bluuebunny/crossref_metadata_2025_split huggingface dataset:
Corpus Callostomy in Treatment of Medically Resistant Epilepsy: Preliminary Results in a Pediatric Population
Authors: Cendes Fernando , Ragazzo Paulo C. , da Costa Valter , Martins Luis F. 
Published: August 2005

Summary:We report the results of 34 patients who underwent corpus callosotomy between 1986 and 1989 with 28–65 months of postoperative follow‐up (mean 42 months). Thirty‐two patients had mental retardation and 26 had significant behavioral problems. Thirteen patients had total section, 8 had subtotal section with preservation of the posterior half of the splenium, and 13 had section of the anterior two thirds of the callosum. Satisfactory seizure control was achieved in 25 patients (73.5%.) Atonic seizures, followed by tonic seizures, generalized tonic‐clonic seizures (GTCs), and atypical absence seizures were most improved. Myoclonic and complex partial seizures (CPS) did not improve significantly. No deterioration in seizure status was observed postoperatively. Two patients developed previously unobserved simple seizures and CPS postoperatively, but they were not as disabling as the preoperative seizures. Among the patients with behavioral problems, 81% had significant decrease in aggressiveness, hyperactivity, and/or attention deficit. Patients who underwent total section had interhemispheric disconnection symptoms that improved progressively and did not interfere with daily life. Decreased speech output, dysarthria, and gait dyspraxia occurred after total callosal section and persisted in 5 of the 13 patients. Patients who underwent anterior two thirds or subtotal sections did not have such symptoms. Early postoperative complications consisted of aseptic ventriculitis (5), subdural hematoma (1), and wound infection (4) and resolved without sequelae.
Suppression of Interictal Spikes and Seizures by Stimulation of the Vagus Nerve
Authors: McLachlan Richard S. 
Published: August 2005

Summary:The effects of electrical stimulation of the vagus nerve, a proposed treatment for patients with intractable epilepsy, on focal interictal spikes produced by penicillin and EEG secondarily generalized seizures induced by pentylenetetrazol were assessed in rats. Interictal spike frequency was reduced by 33% during 20 s of stimulation (p < 0.001) and remained low for ≤3 min. Amplitude of residual spikes was also decreased. Cardiac and respiratory rates were suppressed. Cooling the nerve proximal to the point of stimulation abolished the EEG and respiratory effects. A similar reduction in spike frequency of 39% was obtained by heating the animals' tail (p < 0.01). Vagal stimulation at onset of seizures reduced mean seizure duration from 30.2 ± 15.7 s without stimulation to 5.0 ± 1.8 s (p < 0.01). Only the EEG equivalent of the clonic phase of the seizure was affected. These findings suggest that vagus nerve stimulation can be a potent but nonspecific method to reduce cortical epileptiform activity, probably through an indirect effect mediated by the reticular activating system.
Motor and Sensory Impairments in Children with Intractable Epilepsy
Authors: Beckung Eva , Uvebrant Paul 
Published: August 2005

Summary:During a 3‐year period (1988–1991), 72 children with severe intractable epilepsy were studied. A standardized protocol for assessment of motor and sensory function was designed for school age children. Function was quantified on a 4‐point scale on 47 items, including gross motor function, balance, coordination, strength, range of motion (ROM), velocity, fine motor function, sensation, perception, and neurologic tests. Classification of handicaps according to World Health Organization (WHO) definitions was performed. Videotape documentation completed the assessment. Evaluation of treatment services showed that provision of rehabilitation services had been insufficient and provided only for children with additional major movement disorders, mainly cerebral palsy (CP) cases. To minimize the handicap in children with severe epilepsy, it is essential to clarify the total sensorimotor impairment pattern, including balance, co‐ordination, and perceptual capacity. Impairments in these functions are, as shown in this study, frequent and exist independent of major disabilities such as mental retardation or cerebral palsy. When several neuroimpairments were identified, a multiplicative rather than an additive effect on the total handicap was evident.
Remission of Seizures and Predictors of Intractability in Long‐Term Follow‐Up
Authors: Sillanpää Matti 
Published: August 2005

Summary:In an incidence cohort, remission and relapse rates and determinants were studied in 178 patients followed long‐term. A comparative study of predictive factors was performed in 40 patients with histories of antiepileptic (AED)‐drug‐refractory epileptic seizures in the last 10 years of follow‐up and compared with the other 138 cohort subjects. The two groups were cross‐tabulated with 353 variables of family history, obstetric, developmental and seizure histories, and current medical and social status. Multivariate analyses were applied for control of confounding. Defined or probable remote symptomatic etiology of seizures, abnormal neurologic development/ status, high initial seizure frequency, occurrence of status epilepticus, and poor short‐term effects of AED therapy were significantly associated with long‐term AED refractoriness. On logistic regression analyses, poor short‐term outcome of AED therapy [odds ratio (OR) 3.6; 95% confidence interval (CI) 1.2–10.4], occurrence of status epilepticus (OR 11.4; 95% CI 3.2–41.0), high initial seizure frequency (OR 4.6; 95% CI 1.1–19.3), and remote symptomatic seizure etiology (OR 2.9; 95% CI 1.1–8.2) remained the only independent predictors of seizure intractability. These factors enable early assessment of need for epilepsy surgery.
Interictal Temporal Hypoperfusion Is Related to Early‐Onset Temporal Lobe Epilepsy
Authors: Duncan Roderick , Patterson James , Hadley Donald , Roberts Richard , Bone Ian 
Published: August 2005

Summary:Previous studies of interictal regional cerebral blood flow (rCBF) in temporal lobe epilepsy have shown variable correlations with clinical measures. We used high spatial resolution hexamethyl propyleneamine oxime single photon emission computed tomography (HMPAO SPECT) in 80 consecutive patients with complex partial seizures (CPS), comparing results with those from a large series of normal subjects. Visual image analysis detected abnormalities of rCBF in 41 of 80 (51%; numeric analysis detected abnormalities in 38 of 80). Age at epilepsy onset was significantly younger in patients with temporal hypoperfusion (p = 0.002), and the frequency distribution of hypoperfusion versus age at epilepsy onset was reverse exponential. The results of numerical image analysis showed that degree of hypoperfusion did not vary with age at epilepsy onset. These data suggest a single insult operating early in life as a cause of temporal hypoperfusion, as has been shown for mesial temporal sclerosis (MTS). We could not demonstrate relationships with other clinical variables, including time since last seizure.
Weeping During Psychogenic Nonepileptic Seizures
Authors: Walczak Thaddeus S. , Bogolioubov Alexei 
Published: August 2005

Summary:Ictal weeping may help distinguish psychogenic nonepileptic seizures (PNES) from epileptic seizures. However, the prevalence of weeping during PNES or epileptic seizures is unknown. We reviewed videotapes of recorded events in 84 consecutive patients with PNES or epilepsy. Weeping was observed during 14% of PNES in 31% of patients with PNES. Ictal weeping was not observed in any epileptic seizures occurring in 48 patients. The differences were highly significant. One patient with epileptic seizures originating in the right temporal lobe wept soon after the end of a seizure. Depression was not more common in PNES patients with than without ictal weeping. Weeping during an apparent seizure strongly argues that the event is not epileptic.
Two Patients with Juvenile Myoclonic Epilepsy and Nonconvulsive Status Epilepticus
Authors: Kimura Seiji , Kobayashi Takuya 
Published: August 2005

Summary:We report 2 girls, aged 10 and 13 years, with juvenile myoclonic epilepsy (JME) who had episodes of nonconvulsive status epilepticus (NCSE). Symptoms included only mild lethargy, slow responses, and trembling of the eyelids. There was no ataxia or myoclonus of the limbs or body, and they were always able to respond. Electroencephalograms during these episodes showed almost continuous generalized polyspike‐waves in both patients. Patients with JME can develop NCSE, which may be overlooked because of the subtle clinical symptoms.
Cutis Verticis Gyrata—Mental Deficiency Syndrome: A Patient with Drug‐Resistant Epilepsy and Polymicrogyria
Authors: Striano Salvatore , Ruosi Patrizia , Guzzetta Vito , Perone Lucia , Manto Andrea , Cirillo Sossio 
Published: August 2005

Summary:We report a case of cutis verticis gyrate‐mental deficiency syndrome (CVG‐MD) which was associated with drug‐resistant epilepsy and bilateral occipital polymicrogyria. Genetic analysis showed an increased number of breaks at the 3p14 and 16q23 sites. We hypothesize that a deleterious factor acting at a critical period of intrauterine development could result in the cerebral malformation and in the development of CVG. Neuroradiological investigation is warranted in cases of CVG‐MD.
Predictors of Outcome of Epilepsy Surgery: Multivariate Analysis with Validation
Authors: Armon Carmel , Radtke Rodney A. , Friedman Allan H. , Dawson Deborah V. 
Published: August 2005

Summary: Purpose: To identify predictors of outcome of epilepsy surgery, using the Duke experience, applying multivariate analysis and validation techniques. To compare the results of different modeling algorithms. Few previous studies have reported multivariate analysis, or validated their results.Methods: Records of 116 patients with focal resections for intractable epilepsy from January 1, 1980 through June 30, 1989 were analyzed. Primary outcome variable was patient's condition in second postoperative year: seizure free (except auras), or not. Three predictors of biologic interest were specified a priori for confirmatory analysis. Additional predictors were considered within exploratory analysis. Logistic regression techniques were applied to assess relations with pre‐and postoperative predictors. Internal validity was assessed by repeated random selection of training and validation samples, used in conjunction with bootstrap techniques.Results: By using multivariate analysis, percentage of epileptic EEG activity arising from the site of resection and either imaging localization or lack of use of invasive monitoring were the only statistically significant preoperative predictors for good outcome at 2 years. Presence of seizures'within 2. months of surgery was a significant postoperative predictor for a poor outcome. Adding more variables did not result in significantly improved models. Use of validation techniques reduced the degree of optimism in the predictive value of the models.Conclusions: Pooling of data from multiple institutions is needed to attain the large sample sizes needed for multivariate analysis with validation.
Reproduction Among Individuals with Idiopathic/Cryptogenic Epilepsy: Risk Factors for Reduced Fertility in Marriage
Authors: Schupf Nicole , Ottman Ruth 
Published: August 2005

Summary: Purpose: We wished to determine risk factors for reduced fertility in marriage in men and women with idiopathic/cryptogenic epilepsy and to relate rates of reproduction to the risk of epilepsy in offspring of affected individuals.Methods: We determined history of pregnancy and child bearing among 863 adults with idiopathic/cryptogenic epilepsy (ascertained from voluntary organizations) who had been married at some time in their lives and from their same‐sex siblings without epilepsy who had been married. We examined the effects of seizure type, age at onset, and family history of epilepsy on fertility. Fertility rates were measured as live births per person‐year of marriage before and after onset of epilepsy and compared with fertility rates among same‐sex siblings without epilepsy by incidence rate ratios (IRR).Results: For both men and women with epilepsy, reduced fertility was observed after, but not before, onset of epilepsy: Among both men and women with epilepsy, those with partial onset and early age at onset (<10 years) were more reproductively disadvantaged than those with generalized onset and later age at onset. Among those with epilepsy, men with a family history of epilepsy were less reproductively disadvantaged than men without a family history of epilepsy, whereas women with and without a family history of epilepsy did not differ.Conclusions: We found no evidence of selectively reduced fertility among men with a genetic susceptibility to epilepsy that could account for the higher risk of epilepsy among offspring of affected women than among offspring of affected men.
Characteristics of Seizures in a Population‐Based Series of Mentally Retarded Children with Active Epilepsy
Authors: Steffenburg Ulf , Hagberg Gudrun , Kyllerman Mårten 
Published: August 2005

Summary: Purpose: The characteristics of seizures were analysed in a population‐based study of active epilepsy in 6‐to 13‐year‐old mentally retarded children.Methods: The search procedure included diagnostic registers, EEG registers, and registers of the Education of the Subnormal. Medical files were scrutinized, and clinical examinations and interviews with parents or caretakers or both were performed.Results: The median age of seizure onset was 1·3 years, 3·1 for children with mild retardation and 0·8 for children with severe retardation. Among the 98 children identified, current seizure groups were partial in 20, generalized in 59, and mixed in 19. The prevailing seizure types were tonic‐clonic, myoclonic, atypical absences, and partial complex seizures, present in 42, 33, 23, and 23 children, respectively. A total of 46 children had more than one seizure type. Seizures every day/week occurred in 44 children. There was a constancy between seizure type at onset and later seizure type. Neonatal seizures (n = 25), infantile spasms (n = 12), and status epilepticus (n = 37) occurred independent of one another. Prognostic factors for poor neurologic outcome were early onset of epilepsy, infantile spasms as onset type, and prior neonatal seizures. Children with only partial seizures less frequently had severe mental retardation, cerebral palsy, and visual impairment than those with only generalized seizures.Conclusions: Epilepsies in children with mental retardation are characterized by severe seizure manifestations. The brain damage giving rise to mental retardation and epilepsy is probably the main factor in terms of seizure outcome.
Empirical Techniques for Determining the Reliability, Magnitude, and Pattern of Neuropsychological Change After Epilepsy Surgery
Authors: Hermann Bruce P. , Seidenberg Michael , Schoenfeld Jen , Peterson Jacqueline , Leveroni Catherine , Wyler Allen R. 
Published: August 2005

Summary: Purpose: We assessed test‐retest neuropsychological performance in patients with complex partial seizures to derive reliable change indices (RCIs) and regression‐based norms for change, indices that may be helpful in assessing cognitive outcome after anterior temporal lobectomy. Methods: Forty patients with complex partial seizures (CPS) who did not undergo epilepsy surgery were administered a comprehensive neuropsychological battery on two. occasions. Their test‐retest data were used to compute both RCIs and regression‐based norms for change for each neuropsychological index. RCIs corrected for practice effects provide a confidence interval (CI) indicating the degree of performance change required to exceed the variability attributable to sources of error (e.g., practice, test‐retest reliability). Regression‐based norms for change also correct for several sources of measurement measurement error and examine observed versus expected test‐retest changes on a common metric, thereby facilitating determination of the degree and relative magnitude of change across cognitive domains. Results: Mean changes in test‐retest performance were generally modest, but were evident across several test measures. Our data indicate a considerable degree of individual variability in test‐retest Performance. Conclusions: RCIs and regression‐based norms are complementary indexes and can be particularly useful in examining the test‐retest performance of individual patients who undergo epilepsy surgery as well as in the more general investigation of cognitive outcome after epilepsy surgery.
Incidence of Epilepsy in Rural Iceland: A Population‐Based Study
Authors: Olafsson Elías , Hauser W. Allen , Ludvigsson Pétur , Gudmundsson Gunnar 
Published: August 2005

Summary: Purpose: We wished to determine the incidence of epilepsy in the population of rural Iceland. Methods: Cases were identified through review of records of primary care facilities for the study population, supplemented by review of referrals to EEG facilities and neurologic specialists. Results: The incidence of epilepsy (recurrent unprovoked seizures) was 47 in 100,000. Age‐specific incidence was bimodal, highest in the youngest and oldest age groups. About one third of the patients had an identifiable etiology, and one third had partial seizures. Integration of imaging and neurophysiologic data did little to modify the distribution of etiology or seizure type. Conclusions: The present study confirms findings of other recent studies of incidence in Western Countries.
Autosomal Dominant Nocturnal Frontal Lobe Epilepsy: Electroclinical Picture
Authors: Oldani Alessandro , Zucconi Marco , Ferini‐Strambi Luigi , Bizzozero Daniele , Smirne Salvatore 
Published: August 2005

Summary: Purpose: Nocturnal frontal lobe epilepsy is a disorder that is difficult to diagnose because its clinical presentation is often limited to motor behavior during sleep. For this reason, a misleading diagnosis of benign nocturnal parasomnias might be possible. Recently, an inherited form of nocturnal frontal lobe epilepsy was described in some families. The aim of our work was to describe the electroclinical pattern of a sample of familial cases with this syndrome. Methods: We observed 33 patients, all complaining of frequent nocturnal motor attacks, from eight Italian families. The family trees were strongly supportive of autosomal dominant inheritance. We performed a full‐night video‐polysomnographic monitoring in 12 patients. Results: The recordings showed attacks in all patients, there being a widespread pattern of motor activity. Ictal and interictal EEG abnormalities were often hidden and, unless associated with a video recording, were of no use for the final diagnosis. Intraindividual stereotypy, abrupt onset, and semiology of attacks allowed differentiation from healthy subjects’nocturnal motor behavior. Conclusions: Autosomal dominant nocturnal frontal lobe epilepsy is probably not uncommon. Full‐night video‐polysomnographic monitoring is fundamental for the differential diagnosis of benign parasomnias and, consequently, for appropriate therapy.
The Ictal Bradycardia Syndrome
Authors: Reeves Andrew L. , Nollet Kenneth E. , Klass Donald W. , Sharbrough Frank W. , So Elson L. 
Published: August 2005

Summary: Purpose: Episodic loss of consciousness presents a diagnostic challenge to the neurologist. A perhaps under‐recognized cause of episodic loss of consciousness, which we call the ictal bradycardia syndrome, occurs when epileptic discharges profoundly disrupt normal cardiac rhythm, resulting in cardiogenic syncope during the ictal event. We attempt to determine whether the presence of the ictal bradycardia syndrome provides localizing information regarding the site of seizure onset and to describe the demographics of patients with this syndrome. We also discuss difficulties in diagnosis and treatment. Methods: We review 23 cases of the ictal bradycardia syndrome from the literature and present four additional cases. Brief histories are provided for the four previously unreported cases. Where data are available, cases are analyzed with respect to age, sex, and site of seizure onset. Results: Patients with the ictal bradycardia syndrome ranged from 4 months to 72 years (mean 39 years). There was an approximately 5:1 ratio of males to females. Twenty of the 23 patients (87%) whose site of ictal onset could be localized had temporal lobe epilepsy, although no clear lateralizing predominance was apparent. Conclusions: The ictal bradycardia syndrome should be considered in patients with unusual or refractory episodes of syncope, or in patients with a history suggestive of both epilepsy and syncope. It suggests seizure onset in temporal lobe, and is more commonly diagnosed in males. Diagnosis may be aided by ambulatory EEGECG monitoring. Cardiac pacemaker implantation along with antiepileptic drug therapy may be necessary to minimize the possibility of death.
Cortical Hypometabolism and Delayed Myelination in West Syndrome
Authors: Natsume Jun , Watanabe Kazuyoshi , Maeda Norihide , Kasai Keiko , Negoro Tamiko , Aso Kosaburo , Nakashima Sachie , Tadokoro Masanori 
Published: August 2005

Summary: Purpose: We examined the relation between cortical hypometabolism and delayed myelination in patients with West syndrome (WS). Methods: Serial positron emission tomography (PET) with [18F]fluorodeoxyglucose ([18F]FDG) and magnetic resonance imaging (MRI) were performed in 18 patients with WS, first at the onset of epileptic spasms and later at age 10 months. The age at onset of seizures ranged from 2 to 7 months. Ten patients were diagnosed as having cryptogenic WS and 8 as having symptomatic WS. Results: Cortical hypometabolism was detected in many patients at onset of epilepsy, but disappeared later, whereas delayed myelination tended to become evident with age. PET showed diffuse or focal cortical hypometabolism in 12 patients at onset, but in only 6 patients at age 10 months. MRI showed delayed myelination in only 2 patients at onset of epilepsy, but the number of patients with delayed myelination increased to 12 at age 10 months. Delayed myelination was more often present in patients with cortical hypometabolism. Delayed myelination was noted in 11 (85%) of 13 patients with cortical hypometabolism on first or second PET scans, but in only 1 (20%) of 5 patients who did not show PET abnormalities. Hypometabolism on the first or second PET scan was positively correlated with delayed myelination at age 10 months. Conclusions: In patients with WS, assessing myelination with MRI again at age 8–10 months is important even when MRI at the onset of epilepsy appears normal. Serial MRI and PET scans disclose more detailed pathophysiology of WS.