bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is a Cortical Spike Discharge “Transferred” to the Contralateral Cortex via the Corpus Callosum?: An Intraoperative Observation of Electrocorticogram and Callosal Compound Action Potentials
Authors: Ono Tomonori , Matsuo Atsuko , Baba Hiroshi , Ono Kenji 
Published: March 2003

Summary:  Purpose: By means of the intraoperative electrophysiologic observation, we reevaluated the “transfer” theory that a transcallosal volley invoked by a cortical spike discharge in one hemisphere directly causes its contralateral counterpart via the corpus callosum (CC).Methods: Twenty‐six patients who underwent corpus callosotomy were the subjects of this study. Intraoperatively, electrocorticograms from both hemispheres were simultaneously monitored with callosal compound action potentials (CCAPs) from the CC. Analysis was conducted on (a) the interhemispheric delay of bilaterally synchronous spike‐and‐wave discharges (BSSWs), and (b) the chronological relation between BSSWs and CCAPs.Results: The side of prior spike discharges was never fixed but was occasionally reversed. Interhemispheric delays between the BSSWs were not constant, regardless of direction, and fluctuated in all patients. Most of the interhemispheric delays were distributed within 20 ms with a mode of 0 ms. The waveform of the CCAP was characterized by slow‐rising negative potential change that attained its peak after a cortical spike discharge. These findings were identical in all the patients regardless of whether the BSSWs were changed or unchanged after callosotomy.Conclusions: If the “transfer” role of the CC is true, interhemispheric delays between BSSWs must be longer than interhemispheric axonal conduction time (about 20 ms), and a preceding cortical spike discharge must produce a CCAP and then a contralateral one in order of time. However, this hypothesis was not confirmed in the present study. We propose the interhemispheric recruitment of the epileptogenic state as a different role of the CC on epileptogenesis.
Masking Synchronous GABA‐mediated Potentials Controls Limbic Seizures
Authors: Barbarosie Michaela , Louvel Jacques , D'Antuono Margherita , Kurcewicz Irène , Avoli Massimo 
Published: March 2003

Summary:  Purpose: We determined how CA3‐driven interictal discharges block ictal activity generated in the entorhinal cortex during bath application of 4‐aminopyridine (4AP, 50 μM).Methods: Field potential and [K+]o recordings were obtained from mouse combined hippocampus–entorhinal cortex slices maintained in vitro.Results: 4AP induced N‐methyl‐d‐aspartate (NMDA) receptor–dependent ictal discharges that originated in the entorhinal cortex, disappeared over time, but were reestablished by cutting the Schaffer collateral (n = 20) or by depressing CA3 network excitability with local application of glutamatergic receptor antagonists (n = 5). In addition, two types of interictal activity occurred throughout the experiment. The first type was CA3 driven and was abolished by a non‐NMDA glutamatergic receptor antagonist. The second type was largely contributed by γ‐aminobutyric acid type A (GABAA) receptor–mediated conductances and persisted during blockade of glutamatergic transmission. The absence of CA3‐driven interictal discharges in the entorhinal cortex after Schaffer collateral cut facilitated the GABA‐mediated interictal potentials that corresponded to large [K+]o elevations and played a role in ictal discharge initiation. Accordingly, ictal discharges along with GABA‐mediated interictal potentials disappeared during GABAA‐receptor blockade (n = 7) or activation of μ‐opioid receptors that inhibit GABA release (n = 4).Conclusions: Our findings suggest that CA3‐driven interictal events restrain ictal discharge generation in the entorhinal cortex by modulating the size of interictal GABA‐mediated potentials that lead to large [K+]o elevations capable of initiating ictal discharges in this structure.
Familial Temporal Lobe Epilepsy with Aphasic Seizures and Linkage to Chromosome 10q22‐q24
Authors: Brodtkorb Eylert , Gu Wenli , Nakken Karl O. , Fischer Christine , Steinlein Ortrud K. 
Published: March 2003

Summary:  Purpose: To describe the phenotypic expression of a new family with familial lateral temporal lobe epilepsy with aphasic seizures, and to compare the findings with the clinical features of previously reported families linked to chromosome 10q22‐q24.Methods: Medical records were collected from 12 living affected members. The patients underwent a personal interview and a clinical neurologic examination. Results from interictal scalp EEGs and neuroimaging examinations were obtained.Results: The cardinal ictal symptom was a brief sensory aphasia in eight of the patients. In four, this was accompanied by auditory symptoms, usually in the form of monotonous unformed sounds. Simple partial seizures with psychic or somatosensory seizures also were present. Visual ictal symptoms and complex partial seizures were absent. All patients had generalized tonic–clonic seizures. Magnetic resonance imaging (MRI) or computed tomography (CT) did not reveal morphologic correlates. Improvement with age seemed to occur in many patients. Significant linkage to chromosome 10q22‐q24 was established by testing 17 polymorphic microsatellite markers.Conclusions: The epilepsy of this family appears to represent a variety of autosomal dominant lateral temporal lobe epilepsy. Aphasic seizures and a peculiar seizure‐precipitating effect of the activation of speech (initiation or perception) may serve as markers for identifying further families with this phenotype.
Effect of Gabapentin on the Anticonvulsant Activity of Antiepileptic Drugs against Electroconvulsions in Mice: An Isobolographic Analysis
Authors: Borowicz Kinga K. , Swiader Mariusz , Luszczki Jarogniew , Czuczwar Stanislaw J. 
Published: March 2003

Summary:  Purpose: The objective of this study was the isobolographic evaluation of the interactions between the novel antiepileptic drug (AED) gabapentin (GBP) and a number of other AEDs against electroconvulsion‐induced convulsions in mice.Methods: Electroconvulsions were produced by means of an alternating current (ear‐clip electrodes, 0.2‐s stimulus duration, tonic hindlimb extension taken as the end point). Adverse effects were evaluated with the chimney test (motor performance) and passive‐avoidance task (long‐term memory). Plasma levels of AEDs were measured by immunofluorescence or high‐pressure liquid chromatography.Results: GBP (≤50 mg/kg) remained ineffective on the electroconvulsive threshold. According to the isobolographic analysis, GBP appears to act synergistically with carbamazepine, valproate, phenytoin, phenobarbital (PB), lamotrigine (LTG), and LY 300164. The pharmacokinetic events may be responsible for the interactions of GBP/PB and GBP/LTG, because only PB and LTG significantly elevated the plasma concentration of this AED. Conversely, GBP did not affect the plasma levels of other AEDs used in this study. No adverse effects were induced by combinations of GBP with these AEDs.Conclusions: The isobolographic analysis revealed that combinations of GBP with other AEDs generally results in synergistic (supraadditive) interactions.
Hyperventilation‐induced High‐amplitude Rhythmic Slowing with Altered Awareness: A Video‐EEG Comparison with Absence Seizures
Authors: Lum Leanna M. , Connolly Mary B. , Farrell Kevin , Wong Peter K. H. 
Published: March 2003

Summary:  Purpose: Hyperventilation‐induced high‐amplitude rhythmic slowing (HIHARS) in children may be associated with clinical episodes of altered awareness. The presence of automatisms has been proposed as a distinguishing feature that helps to differentiate absence seizures from nonepileptic causes of decreased responsiveness. This retrospective, controlled, video‐EEG study compared the clinical characteristics of episodes of HIHARS with loss of awareness with those of absence seizures.Methods: The database of a tertiary Children's Hospital was searched for patients studied between April 1993 and April 1997 who had at least one episode of HIHARS with loss of awareness. The absence control group was obtained by selecting the next patient, after an HIHARS study subject, who met the following criteria: (a) had at least one absence seizure occurred during hyperventilation in the EEG recording, and (b) had a diagnosis of idiopathic generalized epilepsy. The video‐EEG and medical histories of all patients were reviewed and summarized.Results: We reviewed video‐EEG recordings of 77 episodes of HIHARS with loss of awareness from 22 children and 107 absence seizures during hyperventilation from 22 children. Eye opening and eyelid flutter were seen more frequently in absence seizures, whereas fidgeting, smiling, and yawning occurred more frequently during HIHARS episodes. Arrest of activity, staring, and oral and manual automatisms were observed in both groups.Conclusions: Automatisms are common in both HIHARS and absence seizures. Yawning, smiling, and particularly fidgeting occur more commonly and eye opening and eyelid flutter less commonly in HIHARS. However, episodes of HIHARS with loss of awareness clinically mimic absence seizures, and these conditions can be distinguished reliably only by EEG.
Effects of Educational Intervention on Changing Parental Practices for Recurrent Febrile Convulsions in Taiwan
Authors: Huang Mei‐Chih , Liu Ching‐Chuan , Chi Yun‐Chan , Thomas Karen , Huang Chao‐Ching 
Published: March 2003

Summary:  Purpose: To evaluate the effects of educational interventions on parental practices for recurrent febrile convulsions (FC).Methods: A 2‐year follow‐up, nonequivalent comparison group design was used to evaluate the intervention effects. Two educational interventions were provided for FC parents in southern Taiwan. The 326 parents voluntarily chose either to receive a mailed pamphlet (n = 196) or to attend a 2‐h educational program (n = 130). Five telephone interviews focused on investigating FC episodes and parental practices for seizures were conducted at months 3, 6, 12, 18, and 24 after the interventions.Results: Of the 326 FC children, 78 (23.9%) had recurrent FCs within the 2‐year follow‐up. Parents who only received pamphlets did not show significant improvements. Parents who attended the educational program demonstrated significant improvements in the recommended practices, particularly in protecting the convulsing child (8.3 vs. 36.1%; p = 0.02 by McNemar) and placing the child on his or her side (19.4 vs. 47.2%; p = 0.01). Nonrecommended practices including rushing the convulsing child to the hospital (88.9 vs. 30.6%; p < 0.01) and putting protective devices in the child's mouth (38.9 vs. 8.3%; p < 0.01) significantly decreased. By generalized estimating equation analyses, the types of interventions are the single significant factor influencing parental practice changes from initial to recurrent FCs.Conclusions: Most parents used inappropriate practices for their child's initial FC. Compared with the mailed pamphlet, the educational program had significant improvements in recommended and nonrecommended practices from initial to recurrent FCs.
The Effect of Age on Seizure Semiology in Childhood Temporal Lobe Epilepsy
Authors: Fogarasi András , Jokeit Hennric , Faveret Eduardo , Janszky József , Tuxhorn Ingrid 
Published: March 2003

Summary:  Purpose: Complex partial seizure is the characteristic seizure type observed in epilepsy arising from temporal lobe structures. The seizure evolution in adult patients is quite stereotyped and well characterized, manifesting initially with an aura, behavioral arrest, and oroalimentary and gestural automatism. A greater variability of semiology including motor features with tonic or myoclonic components, as well as a paucity of automatism, has been reported in young children with temporal lobe epilepsy. The aim of our study was to examine in more detail the effects of age on individual ictal features to be able to determine the critical age when lesional temporal lobe seizure semiology undergoes transition from the pediatric to the more adult‐type clinical pattern.Methods: We performed a video analysis of 83 seizures from 15 children (aged 11–70 months) selected by post–temporal lobectomy seizure‐free outcome, looking specifically at the motor and behavioral (nonmotor) manifestations in relation to age of the children.Results: All of the children younger than 42 months had seizures with early and marked motor features, which included tonic and myoclonic components and epileptic spasms. Parallel with age, the frequency of these motor components decreased, and in five of 11 children older than 3 years, motor features were totally absent. Analyzed quantitatively, we saw a linear and inverse correlation of the ratio of motor components with age at monitoring.Conclusions: These findings support the hypothesis that events in brain maturation significantly affect clinical seizure semiology and may override the more typical localizing features seen in adult‐type temporal lobe epilepsy. These findings are important to consider in the early diagnosis of childhood temporal lobe epilepsy.
Interictal EEG Abnormalities in Patients with Psychogenic Nonepileptic Seizures
Authors: Reuber Markus , Fernández Guillen , Bauer Juergen , Singh Daman D. , Elger Christian E. 
Published: March 2003

Summary:  Purpose: To examine interictal EEG abnormalities in patients with psychogenic nonepileptic seizures (PNESs).Methods: (a) Retrospective study of EEG reports of 187 consecutive patients with PNES seen at the Department of Epileptology, Bonn, Germany; (b) Blinded, multirater comparison of EEGs of all PNES patients with no other clinically recognizable cause of EEG disturbance (n = 50) and healthy controls (n = 50).Results: Of 187 consecutive patients with PNESs, 57 patients had PNESs and epilepsy (PNES+E), and 130 patients, PNESs alone. The diagnosis of additional epilepsy was based on ictal (video‐) EEG or on the critical assessment of all clinical data by an experienced epileptologist. Retrospective review of all available EEG reports showed that 92.9% of patients in the PNES+E and 53.8% in the PNES‐only group had one or more abnormal EEGs (median number of EEGs per patient, three; range, one to 42). In the PNES‐only group, EEG changes were nonspecific in 42.3% of patients. Only 50 of 130 patients with PNESs alone had no other clinically recognizable cause of EEG disturbance and entered the controlled study. In this study, 18% of patients and 10% of controls had abnormal EEGs. The frequency of epileptiform EEG changes was similar to that in previous population studies in both groups (2.0%).Conclusions: PNESs often occur in patients with organic brain disease. Even in patients with PNESs alone and no clinically recognizable cause of EEG disturbance, nonspecific abnormalities are found 1.8 times as often as in healthy controls. Interictal EEG changes are common in patients with PNESs and, in isolation, should not be interpreted as evidence of epilepsy.
Nonsymptomatic Generalized Epilepsy in Children Younger than Six Years: Excellent Prognosis, but Classification Should Be Reconsidered after Follow‐up: The Dutch Study of Epilepsy in Childhood
Authors: Middeldorp C. M. , Geerts A. T. , Brouwer O. F. , Peters A. C. B. , Stroink H. , Van Donselaar C. A. , Arts W. F. M. 
Published: March 2003

Summary:  Purpose: To assess the prognosis and the accuracy of the epilepsy classification in young children with nonsymptomatic generalized epilepsy.Methods: Of the cohort of the Dutch Study of Epilepsy in Childhood (n = 466), all children younger than 6 years with a diagnosis of idiopathic (IGE) or cryptogenic (CGE) generalized epilepsy either at intake (n = 108) and/or after 2 years of follow‐up (n = 102) were included. The number of reclassifications after 2 years was determined, and the reasons for reclassification were analyzed. All children receiving a diagnosis of IGE or CGE at 2 years were followed up for 5 years to study their outcome in terms of terminal remission (TR). Data on their level of intellectual functioning were collected at the start of this analysis.Results: The epilepsy syndrome was reclassified in 17 children. In 14 of them, the seizure type also was reclassified, and in three, the course of the epilepsy determined the new epilepsy type. Two other children had a reclassification of their seizure types without a change of the epilepsy type. Many children were categorized as having IGE not otherwise specified. In all probability, this is a heterogeneous group, containing patients with various epilepsy syndromes, with generalized tonic–clonic seizures as a common hallmark. Of the 102 children with IGE or CGE at 2 years of follow‐up, 75% had a TR of >6 months after 2 years, and 85% a TR of ≥1 year after 5 years.Conclusions: In a fair proportion of children with nonsymptomatic generalized epilepsy in this age group, it is not possible to classify firmly the epilepsy and/or the seizures immediately after the intake. Instead, they are reclassified during the course of the disease. This and the apparent heterogeneity of the category IGE not otherwise specified point to inherent drawbacks of the current International League Against Epilepsy (ILAE) classification of epilepsy and epileptic syndromes. The prognosis of IGE at this young age is generally excellent.
Levetiracetam, a New Antiepileptic Agent: Lack of In Vitro and In Vivo Pharmacokinetic Interaction with Valproic Acid
Authors: Coupez René , Nicolas Jean‐Marie , Browne Thomas R. 
Published: March 2003

Summary:  Purpose: The novel antiepileptic drug (AED) levetiracetam (LEV; Keppra) has a wide therapeutic index and pharmacokinetic characteristics predicting limited drug‐interaction potential. It is indicated as an add‐on treatment in patients with epilepsy, and thus coadministration with valproic acid (VPA) is likely. These studies were performed to determine whether coadministration of LEV with VPA might result in pharmacokinetic interactions.Methods: In vitro assays were performed to characterize the transformation of LEV into its main in vivo metabolite UCB L057. The reaction was examined for its sensitivity to clinically relevant concentrations of VPA. An open‐label, one‐way, one‐sequence crossover clinical trial was conducted in 16 healthy volunteers to assess further the possibility of any relevant pharmacokinetic interaction.Results: Human whole blood and, to a lesser extent, human liver homogenates were demonstrated to hydrolyze LEV to UCB L057, its main metabolite. The reaction possibly involves type‐B esterases and is not affected by 1 mM VPA (i.e., 166 μg/ml). Pharmacokinetic parameters of a single dose of LEV (1,500 mg) coadministered with steady‐state concentrations of VPA (8 days of 500 mg, b.i.d.) did not differ significantly from the pharmacokinetics of LEV administered alone [area under the curve (AUC) of 397 and 400 μg/h/ml, respectively]. Furthermore, LEV did not affect the steady‐state pharmacokinetics of VPA.Conclusions: These findings suggest the absence of a pharmacokinetic interaction between VPA and LEV during short‐term administration, and suggest that dose adjustment is not required when these two drugs are given together.
Quantitative Interictal Subdural EEG Analyses in Children with Neocortical Epilepsy
Authors: Asano Eishi , Muzik Otto , Shah Aashit , Juhász Csaba , Chugani Diane C. , Sood Sandeep , Janisse James , Ergun Eser Lay , Ahn‐Ewing Judy , Shen Chenggang , Gotman Jean , Chugani Harry T. 
Published: March 2003

Summary:  Purpose: We studied the relation between quantitative interictal subdural EEG data and visually defined ictal subdural EEG findings in children with intractable neocortical epilepsy, and determined whether interictal EEG data are predictive of ictal EEG onset zones.Methods: Thirteen children (aged 1.2–15.4 years) underwent prolonged intracranial EEG recording, using 48‐ to 120‐channel subdural electrodes. Three distinct 10‐min segments of the continuous interictal EEG recording were selected for each patient, and the spike frequency for each channel was determined by using an automatic spike‐detection program. Subsequently the average spike frequency of each electrode was compared with ictal assessment (onset, spread, and no early ictal involvement). In addition, 50 distinct interictal spikes were averaged for each patient, and the amplitude and latency after the leading spike (averaged spike showing the earliest peak) were measured for each electrode and analyzed with respect to ictal EEG findings.Results: Reproducibility of the spike‐frequency pattern derived from three 10‐min segments was high (Kendall's W, 0.85 ± 0.08). Electrodes showing the highest spike frequency, the highest spike amplitude, and the leading spike were found to be a part of the seizure onset in 13 of 13, 12 of 13, and 10 of 13 cases, respectively. There was significant correlation between ictal assessment and spike frequency as well as spike amplitude. A receiver operating characteristics analysis showed that a cutoff threshold at 14% of the maximal spike frequency resulted in a specificity of 0.90 and a sensitivity of 0.77 for the detection of seizure‐onset electrodes.Conclusions: Quantitative interictal subdural EEG may predict ictal‐onset zones in children with intractable neocortical epilepsy.
Lipoprotein(a) Concentration Increases during Treatment with Carbamazepine
Authors: Brämswig Suzanne , Sudhop Thomas , Luers Claus , Von Bergmann Klaus , Berthold Heiner K. 
Published: March 2003

Summary:  Purpose: Treatment with carbamazepine (CBZ) is known to affect apolipoprotein B–containing lipoprotein concentrations in serum. However, little is known about the effects of anticonvulsant drugs (AEDs) on lipoprotein(a) [Lp(a)], although Lp(a) has been characterized as independent cardiovascular risk factor. We investigated prospectively the effect of CBZ on lipoprotein(a) concentration in normolipidemic healthy adults.Methods: Twenty male volunteers were included in the study. Lp(a) levels were determined before and 69 ± 19 days after CBZ administration by using an enzyme‐linked immunoassay.Results: CBZ (mean plasma concentration, 6.6 ± 0.6 μg/ml) caused a significant increase in Lp(a) concentrations, with a median change of +19.5% (95% CI: +8.2, +53.3; p < 0.001). Total cholesterol, low density lipoprotein (LDL) cholesterol, and triglycerides also increased significantly.Conclusions: Although the precise mechanism of action of CBZ on Lp(a) elevation remains uncertain, it might be related to its enzyme‐inducing properties. During treatment with CBZ, special focus should be given to elevated LDL cholesterol and Lp(a) concentrations with regard to increased risk for atherosclerotic vascular diseases.