Epilepsy proposed by the Commission on Epidemiology and Prognosis, the International League Against Epilepsy (ILAE) 1993. Methods: From June I to October 1, 1994, 4,803 people out of a total population of 70,394 were surveyed. The questionnaire, which was administered by practitioners and intern doctors, consisted of 15 questions, with a sensitivity of 99.9% and a specificity of 76%. After the survey, neurologists examined all of the 415 people suspected of having epilepsy and classified the seizures of the active cases. Results: Of the 415 suspected cases, 49 people (24 women, 25 men) were determined as having epilepsy on the assessment day of October 1. 1994. The crude point prevalence of active epilepsy was 10.2 of 1,000 for the region. The prevalence of active epilepsy among women was 10.01 of 1,000 and among men was 10.39 of 1,000. Of the 49 cases, 40.8% had generalized seizures, 53.1% had partial onset seizures, and 6.1% could not be classified. Only 7.7% of the cases with partial onset seizures were defined as probable symptomatic cases. Conclusions: Onset of the disease peaked at the first decade of life. On the assessment day, 44.9% of those with epilepsy were receiving treatment, and 65.1% had visited religious figures at the onset or during the course of the disease, a figure that reveals the high prevalence of mystical beliefs about the disease in the study area.
Clinical Research Physical Exercise in Outpatients with Epilepsy
Authors: Nakken Karl Otto 
Published: November 2007

Summary: Purpose: To compare the exercise habits in a sample of adult outpatients with epilepsy with those of a general population of the same age and sex and furthermore to study physical exercise as a seizure precipitant and the risk of sustaining seizure‐related injuries while exercising. Methods: Two hundred four adult outpatients with active epilepsy responded to two questionnaires. The first one, addressing exercise habits, was a selected part of a broad self‐assessing screening used every second year by a marketing and media research institute to reveal changes in the average Norwegian's lifestyle. The exercise habits of the epilepsy population were compared with those of the average population. The other questionnaire, addressing seizures and injuries related to physical exercise, consisted of eight sections and was developed at the National Center for Epilepsy in Norway. Results: The portion of those never exercising was significantly higher among the patient group compared with the average population. Otherwise, the exercise patterns were very similar in the two populations. However, the patients exercised more often in fitness centers and together with friends, whereas individual activities like skiing and swimming were more often preferred by the average Norwegian. Of the 204 patients, 53 and 63% had never experienced seizures during or immediately after exercise, respectively. About 10% of the patients claimed that they had seizures quite often in connection with exercise.However, only 2% had genuine exercise‐induced seizures, here arbitrarily defined as having seizures in > 50% of the training sessions. Among those prone to have exercise‐related seizures, there was a predominance of patients with symptomatic localization‐related epilepsy (i.e., with an underlying structural brain lesion). Most exercise‐related seizures occurred during strenuous activity. About 38% of the patients claimed to have personal experience regarding whether regular physical exercise influenced their seizure disorder; of these, 53% claimed there was no influence, 36% claimed there was a positive influence, and 10% reported a negative influence. Thirty‐six percent of the patients had experienced injuries in connection with physical exercise, but in only 10% were these injuries associated with seizures. The injuries were mostly mild. Conclusions: The surveyed sample of epilepsy outpatients was more active than expected, and their exercise pattern closely resembled that of the average Norwegian population. In the majority of the patients, physical exercise had no adverse effects, and a considerable proportion (36%) claimed that regular exercise contributed to better seizure control. However, in ‐10% of the patients, exercise appeared to be a seizure precipitant, and this applied particularly to those with symptomatic partial epilepsy. The risk of sustaining serious seizure‐related injuries exercising seemed modest.
Rapid Cooling Aborts Seizure‐Like Activity in Rodent Hippocampal‐Entorhinal Slices
Authors: Hill Matthew W. , Wong Michael , Amarakone Aloka , Rothman Steven M. 
Published: November 2007

Summary Purpose: As a preliminary step in the development of an implantable Peltier device to abort focal neocortical seizures in vivo, we have examined the effect of rapid cooling on seizures in rodent hippocampal‐entorhinal slices. Methods: Seizure‐like discharges were induced by exposing the slices to extracellular saline containing 4‐aminopyridine (50 μmol/L). Results: When we manually activated a Peltier device that was in direct contact with the slice, seizures terminated within seconds of the onset of cooling, sometimes preceding a detectable decrease in temperature measured near the top of the slice. However, activation of the Peltier device did not stop seizures when slices were no longer in direct physical contact with the device, indicating that this was not a field effect. When cooling was shut off and temperature returned to 33oC, bursting some‐times returned, but a longer‐term suppressive effect on seizure activity could be observed. In two of our experiments, a custom computer program automatically detected seizure discharges and triggered a transistor‐transistor logic pulse to activate the Peltier device. In these experiments, the Peltier device automatically terminated the slice bursting in less than 4 seconds. When the Peltier device was placed in contact with the normal, exposed cortex of a newborn pig, we found that the cortical temperature decreased rapidly from 36oC to as low as 26oC at a depth of 1.7 mm below the cooling unit. Conclusions: These experiments show that local cooling may rapidly terminate focal paroxysmal discharges and might be adapted for clinical practice.