bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relationship Between Sleep and Epilepsy in Frontal and Temporal Lobe Epilepsies: Practical and Physiopathologic Considerations
Authors: Crespel Arielle , Baldy‐Moulinier Michel , Coubes Philippe 
Published: August 2005

Summary: Purpose: The influence of sleep on the incidence of seizures and the reciprocal effects of epilepsy on sleep were analyzed in 30 patients with intractable partial seizures, all candidates for surgery. Methods: The patients were classified into two groups of 15 patients according to the documented site of the epileptogenic zone: frontal lobe epilepsy (FLE) and medial temporal lobe epilepsy (TLE). Frequency and waking‐sleep distribution of seizures were evaluated by continuous video‐EEG monitoring for 5 days, under defined antiepileptic drug (AED), sleep, and sleep deprivation regimens. Sleep organization was analyzed by polysomnography prior to the presurgical protocol. Results: Significant differences were found between the two groups in sleeping‐waking distribution of seizures under varied conditions, and in the quality of sleep organization. In FLE patients, seizures most often occurred during sleep, although sleep organization was normal. In TLE patients, most seizures occurred while patients were awake, and sleep organization was characterized by a low efficiency index. The difference in seizure distribution between FLE and TLE persisted under all conditions investigated, i.e., after AED discontinuation and sleep deprivation. Conclusions: Sleep recording may be useful for diagnosis of FLE, and monitoring after sleep deprivation for that of TLE. We speculate that sleep‐related seizures in FLE may depend on interaction between frontal lobe areas with the thalamus cortical synchronization system and the acetylcholine regulatory system of waking.
Occipital Lobe Seizures as the Major Clinical Manifestation of Reversible Posterior Leukoencephalopathy Syndrome: Magnetic Resonance Imaging Findings
Authors: Bakshi Rohit , Bates Vernice E. , Mechtler Laszlo L. , Kinkel Peter R. , Kinkel William R. 
Published: August 2005

Summary: Purpose: Reversible posterior leukoencephalopathy syndrome (RPLS) is an increasingly recognized brain disorder most commonly associated with malignant hypertension, toxemia of pregnancy, or the use of immunosuppressive agents. When associated with acute hypertension, RPLS typically occurs concurrently with the fulminant clinical syndrome of hypertensive encephalopathy. We describe occipital lobe seizures, in the setting of only moderate elevations of blood pressure, as the major clinical manifestation of RPLS. Methods: Two patients from the Dent Neurologic Institute are presented with clinical and magnetic resonance imaging(MRI) correlation. Results: New onset secondarily generalized occipital seizures were noted, with MRI findings consistent with RPLS. Both of the patients had chronic renal failure and a moderate acute exacerbation of chronic hypertension. Other features of hypertensive encephalopathy were lacking, such as headache, nausea, papilledema, and an altered sensorium. Magnetic resonance imaging (MRI) showed edematous lesions primarily involving the posterior supratentorial white matter and corticomedullary junction, consistent with RPLS. With lowered blood pressure, the MRI lesions resolved and the patients became seizure‐free without requiring chronic anticonvulsant therapy. Conclusions: Occipital seizures may represent the only major neurologic manifestation of RPLS due to acute hypertension, especially in patients with renal failure. Other evidence of hypertensive encephalopathy, such as cerebral signs and symptoms, need not be present. Blood pressure elevations may be only moderate. Early recognition of this readily treatable cause of occipital seizures may obviate the need for extensive, invasive investigations. Despite the impressive lesions on MRI, prompt treatment of this disorder carries a favorable prognosis.
Celiac Disease, Bilateral Occipital Calcifications and Intractable Epilepsy: Mechanisms of Seizure Origin
Authors: Bernasconi Andrea , Bernasconi Neda , Andermann Frederick , Dubeau François , Guberman Alan , Gobbi Giuseppe , Olivier André 
Published: August 2005

Summary: Purpose: To elucidate the mechanisms of seizure origin in patients with celiac disease and bilateral occipital calcifications (CEBOC). Individuals with CEBOC frequently present with occipital lobe seizures, but additional lesions and additional attack patterns may occur. Methods: We studied two men and one woman who had CEBOC. Villous atrophy was revealed in the two patients who underwent duodenal biopsy. All had a comprehensive presurgical evaluation, including prolonged video‐EEG recordings. Two had magnetic resonance imaging (MRI) with volumetric study of mesial temporal structures (MRIV). One patient had undergone stereotactic intracranial depth electrode studies (SEEG). Results: All patients presented with intractable complex partial seizures. Two had partial simple seizures with visual aura. Neurologic examination was normal; one was of normal intelligence, and two were mildly retarded. Neuroimaging studies showed that each had bilateral occipital calcifications as well as epileptiform abnormalities over temporal lobes. In one, MRI showed an additional right frontal lesion, but SEEG demonstrated right occipital lobe seizure origin with anterior spread; this male patient later underwent a right occipital lobe resection. Another with a history of prolonged febrile convulsions had bilateral hippocampal and amygdalar atrophy demonstrated by MRIV. Conclusions: In one patient, SEEG confirmed that seizures originated in the occipital lobe. The presence of dual pathology was demonstrated in another, raising the possibility of both occipital and temporal seizure onset. The presence of extraoccipital lesions or of mesial temporal atrophy requires SEEG for clarification of seizure onset. In the absence of confounding factors and when laterality can be demonstrated, surgical treatment may be considered.
Do Males 30–50 Years of Age with Chronic Epilepsy and on Long‐Term Anticonvulsant Medication Have Lower‐Than‐Expected Risk of Developing Coronary Heart Disease?
Authors: Nakken Karl Otto , Kornstad Stig 
Published: August 2005

Summary: Purpose: It has been claimed that long‐term use of antiepileptic drugs (AEDs) brings about changes in the lipid profile which might resist development of cardiovascular disease. The aim of this study was to test the following hypothesis: Do males with chronic epilepsy and on long‐term treatment with AEDs have a lower than expected risk of developing coronary heart disease? Methods: The coronary risk profile in 40 male patients with chronic epilepsy, aged 30–50 years, was explored, using an American individual coronary risk factor test program (the Cooper test). We made a survey of the patients' risk factors: total cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides, glucose, blood pressure, body fat percentage, physical fitness, hereditary factors, smoking habits, and degree of stress. Each factor was given a score, and the sum of scores constituted the total coronary risk profile. Eighty men in the same age group, casually selected from an industrial medical service, served as controls. Results: There was no statistically significant difference in the total coronary risk profile between the epilepsy patients and the controls. Nor were there any significant differences among the individual risk factors except for physical fitness level, which was significantly lower among the epilepsy group than among the controls. In the epilepsy group, however, there was a trend toward higher levels of total cholesterol, higher levels of HDL‐cholesterol, lower levels of total cholesterol/HDL‐cholesterol ratio, increased body fat percentage, greater heredity and somewhat greater coronary risk score as compared with the healthy controls, but the differences did not reach statistical significance. The protective effect against coronary heart disease exercised by the enzyme‐inducing AEDs seems to be counteracted by other factors, like reduced physical fitness and increased body fat percentage. Conclusions: Our hypothesis was not confirmed, because we found that the 40 patients with chronic epilepsy tested had about the same risk of developing coronary heart disease as did the control group.
Retrospective Analysis of the Effects of Psychotherapeutic Interventions on Outcomes of Psychogenic Nonepileptic Seizures
Authors: Aboukasm Amer , Mahr Gregory , Gahry Barbara Rader , Thomas Andrea , Barkley Gregory L. 
Published: August 2005

Summary: Purpose: Uncertainty exists regarding the effectiveness of psychotherapy in patients with psychogenic nonepileptic seizures (PNES). We retrospectively reviewed the outcomes of therapeutic interventions in a cohort of patients with PNES. Methods: We identified patients with PNES by outpatient video‐EEG (VEEG) between 1992 and 1996. We retrospectively analyzed the effects on outcomes of various types of interventions for PNES administered at random, using a structured interview and review of medical records. Patients with subjective events and severe psychosis were excluded. Patients who required inpatient monitoring because the outpatient VEEG was inconclusive were also excluded. Results: One hundred patients were diagnosed with PNES between 1992 and 1996: 61 patients completed the study. The average age was 43.3 years, and 90% were female. Nine (15%) had had PNES <1 year, and 7 (11%) had epilepsy. Eleven of 16 patients (68%) who received five or more counseling sessions, including showing the videotaped recording of the nonepileptic spell (13 of 16) by the comprehensive epilepsy program (CEP) psychotherapist had cessation (7 of 16) or reduction (4 of 16) of their episodes. Eleven of 15 patients (73%) who received only the feedback and care of their CEP neurologists had similar favorable outcome. Twelve of 25 patients (48%) who received counseling by a non‐CEP psychotherapist or psychiatrist had cessation (10 of 25) or reduction (2 of 25) of episodes. Five patients who received no feedback or intervention had no improvement (4 of 5) or worsening (1 of 5) of the PNES. Conclusions: Psychotherapy or feedback provided by CEP professionals with experience in epilepsy and PNES improves outcome and may be superior to other or no interventions.
Presurgery Expectations, Postsurgery Satisfaction, and Psychosocial Adjustment After Epilepsy Surgery
Authors: Wheelock Ingrid , Peterson Christopher , Buchtel Henry A. 
Published: August 2005

Summary: Purpose: The medical benefits of epilepsy surgery are well documented, but the psychosocial consequences of surgery have received less attention. This is especially true of the roles of expectations and satisfaction in postsurgery functioning. The present study was designed to examine the relationships between expectation, satisfaction with surgery, and psychosocial functioning in patients and their significant others before and after epilepsy surgery. Methods: The neuropsychology findings of 79 patients undergoing epilepsy surgery were examined from assessments made before, 2 months after, and 1 year after anterior temporal lobectomy (ATL) was performed. The Minnesota Multiphasic Personality Inventory (MMPI) and the Washington Psychosocial Seizure Inventory (WPSI) were used to assess psychosocial functioning. A subset of 32 patients and their significant others were followed prospectively with an additional semistructured interview to assess expectations for and satisfaction with surgery outcome. Results: Before surgery, patients showed considerable problems with psychosocial adjustment. After surgery, patients in the seizure‐free group showed improvements on the psychosocial measures at both follow‐ups, whereas patients with continued seizures showed improvement at the 2‐month follow ‐up and then a decline to baseline or worse at the time of the 1‐year follow‐up. Subjects who were studied prospectively had high presurgery expectations for seizure elimination. After surgery, subjects whose expectations were met reported high satisfaction whereas subjects whose expectations were not met reported low satisfaction. Satisfaction with surgery was associated with better psychosocial functioning. Conclusions: Such data help elucidate the ways in which successful epilepsy surgery results in improved psychosocial functioning. The results identify ways to increase the likelihood that both patients who are seizure‐free and those with reduced seizure frequency may benefit from surgery.
The Efficacy of Lamotrigine in Children and Adolescents with Refractory Generalized Epilepsy: A Randomized, Double‐Blind, Crossover Study
Authors: Eriksson A‐S. , Nergårdh A. , Hoppu K. 
Published: August 2005

Summary: Purpose: We report a double‐blind, placebo‐controlled crossover study of lamotrigine (LTG) as add‐on treatment in therapy‐resistant, generalized epilepsy in children and adolescents (n = 30). Methods: Twenty patients had Lennox‐Gastaut syndrome. Each patient acted as his or her own control. LTG and placebo were randomly added to existing antiepileptic medication (AEDs). The LTG dosage was individualized in an open phase preceding the placebo/treatment phase. Patients who responded to LTG in the open phase went on to the double‐blind phase. “Responders” were defined as patients with a >50% seizure reduction or less severe seizures or both, or improved behavior or improved motor skills or both. “Nonresponders” were defined as children who showed no positive effects of LTG with plasma levels of 10 μg/ml or children who had adverse events during the open phase. Results: There was a clear statistically significant reduction of seizure frequency in LTG compared with placebo treatment. None of the children studied showed abnormal biochemical or hematologic findings, or changes in plasma levels of concomitantly administered AEDs. Conclusions: LTG is a well‐tolerated and effective treatment in children with intractable generalized epilepsies, including those with Lennox‐Gastaut syndrome. The study design allowed a double‐blind placebo‐controlled assessment of LTG although the participating children used 19 different AED combinations at entry.
[31P]/[1H] Nuclear Magnetic Resonance Study of Mitigating Effects of GYKI 52466 on Kainate‐Induced Metabolic Impairment in Perfused Rat Cerebrocortical Slices
Authors: Tang Pei , Liachenko Serguei , Melick John A. , Xu Yan 
Published: August 2005

Summary: Purpose: Kainic acid (KA) has long been used in experimental animals to induce status epilepticus (SE). A mechanistic implication of this is the association between ex‐citotoxicity and brain damage during or after SE. We evaluated KA‐induced metabolic impairment and the potential mitigating effects of GYKI 52466 [1‐(4‐aminophenyl)‐4‐methyl‐7,8‐methylenedioxy‐5H‐2,3‐benzodiazepine] in superfused rat cerebral cortical slices. Methods: Interleaved [31P]/[1H] magnetic resonance spectroscopy (MRS) was used to assess energy metabolism, intra‐cellular pH (pHi), N‐acetyl‐L‐aspartate (NAA) level, and lactate (Lac) formation before, during, and after a 56‐min exposure to 4 mM KA in freshly oxygenated artificial cerebrospinal fluid (OXY‐ACSF). Results: In the absence of GYKI 52466 and during the KA exposure, NAA, PCr, and ATP levels were decreased to 91.1 ± 0.8, 62.4 ± 3.9, and 59.1 ± 4.3% of the control, respectively; Lac was increased to 118.2 ± 2.1%, and pH, was reduced from 7.27 ± 0.02 to 7.13 2 0.02. During 4‐h recovery with KA‐free ACSF, pHi rapidly and Lac gradually recovered, NAA decreased further to 85.5 ± 0.3%, and PCr and AW showed little recovery. Removal of Mg2+ from ACSF during KA exposure caused a more profound Lac increase (to 147.1 ± 4.0%) during KA exposure and a further NAA decrease (to 80.4 ± 0.5%) during reperfusion, but did not exacerbate PCr, ATP, and pH, changes. Inclusion of 100 μM GYKI 52466 during KA exposure significantly improved energy metabolism: the PCr and ATP levels were above 76.6 ± 2.1 and 82.0 & 2.9% of the control, respectively, during KA exposure and recovered to 101.4 ± 2.4 and 95.0 ± 2.4%, respectively, during reperfusion. NAA level remained at 99.8 ± 0.6% during exposure and decreased only slightly at a later stage of reperfusion. Conclusions: Our finding supports the notion that KA‐induced SE causes metabolic disturbance and neuronal injury mainly by overexcitation through non‐N‐methy1‐D‐aspartate (NMDA) receptor functions.
Symptoms of Depression and Anxiety in Pediatric Epilepsy Patients
Authors: Ettinger Alan B. , Weisbrot Deborah M. , Nolan Edith E. , Gadow Kenneth D. , Vitale Susan A. , Andriola Mary R. , Lenn Nicholas J. , Novak Gerald P. , Hermann Bruce P. 
Published: August 2005

Summary: Purpose: We assessed rates of symptoms of anxiety and depression among pediatric patients with epilepsy. Methods: We administered the Revised Child Manifest Anxiety Scale (RCMAS), and Child Depression Inventory (CDI) to 44 epilepsy patients aged 7–18 years (mean age 12.4 years). Demographic, socioeconomic, and epilepsy‐related information was examined in relation to depression and anxiety scores. Results: No patients had been previously identified to have depression or anxiety. However, 26% had significantly increased depression scores and 16% met critieria for significant anxiety symptomatology. Conclusions: Symptoms of depression and anxiety are common among pediatric patients with epilepsy and appear to be overlooked by care providers.
Real‐Time Automated Detection and Quantitative Analysis of Seizures and Short‐Term Prediction of Clinical Onset
Authors: Osorio Ivan , Frei Mark G. , Wilkinson Steven B. 
Published: August 2005

Summary:Purpose:We describe an algorithm for rapid realtime detection, quantitation, localization of seizures, and prediction of their clinical onset.Methods:Advanced digital signal processing techniques used in time‐frequency localization, image processing, and identification of time‐varying stochastic systems were used to develop the algorithm, which operates in generic or adaptable “modes.” The “generic mode” was tested on (a) 125 partial seizures (each contained in a 10‐min segment) involving the mesial temporal regions and recorded using depth electrodes from 16 subjects, and (b) 205 ten‐minute segments of randomly selected interictal (nonseizure) data. The performance of the algorithm was compared with expert visual analysis, the current “gold standard.”Results:The generic algorithm achieved perfect sensitivity and specificity (no false‐positive and no false‐negative detections) over the entire data set. Seizure intensity, a novel measure that seems clinically relevant, ranged between 35.7 and 6129. Detection was sufficiently rapid to allow prediction of clinical onset in 92% of seizures by a mean of 15.5 s.Conclusions:This algorithm, which was implemented with a personal computer, represents a definitive step toward rapid and accurate detection and prediction of seizures. It may also enable development of intelligent devices for automated seizure warning and treatment and stimulate new study of the dynamics of seizures and of the epileptic brain.
Chromosome 20 Ring: A Chromosomal Disorder Associated with a Particular Electroclinical Pattern
Authors: Canevini Maria Paola , Sgro Vincenzo , Zuffardi Orsetta , Canger Raffaele , Carrozzo Romeo , Rossi Elena , Ledbetter David , Minicucci Fabio , Vignoli Aglaia , Piazzini Ada , Guidolin Loredana , Saltarelli Amalia , Bernardina Bernardo dalla 
Published: August 2005

Summary: Purpose: The chromosome 20 ring [r(20)] is a rare chromosomal disorder without clear phenotypical markers. We describe the electroclinical pattern in a group of patients with r(20). Methods: We observed 3 patients (a boy, patient 1; his mother, patient 2; and an unrelated man, patient 3), performing prolonged video‐EEG and cytogenetic studies and fluorescent in situ hybridization (FISH) with chromosome‐specific telomeric probes. Results: All 3 patients had a very similar abnormal electroclinical pattern characterized by long bursts or trains of rhythmic theta waves, which were sharply contoured or had a notched appearance (with no detectable clinical correlate), and generalized spike waves (SW) associated with seizures of probable frontotemporal origin (SFT). In all 3 patients, the cytogenetic analysis of T lymphocytes showed mosaicism with a normal cell line and a second cell line with a chromosome 20, although the latter was little represented in patients 2 and 3. A few cells with a single chromosome 20 were also found. The same cytogenetic findings were confirmed in the lymphoblastoid cell line of patient 1 and in the fibroblasts of patient 3. FISH with chromosome‐specific telomeric probes and TTAGGG sequences demonstrated the integrity of the ring chromosomes. Conclusions: The clinical picture of these patients appears to be related to the instability of the r(20)‐generating cells monosomic for chromosome 20 and is thus haploinsufficient for a gene. In these patients, the electroclinical pattern of theta waves (probably unrelated to epilepsy) and the SW and SFT, even with mild mental retardation (MR) or no MR and without dysmorphic features, suggest that the r(20) syndrome may be present.
Acute Symptomatic Seizure Disorders in Young Children—A Population Study in Southern Taiwan
Authors: Huang Chao‐Ching , Chang Ying‐Chao , Wang Shan‐Tair 
Published: August 2005

Summary: Purpose: To determine the incidence, etiology, and prognosis of acute symptomatic seizures in children by age 3 years. Methods: In a population‐based birth cohort study of all 15,209 neonatal survivors born in Tainan City between October 1989 and December 1991, parents or caretakers of 13,493 children aged 3 years were surveyed by telephone regarding any provoked convulsive disorder, particularly acute symptomatic seizure, in the children; medical records were reviewed. Results: Sixty‐three children (39 boys, 24 girls) had acute symptomatic seizures (incidence O.46 in 100). The leading causes of acute symptomatic seizures were acute gastroenteritis, encephalitis/encephalopathy, and bacterial meningitis. Age‐specific incidence was highest in the group aged 1–12 months. Intracranial hemorrhage, bacterial meningitis, and metabolic disturbance were the major causes of acute symptomatic seizures in children aged 1–12 months. Acute gastroenteritis, encephalitis/encephalopathy, and bacterial meningitis accounted for 85% of the causes in children aged 13–24 months, and gastroenteritis and encephalitislencephalopathy were the predominant causes in those aged 25–36 months. By age 5 years, subsequent unprovoked seizures developed in 14% of the survivors of acute symptomatic seizures. Conclusions: Many acute symptomatic seizures are preventable. The risk of subsequent unprovoked seizures is determined by underlying precipitating factors. Public education regarding the danger of shaken‐baby syndrome and excessive water supplement, as well as and nationwide vaccination against bacterial meningitis in young children, is necessary.