bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accidents and injuries in people with epilepsy attending a tertiary care center in India
Authors: Sapna C.S. , Sheeba S.L. , John J. , Thomas S.V. 
Published: March 2024

ABSTRACT
People with epilepsy have a higher risk of accidents and injuries when compared to others in the community. Seizure frequency and other characteristics of epilepsy and its treatment are known to influence this risk. The risk of accidental injury to people with epilepsy may vary in different geographical areas, according to their life style, leisure activities and other pursuits. The objective was to ascertain the accidents and injuries experienced by a cohort of people with epilepsy in India, and to ascertain any possible predictors. The study was carried out in the Epilepsy Clinic of Sree Chitra Tirunal Institute for Medical Sciences and Technology between January and June 2007. Using a structured questionnaire, we interviewed all consenting adults attending this tertiary epilepsy center who had had active epilepsy for one or more years. Two hundred and fifty five patients completed the study. The diagnoses included localization‐related epilepsy for 62.6% of the patients and generalized epilepsy for the remainder. During the 12 months prior to the interview, 44.8% had had at least one injury; 7.8% had sustained an accident. Road traffic accidents (3.1%), burns (2.5%), electric shocks (0.8%) and near drowning (0.4%) were the commonly reported accidents. Age, sex, type of epilepsy and type of medication had no significant association with the occurrence of injuries or accidents. However, we found that a quarter of the people with epilepsy studied had experienced serious injuries.
Basal ganglia involvement in rotational seizures
Authors: Vercueil Laurent , Kahane Philippe , François‐Joubert Anne , Hirsch Edouard , Hoffmann Dominique , Depaulis Antoine , Marescaux Christian 
Published: March 2024

ABSTRACT
Body rotation during partial epileptic seizures remains a poorly understood clinical feature, possibly related to the ictal involvement of specific cortical areas (e.g. vestibular cortex). However, there are both experimental and clinical arguments which support the hypothesis of basal ganglia asymmetric activation during such complex motor behavior. We report a patient exhibiting rotational seizures which proved to arise from right anterior temporal lobe structures and the orbito‐cingular cortex, as demonstrated during stereotactic EEG recordings. An ictal 99mTc‐ECD‐SPECT study was performed during an electrically induced seizure, similar to the seizures usually experienced by the patient but without a rotatory component, showing a marked increase of cerebral blood flow in the lenticular nucleus, ipsilaterally to the epileptogenic area. This finding suggests that lenticulate involvement might be necessary to produce an ictal circling behavior. As circling behavior can be observed during epileptic seizures originating from areas widely distributed in the cortex, one may postulate that the basal ganglia involvement is the “final common pathway” underlying the rotational part of the clinical symptomatology.
Is it juvenile myoclonic epilepsy?
Authors: Gelisse Philippe , Genton Pierre , Raybaud Charles , Thomas Pierre , Bartolomei Fabrice , Dravet Charlotte 
Published: March 2024

ABSTRACT
A 21‐year old man with marked developmental delay was referred for the diagnosis of myoclonic jerks (MJ), which were sometimes responsible for sudden falls without loss of consciousness, that had begun 2 years before, and for a recent generalized tonic‐clonic seizure preceded by a cluster of MJ. Physical examination revealed a small stature, bilateral pyramidal signs, severe mental retardation, and retinis pigmentosa. Etiological factors for this encephalopathy were not found (muscle and skin biopsies, karyotype and extensive blood chemistry). Waking interictal EEG showed a normal background activity and generalized poly‐spike‐and wave (PSW) discharges. Photic stimulation disclosed a marked photoparoxysmal response, sometimes associated with myoclonic jerks. Three spontaneous jerks accompanied by a burst of generalized PSW were recorded on awakening from a nap. The MRI disclosed wide ventricles, a thin corpus callosum, brainstem atrophy and a so‐called “redundant gyration”; these changes were evocative of acquired perinatal damage. Juvenile myoclonic epilepsy (JME) was diagnosed and valproate was started resulting in complete control of seizures. During a 5‐year follow‐up, the patient has remained seizure‐free and the EEG consistently normal. In our opinion, JME can be diagnosed in very uncommon settings, including patients with significant brain damage, as long as all the other criteria for the diagnosis are present.
Carbamazepine‐induced combined phonic and motor tic in a boy with Down's syndrome
Authors: Holtmann Martin , Korn‐Merker Elisabeth , Boenigk Hans Erich 
Published: March 2024

ABSTRACT
We report the occurrence of a tic in a boy with Down's syndrome. The movement disorder was induced by carbamazepine (CBZ) and resolved completely after discontinuation of CBZ. The development of tics seems to be a rare, idiosyncratic side effect of CBZ in children.
Cortical silent period following transcranial magnetic stimulation in epileptic patients
Authors: Ertaş Nalan Kayrak , Gül Günay , Altunhalka Ahmet , Kirbaş Dursun 
Published: March 2024

ABSTRACT
Cortical silent period (SP) following transcranial magnetic stimulation is mainly due to cortical inhibitory mechanisms. SP may have a value for detecting inhibitory mechanisms in epileptic patients with or without treatment. The aim of this study was to evaluate the effect of both the epilepsy and the antiepileptic medication on these inhibitory mechanisms. The subgroups studied consisted of (a) normal subjects, (b) unmedicated epileptic patients, (c) epileptic patients with uncontrolled seizures under medication, (d) epileptic patients with controlled seizures under medication. SP following transcranial magnetic stimulation was measured in all subjects. The SP values from shortest to the longest were in the following order: 1) normal subjects; 2) epileptic patients with controlled seizures under medication; 3) unmedicated epileptic patients; 4) epileptic patients with uncontrolled seizures under medication. Our findings probably indicate the enhanced interictal inhibitory mechanisms in epilepsy which is resistant to antiepileptic medication.
Melatonin and epileptic seizures in patients with acute intermittent porphyria
Authors: Bylesjö Ingemar , Forsgren Lars , Wetterberg Lennart 
Published: March 2024

ABSTRACT
The objective of this study was to assess melatonin production in patients with acute intermittent porphyria (AIP), with and without known epileptic seizures, as a guide to whether melatonin may have anti‐convulsive or pro‐convulsive effects in AIP.
Melatonin concentration in urine, sampled over eight hours on two consecutive nights, was analysed in eight AIP patients with epileptic seizures and in 14 AIP relatives without epilepsy. The AIP patients with epileptic seizures had a significantly lower urinary excretion of melatonin, compared with their AIP relatives without epilepsy, which may indicate that melatonin has a protective effect on seizures.
Neonatal seizures: Background EEG activity and the electroclinical correlation in full‐term neonates with hypoxic‐ischemic encephalopathy. Analysis by computer‐synchronized long‐term polygraphic video‐EEG monitoring
Authors: Pinto Luisa Comenale , Giliberti Paolo 
Published: March 2024

ABSTRACT
Between 1994 and 2000, 30 full‐term newborns affected by seizures secondary to hypoxic‐ischemic encephalopathy, underwent computerised, polygraphic, video‐EEG recordings during the first 48 hours of life, in our neonatal intensive care unit. In this longitudinal study, recordings lasted an average of 10.5 hours. We studied EEG ictal discharges that lacked a clinical correlate, the semeiotics, and the electroclinical correlation during seizures, by reviewing the time‐synchronised, video‐EEG recordings obtained during these six years. The aim of this investigation was to evaluate the relationship between background EEG activity and the electroclinical correlation or dissociation of the seizures. When background activity was depressed and undifferentiated, the seizures were characterised by the electroclinical dissociation except in instances of focal tonic seizures. With all other background patterns, seizures were invariably accompanied by the electrical correlate, the only exception being ocular signs and oral‐buccal‐lingual movements, which occurred both with and without paroxysmal discharges. Ocular signs and oral‐buccal‐lingual movements were very frequent and were observed with all patterns of background activity. Only on one occasion were they the sole clinical expression of seizures. In our patients, the electroclinical dissociation was constant only if background EEG activity was depressed and undifferentiated. The constant electroclinical dissociation of seizures was closely correlated with the type of background activity, which, in turn, is indicative of severe cerebral damage. (Published with videosequences.)
Update on the mechanisms of action of antiepileptic drugs
Authors: Sills Graeme J. , Brodie Martin J. 
Published: March 2024

ABSTRACT
After a hiatus of almost 20 years, nine new antiepileptic drugs were licensed during the last decade of the 20th century. Expansion of the range of drug treatments for epilepsy complicates selection of the most suitable drug, or combination of drugs, for individual patients. Clinical experience suggests that mechanism of action may become an important criterion in this decision‐making process. At the cellular level, three major pharmacological actions are recognised: modulation of voltage‐dependent ion channels, enhancement of inhibitory neurotransmission, and attenuation of excitatory transmission. This review provides an update on the principal mechanisms of action of a range of established and modern antiepileptic drugs.
Semiology of typical and atypical Rolandic Epilepsy: a video‐EEG analysis
Authors: de Saint‐Martin Anne , Carcangiu Roberta , Arzimanoglou Alexis , Massa Rita , Thomas Pierre , Motte Jacques , Marescaux Christian , Metz‐Lutz Marie‐Noëlle , Hirsch Edouard 
Published: March 2024

ABSTRACT
Since the first descriptions of Rolandic Epilepsy or benign epilepsy with centrotemporal spikes (BECTS), typical and atypical forms have been reported. Indeed, classical focal seizures are sometimes associated with various atypical ictal symptoms and cognitive or behavioural disorders. In an effort to define early clinical and EEG criteria allowing early distinction between typical and atypical forms, we recently conducted a prospective study in a cohort of children with Rolandic Epilepsy. The results of this study have been reported elsewhere. We now discuss the semiological characteristics, and comment on the video‐EEG data collected during this study. Symptoms were classified into three major categories: “classical focal seizures”; “spike and wave related symptoms”; and “paraictal symptoms”. Classical focal seizures constitute the electroclinical expression of the development and the propagation of a focal cortical neuronal discharge. “Spike and wave related symptoms” are brief neurological or neuropsychological phenomena having a relatively strict temporal relation with individual components of isolated focal or generalized spikes and waves. “Paraictal symptoms” consist of acquired progressive and fluctuating motor or cognitive deficits and are not directly correlated with Todd paralysis. We present detailed video‐EEG material of selected cases and discuss the usefulness of such distinctions in terminology. We suggest that variability in clinical expression probably reflects the implication of different pathophysiological mechanisms, which in turn could explain differences in sensitivity to treatment. (Published with videosequences.)
Anticipation des crises d'épilepsie par l'analyse non‐linéaire de l'EEG
Authors: Le Van Quyen Michel 
Published: March 2024

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

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

RÉSUMÉ
Le pronostic et la réputation de bénignité des épilepsies généralisées idiopathiques de l'enfant sont analysées à partir des données publiées et, dans certains cas, d'études personnelles. Sont soulignées essentiellement les perturbations neurocognitives et les difficultés scolaires observées au cours de certains types d'épilepsie: épilepsies absence, épilepsies myocloniques, épilepsies généralisées avec des crises tonicocloniques.
Dans une étude contrôlée concernant les épilepsies absences idiopathiques typiques, nous avons mis en évidence une absence de résultats moyens forts ou supérieurs à l'échelle non verbale et aux résultats globaux du test de Wechsler; une faiblesse significative des compétences mnésiques, une lenteur de réalisation, des signes d'hyperactivité et des troubles de l'attention sont également retrouvés dans 35 à 50 % des cas. La majorité des enfants a des difficultés scolaires à des degrés divers. Ces résultats posent le problème de la réputation de bénignité de la plupart de ces épilepsies.
Anoxic seizures: self‐terminating syncopes
Authors: Stephenson John B.P. 
Published: March 2024

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

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

ABSTRACT

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

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

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

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

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