bluuebunny/crossref_metadata_2025_split huggingface dataset:
Limbic Seizures Alter Reproductive Function in the Female Rat
Authors: Edwards Heather E. , Burnham W. McIntyre , Ng M. Mark , Asa Sylvia , MacLusky Neil J. 
Published: August 2005

Summary: Purpose: Reproductive dysfunction and endocrine disorders are common among women with temporal lobe epilepsy. This study used the kindled rat model to test the hypothesis that limbic seizures directly contribute to reproductive dysfunction. Methods: Kindling electrodes were implanted in the basolateral amygdala in adult female rats. Females were kindled by either brief, daily, suprathreshold stimulations with a bipolar electrode or sham‐kindled (controls). Electrographic and behavioral seizures were monitored. Estrous cycles also were monitored with daily vaginal smears. Results: Seizures arrested ovarian cyclicity in all (n = 42) kindled animals, the rats exhibiting persistent vaginal cornification (PVC). In these animals PVC was associated with high serum estradiol, increased pituitary weight, and polyfollicular ovaries consisting of many cystic follicles, as well as follicles in various stages of growth and atresia. In 93% of females, this effect occurred after the development of stage 5 motor seizures, when focal seizures had secondarily generalized. In contrast, only five (21%) of 24 sham‐kindled controls exhibited PVC. A single injection of progesterone (P4) temporarily restored cyclicity in five (18%) of 28 kindled females exhibiting PVC. In contrast, P4 administration restored cyclicity in all five shamkindled controls that had spontaneously stopped cycling. P4 treatment to kindled females in PVC resulted in a different endocrine profile than that in non‐P4‐treated, kindled rats in PVC. P4‐treated rats had high serum estradiol, testosterone, and prolactin levels; they showed an increase in pituitary weight; and their ovaries contained numerous corpora lutea and cystic follicles surrounded by markedly overdeveloped thecal cell layers. Conclusions: Seizures initiated in the amygdala result in impairment of the hypothalamic‐pituitary axis, resulting in loss of ovarian cyclicity.
Effects of Vigabatrin on the GABAergic System as Determined by [123I]Iomazenil SPECT and GABA MRS
Authors: Verhoeff Nicolaas Paul L. G. , Petroff Ognen A. C. , Hyder Fahmeed , Zoghbi Sami S. , Fujita Masahiro , Rajeevan Nallakkandi , Rothman Douglas L. , Seibyl John P. , Mattson Richard H. , Innis Robert B. 
Published: August 2005

Summary: Purpose: To evaluate effects of vigabatrin (VGB) by using [123I]iomazenil single‐photon emission computed tomography (SPECT) to estimate central γ‐aminobutyric acid (GABAA)/benzodiazepine receptors (BZRs), and magnetic resonance spectroscopy (MRS) to assess tissue GABA levels. Methods: Six patients with partial seizures had both SPECT and MRS before and 25–84 days after starting VGB (3 g p.o., q.d.). SPECT was acquired by using the constant‐infusion method and, after nonuniform attenuation correction, coregistered with T1‐weighted MR Imaging (MRI) A volume of interest (VOI) of 3 × 2 × 2 cc over the occipital cortex, used for MRS acquisition, was positioned on both MRI and coregistered SPECT. Occipital activity was divided by either total plasma activity or plasma [123I]iomazenil concentration to estimate BZR distribution volume (VT‐p and V'T, respectively). Wilcoxon's test was used for VOI differences in GABA levels, BZR VT‐p or V'T. SPM96 (either no global normalization or proportional scaling) was used to compare BZR VT‐p changes in the patients with and without VGB with test‐retest data in eight healthy age‐matched controls. Results: Occipital GABA levels were increased threefold (without VGB, 1.1 ± 0.1μmol/g; with VGB, 2.9 ± 0.5 μmol/g; p = 0.027). BZR distribution volumes showed no change, when estimated by either VT‐p (without VGB, 6.00 ± 0.91 ml/g; with VGB, 5.86 ± 0.44 ml/g; p = 0.92) or V'T (without VGB, 41.1 ± 11.2 ml/g; with VGB, 41.2 ± 9.9 ml/g; p = 0.75). No significant changes were detected by SPM96. Conclusions: A clinically effective dose of VGB caused a threefold increase in tissue GABA levels but was not associated with a substantial BZR downregulation.
Bradycardia and Asystole with the Use of Vagus Nerve Stimulation for the Treatment of Epilepsy: A Rare Complication of Intraoperative Device Testing
Authors: Asconapé Jorge J. , Moore David D. , Zipes Douglas P. , Hartman Laura M. , Duffell William H. 
Published: August 2005

Summary: Purposes: A 56‐year‐old man with mild mental retardation, right congenital hemiparesis, and refractory partial seizures was referred for vagus nerve stimulation (VNS). Methods: Routine lead diagnostic testing during the surgical procedure (1.0 mA, 20 Hz, and 500 μs, for ˜ 17 s) resulted, during the initial two stimulations, in a bradycardia of ˜30 beats/min. A third attempt led to transient asystole that required atropine and brief cardiopulmonary resuscitation. Results: The procedure was immediately terminated, the device removed, and the patient recovered completely. A postoperative cardiologic evaluation, including an ECG, 24‐h Holter monitor, echocardiogram, and a tilt‐table test, was normal. Conclusions: Possible mechanisms for the bradycardia/asystole include stimulation of cervical cardiac branches of the vagus nerve either by collateral current spread or directly by inadvertent placement of the electrodes on one of these branches; improper plugging of the electrodes into the pulse generator, resulting in erratic varying intensity of stimulation; reverse polarity; and idiosyncratic‐type reaction in a hypersusceptible individual. The manufacturer reports the occurrence rate in ˜3,500 implants for this intraoperative event to be approximately one in 875 cases or 0.1%.
Ictal Video‐EEG Recording of Three Partial Seizures in a Patient with the Benign Infantile Convulsions Associated with Mild Gastroenteritis
Authors: Imai Katsumi , Otani Kazumasa , Yanagihara Keiko , Li Zhong‐gi , Futagi Yasuyuki , Ono Jiro , Nagai Toshisaburo , Okada Shintaro 
Published: August 2005

Summary: Purpose: In infants, benign convulsions can be triggered by febrile illness or mild diarrhea such as Rotavirus gastroenteritis. The triggering mechanism of these convulsions is still unknown. In spite of several reports concerning clinical features, the ictal EEG recordings were rarely analyzed by a video‐EEG monitoring system. To reveal a clue for the triggering mechanism of these convulsions, we analyzed the correlation of clinical manifestations and the EEG discharges during the ictal events and compared with previous reports. Methods: The ictal EEG of a cluster of three afebrile convulsions associated with mild gastroenteritis was recorded by an EEG closed‐circuit TV (EEG‐CCTV) monitoring system in a 6‐month‐old healthy female infant. Results: All seizures began as complex partial seizures (CPSs), which exhibited a motionless stare with or without leftward deviation of both eyes, and evolved to secondarily generalized tonic‐clonic seizures (SGTCSs) for −90 s. Each of three ictal discharges began from the right occipital, right centroparietotemporal, and left occipital regions, respectively. Conclusions: Although initiating sites of ictal discharges of benign infantile convulsions associated with mild gastroenteritis (BICE) were previously reported to be variable among patients, these results indicated that those differ among seizures even in a same infant.
Prevalence of Epilepsy in Rural Iceland: A Population‐Based Study
Authors: Olafsson Elias , Hauser W. Allen 
Published: August 2005

Summary: Purpose: To determine the prevalence of epilepsy (recurrent unprovoked seizures) in the population of rural Iceland. Methods: Review of records of primary‐care facilities for the population of rural Iceland supplemented by review of referrals to electroencephalographic facilities and neurologic specialists to identify all individuals with unprovoked seizures or receiving treatment for epilepsy in the calendar year 1993. Results: Crude prevalence was 4.8 per 1,000 and was 4.8/1,000 after age adjustment to the 1970 United States population. Age‐adjusted prevalence was higher in male (5.1) than in female subjects (4.4) and increased with advancing age. Sixty‐two percent of prevalence cases were of unknown cause. Sixty‐three percent of cases had major motor seizures without aura or generalized epileptiform pattern on EEG. Sixty‐four percent of patients had had seizures in the year of observation. Seizure control was inversely correlated with number of medications. Ten percent of the prevalence group was taking no medication, although the frequency of seizures was high in this medication‐free group. Conclusions: Prevalence of epilepsy in rural Iceland is consistent with that reported in recent studies in other developed countries. The data provide insights into the approaches of treatment and use of specialized diagnostic testing in the country. The prevalence is similar to that in other European countries but lower than that reported from rural areas in Latin America.
The Assessment and Treatment of Concerns and Anxiety in Patients Undergoing Presurgical Monitoring for Epilepsy
Authors: Andrewes David , Camp Krystyne , Kilpatrick Christine , Cook Mark 
Published: August 2005

Summary:Purpose:This study investigated the impact of a treatment information package on patients being monitored for possible surgical treatment for temporal lobe epilepsy.Methods:One hundred patients were randomly assigned to either a high‐ or low‐information preparation condition. Levels of anxiety were tested soon after admission by using the Hospital Anxiety and Depression Scale (HADS), The State‐Trait Anxiety Inventory (STAI), and a newly devised questionnaire to assess specific concerns and anxieties of epilepsy patients presenting for monitoring and surgery, the Concerns About Epilepsy Monitoring Questionnaire (CAEMQ). Dispositional desire for information was assessed by the Miller Behavioural Style Scale (MBSS) to investigate whether coping disposition affected coping styles in the hospital setting. Patients assigned to the high‐information condition were exposed to an intervention package, which included viewing a video depicting two separate interviews with patients who had undergone surgery as well as an information package, which described the various tests that the patient would undergo in the course of the monitoring procedure. Patients assigned to the low‐information group were given information that the hospital provided to all patients in their care. All subjects were then retested on anxiety levels a few days later.Results:Those in the high‐information group showed a significant decrease in anxiety and depression levels compared with those in the low‐information group.Conclusions:Within the main findings, an effect of dispositional style was found. Identification as either a monitor or blunter on the MBSS showed different coping strategies on arrival in hospital as measured by the CAEMQ, indicating that the level of information given to patients with epilepsy on arrival needs to be mediated by awareness of these two dispositional styles so that they obtain maximal benefit from the information to which patients with epilepsy are exposed.
Pre‐ and Postoperative Neuropsychological Profiles in Children and Adolescents with Temporal Lobe Epilepsy
Authors: Lendt Michael , Helmstaedter Christoph , Elger Christian Erich 
Published: August 2005

Summary: Purpose: To evaluate the neuropsychological performance of children before and after temporal lobe resection (TLR). Methods: Memory, attention, language, and visuoconstructive abilities were examined in 20 children (age 10–16 years) before, and 3 and 12 months after TLR (right, n = 10; left, n = 10; two‐thirds anterior resection, n = 16; amygdalohippocampectomy, n = 4). Preoperative performance was compared with data of 30 age‐matched healthy children; changes in performance after surgery were determined by repeated‐measurement multivariate analysis of variance (MANOVA) and by use of reliable change indices (RCI). Results: Preoperatively, no differences were observed between patients and controls in verbal and figural memory performance. Children with temporal lobe epilepsy (TLE), however, and particularly those with a left temporal focus, showed significantly reduced language performance. Repeated‐measurement statistics indicated that memory performance did not change after surgery, whereas language performance and attention significantly improved 3 months and 1 year after surgery, respectively. Individual evaluations of memory showed gains in five children and deterioration in four children. Poor seizure control appeared the decisive variable characterizing children with losses in memory. Conclusions: Compared with adults, pre‐ and postoperative memory data suggest less pronounced hemispheric differences in school‐age children with TLE. The results raise the possibility that children have a lower risk of memory deterioration after TLR, which may be due to their larger potential for cerebral plasticity.
EEG Background Delta Activity in Temporal Lobe Epilepsy: Correlation with Volumetric and Spectroscopic Imaging
Authors: Bernasconi Andrea , Cendes Fernando , Lee Jong , Reutens D. C. , Gotman Jean 
Published: August 2005

Summary: Purpose: With quantitative electroencephalogram (EEG) and neuroimaging methods, we examined delta activity, atrophy, and neuronal‐axonal dysfunction of the cerebral gray and white matter in patients with intractable temporal lobe epilepsy (TLE). Based on evidence that lesions of the white matter result in EEG delta activity, we postulated that background abnormalities in patients with TLE are related to changes of the temporal lobe white matter. Methods: We measured interictal delta activity in 34 TLE patients and 10 controls. Spike‐free and artifact‐free EEG samples were selected by visual inspection. A spectral analysis was used to compute the energy in the delta frequency band. We compared the results of the spectral analysis to magnetic resonance imaging‐ (MRI) based volumes of the temporal lobe white and gray matter, the hippocampus and the amygdala and N‐acetyl aspartate (NAA) in the lateral and posterior temporal lobe by using proton magnetic resonance spectroscopic imaging (1H‐MRSI). The degree of correlation between delta activity and the neuroimaging measurements was assessed by using the Pearson correlation coefficient (r). An analysis of variance (ANOVA) was used to examine the influence of the seizure‐focus lateralization on the delta activity and the neuroimaging parameters. Results: There was no significant difference in the amount of delta activity in the temporal lobe between the controls and patients. We found no correlation between delta activity and the neuroimaging measures (p < 0.05). The ANOVA showed significant differences between the patients and controls for the volume of the gray and white matter of the temporal lobe and for the NAA in the lateral and posterior temporal lobe (p > 0.002). Conclusions: The interictal background delta activity was not explained by reduced volume of the temporal lobe white matter, gray matter, or by abnormalities seen in 1H‐MRSI.
Continuous Spike‐and‐Wave Activity During Slow‐Wave Sleep: Syndrome or EEG Pattern?
Authors: Veggiotti Pierangelo , Beccaria Francesca , Guerrini Renzo , Capovilla Giuseppe , Lanzi Giovanni 
Published: August 2005

Summary: Purpose: We reviewed the electroclinical pictures and clinical characteristics of 32 patients with continuous spike‐and‐wave activity during slow sleep (CSWS) to ascertain to what extent this electroencephalogram (EEG) pattern is associated with the age‐related CSWS syndrome as defined by the International League Against Epilepsy (ILAE) International Classification or with different clinical settings. Methods: We reviewed clinical and EEG characteristics of 32 CSWS patients. Results: In all patients, detection of CSWS coincided with a worsening of neurologic status. Ten (34%) patients had the typical features of CSWS syndrome, four were classified as having Landau‐Kleffner syndrome, and three had acquired opercular syndromes. The remaining 15 patients, all with symptomatic epilepsy, had CSWS, which lasted for variable periods and might be related to inappropriate drug choice. Three patients of this group had unilateral CSWS and exhibited worsening of spontaneous movements in the hemibody contra‐lateral to CSWS activity lasting for a few hours after awakening. Conclusions: Our data show that a number of factors can intervene in the genesis of CSWS, which may explain the variability of the associated clinical conditions. In view of this etiologic heterogeneity, it is not possible to classify all the patients with CSWS as having the CSWS syndrome. Therefore, the CSWS syndrome should be considered a category embracing a limited group of patients, whereas the EEG pattern of CSWS is seen commonly in various clinical conditions.
Randomised, Placebo‐Controlled Study of Vigabatrin as First‐Line Treatment of Infantile Spasms
Authors: Appleton R. E. , Peters A. C. B. , Mumford J. P. , Shaw D. E. 
Published: August 2005

Summary: Purpose: Vigabatrin (VGB) has been shown to be an effective drug in the treatment of infantile spasms (West syndrome) in predominantly retrospective and open but also in prospective studies. This prospective, randomised, and placebo‐controlled trial of VGB in infantile spasms was considered to be justified and feasible to confirm or refute these previous findings. Methods: Forty children with newly diagnosed infantile spasms received either VGB or placebo for 5 days in a double blind, placebo‐controlled, parallel‐group study, after which all the infants continuing in the study were treated openly with VGB for a minimum of 24 weeks. Results: Compared with baseline, at the end of the double‐blind phase, the patients treated with VGB had a 78% (95% confidence interval, 55–89%) reduction in spasms compared with 26% (–56–65%) in the group treated with placebo (p = 0.020). Seven VGB‐treated patients and two placebo‐treated patients were spasm free on the final day of the double‐blind period (p = 0.063). At the end of the study, 15 children (38% of the original 40 patients or 42% of the 36 patients who entered the open phase) were spasm free with VGB monotherapy. No patient withdrew from the study because of an adverse event. Conclusions: This unique randomized, placebo‐controlled study is the first to demonstrate the efficacy of a specific drug in the treatment of West syndrome and supports the results of previously published open and prospective trials. It further confirms that VGB could be considered as the drug of first choice in treating infantile spasms.
White‐Matter Change in Mesial Temporal Sclerosis: Correlation of MRI with PET, Pathology, and Clinical Features
Authors: Choi Dongil , Na Dong Gyu , Byun Hong Sik , Suh Yeon‐Lim , Kim Sang Eun , Ro Duk Woo , Chung II Gyu , Hong Seung‐Chyul , Hong Seung Bong 
Published: August 2005

Summary: Purpose: To assess the magnetic resonance imaging (MRI), positron emission tomography (PET), pathology, and clinical findings of patients with the MRI feature of white‐matter change (WMC) in the anterior temporal lobe. Methods: Fifty‐six patients with pathologically proven mesial temporal sclerosis were included in this study. MRI and 18F‐2‐deoxyglucose‐(FDG) PET images were obtained before surgery in all patients. The patients were divided into two groups according to the presence of WMC on their MRI. WMC consists of an indistinct gray‐white matter demarcation and an increased signal intensity of the anterior temporal lobe on T2‐weighted images. The two groups were then compared in terms of MRI, PET, pathology, and clinical features. Results: The MRI feature of WMC was observed in 18 (32%) of the 56 patients. PET images of those patients revealed more severe hypometabolism of the ipsilateral temporal lobes (p > 0.05). In terms of histologic findings, larger numbers of het‐erotopic neurons were observed in the anterior temporal lobe white matter of these patients who also shared the following clinical features: earlier seizure onset, frequent history of febrile convulsions, and favorable surgical outcomes. Conclusions: The MRI feature of WMC is an additive sign for correct seizure lateralization and may be related to a favorable surgical outcome in patients with temporal lobe epilepsy.
The EEG and Prognosis in Status Epilepticus
Authors: Nei Maromi , Lee Jin‐Moo , Shanker Vicki L. , Sperling Michael R. 
Published: August 2005

Summary: Purpose: To examine the relation between specific EEG features and clinical outcome, determine whether a predictable sequence of EEG patterns exists during status epilepticus (SE), and examine the relation between periodic epileptiform discharges (PEDs) and SE. Methods: EEG records of 50 patients with SE admitted to Graduate Hospital between January 1990 and July 1995 were reviewed. Ictal EEGs were available in 72%; 28% had only postictal EEGs. Poor outcome was defined as death or persistent vegetative state, and good outcome as all others. Fisher's Exact test, x2, and t tests were performed for data analysis. Results: Of 50 patients, 72% had a good outcome and 28%, a poor outcome. If PEDs were present at any time during or after SE, outcome tended to be worse (p = 0.053). With PEDs, eight (44%) of 18 had a poor outcome; without PEDs, six (19%) of 32 had a poor outcome. Etiologies for SE did not substantially differ in patients with or without PEDs, and structural abnormalities were not more associated with the presence of PEDs. PEDs were seen both early and late, during and after SE. Other EEG characteristics (lateralized vs. bilateral symmetric ictal EEG, discrete vs. continuous ictal activity, and postictal focal slowing) did not relate to outcome. No predictable sequence of EEG changes was found during SE. Conclusions: PEDs are the only EEG feature related to outcome in SE and are associated with poor outcome independent of etiology.
Self‐Efficacy and Social Support as Mediators in the Relation Between Disease Severity and Quality of Life in Patients with Epilepsy
Authors: Amir Marianne , Roziner Ilan , Knoll Alon , Neufeld Miriam Y. 
Published: August 2005

Summary: Purpose: This study examined the influence of two psychosocial variables mediating between disease severity and quality of life (Qol) in epilepsy; social support and mastery (measured by locus of control and self‐efficacy). A model placing these two variables as mediators between disease severity and QoL was tested with structural equation modeling. Methods: Eighty‐nine patients with epilepsy (58% men, age 36 ± 12 years) were given the following instruments: Liverpool Seizure Severity Scale, Interpersonal Support Evaluation List, Epileptic Self‐Efficacy Scale, Locus of Control scale, and the World Health Organization's Quality of Life Questionnaire, the WHOQOL. Results: Structural equation modeling showed good fit between the research model and the data (Bentler‐Bonett Normalized Index of fit, 0.96; LISREL GFI, 0.95). Ninety percent of the variance of the WHOQOL was explained by a combination of disease severity, self‐efficacy in epilepsy, social support, and locus of control. Mastery was found to mediate the correlation between disease severity and QoL, and social support was found to act as a mediator between disease severity and mastery. Conclusions: The study findings emphasize the possibility of improving QoL among patients with epilepsy by counseling and treatment aimed at reinforcing their self‐efficacy and locus of control, as well as by improving their SoS.