bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bilateral Posterior Parietal Polymicrogyria: A Mild Form of Congenital Bilateral Perisylvian Syndrome?
Authors: Montenegro Maria Augusta , Guerreiro Marilisa M. , Lopes‐Cendes Iscia , Cendes Fernando 
Published: March 2003

Summary:  Purpose: The main features of congenital bilateral perisylvian syndrome (CBPS) are pseudobulbar palsy, cognitive deficits, epilepsy, and perisylvian abnormalities on imaging studies, however, the clinical spectrum of this syndrome is much wider than previously believed and may vary from minor speech difficulties to severely disabled patients. The objective of this study was to present the different imaging and clinical findings of 17 patients with CBPS, their genetic background, and the occurrence of prenatal injury during their pregnancies.Methods: We evaluated 17 consecutive patients with CBPS and divided them into two groups according to the imaging findings: (a) diffuse polymicrogyria around the sylvian fissure and (b) posterior polymicrogyria at the posterior parietal regions. They were systematically interviewed regarding history of prenatal events during their pregnancies, family history of speech difficulties, epilepsy, or other neurologic abnormality.Results: There were seven women, ages ranging from 3 to 41 years (mean, 11.5; median, 7 years). Seven patients had bilateral posterior parietal polymicrogyria (BPPP), and 10 had diffuse bilateral perisylvian polymicrogyria. All seven patients with BPPP had only minor speech difficulties, none had epilepsy, and all but one had a family history of epilepsy or cortical dysgenesis. In contrast, 10 patients with diffuse bilateral perisylvian polymicrogyria had pseudobulbar palsy, four had epilepsy, eight had a history of a major prenatal event, and only four had a family history of epilepsy or developmental delay.Conclusions: These findings suggest that diffuse bilateral perisylvian polymicrogyria appears to be more related to injuries caused by environmental factors, whereas BPPP has a stronger genetic predisposition. In addition, BPPP appears to have a wider clinical spectrum than previously believed, and may represent a milder extreme within the spectrum of CBPS.
A Study of the Effect of Color Photostimulation from a Cathode‐ray Tube (CRT) Display on Photosensitive Patients: The Effect of Alternating Red–Cyan Flicker Stimulation
Authors: Shirakawa Seigo , Funatsuka Makoto , Osawa Makiko , Fujita Michinari , Oguni Hirokazu 
Published: March 2003

Summary:  Purpose: In an attempt to establish evidence for developing better guidelines for the production of animation programs that would not induce photosensitive seizures in Japan, we evaluated the effects of red flicker, alternating red/cyan (complementary color to red) flicker stimuli, and of contrast between the red and cyan frames from a cathode‐ray tube (CRT) display in photosensitive patients.Methods: We studied 35 photosensitive patients. They were exposed to seven types of flicker. The first three types were alternating red/cyan flicker (R/C) with the luminance of cyan set at three different levels, high, equal, and low luminance (65, 20, and 16 cd/m2, respectively) relative to the red (20 cd/m2). The following four types were red, cyan, yellow, and magenta flicker stimuli. EEGs were recorded while the patients watched these stimuli on a CRT display.Results: Rates of photoparoxysmal response (PPR) provocation were 11.4, 13.7, and 14.0% with high‐, no‐ and low‐contrast R/C flicker, respectively, and 3.7% with red flicker. The differences between red and each of the other R/C flicker stimuli were all statistically significant (p<0.05, 0.01, 0.01). No significant differences were found between the effects by each of the three levels of contrast in alternating R/C flicker (p > 0.05).Conclusions: These findings suggest that alternating R/C flicker is more provocative than simple red flicker, and that contrast between frames of different colors may play some role in the effects of alternating flicker stimuli from a CRT display in photosensitive patients. Therefore, caution against the use of the combination of red and cyan, in addition to the red flicker stimulus, should be included in any guidelines drawn up to prevent photosensitive seizures.
Vagus Nerve Stimulation for the Treatment of Bilateral Independent Temporal Lobe Epilepsy
Authors: Alsaadi Taoufik M. , Laxer Kenneth D. , Barbaro Nicholas M. , Marks William J. , Garcia Paul A. 
Published: March 2003

Summary:  Purpose: We studied the effect of vagus nerve stimulation (VNS) on seizure reduction in patients with intractable epilepsy with bilateral independent temporal lobe foci.Methods: Ten patients who met the criterion of the presence of two distinctive clinical and ictal EEG seizure patterns were identified and followed up for 1 year.Results: Six patients had >50% reduction in their seizure frequency that persisted up to ≥1 year of follow‐up, whereas four patients reported small or no reduction in their partial seizures.Conclusions: VNS is often effective and well tolerated in this select group of intractable epilepsy patients.
Enhanced Anticonvulsant Activity of Neuroactive Steroids in a Rat Model of Catamenial Epilepsy
Authors: Reddy Doodipala S. , Rogawski Michael A. 
Published: March 2003

Summary:  Purpose: Perimenstrual catamenial epilepsy may in part be due to withdrawal of the endogenous progesterone‐derived neurosteroid allopregnanolone that potentiates γ‐aminobutyric acidA (GABAA) receptor–mediated inhibition. Here we sought to determine whether the anticonvulsant potencies of neuroactive steroids, benzodiazepines, phenobarbital (PB), and valproate (VPA) are altered during the heightened seizure susceptibility accompanying neurosteroid withdrawal in a rat model of perimenstrual catamenial epilepsy.Methods: Test drugs were evaluated for their ability to alter the convulsant activity of pentylenetetrazol (PTZ) in young adult female rats, in pseudopregnant rats with prolonged exposure to high levels of progesterone (and its neurosteroid metabolites), and in pseudopregnant rats 24 h after acute withdrawal of neurosteroids by treatment with the 5α‐reductase inhibitor finasteride. Test drugs were administered at doses equivalent to twice their ED50 values for protection against PTZ‐induced clonic seizures in naive young adult female rats.Results: The anticonvulsant activity of allopregnanolone (5 mg/kg, s.c.), pregnanolone (5 mg/kg, s.c.), allotetrahydrodeoxycorticosterone (15 mg/kg, s.c.), and tetrahydrodeoxycorticosterone (10 mg/kg, s.c.) were enhanced by 34–127% after neurosteroid withdrawal. The anticonvulsant activity of PB (65 mg/kg, i.p.) was also enhanced by 24% in neurosteroid‐withdrawn animals. In contrast, the anticonvulsant activity of diazepam (4 mg/kg, i.p.), bretazenil (0.106 mg/kg, i.p.), and VPA (560 mg/kg, i.p.) were reduced or unchanged in neurosteroid‐withdrawn animals.Conclusions: The anticonvulsant activity of neuroactive steroids is potentiated after neurosteroid withdrawal, supporting the use of such agents in the treatment of perimenstrual catamenial epilepsy.
Progression of Postictal to Interictal Psychosis
Authors: Tarulli Andrew , Devinsky Orrin , Alper Kenneth 
Published: March 2003

Summary:  Purpose: To describe a case series of patients with both postictal psychosis (PIP) and chronic interictal psychosis (IIP).Methods: We retrospectively reviewed the records of 43 patients with PIP from a comprehensive epilepsy center to find evidence of both PIP and IIP in the same patient.Results: Six (13.9%) of the 43 patients met all the criteria for both PIP and IIP. Five of our six patients had multiple documented PIPs before they became chronically psychotic. The range of length of time between PIP and IIP was 7 to 96 months. Postictal and interictal psychotic behavior was similar or identical in five of six cases.Conclusions: The results of this study suggest a progression from PIP to IIP: there is a similarity between the symptoms of the two psychoses, a history of multiple PIPs before the first IIP, and a period of months to years between PIP and IIP onset.
Peripheral WBC Count and Serum Prolactin Level in Various Seizure Types and Nonepileptic Events
Authors: Shah A. K. , Shein N. , Fuerst D. , Yangala R. , Shah J. , Watson C. 
Published: March 2003

Summary:  Purpose: To analyze effects of different types of seizures and nonepileptic events as well as effects of seizure duration and lapse between the time of seizure and blood collection on serum prolactin level and peripheral white blood cell (WBC) count.Methods: We prospectively collected blood samples from all patients admitted to our Epilepsy Monitoring Unit at baseline and after an event. Blood samples were analyzed, and serum prolactin level and WBC count were determined. Statistical analyses were performed to evaluate the relation of each type of seizure, its duration, and time lapse between a seizure and collection of blood sample to the serum prolactin level and peripheral WBC count.Results: Serum prolactin level increases above twice the level at baseline after a complex partial seizure or a generalized seizure. Peripheral WBC count is elevated above the upper limit of normal in about one third of cases after a generalized seizure. In generalized seizures, the length of a seizure is positively associated, whereas the lapse time between the seizure onset and blood draw is negatively correlated with the increase in WBC count. Thus the longer the seizure and quicker the blood draw, the higher the WBC count.Conclusions: We conclude that complex partial or generalized seizures are associated with an increase in serum prolactin level. Peripheral WBC count increases significantly after a generalized seizure and is probably transient in nature.
Adult‐Onset Idiopathic Generalized Epilepsy: Clinical and Behavioral Features
Authors: Cutting Shawna , Lauchheimer Aaron , Barr William , Devinsky Orrin 
Published: March 2003

Summary:  Purpose: To identify and define clinical and behavioral features of patients with adult‐onset idiopathic generalized epilepsy (IGE).Methods: We reviewed the charts of 313 IGE patients at the NYU Comprehensive Epilepsy Center over the past 5 years to identify patients with adult onset (18 years old or older). We excluded patients with childhood or adolescent symptoms that suggested absence, myoclonic, or tonic–clonic seizures, as well as those with a history of significant head injury or other known causes of localization‐related epilepsy.Results: Forty‐two (13.4%) patients had a clear onset of IGE in adulthood; average age of onset was early 20s (mean, 23.8 years; range, 18–55 years). Twenty‐one patients had adult myoclonic epilepsy (AME, 50%), and three had generalized tonic–clonic seizures on awakening (GTCS‐A, 7%). More than two thirds (n = 30) are well controlled with current antiepileptic drugs (AEDs), and almost 90% are currently employed (n = 37). One third were diagnosed and treated for mental disorders, including depression (n = 12), anxiety (n = 7), obsessive–compulsive personality disorder (n = 2), and postictal psychosis (n = 1).Conclusions: Adult‐onset IGE is associated with a good prognosis. An association may exist between psychological disorders, psychotropic medication, and level of seizure control in adults with IGE.
Seizure Semiology and Neuroimaging Findings in Patients with Midline Spikes
Authors: Kutluay Ekrem , Passaro Erasmo A. , Gomez‐Hassan Diana , Beydoun Ahmad 
Published: March 2003

Summary:  Purpose: Midline epileptiform discharges are rare compared with discharges at other scalp locations. Neuroimaging results and semiologic seizure characteristics of patients with midline spikes are not adequately described. The aim of this study was to describe the neuroimaging findings and detailed seizure semiologies in patients with midline spikes.Methods: We reviewed the EEG database of the University of Michigan Medical Center and identified 35 patients with midline spikes. Information about seizure types and neuroimaging results was obtained from a review of medical records. The seizures were classified according to the International League Against Epilepsy (ILAE) criteria and semiologic classification.Results: Twenty‐nine (83%) patients had a history of seizures. Complex partial seizures and simple partial seizures were the most common seizure types, experienced by 66% of patients. The age at seizure onset was within the first 10 years in 90% of patients. According to the semiologic seizure classification, automotor seizures and tonic seizures were the most common seizure types. Neuroimaging studies were abnormal in 45% of patients. When focal abnormalities were detected, they were lateralized to one of the frontal lobes in all cases.Conclusions: Our results indicate that in the majority of patients, midline spikes represent focal epileptiform activity rather than fragments of generalized discharges, and are most commonly associated with seizures of partial onset. Automotor seizures and tonic seizures are the most common semiologies. Focal radiologic abnormalities tend to be lateralized to one of the frontal lobes.
Significance of Epileptiform Discharges in Patients without Epilepsy in the Community
Authors: Sam Maria C. , So Elson L. 
Published: March 2003

Summary:  Purpose: To determine the frequency of recording epileptiform discharges (EDs) in patients without epilepsy in the community and to assess their risk of seizure disorders subsequently developing.Methods: We identified all outpatient and inpatient EEGs that were recorded in persons residing in Rochester, Minnesota, from 1979 to 1988. Patients with a history of unprovoked seizure disorders before the index EEG were excluded. Periodic lateralized EDs (PLEDs) were not evaluated, because of their well‐established association with seizure disorders.Results: Five hundred twenty‐one patients in the community had no history of unprovoked seizure disorders before their EEG. Sixty‐four (12.3%) patients had EDs; neither isolated unprovoked seizure nor epilepsy developed during 230.8 person‐years of follow‐up. Forty‐seven (73.4%) of the 64 patients had acute or progressive cerebral disorders when EEG detected EDs. Seizures that were acutely provoked by the underlying disorder (enlarging brain tumor, cerebral infarct, or bilateral subdural hematoma, in one patient each) subsequently developed in three (6.3%) of the 64 patients. Seizures of any type did not develop in the 17 patients without acute or progressive cerebral disorders.Conclusions: In a community setting, EDs are sometimes observed in patients without epilepsy. However, nearly three fourths have underlying acute or progressive cerebral disorders. Acutely provoked seizures may develop in a small proportion of patients. Although none of our patients developed isolated unprovoked seizures or epilepsy, a longer period of follow‐up is needed to determine their risks relative to the general population.
Modification of Slow Cortical Potentials in Patients with Refractory Epilepsy: A Controlled Outcome Study
Authors: Kotchoubey B. , Strehl U. , Uhlmann C. , Holzapfel S. , König M. , Fröscher W. , Blankenhorn V. , Birbaumer N. 
Published: March 2003

Summary:  Purpose: To compare self‐regulation of low‐frequency EEG components (slow cortical potentials, SCPs) with other methods of seizure control for patients with drug‐refractory partial epilepsy and to separate the real anticonvulsive effect from placebo effects.Methods: Results of a treatment program of SCP self‐regulation (experimental group) are compared with two groups of patients, one of which learned self‐control of respiratory parameters (end‐tidal CO2 and respiration rate: RES group); the other received medication with new anticonvulsive drugs (AEDs) in combination with psychosocial counseling (MED group). Clinical, cognitive, behavioral, and personality measures were assessed before and after treatment. In addition, to control for placebo responses, patients repeatedly estimated their beliefs in the efficiency of the respective treatment, their satisfaction and expectations, and the quality of the relationship with their therapists.Results: SCP and MED groups showed a significant decrease of seizure frequency, but the RES group did not. Clear positive changes in the sociopsychological adjustment were obtained in all three groups, with the maximal improvement being attained in the RES group.Conclusions: All kinds of therapy result in considerable improvement of patients' emotional state, which may in part be due to potential placebo effects; however, this improvement is not related to the quality of the therapeutic effect proper (i.e., seizure reduction). Traditional double‐blind control group designs are inappropriate for behavioral interventions or treatments with psychoactive pharmacologic drugs. Rather, specific tests can be developed to control the placebo effect and to separate it from the genuine therapeutic effects.
Frontal Lobe Seizure Propagation: Scalp and Subdural EEG Studies
Authors: Blume Warren T. , Ociepa Dorota , Kander Veena 
Published: March 2003

Summary:  Purpose: To study propagation properties of focally originating frontal lobe seizures: principally direction and promptness of ictal spread.Method: Forty‐eight scalp EEG–recorded and 17 subdurally recorded seizures in two separate groups of patients were visually scrutinized.Results: Initial propagation was directed more commonly to contiguous frontal cortex than to the opposite hemisphere in both studies: 58% and 86% for scalp and subdural recordings, respectively. Eighteen (38%) of scalp EEG seizures propagated within 5–10 s of apparent onset, whereas 16 (33%) did so after 11–20 s; no evidence of propagation could be discerned in the remaining 14 (29%). Of subdurally recorded attacks, only four (24%) propagated in the first 4 s; six (35%) did so after a delay of 5–10 s; six (35%) either failed to propagate or did so after ≥20‐s latency. Latency to initial propagation was between 5 and 20 s in 41 (63%) of the 65 seizures in both studies. Ictal activity remained within the frontal lobe of origin for ≥10 s in 39 (81%) of scalp‐recorded seizures and 11 (65%) of subdural seizures. It remained so confined for ≥15 s in 26 (54%) and nine (53%), respectively. Twenty‐four (50%) of scalp‐recorded seizures displayed evidence of opposite hemisphere (bisynchronous or other contralateral) involvement, occurring 5–10 s after onset in eight (17%) seizures and 10–20 s after onset in 16 (33%). Similarly, the subdural study documented spread to the opposite hemisphere in 11 (65%) of seizures with a latency ranging from 1 to 45 s.Conclusions: Frontal lobe seizures in this study propagated less promptly than reputed, and initial spread occurred more commonly to the frontal lobe of origin than to the opposite hemisphere. Such properties underlie the good lateralizing value of clinical semiology of frontal lobe seizures.
Dipole Localization for Identification of Neuronal Generators in Independent Neighboring Interictal EEG Spike Foci
Authors: Ochi Ayako , Otsubo Hiroshi , Chitoku Shiro , Hunjan Amrita , Sharma Rohit , Rutka James T. , Chuang Sylvester H. , Kamijo Ken‐ichi , Yamazaki Toshimasa , Snead O. Carter 
Published: March 2003

Summary:  Purpose: We evaluated dipole localizations of independent neighboring interictal spike foci using scalp electroencephalogram (EEG) to identify neuronal generators of epileptic discharges.Methods: Three pediatric patients with extratemporal lobe epilepsy who had two independent neighboring interictal spike foci on scalp EEG were studied. Prolonged video EEG was digitally recorded from 19 scalp electrodes, whose positions were registered using a three‐dimensional digitizer. Interictal spikes were visually selected based on negative phase reversals on bipolar montages. We analyzed the dipole position and moment of each spike using a single moving dipole and three‐shell spherical head model. The dipoles were overlaid onto magnetic resonance (MR) images and divided into two groups based on two spike foci.Results: The dipoles of the two groups were oriented either tangentially or radially to the scalp in close proximity to each other. The dipoles oriented radially were located underneath the electrode with a negative peak; those oriented tangentially were between electrodes with a negative and positive peak. The positions of tangential dipoles were more concentrated than those of radial dipoles. The epileptogenic regions corresponded to the dipole localizations. Surgical excisions were performed based on the results of electrocorticography. After surgery, two patients were seizure free, and one had rare seizures (follow‐up period, 13–31 months).Conclusions: We showed that dipoles in close proximity but with different orientations projected two negative maxima on scalp EEG in three patients with extratemporal localization‐related epilepsy. Equivalent current dipole analysis of individual interictal spikes can provide useful information about the epileptogenic zone in these patients.
Altered Activities of Rat Brain Metabolic Enzymes in Electroconvulsive Shock—Induced Seizures
Authors: Eraković V. , Župan G. , Varljen J. , Laginja J. , Simonić A. 
Published: March 2003

Summary:  Purpose: Electroconvulsive shock (ECS) induces generalized seizure activity and provides an excellent experimental model for studying the effects of global electrical stimulation on various biochemical parameters. The aim of this work was to investigate the influence of a single or repeated ECS‐induced seizures on rat brain metabolism.Methods: Experiments were carried out on female Hannover—Wistar rats divided into four groups: (a) the control group, which was intact; (b) the 1ECS group, which was killed 2 h after single ECS; (c) the 5ECS group with 24 h rest, which was killed 24 h after the fifth daily ECS; and (d) the 10ECS group with 48 h rest, which was given ECS every 48 h and killed 24 h after the tenth ECS. Activities of glutamate dehydrogenase (GLDH), aspartate‐aminotransferase (AST), alanine‐aminotransferase (ALT), γ‐glutamyltransferase (GGT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), and creatine kinase (CK) in the frontal cortex, cerebellum, hippocampus, and pons/medulla regions were determined.Results: Increased AST, ALP, LDH, and CK activities were detected in all examined regions of the 1ECS and 5ECS groups. ALT activity was increased in both these groups, except in the hippocampus of the 5ECS group, where increased GGT activity was detected. In the hippocampus of 1ECS group, GLDH activity was decreased. Increased hippocampal AST and cortical CK activities, together with increased LDH activities in the cortex, cerebellum, and pons/medulla, were found.Conclusions: ECS treatment induces region‐specific changes in metabolic activity. Neither a 24‐h nor a 48‐h rest period between two ECSs was sufficient for complete brain recovery, although most of the observed increased enzyme activities present in 1ECS and 5ECS were not present in 10ECS.