bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of Postoperative Seizure Control by Hippocampal Event‐Related Potentials
Authors: Grunwald Thomas , Lehnertz Klaus , Pezer Nico , Kurthen Martin , Van Roost Dirk , Schramm Johannes , Elger Christian E. 
Published: August 2005

Summary: Purpose: In spite of unequivocal results of the presurgical evaluation, between 10 and 30% of patients with medial temporal lobe epilepsy (MTLE) do not become seizure free by temporal lobe surgery. Because event‐related potentials (ERPs) recorded within the hippocampal formation have been shown to be sensitive to the epileptogenic process, we examined whether ERPs can help to improve the prediction of postoperative seizure control. Methods: We recorded ERPs to words from bilateral intrahippocampal electrodes by using a visual word‐recognition paradigm in 70 patients with unilateral hippocampal pathology and related these measurements to seizure outcome after temporal lobe surgery. Results: Words elicited N400 potentials, which were reduced in amplitude on repetition on the side contralateral to hippocampal sclerosis. This contralateral repetition effect, however, was significantly diminished in the group of patients who experienced seizure recurrence after the operation. Contralateral repetition effects thus permitted correct prediction of postoperative seizure control in 94% of all patients. Conclusions: Recording ERPs to words within the medial temporal lobes can improve the prediction of postoperative seizure control. Reduced repetition effects contralateral to the side of hippocampal sclerosis may indicate bilateral epileptogenicity.
An Evaluation of the Impact of Health Worker and Patient Education on the Care and Compliance of Patients with Epilepsy in Zimbabwe
Authors: Adamolekun B. , Mielke J. K. , Ball D. E. 
Published: August 2005

Summary: Purpose: The use of primary health care personnel to identify cases of epilepsy and initiate simple treatment protocols has been advocated as a solution to the numeric inadequacy and uneven distribution of medical manpower available for the management of epilepsy in developing countries. This study sought to evaluate the effectiveness of primary health care nurses in the diagnosis and management of epilepsy, as well as the impact of patient‐information pamphlets on drug compliance and clinic attendance of patients with epilepsy. Methods: Primary health care workers from 24 clinics in the Zvimba district in Zimbabwe attended a workshop to improving their knowledge in the diagnosis and management of generalized tonic‐clonic seizures. Half of these clinics (experimental group) subsequently received patient‐information pamphlets for distribution to patients and relatives, whereas the other half (control group) did not. Frequency of clinic attendance, mean seizure frequencies, and mean serum levels of phenobarbitone were compared at baseline and at 6 months after intervention in patients within each group, and at 6 months after intervention between both groups. Results: Community health worker education led to a 74% increase in patient recruitment as well as a marked improvement in patient drug compliance over the 6‐month study period. The use of patient‐information pamphlets led to a marked reduction in patient default from clinic follow‐up, but did not appear to influence drug compliance or seizure frequency. Conclusions: The benefits of these simple and inexpensive interventions make a strong case for their widespread implementation for improved epilepsy care not only in Zimbabwe, but also in other developing countries.
Ictal Bradycardia in a Patient with a Hypothalamic Hamartoma: A Stereo‐EEG Study
Authors: Kahane Philippe , Di Leo Matilde , Hoffmann Dominique , Munari Claudio 
Published: August 2005

Summary: Little is known about bradycardia and cardiac asystole which occur during partial epileptic seizures, especially whether they relate to ictal involvement of well‐defined cortical areas. Several reports based on simultaneous electro‐cardiographic and intracranial depth electroencephalographic monitoring have shown that either the fronto‐orbital cortex or the amygdalohippocampal complex could be responsible for such cardiac variations.We performed stereo‐EEG recordings in a patient with refractory localization‐related epilepsy associated with a hypo‐thalamic hamartoma. We found that other cortical areas, such as the frontocentral region and the temporal neocortex, can contribute to the genesis of ictal bradyarrhythmia. Second, the lesion per se, although located within the hypothalamus, is not involved with this phenomenon.
Risk Factors for a First Febrile Convulsion in Children: A Population Study in Southern Taiwan
Authors: Huang Chao‐Ching , Wang Shan‐Tair , Chang Ying‐Chao , Huang Mei‐Chih , Chi Yun‐Chan , Tsai Jing‐Jane 
Published: August 2005

Summary: Purpose: To identify risk factors for a first febrile convulsion among 3‐year‐old children by a matched case‐control population study. Methods: All 11,714 neonatal survivors born in Tainan City between October 1989 and September 1991 were enrolled. At age 3, 10,460 children were available for telephone survey for febrile convulsions, and were confirmed by home visit interviews. Those without history of seizure were randomly matched to each febrile convulsion case by age, gender, and residence district. Results: Two hundred fifty six children had febrile convulsions, and 218 of them and their matched controls were available for analysis. The febrile convulsion cases had significantly more febrile episodes (four or more) per year (33.0 vs. 22.5%; p = 0.021), and cases had a higher percentage of developmental delay (3.7 vs. 0.4%; p = 0.046) and a higher percentage of febrile convulsions in their siblings (12 vs. 0.4%; p = 0.011) than controls. The other sociodemographic, environmental, and biologic variables showed no differences between cases and controls. Step‐wise logistic regression showed a highly significant independent association between febrile convulsions and history of febrile convulsions in the siblings, and a moderate one between febrile convulsions and the number of febrile episodes per year. Conclusions: The presence of febrile convulsions in the siblings and the number of fever episodes per year were the independent and significant predictors of febrile convulsion for an individual case in our population‐based sample.
Agreement and Correctness in Adjusting Antiepileptic Drug Treatment: A Need for Rational Drug Treatment?
Authors: Smeets R. , Meinardi H. , Talmon J. , Hasman A. 
Published: August 2005

Summary: Purpose: To study interobserver variation in treatment decisions in a first follow‐up contact after initiation of antiepileptic drug (AED) treatment. The results should aid us in the assessment of whether decision support can be of value in this situation. Methods: Data from patient records were used to construct 270 different test cases containing information about the course of the disease after initiation of drug treatment. The cases were presented to five neurologists from different general hospitals who previously agreed about the diagnosis and the initial treatment for these cases. They were asked to write a prescription for each test case. Results: All five neurologists agreed on a treatment decision in 21.9% of the 265 cases available for analysis. Each neurologist made a decision different from the decisions taken by all other neurologists in 14.0–19.6% of the cases. Kappa values for agreement among individual neurologists as well as for agreement between an individual and the group of his peers were low. In 82.6% of the cases, a majority of the neurologists agreed on a treatment decision. Comparing the decisions of individual neurologists with the majority decision reference (219 cases) showed a significant difference in correctness (range, 67.1–82.6%) among the neurologists. Conclusions: The fact that a majority decision could be reached in a considerable number of cases, as well as the variability in adjustment of an initiated drug treatment, leads us to the conclusion that decision support can contribute to a rational adjustment of drug treatment.
EPIMART: Prospective Incidence Study of Epileptic Seizures in Newly Referred Patients in a French Carribean Island (Martinique)
Authors: Jallon Perre , Smadja Didier , Cabre Philippe , Le Mab Guillaume , Bazin Marcel ,   EPIMART
Published: August 2005

Summary: Purpose: To identify, in the population living in the island of Martinique, persons who had their first epileptic seizure or first came to medical attention because of an epileptic seizure. Methods: Between May 1, 1994, and April 30, 1995, we collected all suspected cases of provoked and unprovoked epileptic seizures admitted to the hospitals or addressed to the private neurologists or pediatricians of the island. Results: Three hundred nine cases were collected. Rate of initial diagnosis of provoked and nonprovoked seizures (standardized to the U.S. population): 77.7/100,000, with a bimodal distribution of the cases with age (86 in 0‐ to 10‐year age group and 203 in patients older than 60 years). Sixty‐three cases were classified as provoked seizures (incidence, 16.4/100,000). Alcohol consumption, stroke, and cranial trauma were the most frequent causes (30.1, 20.6, and 18.7%, respectively). Two hundred forty‐six cases were classified as unprovoked seizures (incidence, 64.1): seizures with a stable condition, 74 cases (I, 19.3); seizures with an evolutive condition, 17 cases (I, 4.5); seizures of unknown etiology, 155 cases (I, 40.4). These figures must be considered as the minimal rate. Conclusions: The global incidence rate of newly referred persons with a diagnosis of epileptic seizures in this study is clearly higher than those observed in industrialized countries but lower than those in developing countries. The major risk factors are represented by alcohol consumption, followed by stroke, cranial trauma, and infectious diseases.
Childhood Secondary (Symptomatic) Epilepsy, Seizure Control, and Intellectual Handicap in a Nontropical Region of South Africa
Authors: Leary P. M. , Riordan G. , Schlegel B. , Morris S. 
Published: August 2005

Summary: Purpose: To determine the prevalence of secondary (symptomatic) epilepsy and to ascertain levels of seizure control and intellectual function in a clinic population of children drawn from a poor community in a temperate region of South Africa. Methods: Detailed review of the records of every child with recurrent seizures who attended a special epilepsy outpatient clinic during 1995. Results: A total of 1,017 children was studied. In 432 (43%), there was historic, clinical, and radiologic evidence to suggest that epilepsy was symptomatic of underlying brain damage or defect. Acceptable seizure control was maintained with a single standard anticonvulsant drug (AED) in 65% of cases. In the 6 months preceding the study, 37% of the subjects had remained seizure free. Forty‐seven percent of the study population were considered to be of subnormal intelligence. Conclusions: In a children's hospital outpatient population in the Western Cape region of South Africa, the prevalence of secondary epilepsy is higher than is found in developed countries. There is need within the community for preventive measures aimed at reducing the prevalence of perinatal insults, meningitis, tuberculosis, neurocysticercosis, and cerebral trauma.
Behavioral, Psychotic, and Anxiety Disorders in Epilepsy: Etiology, Clinical Features, and Therapeutic Implications
Authors: Torta Riccardo , Keller Roberto 
Published: August 2005

Summary:This chapter deals with some aspects of psychiatric disturbances in people with epilepsy. Because depression and its treatment are extensively described later in this issue, they are not discussed here. The same pertains to forced normalization.
Incidence of Epileptic Syndromes in Rochester, Minnesota: 1980–1984
Authors: Zarrelli Michele M. , Beghi Ettore , Rocca Walter A. , Hauser W. Allen 
Published: August 2005

Summary: Purpose: To determine the incidence and the distribution of epileptic syndromes in a well‐defined population. Methods: By using the records‐linkage system of the Rochester Epidemiology Project, we screened all the residents of Rochester, Minnesota, who received a diagnosis of seizures, convulsions, or epilepsy from 1980 through 1984. One hundred fifty‐seven residents with incident epilepsy (recurrent unprovoked seizures) were classified by using the International League Against Epilepsy (ILAE) Classification of the Epilepsies and Epileptic Syndromes. Residents with special syndromes were excluded. With a pretested algorithm, patients were classified at three levels of specification: major syndromic groups (e.g., localization‐related syndromes), syndromic subgroups (e.g., idiopathic epilepsy with age‐related onset), and whenever possible, individual syndromes. Results: All but one patient were classified into major syndromic groups and subgroups. The annual age‐adjusted incidence per 100,000 population was 52.3 cases (34.9 for localization‐related epilepsies; 7.7 for generalized epilepsies; 9.7 for undetermined epilepsies). Incidence was 0.2 for idiopathic, 17.2 for cryptogenic, 17.5 for symptomatic localization‐related epilepsies, 3.7 for idiopathic, 1.7 for symptomatic or cryptogenic (age‐related), and 2.3 for symptomatic (non age‐related) generalized epilepsies. Conclusions: With the exception of idiopathic epilepsies, the incidence of the major syndromic categories in our study was higher than that provided by previous population‐based studies.
Hippocampal Asymmetries and White Matter Abnormalities on MRI in Benign Childhood Epilepsy with Centrotemporal Spikes
Authors: Lundberg Staffan , Eeg‐Olofsson Orvar , Raininko Raili , Eeg‐Olofsson Karin Edebol 
Published: August 2005

Summary: Purpose: To look for brain abnormalities by using magnetic resonance imaging (MRI) in patients with benign childhood epilepsy with centrotemporal spikes (BCECTS), which is the most common epilepsy syndrome in children. Methods: Eighteen children, aged 6–12 years, with typical BCECTS were examined with MRI, six of them twice. Results: Some hippocampal abnormality was found in six (33%) of the children, all with the syndrome's typical electroencephalogram (EEG) pattern ipsilaterally. Hippocampal size asymmetry was found in five (28%) children (right side < left in two and left < right in three), and high signal intensities on T2‐weighted images were found in three (17%). Two children also had other abnormalities; one had a heterotopic nodule near the contralateral frontal horn, and one had an Arnold‐Chiari malformation. The hippocampal asymmetry remained unchanged in three of the children who were reexamined after 2 years. High signal intensities on T2‐weighted images were seen beneath the cortex‐white matter junction in the frontal and temporal lobes of five (28%) children, one of whom also had a hippocampal asymmetry. MRIs were normal in eight (44%) children. Conclusion: For the first time, hippocampal asymmetries and white‐matter abnormalities have been detectable on the MRIs of children with typical BCECTS. The etiology of the former is unclear, whereas the latter may be a result of a maturational delay involving a defective myelination. Long‐term follow‐up studies are needed to evaluate the relation between these findings and the clinical course of BCECTS.
Autosomal Dominant Nocturnal Frontal Lobe Epilepsy: An Electroclinical Study of a Norwegian Family with Ten Affected Members
Authors: Nakken Karl Otto , Magnusson Andres , Steinlein Ortrud K. 
Published: August 2005

Summary: Purpose: The aim of the study was to describe in detail the electroclinical findings associated with a mutation in the acetylcholine receptor in a Norwegian family with autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE). Furthermore, we compared the clinical features associated with this mutation with those of an Australian family with a different mutation at the same locus, as well as with those of eight Italian families with ADNFLE and without a verified mutation in this gene. Methods: We obtained medical records from all of the 10 known affected members of the Norwegian family. A personal interview and a clinical neurologic examination were carried out in six of them. Interictal and ictal scalp EEG recordings were obtained in eight and three, respectively, computed tomography/magnetic resonance imaging (CT/MRI) in five, and blood samples for genetic analysis in seven individuals. The clinical features after an insertion of a leucine residue in the α4 subunit of the neuronal nicotinic acetylcholine receptor are examined. Furthermore, the clinical features that accompany this insertion and the clinical features associated with a missense mutation (Ser248Phe) in the same gene were compared. Results: All the affected individuals had a seizure semiology consistent with frontal lobe seizures. Their seizures started in childhood (mean age, 8 years) and were often misinterpreted as benign nocturnal parasomnias, nocturnal paroxysmal dystonia, or a psychiatric disorder. The affected family members were of normal intellect and showed no abnormalities at neurologic and neuroradiologic examinations. Interictal scalp EEG registrations were mostly normal, ictal scalp EEG registrations in three individuals revealed left frontal low‐voltage epileptiform discharges in two, and only shallow arousal preceding the attack in one. Although the seizure susceptibility varied among the affected individuals, the epilepsy course was mostly benign. Conclusions: Patients with ADNFLE, either with the 776ins3 mutation or the Ser248Phe mutation, and those without any recognized mutation in the acetylcholine receptor, have strikingly homogeneous phenotypes, and it seems difficult to separate them on clinical grounds.
Violence and Epilepsy: A Close Relation Between Violence and Postictal Psychosis
Authors: Kanemoto Kousuke , Kawasaki Jun , Mori Etsuko 
Published: August 2005

Summary: Purpose: We investigated the incidence of well‐directed violent behavior and suicide attempts in patients with temporal lobe epilepsy, with special attention to postictal psychosis. Methods: We compared 57 episodes of postictal psychosis with 62 episodes of acute interictal (or alternative) psychosis and with 134 complex partial seizures. All patients were matched for age and for age at onset of seizures. Results: The incidence of well‐directed violent behavior against human beings was significantly higher (23%) during postictal psychotic episodes than during acute interictal episodes (5%) and postictal confusion (1%). Suicide attempts were also more frequent during postictal psychosis (7%) than during either acute interictal psychosis (2%) or postictal confusion (0%). Conclusions: Our study showed that well‐directed violent and self‐destructive behavior was not a feature of epileptic psychosis in general but a specific hallmark of postictal psychosis.
Spitting Automatism in Complex Partial Seizures: A Nondominant Temporal Localizing Sign?
Authors: Voss Nicholas F. , Davies Keith G. , Boop Frederick A. , Montouris Georgia D. , Hermann Bruce P. 
Published: August 2005

Summary: Purpose: Spitting as an ictal automatism has been rarely reported. We aimed to establish its potential lateralizing and localizing significance. Methods: Review of patients undergoing surgery for intractable epilepsy at two comprehensive epilepsy centers. Results: Five patients were found who had spitting as a stereotyped automatism of their complex partial seizures. All had evidence of right temporal ictal onset and underwent resective surgery. Two had tumors; one, a cavernous angioma; one, hippocampal gliosis, and one, hippocampal sclerosis. We found no instances of ictal spitting in patients with left hemisphere onset. Conclusions: Spitting as an automatism in complex partial seizures, although uncommon, may be a localizing sign to the nondominant temporal lobe.
Combined Measurements of Hippocampal N‐Acetyl‐Aspartate and T2 Relaxation Time in the Evaluation of Mesial Temporal Lobe Epilepsy: Correlation with Clinical Severity and Memory Performances
Authors: Namer I. J. , Bolo N. R. , Sellal F. , Nguyen V. H. , Nedelec J. F. , Hirsch E. , Marescaux C. 
Published: August 2005

Summary: Purpose: In this study we tried to find a correlation between the clinical severity and memory performances, by comparing proton magnetic resonance (MR) spectroscopy and T2 relaxation time measurements in the hippocampi, in a homogeneous group of 27 patients with unilateral mesial temporal lobe epilepsy with ipsilateral hippocampal sclerosis on MR imaging, with a view to answer the following questions: (a) how sensitive is this approach for the assessment of the apparently normal contralateral hippocampus, (b) do the results relate to the clinical severity, and (c) does it allow evaluation of the degree of hippocampal dysfunction. Methods: Volume‐selective proton MR spectroscopy of the head of both hippocampi was performed at 3 T, by using the PRESS sequence, with an echo time of 135 ms, to estimate NAA/(Cho + Cr) ratios. The relaxation times were measured at 0.28 T, by using a conventional Carr‐Purcell‐Meiboom‐Gill sequence, with a repetition time of 2,000 ms, an echo time of 15 ms, and 48 echoes. Results: The combination of NAA/(Cho + Cr) ratio and T2 relaxation time values was allowed to classify contralateral hippocampus abnormalities in two groups: first, decreased NAA/(Cho + Cr) ratio with strongly increased T2 relaxation time values corresponding to abnormalities observed in sclerotic ipsilateral hippocampi; and second, decreased NAA/(Cho + Cr) ratio with normal or slightly increased T2 relaxation time values. Whereas the NAA/(Cho + Cr) ratio or T2 relaxation time value alone was not correlated with memory performances, their association shows that left hippocampal injury evaluated both by NAA and T2 relaxation time measurements was clearly correlated with verbal memory scores, and right hippocampal injury, with visual memory scores. On the other hand, the maximal seizure frequency reported by the patients was correlated with ipsilateral NAA/(Cho + Cr) ratio and T2 relaxation time values but not with contralateral results. Conclusions: We showed that the combination of NAA and T2 relaxation time measurements can be used to examine the degree of ipsi‐ and contralateral hippocampal dysfunction or injuries and their relations with memory performances in the presurgical evaluation of patients.
Low Insulin‐Like Growth Factor (IGF‐1) in the Cerebrospinal Fluid of Children with Progressive Encephalopathy, Hypsarrhythmia, and Optic Atrophy (PEHO) Syndrome and Cerebellar Degeneration
Authors: Riikonen Raili , Somer Mirja , Turpeinen Ursula 
Published: August 2005

Summary: Purpose: In patients with progressive encephalopathy, hypsarrhythmia, and optic atrophy (PEHO) syndrome, the pathophysiology underlying early progressive cerebellar and brainstem degeneration and severe epilepsy is unknown. Because insulin‐like growth factor (IGF)‐1 has been shown significantly to promote survival of cerebellar neurons, we wanted to see if the IGF system played a role in the pathogenesis of cerebellar atrophy. Methods: We used a sensitive enzyme immunoassay kit for measuring cerebrospinal fluid (CSF) IGF‐1 and insulin‐like growth‐binding protein (IGFBP)‐3 in four groups of patients: PEHO syndrome patients (eight), PEHO‐like patients (seven), age‐matched controls (31), and patients with other types of cerebellar atrophy (11). Results: Patients with PEHO syndrome and those with other progressive, degenerative cerebellar diseases had lower levels of CSF IGF‐1 than the controls with other neurologic diseases. The CSF IGF‐1 also allowed us to differentiate the “true” PEHO patients from the “PEHO‐like” patients (those with similar clinical symptoms but without the typical neuroophthal‐mologic or neuroradiologic findings). The concentrations of IGFBP‐3 did not significantly differ in any of the patient or control groups studied. Conclusions: CSF IGF‐1 levels might be used as a marker of the degeneration of neurons in specific areas.