bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Incorporating Memory Confidence Ratings and Language Handicap Modifications on Intracarotid Amobarbital Procedure (Wada Test) Memory Asymmetry Scores
Authors: Hamberger Marla J. , Hirsch Lawrence J. 
Published: August 2005

Summary: Purpose: Intracarotid amobarbital procedure (IAP) memory asymmetry scores are often considered in determining lateralization of temporal lobe seizure foci. Additionally, these scores sometimes influence treatment plans for epilepsy surgery candidates. We examined the effects of two scoring modifications on IAP asymmetry scores: incorporating memory confidence ratings (MC), and use of a language handicap (LH) (i.e., adding a point to the memory score with anesthetization of the language‐dominant hemisphere), both of which could be applied to most IAP protocols despite variations in testing methods among epilepsy surgery programs. Methods: Sixty‐nine consecutive unilateral temporal lobe epilepsy (TLE) patients with subsequent good surgical outcomes (Engel I or II) underwent bilateral IAP testing. Confidence ratings were obtained for all memory responses. The incorporation of confidence ratings and the application of a language handicap for dominant‐hemisphere injections were applied to memory asymmetry scores in all combinations, resulting in four scoring methods. Results of the four methods were compared with respect to the proportion of patients lateralized accurately by each method. Results: No patients were falsely lateralized with any method. Percentage of patients correctly lateralized with each scoring method is shown in Table 2. The results obtained with MC and with MC + LH (67% and 64% of patients accurately lateralized, respectively) were significantly better than results obtained with LH (55%, p < 0.05). No other differences were significant. Conclusions: Although not statistically superior to standard methods, these results suggest that incorporating memory confidence ratings into IAP protocols may increase the likelihood of obtaining asymmetry scores that accurately lateralize to the hemisphere of seizure onset. In contrast, inclusion of a language handicap for scores obtained with the languagedominant ICA injection were not helpful and may even decrease the probability of obtaining clinically useful lateralizing data. These scoring modifications can be applied to most IAP protocols.
Photic Reflex Myoclonus: A Neurophysiological Study in Progressive Myoclonus Epilepsies
Authors: Rubboli Guido , Meletti Stefano , Gardella Elena , Zaniboni Anna , D'Orsi Giuseppe , Dravet Charlotte , Tassinari Carlo Alberto 
Published: August 2005

Summary:Purpose: To investigate the neurophysiological features of photic reflex myoclonus (PRM) in patients with progressive myoclonus epilepsies (PMEs) of different types (Unverricht‐Lundborg disease, Lafora's disease, cryptogenic).Methods: All patients underwent computerized video‐polygraphic recordings, collecting electromyographic (EMG) activity from several cranial and limb muscles. PRM was elicited by intermittent photic stimulation (IPS).Results: IPS could evoke PRM with a 1:1 relation at frequencies up to 12 Hz. Back‐average of the EEG, triggered from the onset of PRM at the upper limbs, showed a contralateral positive‐negative transient in central region, preceded by ∼10 ms by a similar, ipsilateral occipital wave. When IPS induced bilateral jerking, a time lag of ∼10 ms between the homologous muscles of the two sides was observed, paralleled by a similar delay between the associated contralateral EEG transients in the two central regions, suggesting spread of cortical myoclonic activity from one hemisphere to the other via transcallosal fibers. PRM propagated in different cranial and limb muscles according to a rostrocaudal pattern, with latencies compatible with a transmission along fast‐conducting corticospinal motor pathways.Conclusions: In our PME patients, PRM presented uniform neurophysiological features, indicating the participation of both occipital and motor cortices, with bilateral spread presumably mediated by transcallosal connections and propagation down the spinal cord via fast‐conducting corticospinal pathways.
Seizures During Video‐Game Play and Other Common Leisure Pursuits in Known Epilepsy Patients Without Visual Sensitivity
Authors: Millett C. J. , Fish D. R. , Thompson P. J. , Johnson A. 
Published: August 2005

Summary:Purpose: Some individuals who are negative to flash/pattern sensitivity have been reported to experience seizures while exposed to video games. This study seeks to examine systematically whether exposure to video‐game material is a risk factor for seizures in patients with chronic epilepsy without visual sensitivity.Methods: Two hundred and twelve chronic epilepsy patients participated in the study. All were negative to rigorous flash and pattern sensitivity testing. They were randomly allocated to a video game‐playing session or to a period of leisure (involving reading, physical exercise, puzzles, etc.) and then alternated between these activities for a fixed total of eight 45‐min periods while undergoing video‐EEG monitoring. The study ceased if the participant experienced a clinical seizure.Results: Twenty‐five of 212 subjects experienced a seizure while participating in the study. Thirteen seizures occurred during periods of video‐game play, and 12 during alternative leisure.Conclusions: We have not identified a greater risk of seizures in patients with (not visually sensitive) epilepsy during videogame play compared with other common leisure pursuits. Furthermore, we exposed a large population (212 patients) mostly with severe epilepsy, mainly drug reduced and some sleep deprived, to prolonged video game‐playing without observing a significant excess number of seizures. This finding provides strong support for the hypothesis that seizures during video game play in the >95% of the epilepsy population without visual sensitivity are most likely to represent a chance occurrence, although, as always, each individual should be carefully assessed.
Zonisamide
Authors: Leppik Ilo E. 
Published: August 2005

Summary:Zonisamide (ZNS) is a broad‐spectrum antiepileptic drug in both animal models of epilepsy and patients with epilepsy. It is effective for both localization‐related and generalized epilepsies and appears to be particularly potent in progressive myoclonic epilepsy syndromes. Its pharmokinetic profile is favorable, with a long half‐life and low protein binding. However, its insolubility may make the development of a parenteral formulation difficult. Its safety profile is good, although teratogenicity in animal models is of concern. Adult doses of 400–600 mg per day in two doses, with blood levels from 20 to 30 mg/ml, appear to be effective.
Topiramate
Authors: Glauser Tracy A. 
Published: August 2005

Summary:Six studies are cited to demonstrate that topiramate is effective as adjunctive therapy for refractory partial‐onset seizures in adults. Subsequent studies indicate that topiramate is also effective as monotherapy in adults and as adjunctive therapy for partial‐onset seizures in children, tonic‐clonic seizures of nonfocal origin in children and adults, and drop attacks in Lennox‐Gastaut syndrome. Adverse effects for adults and children included dizziness, fatigue, ataxia, confusion, somnolence, nephrolithiasis, paresthesia, and weight loss. More adverse effects were observed at higher doses. Topiramate exhibits rapid absorption, long duration of action, and minimal interaction with other antiepileptic drugs.
Increased Sensitivity to Seizures in Mice Lacking Cellular Prion Protein
Authors: Walz Roger , Amaral Olavo B. , Rockenbach Isabel C. , Roesler Rafael , Izquierdo Iván , Cavalheiro Esper A. , Martins Vilma R. , Brentani Ricardo R. 
Published: August 2005

Summary: Purpose: The physiologic role of the cellular prion protein (PrPc) is unknown. Mice devoid of PrPc develop normally and show only minor deficits. However, electrophysiologic and histologic alterations found in these mice suggest a possible role for PrPc in seizure threshold and/or epilepsy. Methods: We tested the sensitivity of PrPc knockout mice to seizures induced by single convulsant or repeated subconvulsant (kindling) doses of pentylenetetrazol (PTZ), and to status epilepticus (SE) induced by kainic acid or pilocarpine. Results: In PTZ kindling, seizure severity progressed faster in the PrPc knockout group, in which 92.8% reached stage 5 or death after 4 days of stimulation, as opposed to 38.4% in wild‐type animals. After 10 injections, mortality was 85.7% among knockouts and 15.3% among controls. After a single PTZ injection (60 mg/kg), overall mortality due to seizures was 91% in knockout mice, but only 33% among wild‐type animals. Pilocarpine‐induced SE (320 mg/kg) caused an 86.7% mortality in knockouts, as opposed to 40% in wild‐type animals. Finally, after kainic acid injections (10 mg/kg), 70% of the knockouts developed at least one severe seizure, and 50% showed repetitive seizures, whereas no wild‐type animal exhibited observable seizures. Conclusions: Animals lacking cellular prion protein expression are more susceptible to seizures induced by various convulsant agents. This is perhaps the most striking alteration yet found in PrPc‐null mice, who at first analysis appeared to be completely normal. A possible role for PrPc in chronic and idiopathic (familial), secondary, or cryptogenic epilepsies in humans remains to be investigated.
Apolipoprotein E Polymorphisms and the Risk of Nonlesional Temporal Lobe Epilepsy
Authors: Gambardella Antonio , Aguglia Umberto , Cittadella Rita , Romeo Nelide , Sibilia Grazia , LePiane Emilio , Messina Demetrio , Manna Ida , Oliveri Rosario L. , Zappia Mario , Quattrone Aldo 
Published: August 2005

Summary: Purpose: To evaluate whether the inheritance of the apolipoprotein E (ApoE) ε4 allele is a risk factor for nonlesional temporal lobe epilepsy (TLE), and to determine whether the newly described ‐491 A/T ApoE polymorphism may independently affect the risk of nonlesional TLE. Methods: The study group consisted of 63 patients (35 women and 28 men; age at onset of epilepsy, 30.6 ± 19.6 years; mean (±SD). All of them had received a diagnosis of nonlesional TLE after a detailed clinical, electroencephalographic, and brain magnetic resonance investigation. The ApoE polymorphisms were determined from blood samples by standard methods. The molecular study also was performed in 220 age‐ and sex‐matched normal individuals. Results: There were no differences between TLE patients and controls in either allelic or genotypic frequencies of the ApoE and ‐491 A/T polymorphisms. Moreover, no effect of ApoE or ‐491 A/T polymorphisms was found on the age at onset and severity of epilepsy. Conclusions: The allelic and genotypic frequencies of ApoE polymorphisms in Italian patients with nonlesional TLE are comparable to control values, indicating that ApoE polymorphisms are not a significant genetic risk factor for the occurrence of nonlesional TLE.
Improvement and Deterioration of Seizure Control During the Postsurgical Course of Epilepsy Surgery Patients
Authors: Ficker D. M. , So E. L. , Mosewich R. K. , Radhakrishnan K. , Cascino G. D. , Sharbrough F. W. 
Published: August 2005

Summary: Purpose: To determine the factors associated with changes in seizure control during the postsurgical course of epilepsy surgery patients. Methods: Evaluation of patients after consecutive temporal and frontal resection whose seizure frequency was scored for each year of postsurgical follow‐up. In each cohort, patients with a change in their seizure control after the first postsurgical year were compared with control subjects to determine factors that may be responsible for the change. Results: Thirty‐three (15%) of 214 temporal lobectomy versus 12 (20%) of 59 frontal resection patients experienced a change in seizure control (p < 0.05). Ten (5%) of 214 temporal lobectomy versus nine (15%) of 59 frontal resection patients experienced an improvement in seizure control (p = 0.009), but 23 (11%) of 214 temporal lobectomy versus three (5%) of 59 frontal resection patients had a worsening in seizure control (p < 0.05). In temporal lobectomy patients, preoperative unilateral temporal epileptiform discharges were associated with improvement (p = 0.03), whereas older age at surgery was associated with worsening of seizure control (p = 0.007). In frontal resection patients, presence of a congenital central nervous system (CNS) anomaly was associated with late improvement in seizure control (p = 0.006). Conclusion: During the postsurgical course, an improvement in seizure control is more common after frontal resection than after temporal lobectomy. Factors associated with improvement are the presence of a congenital CNS abnormality in frontal resection patients, and the occurrence of preoperative unilateral epileptiform discharges in temporal lobectomy patients. Older age at temporal lobectomy may be associated with greater risk of worsening seizure control.
Psychosis After Resection of Ganglioglioma or DNET: Evidence for an Association
Authors: Andermann Lisa F. , Savard Ghislaine , Meencke Heinz Joachim , McLachlan Richard , Moshé Solomon , Andermann Frederick 
Published: August 2005

Summary: Purpose: David Taylor and Murray Falconer suggested that some patients may develop a psychotic illness after resection of a ganglioglioma that led to intractable seizures. They implied that the mechanism of this association remained unclear. This concept is currently not universally accepted (M. Trimble, personal communication). Methods: We studied six children or young adults from four centers who developed psychosis after resection of a ganglioglioma or dysembryoplastic neuroepithelioma (DNET). Results: All patients were operated on because of intractable epilepsy. The lesions involved mainly the temporal lobe. Patients had good outcomes for seizure control. In none of the six was potentially psychogenic medication used nor were the psychotic symptoms postictal in nature. The psychosis was schizophreniform with paranoid features and prominent depressive symptoms. Although some behavioral abnormalities were described preoperatively, none had been psychotic before operation. This type of psychotic reaction was not encountered in the four centers in a comparable period after resection of other types of lesions. This complication is rare; it occurred in only one of 39 patients who had such a lesion resected. Conclusions: Psychotic illness may rarely occur after resection of a ganglioglioma or DNET for treatment of intractable epilepsy. This does not seem to occur after removal of other types of lesions. Because the patients had good outcomes for seizures, the mechanism may be related to “forced normalization.” The original observations of Taylor and Falconer are confirmed by this study; the reasons for the selective occurrence, however, remain speculative.
Short‐Term Mortality After a First Epileptic Seizure: A Population‐Based Study
Authors: Loiseau Jérôme , Picot Marie‐Christine , Loiseau Pierre 
Published: August 2005

Summary: Purpose: To determine the short‐term mortality in a prospective incidence cohort of patients included after any kind of first afebrile epileptic seizure (i.e., provoked and unprovoked). Methods: Information on death occurring within the first year of follow‐up was collected in a cohort of 804 patients with a first seizure between March 1, 1984, and February 28, 1985, in southwest France. The variables analyzed were the etiology of seizure, cause of death, interval between seizure and death, and age of patients. Results: By the end of the 1‐year follow‐up, there were 149 deaths among these patients as compared with 16 expected deaths [standardized mortality ratio (SMR), 9.3; 95% confidence interval (CI), 7.9–10.9]. There were no deaths in patients with idiopathic seizures. Patients with cryptogenic seizures had slightly increased mortality (SMR, 1.6; 95% CI, 0.4–4.1). Mortality was increased for patients with remote symptomatic seizures (SMR, 6.5; 95% CI, 3.8–10.5), provoked seizures (SMR, 10.1; 95% CI, 8.1–12.4), and seizures due to a progressive neurologic condition (SMR, 19.8; 95% CI, 14.0–27.3). Causes of death were underlying pathology (64%), unrelated condition (20%), unknown cause (9%), seizure‐related death (6%), and one suicide. Conclusions: Early mortality clearly differed according to the etiology of the first seizure. The highest mortality was associated with provoked seizures and with seizures caused by progressive central nervous system disorders. Patients died far more often from underlying or unrelated conditions than from seizures.
Correlations Between Granule Cell Dispersion, Mossy Fiber Sprouting, and Hippocampal Cell Loss in Temporal Lobe Epilepsy
Authors: Bahh Bouchaib El , Lespinet Véronique , Lurton Dominique , Coussemacq Monique , Salle Gildas Le Gal La , Rougier Alain 
Published: August 2005

Summary: Purpose: Correlations between granule cell dispersion (GCD), collateral mossy fiber (MF) sprouting, and hippocampal cell loss were studied to assess the relation between GCD and synaptic reorganization in the dentate gyrus of patients with epilepsy. Methods: Twenty specimens from patients with medically intractable temporal lobe epilepsy (TLE) were studied along with two control specimens. GCD was considered to be present when the stratum granulosum was wider than 120 μm, the close apposition between the granule cell (GC) soma was lost, and GCs were scattered in the molecular layer (ML). Patterns of MF sprouting were differentiated as wide or narrow according to the area of neo‐Timm's staining in the ML. GC loss and volumetric cell‐density decreases in the different subfields were assessed. Results: MF sprouting was observed in 16 (80%) and GCD in nine (45%) cases. A significant correlation was found between MF sprouting and cell loss in all the subfields except the cornu Ammonis field 2 (CA2). A wide band of MF sprouting was associated with severe cell loss. Cases with GCD had a wide band of MF sprouting and also a higher degree of cell loss than cases without GCD. Conclusion: GCD is associated with a specific pattern of MF sprouting, but cell loss was found to be a major determinant for MF reorganization.
Periictal Diffusion‐Weighted Imaging in a Case of Lesional Epilepsy
Authors: Diehl B. , Najm I. , Ruggieri P. , Foldvary N. , Mohamed A. , Tkach J. , Morris H. , Barnett G. , Fisher E. , Duda J. , Lüders H. O. 
Published: August 2005

Summary: Purpose: Diffusion‐weighted MR imaging (DWI) has been used for the early diagnosis of acute ischemic lesions in humans and in animal models of focal status epilepticus. We hypothesized that DWI may be a sensitive, noninvasive tool for the localization of the epileptogenic area during the periictal period. Methods: A periictal DWI study was performed on a 35‐year‐old patient during focal status epilepticus with repetitive prolonged focal motor seizures originating from a lesion in the right frontal lobe. DWI results were analyzed visually and by calculating apparent diffusion coefficient (ADC) maps. Results: On DWI, a single area of signal increase (decrease in ADC) was found in the region of focal electrocorticographic seizures that was mapped intraoperatively. Conclusions: Ictal/postictal DWI may be a useful technique for seizure localization in patients with lesional epilepsy.
Hippocampal and Entorhinal Cortex High‐Frequency Oscillations (100–500 Hz) in Human Epileptic Brain and in Kainic Acid‐Treated Rats with Chronic Seizures
Authors: Bragin Anatol , Engel Jerome , Wilson Charles L. , Fried Itzhak , Mathern Gary W. 
Published: August 2005

Summary: Purpose: Properties of oscillations with frequencies >100 Hz were studied in kainic acid (KA)‐treated rats and compared with those recorded in normal and kindled rats as well as in patients with epilepsy to determine differences associated with epilepsy. Methods: Prolonged in vivo wideband recordings of electrical activity were made in hippocampus and entorhinal cortex (EC) of (a) normal rats, (b) kindled rats, (c) rats having chronic recurrent spontaneous seizures after intrahippocampal KA injections, and (d) patients with epilepsy undergoing depth electrode evaluation in preparation for surgical treatment. Results: Intermittent oscillatory activity ranging from 100 to 200 Hz in frequency and 50–150 ms in duration was recorded in CA1 and EC of all three animal groups, and in epileptic human hippocampus and EC. This activity had the same characteristics in all groups, resembled previously observed “ripples” described by Buzsáki et al., and appeared to represent field potentials of inhibitory postsynaptic potentials (IPSPs) on principal cells. Unexpectedly, higher frequency intermittent oscillatory activity ranging from 200 to 500 Hz and 10–100 ms in duration was encountered only in KA‐treated rats and patients with epilepsy. These oscillations, termed fast ripples (FRs), were found only adjacent to the epileptogenic lesion in hippocampus, EC, and dentate gyrus, and appeared to represent field potential population spikes. Their local origin was indicated by correspondence with the negative phase of burst discharges of putative pyramidal cells. Conclusions: The persistence of normal‐appearing ripples in epileptic brain support the view that inhibitory processes are preserved. FRs appear to be field potentials reflecting hypersynchronous bursting of excitatory neurons and provide an opportunity to study the role of this pathophysiologic phenomenon in epilepsy and seizure initiation. Furthermore, if FR activity is unique to brain areas capable of generating spontaneous seizures, its identification could be a powerful functional indicator of the epileptic region in patients evaluated for surgical treatment.
Influence of Valproate Monotherapy on Platelet Activation and Hematologic Values
Authors: Zeller Joern A. , Schlesinger Stefan , Runge Uwe , Kessler C. 
Published: August 2005

Summary: Purpose: Valproate (VPA) has been linked to coagulation disturbances, with both impaired and exaggerated clotting, which has been attributed to an effect of VPA on platelets or hemostatic proteins. Additional thrombocytic function testing may help to identify patients at risk of increased bleeding caused by platelet dysfunction. Methods: We evaluated the influence of VPA on hematologic routine values and platelet activation by using immunostaining and flow cytometry in 30 patients receiving long‐term VPA therapy and in 30 controls. Results: The fraction of activated platelets was similar in both groups; however, the general extent of platelet activation was significantly lower in the patient group, with considerable interindividual variability. In addition, patients had a significantly lower platelet count, prolonged thrombin time, and higher mean corpuscular hemoglobin. Conclusions: Our data confirm the previously reported hematologic changes caused by VPA and additionally suggest that VPA impairs procoagulatory thrombocytic function, which is reflected by reduced platelet activation and increased thrombin time. Possible mechanisms of VPA‐platelet interaction are discussed.