bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adolescents with Active or Inactive Epilepsy or Asthma: A Comparison of Quality of Life
Authors: Austin Joan K. , Huster Gertrude A. , Dunn David W. , Risinger Michael W. 
Published: August 2005

Summary: Purpose: We compared quality of life (QOL) in youth with inactive or active epilepsy with that of a similar sample of youth with asthma. We explored 19 different dimensions in three domains (psychological, social, and school) and also determined differences related to illness severity and gender. Methods: Subjects were 228 adolescents (117 with epilepsy and 111 with asthma). Data were collected from clinic records and from the adolescents, their mothers, and their teachers through questionnaires and structured interviews. Data were analyzed by analysis of covariance. Results: The analysis with all 19 QOL variables indicated a significant difference between the total asthma and the total epilepsy samples (multivariate F = 3.36, p = 0.0001). Further evaluation reflected differences between the epilepsy group and the asthma group on 13 of the 19 QOL variables. When active and inactive epilepsy and asthma groups were compared, youth with active epilepsy were faring worse than all other groups in 10 areas. Moreover, youth with inactive epilepsy were faring worse than those with inactive asthma in four areas. Illness severity and sex differences were more strongly related to QOL in the epilepsy sample than in the asthma sample. Sex‐severity interactions suggested that girls with high seizure severity were most at risk for QOL problems. Conclusions: Youth with active epilepsy generally had the poorest QOL. Severe seizures and female sex were associated with more problems. Sex‐severity interactions should be explored in future research.
Will a Critical Level of Hyperventilation‐Induced Hypocapnia Always Induce an Absence Seizure?
Authors: Wirrell Elaine C. , Camfield Peter R. , Gordon Kevin E. , Camfield Carol S. , Dooley Joseph M. , Hanna Brian D. 
Published: August 2005

Summary:We wished to determine if the degree of hypocapnia correlates with increased frequency of absence seizures and if there is a critical pCO2 at which absence seizures are reliably provoked. Twelve untreated children with newly diagnosed absence epilepsy were continuously monitored by EEG and end‐expiratory CO2 recording during quiet respiration and hyperventilation (to absence seizure or exhaustion) while breathing four gas mixtures: (a) room air, (b) 100% O2, (c) 4% CO2 in room air, or (d) 4% CO2+ 96% O2. In quiet respiration, a reduction in number of spike and wave bursts and total seconds of spike and wave was noted in children breathing supplemental CO2 (gases c and d vs. gases a and b), p < 0.05. Supplemental O2 had no effect. Eight subjects had absence seizures elicited with each trial of hyperventilation. All subjects had their own critical pCO2, ranging from 19 to 28 mmHg. Three children had no seizures, two despite hypocapnia to pCO2 of 19 and 21 and 1 who achieved a pCO2 of only 25. In 1, absence seizures were provoked in only six of nine hyperventilation trials to pCO2 of 17–23. In 67% of subjects, absence seizures were reliably provoked by hypocapnia. Critical pCO2 varied among children with absence. Determination of whether variation in sensitivity to hypocapnia may be helpful in determining response to antiepileptic drugs (AEDs) or remission of seizures will require further study.
A Brief Questionnaire to Screen for Quality of Life in Epilepsy The QOLIE‐10
Authors: Cramer Joyce A. , Perrine Kenneth , Devinsky Orrin , Meador Kimford 
Published: August 2005

Summary: Purpose: To evaluate a brief questionnaire to screen aspects of health‐related quality of life for persons with epilepsy. Methods: A study of 304 adults with epilepsy was undertaken at 25 seizure clinics in the United States. It was used for derivation of a brief screening tool from a longer instrument (QOLIE‐89). Results: The 10–item questionnaire (QOLIE‐10) covers general and epilepsy‐specific domains, grouped into three factors: Epilepsy Effects (memory, physical effects, and mental effects of medication), Mental Health (energy, depression, overall quality of life), and Role Functioning (seizure worry, work, driving, social limits). Scale scores were significantly different among seizure groups (p = 0.003). Conclusions: The QOLIE‐10 can be completed by a patient in several minutes and reviewed rapidly by the physician. This screening tool could provide potentially useful information for initial assessment or follow‐up of problem areas that are not commonly evaluated during routine clinical visits with patients with epilepsy.
Magnetic Resonance Spectroscopy
Authors: Duncan John S. 
Published: August 2005

Summary:Magnetic resonance spectroscopy (MRS) is noninvasive and may be readily combined with magnetic resonance imaging (MRI). Attention has focussed on proton (1H) and phosphorus (31P) MRS, and studies have been undertaken by using single voxels or many voxels simultaneously (chemical‐shift imaging, magnetic resonance spectroscopic imaging). The latter is more difficult and prone to artefact but potentially yields significantly more information. 1H MRS has principally yielded data on concentrations of N‐acetyl aspartate (NAA), choline, creatine, and phosphocreatine. NAA is located primarily within neurons, and reduction of the ratio of NAA to choline, creatine, and phosphocreatine is a marker of neu‐ronal loss and dysfunction. This technique may be useful as a noninvasive tool for localizing epileptogenic foci, but its role requires further evaluation. As with all functional imaging methods, coregistration with high‐quality MRI is essential for interpreting data. 1H MRS can be used also to estimate cerebral concentrations of several neurotrans‐mitters: glutamate, glutamine, and γ‐aminobutyric acid (GABA). This may prove useful for characterizing the neurometabolic profiles of patients with different epilepsy syndromes and for evaluating the effects of medical and surgical treatments. 31P MRS can detect adenosine tri‐phosphate, phosphodiesters, phosphomonoesters, phosphocreatine, and inorganic phosphate, and estimate intra‐cerebral pH. Abnormalities that have been associated with epileptogenic brain areas include increased inorganic phosphate, reduced phosphomonoesters, and increased pH. Only small numbers of patients have been studied, however, so that conclusions are not definitive, and the clinical role of this technique is not yet established.
Coupling of Cortical and Thalamic Ictal Activity in Human Partial Epilepsy: Demonstration by Functional Magnetic Resonance Imaging
Authors: Detre John A. , Alsop David C. , Aguirre Geoffrey K. , Sperling Michael R. 
Published: August 2005

Summary: Purpose: To localize metabolic coupling between a cortical seizure focus and other brain regions by using functional magnetic resonance imaging (fMRI) data of ictal events obtained in a patient with frequent partial seizures involving his right face. Methods: Cross‐correlation analysis was used to examine time‐dependent alterations in regional signal intensity that correlated with signal‐intensity changes from a well‐characterized cortical seizure focus in a patient with frequent partial seizures. Results: Signal changes in the left ventrolateral thalamus showed a high degree of temporal correlation with signal changes in the left frontal cortical seizure focus, demonstrating close corticothalamic coupling of metabolism. Conclusions: A significant role for thalamocortical interactions in the pathophysiology of epilepsy has been suggested by studies in animal models and human patients. This finding provides further support for the integral involvement of the thalamus in human focal epilepsy and underscores the potential for identifying neuronal networks by using cross‐correlation analysis of fMRI data.
Subdural Recording of Ictal DC Shifts in Neocortical Seizures in Humans
Authors: Ikeda Akio , Terada Kiyohito , Mikuni Nobuhiro , Burgess Richard C. , Comair Youssef , Taki Waro , Hamano Toshiaki , Kimura Jun , O.Lüders Hans , Shibasaki Hiroshi 
Published: August 2005

Summary: Purpose: Invasive ictal EEG recording is often necessary to delineate epileptogenic areas in patients with intractable partial epilepsy, but even intracranial ictal recordings often reveal ill‐defined onset zones in neocortical epilepsy. We studied the physiologic significance of ictal direct current (DC) potentials recorded intracranially in human epilepsy. Methods: We made intracranial ictal EEG recordings in three patients with intractable partial seizures arising from frontal, lateral temporal, and parietal neocortical areas by using closely spaced subdural electrodes (platinum in two patients and stainless steel in one patient) with both standard (1.5 Hz) and open (0.016 Hz) low‐frequency filter (LFF) settings. Results: The initial ictal pattern was localized to two to nine subdural electrodes and characterized by very low voltage and high‐frequency rhythmic activity (“electrode‐cremental pattern”). A slow‐rising negative potential (DC potential) was seen in a slightly more restricted area (two to six electrodes) and occurred 1–10 s before the initial ictal EEG discharges in two patients. Conclusions: These results agree with those of previous studies of ictal DC shifts in animals and suggest that ictal DC shifts may be helpful in delineating the epileptogenic area more precisely in human epilepsy.
Age‐Specific Effects of Baclofen on Pentylenetetrazol‐Induced Seizures in Developing Rats
Authors: Velíšková Jana , Velíšek Libor , Moshé Solomon L. 
Published: August 2005

Summary: Purpose: To determine whether seizures have age‐specific features, we studied the role of γ‐aminobutyric acid, (GABAB) transmission in rats of various ages (9, 15, 30, and 60 postnatal days). Methods: We used a GABA, receptor agonist baclofen (2 or 5 mg/kg intraperitoneally, i.p.) and a GABAB receptor antagonist CGP 35348 (100 or 600 mg/kg i.p.) in the pentylenetetrazol (PTZ)‐induced model of clonic and tonic‐clonic seizures (100 mg/kg subcutaneously, s.c.). Results: Whereas baclofen was anticonvulsant and CGP 35348 proconvulsant in most animals, there were distinct age‐related differences in the effectiveness of these drugs and the antagonist had some anticonvulsant activity in adults. Furthermore, the two drugs acting at GABAB receptors had a different profile of action in clonic seizures as compared with tonic‐clonic seizures. Conclusions: The differences in the age‐specific action of the GABAB agonist and antagonist suggest that different GABAB receptor subsets may mediate the drug effects. The results indicate that putative antiepileptic drugs (AEDs) must be tested during development because it may not be possible to extrapolate age‐specific anticonvulsant effects from studies in adult animals.
Temporal Lobe Epilepsy Subtypes: Differential Patterns of Cerebral Perfusion on Ictal SPECT
Authors: Ho Susan S. , Berkovic Samuel F. , McKay W. John , Kalnins Renate M. , Bladin Peter F. 
Published: August 2005

Summary: Purpose: We studied cerebral perfusion patterns in the various subtypes of TLE, as determined by pathology and good outcome after temporal lobectomy (as confirmation of temporal origin). Methods: We studied clinical features and ictal technetium 99m hexamethyl‐propyleneamineoxime (99mTc‐HM‐PAO) single‐photon emission‐computed tomography (SPECT) in four subgroups of patients with intractable temporal lobe epilepsy (TLE) treated with surgery: hippocampal sclerosis (group 1, n = 10), foreign‐tissue lesion in mesial temporal lobe (group 2, n = 8), foreign‐tissue lesion in lateral temporal lobe (group 3, n = 7), and normal temporal lobe tissue with good surgical outcome (group 4, n = 5). Results: No major clinical differences in auras, complex partial seizures or postictal states were identified among the groups. Ictal SPECT showed distinct patterns of cerebral perfusion in these subtypes of TLE. In groups 1 and 2, hyperperfusion was seen in the ipsilateral mesial and lateral temporal regions. In group 3, hyperperfusion was seen bilaterally in the temporal lobes with predominant changes in the region of the lesion. Hyperperfusion was restricted to the ipsilateral anteromesial temporal region in group 4. Ipsilateral temporal hyperperfusion in mesial onset seizures can be explained by known anatomic projections between mesial structures and ipsilateral temporal neocortex. Bilateral temporal hyperperfusion in lateral onset seizures can be explained by the presence of anterior commissural connections between lateral temporal neocortex and the contralateral amygdala. Conclusions: We conclude that the perfusion patterns seen on ictal SPECT are helpful for subclassification of temporal lobe seizures, whereas clinical features are relatively unhelpful. These perfusion patterns provide an insight into preferential pathways of seizure propagation in the subtypes of TLE.
Quantitative MRI in Outpatient Childhood Epilepsy
Authors: Lawson John A. , Cook Mark J. , Bleasel Andrew F. , Nayanar Vimala , Morris Kevin F. , Bye Ann M. E. 
Published: August 2005

Summary: Purpose: In adult studies, MRI volumetrics is a proven technique in presurgical assessment of epilepsy. Hippocampal volume loss is maximal in the syndrome of mesial temporal lobe epilepsy. We aimed (a) to validate this methodology in a pediatric outpatient epilepsy population (b) to determine the relationship of hippocampal asymmetry (HA) to epileptic syndromes and risk factors.Methods: Two neurologists classified the epileptic syndrome in 79 pediatric outpatients, according to the International Classification of Epilepsies and Epileptic Syndromes (ILAE). Hippocampal volumetrics were performed in all patients. HA was defined according to adult control values.Results: Inter‐rater variability on measurement of HA was very small (Correlation of test retest of 0.97 on 17 children <3 years old). The rate of HA was 44/79 (57%). In 21 patients, (27%) potentially epileptogenic lesions (other than HA) were identified (cerebral dysgenesis n = 11). HA was present in 9/15 (60%) of temporal lobe epilepsy and in 15/28 (54%) extratemporal onset epilepsy and 5/11 (46%) of generalized symptomatic epilepsy. Analysis confined to <13 years also showed HA was not specific for epileptic syndrome. There was no significant association of febrile convulsions (13%) with HA or temporal lobe epilepsy.Conclusions: There is a high incidence of HA in childhood epilepsy. HA was not confined to clinically defined temporal lobe epilepsy. The poor correlation of epileptic syndrome to quantitative MRI findings may be due to the inadequacies of epilepsy classification in the younger child, with the clinical semiology providing misleading localizing information. Normative childhood data for hippocampal volumes and symmetry is needed.
Relations Between EEG Seizure Morphology, Interhemispheric Spread, and Mesial Temporal Atrophy in Bitemporal Epilepsy
Authors: Spanedda F. , Cendes F. , Gotman J. 
Published: August 2005

Summary: Purpose: A strong relation exists between lateralization of seizure onset in temporal‐lobe epilepsy and atrophic mesial structures measured by volumetric magnetic resonance imaging (MRI). We examined whether this relation extended to subregions of the mesial temporal lobe and whether the trend for seizures to spread contralaterally could be related to the localization of atrophy.Methods: We analyzed 362 seizures (with and without clinical signs) from 23 patients having bitemporal epilepsy in whom intracerebral electrodes were implanted for presurgical evaluation. Patients had measurements of hippocampal and amygdala volumes, including comparison with normal controls. We assessed on EEG the laterialization and localization of seizure onset and the trend to spread to the contralateral side (proportion of seizures that spread for each patient). We included all seizures, independent of the presence of clinical manifestations. These features were related to presence and localization of atrophy.Results: Among the 19 patients with mesial atrophy, agreement between side of prevalent seizure onset and predominant atrophy was found in 10 (53%). From 99 seizures starting in a temporal lobe with atrophy limited to the hippocampus, 67% started simultaneously in amygdala and hippocampus, 20% in hippocampus, and 13% in amygdala. From 137 seizures starting in a temporal lobe with amygdala and hippocampal atrophy, 47% started in amygdala and hippocampus, 48% in hippocampus, and 5% in amygdala. The trend to spread was 45% to the most atrophic side and 62% to the normal or less atrophic side.Conclusions: When examining amygdala and hippocampus in this group of patients with bitemporal epilepsy, regions of seizure onset did not correspond to regions of predominant atrophy. The likelihood that seizures spread contralaterally was not influenced by atrophy in the region targeted by the spread. Precise relation between mesial temporal atrophy and seizures remain to be elucidated.
Localization of Epileptic Auras Induced on Stimulation by Subdural Electrodes
Authors: Schulz R. , Lüders H. O. , Tuxhorn I. , Ebner A. , Holthausen H. , Hoppe M. , Noachtar S. , Pannek H. , May Th. , Wolf P. 
Published: August 2005

Summary: Purpose: This study evaluates the localization of stimulation‐induced auras (SIA) and tries to determine whether the SIA can help to define the boundaries of resection in epilepsy surgery.Methods: Using subdural grid electrodes, 31 patients with drug resistant focal epilepsy were examined in a retrospective and prospective study lasting 2 years.Results: On stimulation by subdural electrodes, we elicited habitual auras in 16 patients (52%). The zone of SIA overlapped the epileptogenic lesion in 12 patients (75%), the EEG seizure onset zone in 12 patients (75%), and the irritative zone of interictal spikes in eight patients (50%). Postoperative results showed a significant correlation with the complete removal of the epileptogenic lesion (p c 0.001). Because the number of patients in the study was small, we could not find a significant correlation with the complete removal of the SIA zone, EEG seizure onset zone. and irritative zone.Conclusions: Our study confirms previous analyses which indicate that complete resection of the epileptogenic lesion is essential to achieve a good outcome. Frequent overlap of the SIA zone with the epileptogenic lesion and the EEG seizure onset zone indicates proximity of the SIA with the epileptogenic zone. Nevertheless, this study does not support the concept that the SIA zone and the EEG seizure onset zone have additional value in defining the boundaries of resection in epilepsy surgery. Three case presentations suggest that SIA result from facilitated pathways between the stimulated cortex, the epileptogenic zone around the lesion, and the symptomatogenic zone. Functional reorganization in the vicinity of the cortical lesion cannot be ruled out but was not seen in our patients. Thus, SIA often do not reflect the normal function of the stimulated underlying cortex.
The Contribution of Tertiary Centers to the Quality of the Diagnosis and Treatment of Epilepsy
Authors:   Osservatorio Regionale per l'Epilessia (OREp), Lombardy
Published: August 2005

Summary: Purpose: A survey was made of a network of 14 epilepsy centers in Italy to assess whether integrated diagnosis and treatment monitoring led to a more precise syndromic classification of the patients and a better response to treatment.Methods: Data on the diagnosis and treatment of epilepsy and the degree of seizure control were recorded in a register on 2 separate occasions, on June 30, 1990 (to), before starting the integrated activities, and on June 30, 1992 (tl), on completion of a 2–year follow‐up. Each patient's history was required to fit a specific category of the International Classification of the Epilepsies (ICE) (1). Response to treatment was classified as complete remission, occasional seizures, recurrent nonrefractory seizures, and drug‐resistant epilepsy. A total of 3,469 patients of the ages of 4–80 years were enrolled.Results: At to, 44% of cases had localization‐related epilepsy, 31% generalized epilepsy, 9% undetermined epilepsy, 6% special syndromes, and 10% epileptic syndromes with atypical features. At tl, the percentages in each category were 51, 27, 7, 6, and 9%. The cases classified as “other” within each syndromic category at to were 11–23% and remained unchanged at tl. Patients with symptomatic localization‐related epilepsies were largely recoded as symptomatic or cryptogenic epilepsies. About one‐third of patients with symptomatic generalized epilepsy were recoded as localization‐related epilepsies. Nine percent of patients were classified as “uncertain” epilepsies at to, and the same proportion at t1. However, many “uncertain” diagnoses became “definite” and vice versa.Conclusions: There was a slight increase in the proportion of patients achieving complete remission (from 13 to 28%) and untreated patients (from 10 to 17%). Nine percent of patients unresponsive to treatment at to had achieved remission at t1l Drug resistance was confirmed in 78% of cases and was mostly independent of the therapeutic decision. Ten percent of cases achieved remission with unchanged or simplified treatment schedules.
Short‐Term Mortality After a First Episode of Status Epilepticus
Authors: Logroscino Giancarlo , Hesdorffer Dale C. , Cascino Gregory , Annegers John F. , Hauser W. Allen 
Published: August 2005

Summary: Purpose: Studies evaluating short‐term mortality among people who experience status epilepticus (SE) have produced conflicting results. Most studies are derived from clinical series with results affected by unspecified follow‐up period and select referral of cases. This study was planned to evaluate short‐term mortality after a first episode of SE.Methods: We performed a population‐based retrospective cohort study to determine the short‐term mortality following a first episode of SE. Between January 1,1965 and December 31, 1984, we studied all first episodes of a febrile SE who received medical attention in Rochester, Minnesota. Cases were followed until death or end of the study (February 1996).Results: Mortality within the first 30 days was 19% (38 deaths out of 201 incident SE). Thirty‐four deaths (89%) occurred among those with non febrile acute symptomatic SE, while 4 deaths (11%) occurred among those with unprovoked SE. Within the acute symptomatic group, after adjusting for age, there was a decreased risk of death in women (RR = 0.4; 95% CI: 0.2–0.9). No effect of duration or seizure type was shown after adjusting for other risk factors.Conclusions: One out of 5 subjects with SE died within the first 30 days. Short‐term mortality is associated with the presence of an underlying acute etiology. Among acute symptomatic cases, women had a decreased risk of dying.