bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of Hippocampal Atrophy: A Serial Magnetic Resonance Imaging Study in a Patient Who Developed Epilepsy After Generalized Status Epilepticus
Authors: Wieshmann Udo C. , Woermann F. G. , Lemieux L. , Free S. L. , Bartlett P. A. , Smith S. J. M. , Duncan J. S. , Stevens J. M. , Shorvon F. D. 
Published: August 2005

Summary: Purpose: To investigate changes in hippocampal volume. Methods: We used serial magnetic resonance imaging (MRI) in a patient who developed chronic epilepsy after having generalized tonic‐clonic status epilepticus (SE). Five MRI investigations were performed during SE and a 58‐month follow‐up period. Hippocampal volumetric measurements and coregistration of scans were performed to detect hippocampal atrophy. Results: During status both mesiotemporal regions returned a high signal on T,‐weighted images. Two months after the onset of SE, bilateral hippocampal atrophy was detected. Further progressive hippocampal atrophy was detected in the subsequent 58 months by both hippocampal volumetric measurements and coregistration of scans. Conclusions: Our findings suggest that hippocampal atrophy is a process that may continue after the end of the SE.
Failure of Absorption of Gabapentin After Rectal Administration
Authors: Kriel Robert L. , Birnbaum Angela K. , Cloyd James C. , Ricker Beverly J. , Saete Carolyn Jones , Caruso Kimberly J. 
Published: August 2005

Summary: Purpose: We wished to determine the extent of absorption of gabapentin (GBP) after rectal administration to children on maintenance therapy. Methods: Two children scheduled for extensive surgery received GBP rectally and orally. A pharmacokinetic profile was derived after each route of administration. Results: Serum GBP levels after rectal administration decreased at a rate similar to their rate of decrease after oral administration. However, GBP concentrations were much lower after rectal administration; therefore, we concluded that the aqueous solution was poorly absorbed rectally. The GBP half–life (t1/2) for the 2 children after oral doses were 4.2 and 4.8 h. Conclusions: Rectal administration of GBP is not satisfactory when oral administration is interrupted. When oral GBP therapy is temporarily discontinued, clinicians should consider administration of alternative antiepileptic drugs (AEDs) that can be administered parenterally or rectally.
Comparative Epidemiology of Epilepsy in Pakistan and Turkey: Population‐Based Studies Using Identical Protocols
Authors: Aziz H. , Güvener A. , Akhtar S. W. , Hasan K. Z. 
Published: August 2005

Summary: Purpose: To determine comparative prevalence rates, demographics, phenomenology, seizure classification, presumptive etiology, treatment status, and selected socioan‐thropological aspects of epilepsy in Pakistan and Turkey. Methods: A population‐based, cross‐cultural comparative study of epilepsy was designed with identical protocols to be performed simultaneously in Pakistan and Turkey. The essential feature of the design was an unselected population, with reference to their previous medical contact, and use of standardized International Community‐Based Epilepsy Research Group (ICBERG) protocols to assess cross‐cultural differences. Results: In all, 24,130 persons in Pakistan and 11,497 persons in Turkey (both urban and rural, of all ages and both sexes) were studied. The crude prevalence rate of epilepsy was 9.98 in 1,000 in Pakistan and 7.0 in 1,000 in Turkey (14.8 in 1,000 in rural and 7.4 in 1,000 in urban areas of Pakistan; 8.8 in 1,000 in rural and 4.5 in 1,000 in urban areas of Turkey). In both countries, epilepsy was twice as prevalent in rural areas than in urban areas. Mean age of onset of epilepsy was 13.3 years in Pakistan and 12.9 years in Turkey. Overall frequency of seizure types was similar in both countries, with no urban/rural differences. The frequency distribution in Pakistan and Turkey, respectively, was as follows: generalized tonic‐clonic, 80.5 and 65.4%; simple partial, 5 and 7.4%; complex partial, 5 and 12.3%; generalized absence, 0.8 and 4.9%; tonic and atonic, 5.8 and 3.7% each; and myoclonic, 5.8 and 1.2%. A putative cause for the epilepsy could be attributed in 38.4% of cases in Pakistan and 35.7% of cases in Turkey. Only 3% of patients in Pakistan, but 71% of patients in Turkey, believed that their illness was due to supernatural causes. The treatment status was very poor. In Pakistan, 27.5% of people with epilepsy in urban areas and 1.9% of people with epilepsy in rural areas were receiving antiepileptic drugs (AEDs) at the time of the survey. In, Turkey 30% of patients were receiving AEDs (marginally higher in rural areas). Conclusions: The prevalence of epilepsy is slightly higher in Pakistan than in Turkey; some marginal differences in age and sex distribution, are not statistically significant. The results are comparable to those in Ecuador, where the same epidemiologic protocol was used.
Protective Effect of Zonisamide, an Antiepileptic Drug, Against Transient Focal Cerebral Ischemia with Middle Cerebral Artery Occlusion‐Reperfusion in Rats
Authors: Minato Hisao , Kikuta Chie , Fujitani Buichi , Masuda Yoshinobu 
Published: August 2005

Summary: Purpose: The antiepileptic effects of zonisamide (ZNS) have been well documented experimentally and clinically. The purpose of this study was to examine whether ZNS reduces cerebral damage after transient focal ischemia in rats. Methods: Ischemia was induced by a transient occlusion of the left middle cerebral artery (MCA) with a 3‐0 nylon monofilament for 90 min. Neurological evaluation was performed by measuring the event of neurological deficit of the contralateral forepaw and hindpaw at 10 min and 1 day after MCA occlusion (MCAo). Brain infarct size was determined by measuring triphenyltetrazonium chloridenegative stained area of the serial brain sections 1 day after MCAo. Results: The pre‐ or postischemic treatment with ZNS [(10–100 mgkg P.o.), 30 min before and 4 h after or 15 min and 4 h after the occlusion] markedly reduced cerebral damage in the ipsilateral hemisphere and the neurological deficit induced by transient ischemia. The reducing effect on the damage was observed in the cortical and subcortical regions. Preischemic treatment with carbamazepine (CBZ 60 mgkg p.0. twice 30 min before and 4 h after MCAo) tended to reduce the cerebral damage and neurological deficit, but the lower dose (20 mg/kg p.o. twice) did not. Valproate (VPA 1,000 mgkg p.o. twice) also had no effect. Conclusions: ZNS at the anticonvulsant dose, unlike CBZ and VPA, ameliorated the brain infarction and the event of neurological deficit after transient focal cerebral ischemia. These data suggest that ZNS has therapeutic potential in protecting against ischemic cerebral damage, such as stroke.
Maternal Use of Antiepileptic Drugs and the Risk of Major Congenital Malformations: A Joint European Prospective Study of Human Teratogenesis Associated with Maternal Epilepsy
Authors: Samrén E. B. , van Duijn C. M. , Koch S. , Hiilesmaa V. K. , Klepel H. , Bardy A. H. , Mannagetta G. Beck , Deichl A. W. , Gaily E. , Granström I. L. , Meinardi H. , Grobbee D. E. , Hofman A. , Janz D. , Lindhout D. 
Published: August 2005

Summary: Purpose: To quantify the risks of intrauterine antiepileptic drug (AED) exposure in monotherapy and poly‐therapy. Methods: Data from five prospective European studies totaling 1,379 children were pooled and reanalyzed. Data were available for 1,221 children exposed to AED during pregnancy and for 158 children of unexposed control pregnancies. Results: Overall, when comparing a subgroup of 192 children exposed to AED with 158 children of matched nonepileptic controls, there was an increased risk of major congenital malformations (MCA) in children exposed to AED during gestation [relative risk (RR) 2.3; 95% confidence interval (CI): 1.2–4.7]. A significant increase in risk was found for children exposed to valproate (VPA) (RR 4.9; 95% CI: 1.6–15.0) or carbamazepine (CBZ) (RR 4.9; 95% CI: 1.3–18.0) in monotherapy. When comparing different AED regimens during all 1,221 pregnancies, risks of MCA were significantly increased for the combination of phenobarbital (PB) and ethosuximide (RR 9.8; 95% CI: 1.4–67.3) and the combination of phenytoin, PB, CBZ, and VPA (RR 11.0; 95% CI: 2.1–57.6). Offspring of mothers using > 1,000 mg VPNday were at a significantly increased risk of MCA, especially neural tube defects, compared to offspring exposed ≥600 mg VPNday (RR 6.8; 95% CI: 1.4–32.7). No difference in risk of MCA was found between the offspring exposed to 601–1,000 mg/day and ≥600 mg/day. Conclusions: This reanalysis shows that VPA is consistently associated with an increased risk of MCA in babies born to mothers with epilepsy. Significant associations were also observed with CBZ. Larger prospective population‐based studies are needed to evaluate the risks of many other less frequently prescribed treatment regimens, including newly marketed AEDs.
Changes in Regional Cerebral Blood Flow Beyond the Temporal Lobe in Unilateral Temporal Lobe Epilepsy
Authors: Rabinowicz Adrian L. , Salas Ezequiel , Beserra Felix , Leiguarda Ramon C. , Vazquez Silvia E. 
Published: August 2005

Summary: Purpose: Single photon emission computed tomography (SPECT) is widely used to evaluate functional abnormalities during the epileptic event. Changes in regional cerebral blood flow (rCBF) are well defined in patients with temporal lobe epilepsy (TLE) undergoing surgical resection. Nonetheless, the interpretation of ictal abnormalities in CBF beyond the temporal lobes has not been carefully addressed. Methods: We assessed 4 patients with pathologically proven unilateral TLE who had significant ipsilateral frontal hypoperfusion in ictal studies with no other abnormalities but chronic epilepsy accounting for such findings. Patients were assessed as candidates for surgery by interictal EEG, neuropsychological studies, brain magnetic resonance imaging, scalp electrode video‐EEG monitoring, and ictal SPECT. Results: Characteristic hyperperfusion was evident over the temporal lobe ipsilateral to the EEG focus, with significant hypoperfusion over the frontal region in 3 patients. In patient 4, frontal hypoperfusion was not statistically significant. Conclusions: SPECT demonstrated relative rCBF changes beyond the epileptogenic zone in unilateral TLE. Our findings provide further insight into the pathophysiological changes underlying this condition.
Olfactory Prodromal Symptoms and Unilateral Olfactory Dysfunction Are Associated in Patients with Right Mesial Temporal Lobe Epilepsy
Authors: Lehrner J. , Baumgartner C. , Serles W. , Olbrich A. , Pataraia E. , Bacher J. , Aull S. , Deecke L. 
Published: August 2005

Summary: Purpose: We report a patient with mesial temporal lobe epilepsy (MTLE) with olfactory prodromal symptoms manifested as an unpleasant smell of onions, who was found to have an ipsilateral deficit of olfactory naming (olfactory agnosia). Methods and Results: Preoperative olfactory testing revealed a selective right‐sided olfactory deficit for naming of odors. Olfactory threshold was within the normal range. The patient has been seizure free after selective amygdalohippocampectomy for 4 months. No olfactory prodromal events have occurred since surgery. Olfactory testing 3 months after resection showed that right‐sided odor naming was still impaired. Conclusions: We conclude that olfactory prodromal symptoms may be associated with unilateral olfactory dysfunction, and lateralization of seizure origin may be possible by unilateral olfactory testing.
Phenytoin‐Induced Teratogenesis: A Molecular Basis for the Observed Developmental Delay During Neurulation
Authors: Bennett Gregory D. , Lau Franciscus , Calvin James A. , Finnell Richard H. 
Published: August 2005

Summary: Purpose: We wished to determine whether chronic phenytoin (PHT) exposure could impair neural development and if any morphological alterations could be linked to changes in gene expression.Methods: Pregnant SWV mice were chronically administered PHT 40 mgkglday from gestational day (GD) 0:12 (day:h) until they were killed at various timepoints throughout neural tube closure (NTC). At each timepoint, embryos from both treated and control dams were collected and scored for their progression through NTC. The neural tubes were then isolated and subjected to in situ transcription (IST) and antisense RNA amplification procedures. Using these techniques, we examined the expression of 10 genes: N‐cadherin (Ncad), collagen type IV (col‐IV), bcl‐2, c‐jun, PAX‐3, collular retinol binding protein‐2 (CRBP‐2), retinoic acid receptor a (RARα), transforming growth factorβ2, (TGFβ2), wee‐1, and EMX‐2.Results: Chronic PHT exposure not only caused a delay in NTC whereby exposed embryos lagged behind the controls at each collection timepoint, but also significantly altered the expression of specific genes at distinct times during NTC. Early in NTC, PHT induced a significant reduction in the expression of N‐cad, col‐IV, and c‐jun in exposed embryos as compared with controls. In contrast, during the midstages of NTC, the only significant molecular alterations observed in the PHT‐exposed embryos was the continued decreased expression of col‐IV and an increase in CRBP‐2 expression. Finally, in the latter stages of NTC, PHT caused a significant reduction in the expression of bcl‐2, RARα, TGFβ2, EMX‐2, and PAX‐3.Conclusions: These results show that although the effects of PHT are morphologically subtle, causing a delay in the development of the neural tube, this delay is accompanied by alterations in critical genes at crucial times of neural development that may account for the observed neurological deficits often associated with PHT exposure.
Physical Activity, Heath‐Related Fitness, and Health Experience in Adults with Childhood‐Onset Epilepsy: A Controlled Study
Authors: Jalava Merja , Sillanpaa Matti 
Published: August 2005

Summary: Purpose: To show any possible associations between childhood‐onset epilepsy and physical activity, health‐related fitness, and health experience.Methods: A population‐based cohort of 176 patients with epilepsy since childhood was monitored for a mean of 35 years. Patients with recurrent, unprovoked epileptic seizures with no associated initial neurologic impairment or disability, termed those with “epilepsy only” (n = 100), were compared with matched controls for self‐reported physical activity, health experience, laboratory tests, body mass index, and muscle power tests.Results: On the basis of muscle tests, physical fitness proved to be significantly poorer in patients with “epilepsy only” than in matched controls. During the preceding year, 22% of patients and 24% of controls had reduced their physical activities because of some illness; only 2% reduced their physical activities because of epilepsy. No significant difference was found in blood status, except for a lower serum creatinine level in the patients. Current antiepileptic drug (AED) therapy appeared significantly associated with lower hemoglobin and creatinine levels and higher highdensity lipoprotein values. The patients perceived their health status to be comparable with that of controls, irrespective of physical inactivity, continued seizures, or AED monotherapy. However, patients receiving AED polytherapy perceived their health as rather poor or very poor significantly more often than did controls.Conclusions: Based on objective muscle tests, adults with childhood‐onset “epilepsy only” have poorer physical fitness than do matched controls, but they have a feeling of good personal health.
Pharmacokinetics and Safety of Tiagabine in Subjects with Various Degrees of Hepatic Function
Authors: Lau Alan H. , Gustavson Linda E. , Sperelakis Rita , Lam Nancy P. , El‐Shourbagy Tawakol , Qian Jiang X. , Layden Thomas 
Published: August 2005

Summary: Purpose: To evaluate the pharmacokinetics and safety of multiple oral doses of tiagabine HC1 in subjects with different degrees of hepatic impairment.Methods: Four subjects with mild hepatic impairment, three subjects with moderate hepatic impairment, and six matched normal subjects received twice daily oral tiagabine HCl for 5.5 days. Serial blood specimens were obtained for 48 h after the final dose. Total and unbound tiagabine plasma concentrations were determined by high‐performance liquid chromatography (HPLC) and ultrafiltration, respectively. Pharmacokinetic parameters were compared between the groups by analysis of covariance.Results: For total tiagabine concentrations in normal subjects and subjects with mild and moderate hepatic impairment, Cmax values (mean i SD) were 117 ± 54, 172 ± 40, and 172 ± 28 ng/ml; Cmin values were 13 ± 4,27 ± 4, and 28 ± 6 ng/ml; areas under the plasma concentration‐time curve were 396 ± 59, 633 ± 16, and 675 ± 32 ng Wml, and elimination half‐lives (harmonic means) were 7, 12, and 16 h, respectively. Unbound tiagabine coricentrations, area under the unbound plasma concentration‐time curve, and the free fractions were increased in the hepatically impaired subjects. Reduced serum albumin and α1‐acid glycoprotein concentrations may have contributed to increases in the unbound fraction. Adverse events observed included dizziness, tremor, nausea, somnolence, incoordination, and unsteady gait. The frequency of these events was increased in the subjects with liver impairment.Conclusions: Because of the decreased drug elimination caused by liver function impairment, reduced doses or increased dosing interval or both may be needed to attain therapeutic plasma drug concentrations. Time to reach steady state also may be prolonged. The patients should be monitored closely for potential neurologic adverse events.
Clonidine and Methohexital‐Induced Epileptic Magnetoencephalographic Discharges in Patients with Focal Epilepsies
Authors: Kirchberger K. , Schmitt H. , Hummel C. , Peinemann A. , Pauli E. , Kettenmann B. , Stefan H. 
Published: August 2005

Summary: Purpose: During presurgical evaluation, 14 patients with medically intractable focal epilepsies underwent magnetoencephalographic (MEG) recordings for focus localization. To increase the number of epileptic discharges required for MEG analysis, we administered methohexital (MHT), a short‐acting barbiturate known to provoke epileptic activity. We also investigated the spike‐provoking properties of clonidine in comparison with MHT. Methods: Patients were briefly anesthetized with intravenously administered MHT after being premedicated orally with clonidine. Numbers and locations of epileptic MEG discharges were assessed after clonidine premedication as well as during MHT anesthesia. Results were compared with baseline MEG recordings. Results: MHT increased the frequency of focal epileptic discharges in 8 of 13 patients (1 of the 14 patients did not receive MHT after premedication with clonidine). Premedication with clonidine also increased focal epileptic discharges in 9 of 14 patients. The numbers of epileptic signals and numbers of spikes contributing to MEG source localizations were significantly increased in MEG recordings under both treatment conditions (clonidine premedication and MHT anesthesia) as compared with baseline MEG recordings. Conclusions: Our results confirmed the selective proconvulsive effects of MHT on the epileptic focus, as previously suggested by EEG and electrocorticographic (ECoG) investigations. However, our present data establish for the first time that clonidine increases epileptic activity in patients with seizure disorders and indicate that clonidine is suitable as an activating agent for localization of epileptogenic foci by MEG. This effect of clonidine on specific epileptic activity also indicates that specific care must be taken when clonidine is used as an antihypertensive drug in patients with seizure disorders.
Rolandic Epilepsy: An Incidence Study in Iceland
Authors: Astradsson Arnar , Olafsson Elias , Ludvigsson Petur , Björgvinsson Hilmar , Hauser W. Allen 
Published: August 2005

Summary: Purpose: We wished to determine incidence, clinical features, and prognosis of benign rolandic seizures (BRS) and benign rolandic epilepsy (BRE) in a total population. Methods: Cases were ascertained through review of all EEG records, and diagnosis was verified by review of medical records. Follow‐up information regarding seizures and treatment was obtained from parents and treating physicians. Results: In the Icelandic population aged 3–15 years, the incidence of BRS is 6.2 and BRE 4.7 in 100,000. Five years after onset 95% were seizure‐free. At last follow‐up, all were seizure free and had not been treated with antiepileptic drugs (AEDs) for at least 1 year. Conclusions: Our study demonstrates that BRS is a common entity in children. The prognosis is excellent and treatment is not necessary in all cases. It is important to identify BREBRS correctly and distinguish it from other types of epilepsy.
Epilepsy in Patients with Multiple Sclerosis: Radiological‐Clinical Correlations
Authors: Moreau Th. , Sochurkova D. , Lemesle M. , Madinier G. , Billiar Th. , Giroud M. , Dumas R. 
Published: August 2005

Summary: Purpose: To determine potential mechanisms of epilepsy in patients with multiple sclerosis (MS). Methods: Among 402 patients with clinically and radiologically defined MS, including de novo cases, presenting to the Neurology Service, University Hospital of Dijon, we identified 17 with epileptic seizures (4.25%). Among them, the percentage with partial seizures (50%) was greater than that in the reference population. Results: In most of the patients with MS, plaques were localized in the frontal region, associated with frontal and callosal atrophy, a frontal syndrome, and severe disability status (as assessed by a standard scale). Magnetic resonance imaging (MRI) showed numerous subcortical plaques. Seizures generally were well controlled with antiepileptic drugs (AEDs). Conclusions: Our data suggest that the subcortical plaques of MS underlie seizure activity in patients with MS and epilepsy.
Long‐Term Survival of People with Unprovoked Seizures: A Population‐Based Study
Authors: Olafsson Elias , Allen Hauser W. , Gudmundsson Gunnar 
Published: August 2005

Summary: Purpose: Few population‐based studies of longterm survival in people with seizures or epilepsy have been made. Methods: Between January 1, 1960 and December 31, 1964, we identified 224 incidence cases of unprovoked seizures in Iceland and determined survivorship status and date of death for the cases as of January 1, 1996. We compared survivorship with that expected based on data from age‐/sex‐specific life tables from the country for 1961–1990 and calculated the standardized mortality ratio (SMR). Results: By 30 years after diagnosis, there were 45 deaths among patients with unprovoked seizures as compared with an expected 28 deaths [standardized mortality ratio (SMR) 1.6; 95% confidence interval (CI) 1.2–2.21. Patients with unprovoked seizures of unknown etiology did not have a significant increase in mortality overall (SMR 1.3, 95% CI 0.8–1.9) or in any time interval. For patients with remote symptomatic un provoked seizures, mortality was increased (SMR 2.3, 95% CI 1.4–3.5). This increase was attributable to excess mortality for the first 15 years after diagnosis (SMR 4.1, 95% CI 2.4–6.6), and SMR was not different after that time. Conclusions: Survivorship was decreased for the population of patients with unprovoked seizures. The increased mortality was primarily due to excess mortality in patients with remote symptomatic seizures, occurring in the first 15 years after diagnosis. Overall mortality for idiopathic unprovoked seizures was not significantly increased.