bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relationship Between Quantitative MRI and Neuropsychological Functioning in Temporal Lobe Epilepsy
Authors: Baxendale S. A. , van Paesschen W. , Thompson P. J. , Connelly A. , Duncan J. S. , Harkness W. F. , Shorvon S. D. 
Published: August 2005

Summary: Purpose: Quantitative MRI techniques provide an unparalleled opportunity to examine in vivo the relationship between the extent and laterality of hippocampal pathology and associated neuropsychological deficits. The purpose of this study was to examine the nature of the relationship between quantitative measures of hippocampal pathology and neuropsychological measures, using a multivariate approach. Methods: We examined the relationship between two MRI measures of hippocampal structure; hippocampal volumes (HCvol) and T2 relaxation times (HCT2), and memory performance, in 80 presurgical temporal lobe epilepsy patients. Results: As a group, patients with left hippocampal sclerosis (LHS) performed more poorly that those with right hippocampal sclerosis (RHS) on immediate and delayed prose recall. In the group as a whole, right hippocampal volume was significantly correlated with the delayed recall of a complex figure. None of the verbal memory test scores were significantly correlated with the right or left HCvol or HCT2 measures. However, stepwise multiple regression analyses indicated that up to a third of the variation in specific test scores could be explained by the quantitative MRI hippocampal measures in conjunction with chronological age, and age at onset of habitual epilepsy. Left hippocampal measures explained 24% of the variance in the story‐recall tasks, while right hippocampal measures explained 18% of the variance in a design‐learning task and 32% of the variance in a figure‐recall task. Conclusions: Our results provide some support for the lateralised model of material specific memory deficits, but suggest that a number of demographic and epilepsy‐related factors may interact with the extent and laterality of hippocampal pathology in shaping the nature of the associated neuropsychological deficit.
Melatonin Inhibits Iron‐Induced Epileptic Discharges in Rats by Suppressing Peroxidation
Authors: Kabuto Hideaki , Yokoi Isao , Ogawa Norio 
Published: August 2005

Summary: Purpose: Intracortical injection of iron ion induces recurrent seizures and epileptic discharges in the electrocorticogram. This observation may be used as a model of post‐traumatic epilepsy. The involvement of iron‐mediated oxygen free radical species and neuronal lipid peroxidation in iron‐induced seizure has been suggested. Melatonin exerts free radical scavenging properties. In this study, we examined the protective effect of melatonin against iron‐induced seizures. Methods: We examined the protective effect of melatonin against in vitro iron‐induced oxidative damage in homogenates from rat cerebral cortex, by measuring the concentration of thiobarbituric acid reactive substances (TBARS), as an index of oxidative damage. We also examined the effect of melatonin on the appearance of epileptic discharges in the EEG following injection of FeCl3 into the sensorimotor cortex in anesthetized rats, and by measuring the concentration of TBARS in the brain tissue. Results: FeCl3 increased the concentration of TBARS in brain homogenates in a concentration‐dependent manner, and melatonin reduced FeCl3‐induced rise in TBARS in a dose‐response fashion. Pretreatment with melatonin suppressed or delayed the development of FeCl3‐induced epileptic discharges and decreased the concentration of TBARS in brain tissues. Conclusions: Our results suggest that iron ion generates oxygen free radical species that induce neuronal macromolecular peroxidation and seizure, and that melatonin inhibits iron‐induced seizures by scavenging free radicals.
Does Presurgical IQ Predict Seizure Outcome After Temporal Lobectomy ? Evidence from the Bozeman Epilepsy Consortium
Authors: Chelune Gordon J. , Naugle Richard I. , Hermann Bruce P. , Barr William B. , Trenerry Max R. , Loring David W. , Perrine Kenneth , Strauss Esther , Westerveld Michael 
Published: August 2005

Summary: Purpose: Considerable debate exists Concerning whether the presence of low preoperative IQ should be a contraindication for focal resective epilepsy surgery. Methods: We examined the relationship between baseline IQ scores and seizure outcome in 1,034 temporal lobectomy cases from eight epilepsy surgery centers participating in the Bozeman Epilepsy Consortium. Results: Those patients who continued to have seizures following surgery had statistically lower preoperative IQ scores than those who were seizure‐free (p < 0.009), but only by 2.3 points. This small but statistically significant relationship was fairly robust; it was observed across seven of the eight centers, and indicates that the findings can be generalized. Among patients with IQ scores of ≤75, 32.8% continued to have seizures following surgery, whereas 23.8% and 16.9% were not seizure‐free when IQ scores were between 76 and 109 and ≥110, respectively. Relative risk analyses revealed no significant increase in risk among patients with low IQ scores who had no structural lesions other than mesial temporal sclerosis. However, patients with IQ scores of ≤75 had nearly a fourfold (390%) increase in risk for continued seizures as compared with those with higher IQ scores if structural lesions were present. Conclusions: While our results suggest that preoperative IQ scores alone are not good predictors of seizure outcome and should not be used to exclude patients as potential surgical candidates. IQ scores can be useful for counseling patients and their families concerning the relative risks of surgery.
Familial Occurrence of Epilepsy in Children with Newly Diagnosed Multiple Seizures: Dutch Study of Epilepsy in Childhood
Authors: Callenbach Petra M. C. , Geerts Ada T. , Arts Willem Frans M. , van Donselaar Cees A. , Boudewyn Peters A. C. , Stroink Hans , Brouwer Oebele F. 
Published: August 2005

Summary: Purpose: To study the familial occurrence of epilepsy in children with newly diagnosed multiple unprovoked seizures. Methods: Between August 1988 and September 1992, 462 children with two or more unprovoked seizures were included in the prospective Dutch Study of Epilepsy in Childhood. Seizures and epilepsy syndromes of probands were classified according to the International Classifications. Probands with at least 1 first‐degree relative with epilepsy were selected. Seizures and syndromes of their relatives were classified using medical files and telephone interviews. Results: In 42% of the probands, the epilepsy was classified as localization‐related, in 57% as generalized, and in 1% as undetermined whether focal or generalized. The 47 (10.2%) children with at least 1 first‐degree relative with epilepsy less frequently had localization‐related epilepsy (23%) and more often had generalized epilepsy (77%) as compared with the total group of probands. Fifty‐eight first‐degree and 21 other relatives had epilepsy. Thirty‐three of the 40 (83%) first‐degree relatives with idiopathic or cryptogenic epilepsy had the same seizure type as the proband, but detailed information about their seizures was sometimes difficult to obtain. Of the 12 first‐degree relatives with epilepsy syndromes classifiable according to the International League Against Epilepsy (ILAE) 7 (58%) had the same syndrome as the proband. Conclusions: In 10% of children with newly diagnosed epilepsy, the condition is familial. Relatively more often, these children have generalized epilepsy syndromes as compared with children with a negative family history. Most of the relatives with idiopathic or cryptogenic epilepsy had the same sei‐ zure type as the proband. These findings confirm the role of genetic factors in the pathogenesis of epilepsy.
Factors Distinguishing Families of Patients with Psychogenic Seizures from Families of Patients with Epilepsy
Authors: Wood Beatrice L. , McDaniel Susan , Burchfiel Kendra , Erba† Giuseppe 
Published: August 2005

Summary: Purpose: Psychogenic seizures (PS) (emotionally based nonelectrical seizures) have been explained by psychodynamics and trauma. However, the family health literature suggests that somatization, of which psychogenic seizures are a form, may run in families and be determined by family patterns of response to distress. This study compared families of patients with PS and those of patients with epilepsy on variables of distress (anxiety and depression) and somatization. Methods: Eighteen patients (9 with PS and 9 with epilepsy) matched for age and education, and their families answered the Health Status Questionnaire (HSQ), the Weinberger Adjustment Inventory (WAI), the Family Emotional Involvement and Criticism Scale (FEICS), Barsky's Somatization Symptom Inventory (SS), and the Dissociation Experience Scale (DES). Family members' scores were averaged to obtain “family scores.” Results: Patients with PS and those with epilepsy did not differ in any of the measures. However, families of patients with PS reported more health problems, distress, and criticism than did families of patients with epilepsy (p < 0.05). Families of patients with PS had increased criticism and somatic problem scores comparable to those of both types of patients. Conclusions: Although epilepsy causes patients physical and emotional problems, their families are relatively healthy. In contrast, families of patients with PS are more troubled and may unwittingly contribute to PS through family distress, criticism, and tendencies to somatize.
The Demand for Hospital Services for Patients with Epilepsy
Authors: Currie Craig J. , Morgan Christopher LI. , Peters John R. , Kerr Michael 
Published: August 2005

Summary: Purpose: To describe the patterns of inpatient and outpatient hospital care for patients with epilepsy in our health district. Methods: Routine hospital data for the health district of South Glamorgan (population 408,000) underwent record linkage to identify those records relating to the same patients and to flag those records for patients with epilepsy. This data was analyzed to determine inpatient and outpatient activity by specialty and compared with the nonepileptic population. Results: We identified 2,267 patients representing a prevalence of 0.56%. The average age was 46 years in both male and female patients. This group, which constituted 1.5% of the hospital population, was responsible for 2.8% of all admissions but, because of increased length of stay, utilized 7.3% of all bed days. The total cost of care for this group lies between these two extreme values and is dependent on case seventy. The patterns of associated diagnoses differed considerably in three arbitrary age groups (0–18, 19–55, >55 years). Conclusions: This study quantifies for the first time the level of demand that this subpopulation places on the service as a whole, and begins to illustrate that there may be evidence for cost containment by, for example, a reduction in multiple admissions. The demand for inpatient services is greater than we would have predicted.
Phenytoin Blocks the Reversal of a Classically Conditioned Discriminative Eyeblink Response in Rabbits
Authors: Churchill James D. , Voss Steven E. , Miller Daniel P. , Steinmetz Joseph E. , Garraghty Preston E. 
Published: August 2005

Summary: Purpose: Cognitive deficits associated with chronic treatment with phenytoin (PHT) have been reported. PHT blocks transfer from a signaled appetitive bar press to an active avoidance response in rats. We investigated the effects of PHT and the prodrug fosphenytoin in rabbits required to learn a discrimination and reversal of a classical eyeblink conditioning paradigm. Methods: Before drug treatment was started, rabbits were trained to produce a discriminated eyeblink response. PHT (n = 7) was administered centrally or the prodrug fosphenytoin (n = 2) was given systemically. Control animals were similarly treated centrally with either saline (n = 3) or no drug treatment (n = 13). Rabbits were then challenged with a stimulus reversal while being maintained on the respective drug. Results: On the first day of reversal training, control animals typically displayed high response rates to both tones, followed by a reduction in responsiveness to the new conditioned stimulus (CS‐) in the ensuing days. In contrast, PHT‐treated animals failed to suppress responsiveness to the new CS‐. Conclusions: The response patterns observed are similar to those observed in rabbits with hippocampal ablations, leading us to suggest that the adverse effects of phenytoin may be due to actions in the hippocampus.
Neuronal Complexity Loss in Interictal EEG Recorded with Foramen Ovale Electrodes Predicts Side of Primary Epileptogenic Area in Temporal Lobe Epilepsy: A Replication Study
Authors: Weber B. , Lehnertz K. , Elger C. E. , Wieser H. G. 
Published: August 2005

Summary: Purpose: To investigate whether a correct lateralization of the primary epileptogenic area by means of neuronal complexity loss analysis can be obtained from interictal EEG recordings using semi‐invasive foramen ovale electrodes. In a previous study with recordings from intrahippocampal depth and subdural strip electrodes it was shown that the dynamics of the primary epileptogenic area can be characterized by an increased loss of neuronal complexity in patients with unilateral temporal lobe epilepsy (TLE). Methods: Neuronal complexity loss analysis was applied. This analysis method is derived from the theory of nonlinear dynamics and provides a topological diagnosis even in cases where no actual seizure activity can be recorded. We examined interictal EEG recorded intracranially from multipolar foramen ovale electrodes in 19 patients with unilateral TLE undergoing presurgical evaluation. Results: The primary epileptogenic area was correctly lateralized in 16 of the 19 investigated patients. The misclassification of the side of seizure onset in three patients might be attributed to the larger distance between the foramen ovale electrodes and the mesial temporal structures as compared to intrahippocampal depth electrodes. Conclusions: Our results confirm the previous findings and provide further evidence for the usefulness of nonlinear time‐series analysis for the characterization of the spatiotemporal dynamics of the primary epileptogenic area in mesial temporal lobe epilepsy.
Cortical Excitability in Patients After Loading Doses of Lamotrigine: A Study with Magnetic Brain Stimulation
Authors: Manganotti P. , Bongiovanni L. G. , Zanette G. , Turazzini M. , Fiaschi A. 
Published: August 2005

Summary: Purpose: Transcranial magnetic stimulation (TMS) of the brain allows the pharmacologic effects of anti‐convulsant drugs (AEDs) on the excitability of motor cortico‐spinal pathways to be evaluated in patients with epilepsy and normal subjects. However, no study has yet documented the changes in motor excitability in patients treated with lamotrigine (LTG). We aimed to study the effects of loading doses of LTG on TMS recordings in patients with epilepsy at the beginning of their treatment. Methods: We investigated single‐pulse TMS in six patients with complex partial seizures. The TMS recordings were performed in five sessions before and during 5 weeks of treatment. Motor threshold, motor‐evoked potential (MEP) amplitude, cortical silent period, and peripheral conduction velocity were used as parameters of evaluation. LTG was started with a dosage of 25 mg/day until a daily maintenance dosage of 200 mg/day was reached. Results: The motor threshold activation of thenar muscles was significantly increased by LTG after 2 weeks of treatment and was increased in a parallel way to the loading dose of the drug at week 3 and 5 of treatment. The MEP size recorded from the thenar muscles did not show significant changes at high‐ or low‐intensity stimulation. The cortical silent period remained unchanged at low‐ and high‐intensity stimulation. The absolute latency of MEPs after cortical and cervical stimulation was unchanged, as was the central motor conduction time. Conclusions: Our study documents that loading doses of LTG, administered as monotherapy, progressively increases patients' motor thresholds over short periods.
Extremely Acute Phenytoin‐Induced Peripheral Neuropathy
Authors: Yoshikawa Hideto , Abe Tokinari , Oda Yoshihiko 
Published: August 2005

Summary: Purpose: Peripheral neuropathy is a rare adverse effect associated with phenytoin (PHT), and it usually occurs after the prolonged use of PHT. Acute PHT‐induced peripheral neuropathy is extremely rare. Methods: An 18‐year‐old girl was admitted for the control of epilepsy. Just a few hours after the administration of PHT, she complained of distal lower‐extremity paresthesia in a stocking distribution and motor weakness: the Achilles tendon reflex was absent. Results: Electrophysiological studies revealed slightly reduced sensory‐conduction velocity and mild prolongation of distal latency in the lower extremities. After the discontinuation of PHT, these symptoms disappeared gradually, and sensory‐conduction velocity and distal latency became normal. Conclusions: Although it has been reported that peripheral neuropathy occurred after treatment with PHT for a week, there has been no report of a patient such as ours, who developed peripheral neuropathy just a few hours after the initial administration of PHT. The underlying mechanism remains unknown; however, we should pay attention to such extremely acute peripheral neuropathy when using PHT.
Pharmacokinetics of Fosphenytoin in Patients with Hepatic or Renal Disease
Authors: Aweeka Francesca T. , Gottwald Mildred D. , Gambertoglio John G. , Wright Teresa L. , Boyer Thomas D. , Pollock Alan S. , Eldon Michael A. , Kugler Alan R. , Alldredge Brian K. 
Published: August 2005

Summary: Purpose: The pharmacokinetic behavior of fosphenytoin (FOS), the water‐soluble prodrug of phenytoin (PHT), has been characterized in normal subjects. This is the first study of the effect of hepatic or renal disease on the rate and extent of conversion of FOS to PHT. Methods: A single dose of fosphenytoin (250 mg over a period of 30 min) was administered to subjects with hepatic cirrhosis (n = 4), renal disease requiring maintenance hemodialysis (n = 4), and healthy controls (n = 4). Serial plasma concentrations were measured, and pharmacokinetic parameters were calculated. Results: The mean time to reach the peak plasma FOS concentration was similar for each of the three groups. However, the mean time to achieve peak plasma concentrations of PHT tended to occur earlier in the hepatic or renal disease groups than in healthy subjects. The half‐life of FOS was 4.5, 9.2, and 9.5 min for the three groups, respectively. There was a trend toward increased FOS clearance and earlier peak PHT concentration in subjects with hepatic or renal disease. This finding is consistent with decreased binding of FOS to plasma proteins and increased fraction of unbound FOS resulting from decreased plasma protein concentrations associated with these disease states. The conversion of FOS to PHT was equally efficient in subjects with hepatic or renal disease and healthy subjects. Conclusions: Although the differences in pharmacokinetic parameters between the three groups were not statistically significant, these data suggest the need for close clinical monitoring during FOS administration to patients with hepatic or renal disease. To minimize the incidence of adverse effects in this patient population, FOS may need to be administered at lower doses or infused more slowly.
Analysis of Temporal Lobe Resections in MR Images
Authors: Moran Nicholas F. , Lemieux Louis , Maudgil David , Kitchen Neil D. , Fish David R. , Shorvon Simon D. 
Published: August 2005

Summary: Purpose: The nature of the resection in surgery for intractable medial temporal lobe epilepsy is likely to be a principal factor determining seizure and neuropsychological outcome. However, there is no universally accepted system for describing the characteristics of individual resections to allow comparison between patients and patient groups treated at different institutions. We therefore developed a technique of volumetric analysis of temporal lobe resections. Methods: With comparison of coregistered pre‐ and postoperative, volumetric magnetic resonance imaging (MRI) scans in 10 subjects, the volumes of six temporal lobe substructures were determined by manual delineation in the pre‐ and postoperative images for each case, allowing the extent of resection to be determined. Results: The substructures and their extent of resection were measured with acceptable repeatability in each case. Conclusions: We developed a reliable method for the quantitative description of temporal lobe resections. This will be of application in determining the relation between the anatomic nature of the resection in intractable epilepsy and the seizure and neuropsychological outcome.
Value of Inpatient Diagnostic CCTV‐EEG Monitoring in the Elderly
Authors: Drury Ivo , Selwa Linda M. , Schuh Lori A. , Kapur Jaideep , Varma Navin , Beydoun Ahmad , Henry Thomas R. 
Published: August 2005

Summary: Purpose: To examine the outcome of inpatient diagnostic closed circuit TV‐EEG (CCTV‐EEG) monitoring in a consecutive series of elderly patients admitted to an adult epilepsy‐monitoring unit (EMU) over a continuous 6‐year period. Methods: Retrospective review of all admissions to a university hospital adult EMU. Those older than 60 years were identified. Patients who were monitored for status epilepticus were excluded. Data on duration of events, frequency of events, physical examination, medications, preadmission EEG, brain imaging, length of stay, and interictal and ictal EEG were obtained. Results: Of the 18 patients admitted for monitoring only, mean age was 69.5 years (range, 60–90 years). Mean length of stay was 4.3 days (range, 2–9 days). Five patients had complex partial seizures recorded. Three patients, all treated with antiepileptic drugs (AEDs), had no spells recorded, and no additional diagnostic information was gained from the admission. The other 10 patients, eight of whom had been treated with AEDs, were symptomatic during their admission, leading to a variety of neurologic but not epileptic, psychiatric, or other medical disorders, and allowing tapering of AEDs. Conclusions: In elderly patients with suspected epilepsy, CCTV‐EEG is a very useful diagnostic tool. In this series of 18, 10 patients were diagnosed with potentially treatable medical illnesses not responsive to AEDs.