bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurosteroid Withdrawal Model of Perimenstrual Catamenial Epilepsy
Authors: Reddy Doodipala S. , Kim Hee‐Yong , Rogawski Michael A. 
Published: March 2003

Summary:  Purpose: Perimenstrual catamenial epilepsy, the increase in seizure frequency that some women with epilepsy experience near the time of menstruation, may in part be related to withdrawal of the progesterone metabolite allopregnanolone, an endogenous anticonvulsant neurosteroid that is a potent positive allosteric γ‐aminobutyric acidA (GABAA) receptor modulator. The objective of this study was to develop an animal model of perimenstrual catamenial epilepsy for use in evaluating drug‐treatment strategies.Methods: A state of prolonged high serum progesterone (pseudopregnancy) was induced in 26‐day‐old female rats by sequential injection of pregnant mares' serum gonadotropin and human chorionic gonadotropin. Neurosteroid withdrawal was induced by treatment with finasteride (100 mg/kg, i.p.), a 5α‐reductase inhibitor that blocks the conversion of progesterone to allopregnanolone. Plasma progesterone and allopregnanolone levels were measured by gas chromatography/electron capture negative chemical ionization mass spectrometry. Seizure susceptibility was evaluated with the convulsant pentylenetetrazol (PTZ).Results: Plasma allopregnanolone levels were markedly increased during pseudopregnancy (peak level, 55.1 vs. control diestrous level, 9.3 ng/mL) and were reduced by 86% 24 h after finasteride treatment (6.4 ng/mL). Progesterone levels were unaffected by finasteride. After finasteride‐induced withdrawal, rats showed increased susceptibility to PTZ seizures. There was a significant increase in the number of animals exhibiting clonic seizures when challenged with subcutaneous PTZ (60 mg/kg) compared with control pseudopregnant animals not undergoing withdrawal and nonpseudopregnant diestrous females. The CD50 (50% convulsant dose) was 46 mg/kg, compared with 73 mg/kg in nonwithdrawn pseudopregnant animals and 60 mg/kg in diestrous controls. The threshold doses for induction of various seizure signs, measured by constant intravenous infusion of PTZ, were reduced by 30–35% in neurosteroid‐withdrawing animals compared with control diestrous females. No change in threshold was observed in pseudopregnant rats treated from days 7 to 11 with finasteride, demonstrating that high levels of progesterone alone do not alter seizure reactivity.Conclusions: Neurosteroid withdrawal in pseudopregnant rats results in enhanced seizure susceptibility, providing an animal model of perimenstrual catamenial epilepsy that can be used for the evaluation of new therapeutic approaches.
Childhood Epilepsy Due to Neurocysticercosis: A Comparative Study
Authors: Ferreira Lisiane S. , Zanardi Verônica A. , Scotoni Anna E. , Li Li Min , Guerreiro Marilisa M. 
Published: March 2003

Summary:  Purpose: To assess the clinical profile of pediatric patients with epilepsy and neurocysticercosis (NC), and compare them with a group of pediatric patients with benign partial epilepsy to determine clinical differences, response to treatment, and prognosis.Methods: We studied 28 patients (16 girls) with probable or definitive diagnosis of NC and epilepsy and 32 patients (16 girls) with partial benign epilepsy (BE). All patients had normal neurologic examination. We compared NC and BE patients looking for differences in demographics (age at first seizure, gender, family history); clinical presentation (type, frequency, duration, and total number of seizures, duration of epilepsy, status epilepticus, cluster, and postictal deficit); treatment [duration, number of antiepileptic drugs (AEDs), maximal dose, drug association, number of seizure‐free patients, time to obtain control and recurrence after medication discontinuation]; complementary examinations (the first and the last EEG).Results: The mean follow‐up was 5.4 years for the 28 NC patients and 4.6 years for the 32 BE patients (p = 0.98). We did not find statistical differences between NC and BE in gender, family history, types of seizures, frequency and length of seizures, previous status epilepticus, seizure clustering, and presence of postictal deficits. However, we found that NC compared with BE patients had significant longer AED treatment, more seizures after AED introduction, tried more AEDs and at maximal dose, and in 20%, required polytherapy. The recurrence rate in NC was 54.4% and this was not significantly associated with number of lesions and disease activity seen on CT scans or the presence of EEG abnormalities.Conclusions: NC presents with a mild form of epilepsy in terms of seizure severity; however, it is more challenging in regard to drug management and has a less favorable long‐term prognosis in terms of seizure remission. The number of lesions or disease activity seen on computed tomography (CT) as well as EEG abnormalities have no prognostic value in childhood epilepsy due to NC.
Mental Retardation in Pediatric Candidates for Epilepsy Surgery: The Role of Early Seizure Onset
Authors: Vasconcellos Elza , Wyllie Elaine , Sullivan Shawn , Stanford Lisa , Bulacio Juan , Kotagal Prakash , Bingaman William 
Published: March 2003

Summary:  Purpose: We sought to determine whether early age at seizure onset is a risk factor for mental retardation, independent of etiology. Assessment of risk for mental retardation with continued uncontrolled seizures plays a role in considerations of timing for epilepsy surgery. Previous studies have indicated that onset of seizures in the first years of life may be a risk factor for mental retardation, but the etiologies of the epilepsies were not included in the analyses.Methods: Intellectual function was assessed at ages 2–20 years during presurgical evaluation in 100 patients with intractable epilepsy due to focal lesions limited to part of one lobe of the brain. Mental retardation (MR) was defined as Full‐Scale Intelligence Quotient (FSIQ) ≤70. The age at seizure onset and the seizure frequency were obtained retrospectively.Results: Younger ages at seizure onset were associated with lower FSIQ scores, and mean FSIQ was also significantly lower for patients with onset of epilepsy at ≤24 months of age (74.0 ± 21.5) versus that in patients with onset of epilepsy later in life (87.8 ± 18.8; p = 0.005). The frequency of patients with MR was significantly higher for patients with seizure onset at ≤24 months of age (15 of 33, 46%) than for patients with seizure onset later in life (eight of 67, 12%; p < 0.001). This difference persisted within etiologic subgroups. For patients with focal malformation of cortical development, MR was seen in eight (50%) of 16 patients with seizure onset at ≤24 months versus two (10%) of 20 patients with seizure onset at >24 months (p < 0.001); for patients with tumor, MR was seen in four (50%) of eight patients with seizure onset at ≤24 months versus four (13%) of 30 patients with seizure onset at >24 months (p = 0.003); and for patients with hippocampal sclerosis, MR was seen in two (28%) of seven patients with seizure onset at ≤24 months versus none of 30 patients with seizure onset at >24 months (NS). Within the subgroup with daily seizures, MR was present in 13 (65%) of 20 patients with seizure onset at ≤24 months versus five (17%) of 29 patients with seizure onset later in life (p = 0.001).Conclusions: These results indicate that onset of intractable epilepsy within the first 24 months of life is a significant risk factor for MR, especially if seizures occur daily. The risk based on early age at seizure onset appeared independent of etiology and persisted within subgroups of patients with focal malformation of cortical development, tumor, or hippocampal sclerosis. Prospective studies will be important to clarify whether early surgical intervention may reduce the risk for subsequent MR in carefully selected infants.
An Incident Case–Control Study of First Unprovoked Afebrile Seizures in Children: A Population‐Based Study of Pre‐ and Perinatal Risk Factors
Authors: Sidenvall R. , Heijbel J. , Blomquist H. K. , Nyström L. , Forsgren L. 
Published: March 2003

Summary:  Purpose: The aim of this prospective incident community‐based study was to assess the influence of pre‐ and perinatal risk factors in children in whom an unprovoked afebrile epileptic seizure later developed.Methods: From November 1, 1985, until June 30, 1987, 75 children aged 0–15 years with a first unprovoked afebrile seizure were identified. After exclusion of cases with neonatal seizures (n = 14), two controls per case were selected from the same province in northern Sweden matched by age and sex. Files from maternity wards and pediatric clinics could be traced for 58 cases and 109 controls. These formed the study group.Results: In the univariate analysis, the risk for an unprovoked afebrile seizure was significantly elevated for birth order (OR = 9.3; CI, 2.2–39), vaginal bleeding (OR = 17; 95% CI, 3.5–85), onset of hypertension during pregnancy (OR = 4.8; CI, 1.3–17), cesarean section (OR = 18; 95% CI, 3.7–88), short or long gestational age (OR = 6.7; 95% CI, 2.0–22), and an Apgar score ≤6 at any time (OR = 3.8; 95% CI, 1.2–12). None of these six factors was present in 48.3% of the cases and 89% in the controls. A combination of two or more risk factors found to be significant in the univariate analysis showed a pronounced increased risk for seizures (OR = 19; 95% CI, 5.6–65). In the multivariate analysis, the following characteristics remained statistically significant: vaginal bleeding, gestational age, and Cesarean section. Furthermore, smoking also was identified as a risk factor in the multivariate analysis (OR = 3.4; 95% CI, 1.1–10).Conclusions: Both pre‐ and perinatal factors may be associated with later development of epileptic seizures in children. However, in many of the cases, no such factors were identified.
Memory Outcome after Left Anterior Temporal Lobectomy in Patients with Expected and Reversed Wada Memory Asymmetry Scores
Authors: Sabsevitz David S. , Swanson Sara J. , Morris George L. , Mueller Wade M. , Seidenberg Michael 
Published: March 2003

Summary:  Purpose: The ideal candidate for anterior temporal lobectomy surgery shows a Wada memory asymmetry (WMA) score characterized by better memory performance in the hemisphere contralateral to the seizure focus relative to the ipsilateral (surgical) hemisphere. However, some surgical candidates show a reversed WMA or better Wada memory performance in the hemisphere of surgical interest relative to the hemisphere contralateral to the seizure focus. To date, no data are available contrasting memory and seizure outcome for these two Wada groups. The present study compared memory and seizure outcome after left anterior temporal lobectomy (L‐ATL) in patients showing expected and reversed WMA scores, and also examined the relationship of the individual hemisphere Wada memory scores for predicting verbal memory outcome after L‐ATL.Methods: We compared 6‐month postoperative verbal memory change scores and seizure outcome in L‐ATL patients with either an expected (n = 12) or reversed WMA (n = 9) pattern on Wada memory testing.Results: L‐ATL patients showing a reversed WMA score had a poorer verbal memory outcome and poorer seizure control after surgery compared with patients showing a WMA score in the expected direction.Conclusions: L‐ATL patients with a reversed WMA score have a greater risk for memory morbidity and poorer seizure outcome than do patients with a WMA score in the expected direction. The WMA score was the best predictor of memory outcome after L‐ATL. When the WMA score is not considered, both individual Wada hemisphere scores (contralateral and ipsilateral) provided significant and independent contribution to predicting postoperative verbal memory functioning. These findings are discussed in the context of the functional reserve and hippocampal adequacy models of memory change after temporal lobectomy.
Lateralized Postictal EEG Delta Predicts the Side of Seizure Surgery in Temporal Lobe Epilepsy
Authors: Jan Mohammed M. S. , Sadler Mark , Rahey Susan R. 
Published: March 2003

Summary:  Purpose: The concordance of lateralized EEG postictal polymorphic delta activity (PPDA) to the side of seizure origin in temporal lobe epilepsy (TLE) has received limited study. Our objective was to study the lateralizing value of PPDA in patients with documented TLE.Methods: A cohort of consecutive adults with TLE, detailed presurgical evaluation before temporal lobectomy, and minimal follow‐up of 2 years were included. One author masked the ictal rhythm of presurgical EEGs and randomly presented 20 s of preictal and the postictal EEG to two electroencephalographers who were blind to all clinical data. They independently assigned PPDA to one of three categories: not present, bilateral, or lateralized (defined as newly appearing or an amplitude >50% of the preictal record).Results: Eighty seizures from 29 patients were studied. Fifteen patients had a left, and 14 had a right temporal lobectomy. Twenty‐three patients were seizure free or substantially improved (defined as simple partial or nocturnal seizures only). Lateralized PPDA was present in 64% of all EEGs and at least one record from 22 (76%) patients. Lateralized PPDA, when present, was concordant with the side of surgery in 96% of the EEGs.Conclusions: Lateralized PPDA is highly predictive of the side of ultimate temporal lobectomy, and by inference the side of seizure origin.
Patients Treated with Vigabatrin Exhibit Central Visual Function Loss
Authors: Hilton Emma J. Roff , Cubbidge Robert P. , Hosking Sarah L. , Betts Tim , Comaish Ian F. 
Published: March 2003

Summary:  Purpose: To investigate visual function in the central 10 degrees in patients who have undergone vigabatrin (VGB) antiepileptic drug (AED) therapy with the aim of identifying a clinical regimen for assessing central visual function.Methods: The sample comprised 12 epilepsy patients (mean age, 38.6 ± 11.7 years) who had been treated with VGB (either as monotherapy or polytherapy). A number of central visual‐function tests were carried out for each eye, including high‐contrast LogMAR visual acuity, short‐wavelength automated perimetry (SWAP 10‐2), spatial contrast sensitivity (CSV‐1000), and Farnsworth‐Munsell (FM) 100‐hue colour discrimination.Results: The group mean cumulative VGB dose was 5,086 ± 3,245 g. The average SWAP 10‐2 mean deviation (MD) for the group was –3.24 ± 3.23 dB; 14 eyes of eight patients showed defects (range, –1.62 to –9.46 dB). The square root of the group mean total error score for FM 100‐hue was 7.42 ± 3.84; nine eyes of five patients were classified as abnormal with an unsolved colour axis suggestive of complex drug interactions. For contrast sensitivity, 15 eyes of eight patients yielded abnormal results in one or more spatial frequencies. Defects were more prominent at higher spatial frequencies. Overall, four patients had defects in all three visual‐function tests, six patients had mixed defects, and two patients were normal.Conclusions: Visual‐function deficits in epilepsy patients treated with VGB are present in the central 10 degrees of the retina. We recommend a battery of investigations, including SWAP 10‐2 and spatial contrast sensitivity testing, to assess central visual function.
Atypical Antipsychotics and Serotoninergic Antidepressants in Patients with Epilepsy: Pharmacodynamic Considerations
Authors: Torta Riccardo , Monaco Francesco 
Published: March 2003

Summary:  Purpose: To discuss the pharmacodynamic aspects of the administration of atypical antipsychotics (APs) and serotoninergic antidepressants (SSRIs) to patients with epilepsy.Methods: This article represents an overview of all studies concerning the administration of APs and SSRIs to people with epilepsy. In particular, it deals with the relationship between neuroleptics (NLTs), APs, SSRIs, serotonin, and dopamine, with special focus on the possible epileptogenic role of psychoactive drugs.Results: NLTs may induce seizures by blocking D2, H1, and .1 receptors, or by sexual hormone activation or a pharmacologic kindling mechanism. The difference among APs in their ability to induce seizures is related mainly to the percentage of D2‐receptor occupancy and possibly also to their action on neurosteroids. Seizures occur at SSRIs therapeutic doses, with a 0.1–4% incidence. Coversely, in animal studies fluoxetine was claimed to exert an anticonvulsant action.Conclusions: The study of the pharmacodynamic aspects of the administration of APs and SSRIs to patients with epilepsy can help to evaluate the importance of some mechanisms of action of several psychoactive drugs in relation to their pro‐ or anticonvulsant activity.
Effect of Electrical Stimulation of the Nucleus of the Solitary Tract on the Development of Electrical Amygdaloid Kindling in the Cat
Authors: Magdaleno‐Madrigal Victor M. , Valdés‐Cruz Alejandro , Martínez‐Vargas David , Martínez Adrián , Almazán Salvador , Fernández‐Mas Rodrigo , Fernández‐Guardiola Augusto 
Published: March 2003

Summary:  Purpose: This work analyzed the effect of electrical stimulation of the nucleus of the solitary tract (NTS) on the development of electrical amygdaloid kindling (AK) in freely moving cats.Methods: Nine male adult cats with implanted electrodes in both amygdalae (basolateral nucleus), both lateral geniculate bodies, left NTS, and both prefrontal cortices were used. Electromyogram and electrooculogram also were recorded. The AK was performed every 24 h (1‐s train, 1‐ms pulses, 60 Hz, 300–600 μA). The NTS was stimulated previously for 1 min (0.5‐ms pulses, 30 Hz, 150–300 μA), just before the AK at 10:00 a.m., and then every 60 min, 4 times, from 11:00 a.m. to 2:00 p.m. On different days, all NTS stimulation was suspended, and AK was continued until stage VI kindling was reached.Results: Behavioral changes produced by the stimulation of the NTS were blinking, immobility periods with upward sight, licking, and swallowing. Animals with simultaneous stimulation of NTS and AK did not reach stage VI, remaining in behavioral stages I–III. Stage VI was reached after NTS stimulation was intentionally suspended. The amplitude, duration, and the propagation of the amygdaloid afterdischarge did not exhibit progressive evolution during NTS stimulation. A regression analysis was performed between the number of days with only AK stimulation and days with simultaneous NTS stimulation, which showed a positive correlation (values of r = 0.84).Conclusions: Our results suggest that NTS stimulation interferes with the development of convulsive evolution and secondary generalization. This delay effect may be due to the activation of the locus ceruleus and some areas of the midbrain reticular formation, among other structures, which has been demonstrated to inhibit experimental convulsive seizures.
Topiramate Kinetics during Delivery, Lactation, and in the Neonate: Preliminary Observations
Authors: Öhman Inger , Vitols Sigurd , Luef Gerhard , Söderfeldt Birgitta , Tomson Torbjörn 
Published: March 2003

Summary:  Purpose: To study the pharmacokinetics of topiramate (TPM) during delivery, lactation, and in the neonate.Methods: TPM concentrations in plasma and breast milk were measured with fluorescence polarization immunoassay (FPIA) in five women with epilepsy treated with TPM during pregnancy and lactation. Blood samples were obtained at delivery from mothers, from the umbilical cord, and from the newborns on three occasions (24, 48, and 72 h) after delivery. Blood and breast milk also were collected from mothers 2 weeks, and 1 and 3 months postpartum. Blood samples also were drawn from the infants during breast‐feeding. Three of the mother–infant pairs were studied both at delivery and during lactation; two contributed with data from delivery only.Results: The umbilical cord plasma/maternal plasma ratios were close to unity, suggesting extensive transplacental transfer of TPM. The mean milk/maternal plasma concentration ratio was 0.86 (range, 0.67–1.1) at 2–3 weeks after delivery. The milk/maternal plasma concentration ratios at sampling 1 and 3 months after delivery were similar (0.86 and 0.69, respectively). Two to 3 weeks after delivery, two of the breast‐fed infants had detectable (>0.9 μM) concentrations of TPM, although below the limit of quantification (2.8 μM), and one had an undetectable concentration.Conclusions: Our limited data suggest free passage of TPM over the placenta and an extensive transfer into breast milk. Breast‐fed infants had very low TPM concentrations, and no adverse effects were observed in the infants.
Various Findings in Surgically Treated Epilepsy Patients with Dysembryoplastic Neuroepithelial Tumors in Comparison with Those of Patients with Other Low‐grade Brain Tumors and Other Neuronal Migration Disorders
Authors: Degen Rolf , Ebner Aloys , Lahl Rainer , Leonhardt Stephanie , Pannek Heinz W. , Tuxhorn Ingrid 
Published: March 2003

Summary:  Purpose: To determine whether dysembryoplastic neuroepithelial tumors (DNTs) that belong to the neuronal migration disorders (NMDs) are to be classified with them or with “other low‐grade brain tumors” regarding several etiologic, clinical, magnetic resonance imaging (MRI), and EEG findings.Methods: These findings of 21 DNT patients were compared with those of 13 consecutive patients with other low‐grade brain tumors and 41 NMD patients.Results: The result is absolutely clear: nearly all findings in DNT patients (complications during pregnancy, birth, the newborn period and the postnatal period, age at first seizure, epileptic syndrome, seizure type, febrile seizures, retarded milestones, intellectual and neurologic deficits, MRI, interictal and ictal EEG findings) being similar or in agreement with those of other low‐grade brain tumors, not with those of other NMDs.Conclusions: Regarding various clinical features including surgery outcome, MRI, and EEG findings, DNTs should be classified with the other low‐grade brain tumors, rather than with NMDs.