bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality‐of‐Life and Behavioral Outcome Measures in Randomized Controlled Trials of Antiepileptic Drugs: A Systematic Review of Methodology and Reporting Standards
Authors: Baker Gus A. , Hesdon Bernadette , Marson Anthony G. 
Published: August 2005

Summary: Purpose: To review the methodology and use of quality‐of‐life and behavioral measures used in randomized controlled trials (RCTs) of antiepileptic drugs in patients with epilepsy. Methods: Trial reports were found by searching a previously developed comprehensive database of epilepsy RCTs and searching through journals by hand. Inclusion and exclusion criteria were applied, and methodological and quality‐of‐life and behavioral measure data were extracted. Results: There were 52 different measures used in 46 trials, with the Profile of Mood States, the Minnesota Multiphasic Personality Inventory, and the Washington Psychosocial Seizure Inventory being applied the most frequently. Overall, evidence of the reliability, validity, and sensitivity of measures used in populations of people with epilepsy was sparse. There was also little information on the clinical interpretation of the results. Conclusion: Our results highlight a consistent failure to apply quality‐of‐life and behavioral measures in RCTs in a systematic way. We found repeated evidence of researchers' failure to review the use of previous measures and selection of measures without evidence of their appropriateness for use in a population with epilepsy. We recommend the use of quality‐of‐life and behavioral measures in RCTs with proven psychometric properties in a population with epilepsy.
Moderators of the Effect of Preoperative Emotional Adjustment on Postoperative Depression After Surgery for Temporal Lobe Epilepsy
Authors: Derry Paul A. , Rose Kristopher J. , McLachlan Richard S. 
Published: August 2005

Summary: Purpose: Other outcome measures besides seizure control must be considered when assessing the benefit of epilepsy surgery. We investigated the effect of preoperative psychosocial adjustment on postoperative depression in epilepsy patients followed up prospectively for 2 years after temporal lobectomy. Methods: The Washington Psychosocial Seizure Inventory (WPSI) evaluated psychosocial functioning; the Centre for Epidemiological Studies Depression Scale (CES‐D) measured depression. Both were completed at baseline and follow‐up. Results: Follow‐up occurred in 39 temporal lobectomy patients at 2 years after surgery. Greatest improvement in depression scores was limited to patients with good seizure outcomes (seizure free, or marked reduction in seizure frequency), and seizure outcome was a significant predictor of postoperative depression. Despite this, preoperative scores on the emotional adjustment scale of the WPSI were most highly correlated with depression 2 years after surgery. To clarify this relation, moderated hierarchic regression suggested that good preoperative emotional adjustment (WPSI) was generally associated with less depression after surgery. Moreover, poorer preoperative adjustment combined with older age, generalized seizures, the finding of preoperative neurologic deficits, a family history of psychiatric illness, and/or a family history of seizures was related to higher depression scores 2 years after surgery. Conclusions: Depression after temporal lobectomy is dependent on a complex interaction of variables and can have a significant effect on indices of postoperative adjustment. The WPSI emotional adjustment scale may help to predict which patients are likely to be chronically depressed after surgery.
Negative Emotions in Children with Newly Diagnosed Epilepsy
Authors: Oostrom K. J. , Schouten A. , Olthof T. , Peters A. C. B. , Jennekens‐Schinkel A. 
Published: August 2005

Summary: Purpose: To understand the emotional predicament in children with recently diagnosed idiopathic or cryptogenic epilepsy. Methods: We used the well‐tried method of structured projection for the first time in children with epilepsy. Thirty‐six children with epilepsy, aged 7–15 years (mean age, 9.5 years) and in 35 control children aged 7–15 years (mean age, 9.4 years), attributed shame and guilt in relation to three types of situation (non‐illness related, illness related, and epilepsy related). Children were evaluated twice: shortly after diagnosis, before antiepileptic drug (AED) use and after an interval of 3 months. Results: Children with epilepsy and healthy controls were similar in their way of attributing shame and guilt. However, the type of situation was of influence: Both children with epilepsy and healthy children attributed more shame to incompetence due to epilepsy than to incompetence due to other illnesses. Conclusions: Increased affective problems in childhood epilepsy cannot be explained by excessive attribution of shame and guilt, affects known to be important precursors of psycho‐pathology, yet both healthy children and children with epilepsy attribute more shame to epilepsy than to other illnesses. Epilepsy is not like any other disease.
The Impact of Childhood Epilepsy on Neurocognitive and Behavioral Performance: A Prospective Longitudinal Study
Authors: Bailet Laura L. , Turk William R. 
Published: August 2005

Summary: Purpose: To assess neurocognitive and behavioral performance in children with idiopathic epilepsy (CWE, n = 74), their siblings without epilepsy (control, n = 23), and children with migraine (CWM, n = 13), and to identify medical factors related to learning or behavioral problems in CWE. Methods: Subjects, ages 8–13 years with IQs of ≥80, completed a neurocognitive test battery annually for ≤3 years. For CWE, age at seizure onset, most recent EEG results, seizure type, seizure frequency, current antiepileptic drug (AED), and most recent AED serum levels were documented at each visit. Results: CWE and CWM had high rates of grade retention and placement in special education compared with sibling controls. CWE performed worse than controls on numerous neurocognitive variables. These differences persisted over time. CWE with abnormal EEGs scored lower than CWE with normal EEGs on reading and spelling measures, even with comparable IQs. Age at seizure onset, seizure type, and seizure frequency were not related to neurocognitive or behavioral test scores. CWE taking carbamazepine (CBZ) performed better than CWE taking valproate (VPA) on academic achievement measures, although the study lacked controls necessary to assess this finding thoroughly. CWM did not differ from CWE or controls in cognitive or academic achievement skills. Conclusions: Long‐term risk of learning problems exists among CWE as compared with controls, even with normal IQs and well‐controlled seizures. Predicting learning problems in CWE based on medical factors remains elusive. Monitoring of educational progress and neurocognitive screening may be most effective in assessing academic risk for CWE.
Lateralizing Value of Asymmetric Tonic Limb Posturing Observed in Secondarily Generalized Tonic–Clonic Seizures
Authors: Kotagal Prakash , Bleasel Andrew , Geller Eric , Kankirawatana Pongkiat , Moorjani Bhagwan I. , Rybicki Lisa 
Published: August 2005

Summary: Purpose: A striking asymmetry of limb posture occurs during secondarily generalized tonic–clonic (GTC) seizures wherein one elbow is extended while the other is flexed during the tonic phase of the GTC seizure. We have named this phenomenon asymmetric tonic limb posturing (ATLP) or the “Figure 4 Sign.” Methods: Fifty‐nine secondarily GTC seizures from 31 patients with partial epilepsy who underwent successful epilepsy surgery were analyzed, in addition to another group of 64 GTC and generalized clonic seizures from 26 patients collected prospectively over a 7‐month period. Three observers reviewed these seizures blinded to the side of ictal EEG onset and other clinical data. Results: The extended elbow was contralateral to the side of ictal onset in 35 of 39 patients who had ATLP during their seizures. The kappa index, a measure of interobserver agreement, was calculated, and ATLP was found to have very good agreement between observers. Conclusions: In secondarily generalized tonic–clonic seizures, ATLP (Figure 4 Sign) may sometimes be only available lateralizing sign.
Effects of Circadian Regulation and Rest—Activity State on Spontaneous Seizures in a Rat Model of Limbic Epilepsy
Authors: Quigg Mark , Clayburn Hope , Straume Martin , Menaker Michael , Bertram Edward H. 
Published: August 2005

Summary: Purpose: Circadian regulation via the suprachiasmatic nuclei and rest–activity state may influence expression of limbic seizures. Methods: Male rats (n = 14) were made epileptic by electrical stimulation of the hippocampus, causing limbic status epilepticus and subsequent seizures. We monitored seizures with intrahippocampal electrodes in 12–12‐h light/dark (LD) cycles and in continuous dark (DD). We used radiotelemetry monitoring of activity to measure state and body temperature to determine circadian phase. Cosinor analysis and χ2 tests determined whether seizures occurred rhythmically when plotted by phase. State was defined as inactive or active in 10‐min epochs based on whether activity count was below or above a cut‐off value validated from video observation. Results: In LD, the peak seizure occurrence was 14:59 h after circadian temperature peak (95% confidence limit, 13:37–16:19). Phasic seizure occurrence persisted in DD for 14:05 (12:31–15:38), p < 0.0001, against uniform mean distribution. In LD, 14,787 epochs contained 1,268 seizures; seizures preferentially occurred during inactive epochs (965 observed, 878 expected in proportion to the overall distribution of inactive versus active epochs; p < 0.001). In DD, 20,664 epochs contained 1,609 seizures; seizures had no preferential occurrence by state (999 observed, 1,025 expected; p = 0.16). Conclusions: Limbic seizures occurred with an endogenous circadian rhythm. Seizures preferentially struck during inactivity during entrainment to the light–dark cycle.
Anterior Cingulate Gyrus Epilepsy: The Role of Ictal rCBF SPECT in Seizure Localization
Authors: San Pedro Elmer C. , Mountz James M. , Ojha Buddhiwardhan , Khan Adil A. , Liu Hong‐Gang , Kuzniecky Ruben I. 
Published: August 2005

Summary: Purpose: The goal of this report is to demonstrate the utility of ictal brain single photon emission tomography (SPECT) in a 39‐year‐old man with complex partial seizures arising from the anterior cingulate gyrus. Seizures originating from the anterior cingulate gyrus are difficult to localize because they have variable ictal semiology, are usually brief, and have rapid cortical propagation. Methods: Clinical neurologic examination, electroencephalography, extended video‐electroencephalography with scalp and sphenoidal electrodes, magnetic resonance imaging, computed tomography, and ictal brain SPECT with Tc‐99m HMPAO were performed to identify the seizure focus. The patient's regional cerebral blood flow (rCBF) findings were compared with those of eight normal controls, and changes in rCBF were assessed by comparing the patient's ictal scan with those of normal controls at rest by using statistical parametric mapping (SPM). Results: Clinical and neurologic evaluations failed to demonstrate the epileptogenic focus. Ictal rCBF brain SPECT showed a focal region of hyperperfusion in the anterior cingulate gyrus. By using SPM, the ictal blood flow increase in the right anterior cingulate gyrus (x, y, z, –6, 42, 24 mm) was found to be statistically significant when compared with normal controls (z score, 4.88, p < 0.001). Subdural EEG recordings with intracranial electrodes positioned over this location confirmed that the cingulate gyrus was the origin of the seizures, and surgical resection resulted in >90% seizure reduction. Conclusions: We concluded that ictal brain SPECT localization in conjunction with subdural electrode confirmation is a useful test in the presurgical evaluation of difficult to localize cingulate epilepsy.
Distinct Behavioral and EEG Topographic Correlates of Loss of Consciousness in Absences
Authors: Vuilleumier P. , Assal F. , Blanke O. , Jallon P. 
Published: August 2005

Summary: Purpose: To describe the behavioral and EEG topographic correlates of absences with 3‐Hz generalized spike‐waves and partitioned impairment of consciousness. Methods: Two adult women had so‐called “phantom” absences, characterized by brief and mild impairments of consciousness that were previously inconspicuous to both patient and physician. Neuropsychological examination was performed under video‐EEG monitoring during absence status. EEG topographic mapping of spike‐wave discharges was obtained in the two cases. Results: Only mild attentional and executive disturbances were observed during absence status despite prolonged discharges. Spike‐wave bursts were associated with selective impairment in the initiation of response and self‐generated action, whereas short‐term storage of external information during discharges was fully preserved. This is consistent with a predominant involvement of frontomesial cortex demonstrated by topographic mapping of spike‐wave discharges in the two cases. By contrast, in two other patients with typical absences and a complete lack of retention for information given during the discharges, topographic mapping found a more lateral frontal involvement by spike‐wave activity. Conclusions: Different types of absence seizures may impair distinct components of conscious behavior. A predominant involvement of frontomesial thalamocortical circuitry may underlie an “inconspicuous” disorder of consciousness as seen in phantom absences with selective loss of initiation and goal‐oriented behavior, whereas involvement of more lateral frontal areas in typical absences may additionally disrupt working memory processes.
Reduction of Benzodiazepine Receptor Binding is Related to the Seizure Onset Zone in Extratemporal Focal Cortical Dysplasia
Authors: Arnold Stephan , Berthele Achim , Drzezga Alexander , Tölle Thomas R. , Weis Serge , Werhahn Konrad J. , Henkel Anja , Yousry Tarek A. , Winkler Peter A. , Bartenstein Peter , Noachtar Soheyl 
Published: August 2005

Summary: Purpose: Comparison of regional reduction of GABA receptor binding and seizure onset zone in patients with extratemporal epilepsy due to focal cortical dysplasia. Methods: Two patients with frontal lobe epilepsy who remained seizure free after partial frontal lobe resection were investigated with magnetic resonance imaging, positron emission tomography (PET) with 18F‐fluoro‐deoxy‐glucose (FDG) and 11C‐flumazenil, subdural EEG‐video recordings, and post‐operative benzodiazepine (BDZ)‐receptor autoradiography. Results: The area of reduced BDZ‐receptor binding as documented by preoperative flumazenil‐PET and postoperative BDZ‐receptor autoradiography corresponded to the seizure on‐set zone and was smaller than the interictal hypometabolism documented by FDG‐PET. Conclusion: Flumazenil‐PET is a useful tool for localization of the epileptogenic zone in patients with extratemporal epilepsy caused by focal cortical dysplasia. Neuronal distribution of BDZ‐receptor density confirms in vivo flumazenil‐PET findings. The regional reduction of BDZ‐receptor binding in focal cortical dysplasia seems to be confined to the seizure onset zone and not to the extent of dysplastic cortex.
The Epilepsy of Emperor Michael IV, Paphlagon (1034–1041 A.D.): Accounts of Byzantine Historians and Physicians
Authors: Lascaratos J. , Zis P. V. 
Published: August 2005

Summary: Purpose: Presentation of epilepsy suffered by Byzantine Emperor Michael IV, Paphlagon (who reigned from 1034 to 1041 A.D.) and the attitude of his contemporary society to his disorder. Methods: Research into the accounts of Byzantine historians and chroniclers referring to the case of the emperor and Byzantine medical texts revealing the opinion of official medicine about the disorder. Results: Byzantine historians and chroniclers provide detailed clinical descriptions of the seizures of Emperor Michael IV. Nearly all, expressing popular opinion, considered his disease to be demonic possession that constituted a form of divine punishment for the emperor's adultery and act of murder; his royal entourage continually attempted euphemistically to present this condition as a psychic disease. On the contrary, research into Byzantine medical texts reveals that the physicians, already from the 4th century, following Hippocratic tradition, believed that epilepsy was primarily a brain‐related disorder and based their treatment on this etiological principle. Conclusions: From the study of the Byzantine histories and chronicles, it can be deduced that Emperor Michael IV, Paphlagon, suffered from generalized tonic‐clonic epileptic seizures. Despite the concept then held by well‐educated Byzantine doctors, who considered epilepsy a brain disorder, information indicates the deep prejudices of his social environment.
Autosomal Dominant Partial Epilepsy with Auditory Features: Description of a New Family
Authors: Michelucci R. , Passarelli D. , Pitzalis S. , Dal Corso G. , Tassinari C. A. , Nobile C. 
Published: August 2005

Summary: Purpose: To report the clinical and genetic study of a new family with autosomal dominant partial epilepsy with auditory features (ADPEAF). Methods: All the living affected members underwent a full clinical, neurophysiological, and magnetic resonance imaging (MRI) study. Genetic analysis was performed by typing their DNA with seven microsatellite markers previously found to cosegregate with ADPEAF on chromosome 10q24. Results: The three living affected members had a childhood onset of rare and drug‐responsive tonic‐clonic seizures constantly preceded by a humming sensation. Routine and sleep electroencephalograms revealed rare and inconstant focal abnormalities over both temporal regions. MRI detected atrophy with increased T2 signal in the subcortical lateral portion of the right temporal lobe in one case. Analysis of 10q24 polymorphic alleles showed the same haplotype in all three affected members but different alleles in unaffected individuals. Conclusions: ADPEAF is a distinct condition with homogeneous clinical features. Genetic findings are consistent with linkage of ADPEAF to chromosome 10q24.
Effects of Lamotrigine on Field Potentials and Long‐Term Potentiation in Guinea Pig Hippocampal Slices
Authors: Langosch Jens Michael , Zhou Xiao‐Yan , Frick Alex , Grunze Heinze , Walden Jörg 
Published: August 2005

Summary: Purpose: To investigate the effects of lamotrigine (LTG), a new anticonvulsant, on neuronal excitability, synaptic transmission, and long‐term potentiation (LTP) in guinea pig hippocampal slices. Methods: Electrically evoked field excitatory postsynaptic potentials (fEPSPs) and population spikes (PSs) were investigated in the CA1 region of the hippocampus. Results: The concentration–response curves showed different actions of LTG in concentrations near therapeutic plasma levels (10 μM) on fEPSPs and PSs. The initial slopes of fEPSPs were not affected, whereas the amplitudes of PSs were significantly decreased. Higher concentrations of LTG decreased both fEPSP slopes and PS amplitudes; however, the effects on PSs were much stronger. Also, there were no differences in fEPSP slopes or PS amplitudes compared with controls when LTP was induced in the presence of LTG (10 μM). Conclusions: Our data are in contrast to previous findings that suggest LTG acts primarily on presynaptic sites by blocking the release of excitatory amino acids. Further, LTP was not affected by LTG.
Genetic Localization of the Ca2+ Channel Gene CACNG2 Near SCA10 on Chromosome 22q13
Authors: Burgess Daniel L. , Matsuura Tohru , Ashizawa Tetsuo , Noebels Jeffrey L. 
Published: August 2005

Summary: Purpose: Voltage‐dependent calcium channel mutations have been associated with spinocerebellar ataxia in humans (SCA6) and with ataxia, progressive cerebellar degeneration, and epilepsy in mice (tottering, lethargic, and stargazer). A novel autosomal dominant spinocerebellar ataxia syndrome with epilepsy (SCA10) was recently mapped to chromosome 22q13. The human ortholog of the mouse stargazer locus, the calcium channel γ subunit gene CACNG2, also is located in this region. Because the phenotypes of stargazer mice and SCA10 patients were similar, consisting of both cerebellar ataxia and seizures, we hypothesized that CACNG2 was a likely candidate for the SCA10 locus. Methods: Polymerase chain reaction (PCR) based assays were developed for two polymorphic microsatellite markers near CACNG2. The location of CACNG2 was determined by linkage and haplotype analysis of the genotypes of 22 individuals from a human pedigree segregating SCA10. Results: SCA10 was previously localized distal to marker D22S1177 on chromosome 22q13. We determined that CACNG2 was linked to D22S283 and D22S1177 with the marker order: centromere‐D22S283‐bcmDLB1 (CACNG2)–D22S1177‐D22S423‐telomere. Thus CACNG2 is located proximal to the SCA10 recombinant interval. Conclusions: Here we report the first genetic linkage of CACNG2 on chromosome 22q13 and exclude it as a candidate for SCA10. In addition, our data clarify the relation between the physical and genetic linkage maps of this region and will facilitate isolation of the SCA10 gene.
Effects of Retigabine (D‐23129) on Different Patterns of Epileptiform Activity Induced by Low Magnesium in Rat Entorhinal Cortex Hippocampal Slices
Authors: Armand V. , Rundfeldt C. , Heinemann U. 
Published: August 2005

Summary: Purpose: The objective of this study was to evaluate the effect of a new antiseizure drug, retigabine (D‐23129; N‐(2‐amino‐4‐[fluorobenzylamino]‐phenyl) carbamic acid ethyl ester) on low‐Mg2+‐induced epileptiform discharges in rat in vitro. Methods: Three types of epileptiform discharges (recurrent short discharges in the hippocampus, seizure‐like events, and late recurrent discharges in the entorhinal cortex) were elicited in rat combined entorhinal cortex‐hippocampal slices by perfusion with low‐Mg2+‐artificial cerebrospinal fluid (ACSF). The antiepileptic properties of retigabine were evaluated as effect on the frequency and amplitude of the epileptiform activities as well as time of onset of the effect in the entorhinal cortex (EC) and in hippocampal area CA1 (CA1) by using extracellular recording techniques. Results: Retigabine (20 μM) reversibly suppressed the recurrent short discharges otherwise sensitive only to high doses of valproate (VPA) but insensitive to standard antiepileptic drugs (AEDs) in CA1, whereas 10 μM reduced the frequency of discharges by 34 ± 18.8%, with no significant effect on the amplitude. In EC, retigabine (50 μM) reversibly suppressed the seizure‐like events, whereas μM blocked seizure‐like events in 71.5% of the slices. The seizure‐like events were also sensitive to standard AEDs. Late recurrent discharges in EC that are not blocked by standard AEDs were reversibly suppressed by retigabine (100 μM), whereas 50 μM reduced the frequency of the discharges by 94.4 ± 7.7%, and 20 μM, by 74.2 ± 18.0%, with no significant effect on the amplitude. Conclusions: Retigabine is an effective AED with suppressive effects on recurrent short discharges and on late recurrent discharges normally insensitive to standard AEDs.