bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective Study of Seizures in the Elderly in the Marshfield Epidemiologic Study Area (MESA)
Authors: Ruggles Kevin H. , Haessly Sharon M. , Berg Richard L. 
Published: March 2003

Summary:  Purpose: To assess the incidence, etiology, antiepileptic drug (AED) use, and quality of life in patients having their first seizure at age 50 years or older.Methods: All patients in the Marshfield Epidemiologic Study Area (MESA) aged 50 years or older having their first seizure between July 1, 1996, and June 30, 1998, were identified through the diagnostic coding system. Patients were followed up for 12 months for recurrent seizures. Etiologies, drug treatments, magnetic resonance imaging (MRI), computed tomography (CT), or EEG results and medication adverse effects were recorded. Those patients who reached 1‐year follow‐up received a quality of life (QOLIE‐31) survey.Results: Forty‐eight patients having a first seizure were identified (162 of 100,000). Twelve patients had had recurrent seizures, and 36 had a single seizure at the time of study entry. Fourteen of these 36 had had an abnormal MRI, CT, or EEG. The remaining 22 had a single seizure and normal imaging and EEG. Six of these had one or more subsequent seizures, and all six were in the group with normal tests. Etiologies included vascular, neoplasm, trauma, dementia, metabolic, and unknown. Seventy‐five percent of the patients achieved seizure control with phenytoin, carbamazepine, and/or valproate. Twenty‐seven percent experienced adverse side effects. None had been given second‐generation AEDs as an initial treatment. Thirty‐one patients received the QOLIE‐31 survey; 20 did not complete the survey for various reasons. The mean QOLIE‐31 scores for those completing the survey were significantly higher than those of the reference cohort.Conclusions: The incidence of first seizure in MESA is high in the elderly and increases with advancing age. As in other studies, vascular causes accounted for the largest etiology. Use of new AEDs was uncommon. There was a high incidence of untoward side effects related to the traditional AEDs. High morbidity and mortality unrelated to seizures limits follow‐up analysis in the elderly. Quality‐of‐life analysis via QOLIE questionnaires is problematic in this population.
Benzodiazepine–GABAAReceptor Binding Is Very Low in Dysembryoplastic Neuroepithelial Tumor: a PET Study
Authors: Richardson M. P. , Hammers A. , Brooks D. J. , Duncan J. S. 
Published: March 2003

Summary: Purpose:To determine the nature of abnormalities of γ‐aminobutyric acid (GABA)A–central benzodiazepine (BZD) receptor binding in patients with dysembryoplastic neuroepithelial tumor (DNET) in comparison with normal controls.Methods:Five patients with DNET and 24 normal controls underwent (11C)flumazenil positron emission tomography (PET) to measure (11C)flumazenil volume of distribution (FMZVD) at the voxel level. Patients were compared with normal controls by using statistical parametric mapping (SPM) and also a partial‐volume effect (PVE) corrected volume‐of‐interest (VOI) analysis covering the entire brain. First, using SPM, the highest Z‐score for the entire image representing FMZVD decreases in comparison with the normals was found. Second, regions of abnormal FMZVD were located using SPM, p < 0.001 uncorrected, corrected p < 0.05. Finally, PVE‐corrected measures of FMZVD were calculated for each patient VOI and compared wih those of normals, using significance levels of >2.5 standard deviations (SD) for the DNET and >3 SD for all other regions.Results:In all cases, the highest Z‐score across the whole image representing decreased FMZVD was within the DNET. In three cases SPM revealed a single region of significantly reduced FMZVD, within the DNET in all three. VOI analysis showed PVE‐corrected FMZVD was significantly low in the DNET in four cases. VOI analysis also showed seven other regions of abnormal FMZVD; three were adjacent to a DNET, and two were in mesial temporal areas not affected by DNET.Conclusions:FMZVD is low in DNET, probably contributing to epileptogenicity.
Prevalence of Anti‐cardiolipin, Anti‐β2 Glycoprotein I, and Anti‐prothrombin Antibodies in Young Patients with Epilepsy
Authors: Cimaz R. , Romeo A. , Scarano A. , Avc̆in T. , Viri M. , Veggiotti P. , Gatti A. , Lodi M. , Catelli L. , Panzeri P. , Cecchini G. , Meroni P. L. 
Published: March 2003

Summary:  Purpose: To measure anti‐cardiolipin (aCL), anti‐β2 glycoprotein I (anti‐β2GPI), and anti‐prothrombin (aPT) antibodies in young patients with epilepsy, and to correlate their presence with demographic data, clinical diagnoses, laboratory and neuroradiologic findings, and antiepileptic drugs (AEDs).Methods: Sera from one hundred forty‐two consecutive patients with epilepsy with a median age of 10 years were tested for aCL and anti‐β2GPI autoantibodies by solid‐phase assays. aPT antibodies also were assayed in sera from 90 patients. Positive results were confirmed after a minimum of 6 weeks. Antinuclear antibodies (ANAs) and antibodies against extractable nuclear antigens (ENAs) also were tested.Results: An overall positivity of 41 (28.8%) of 142 sera was found. Fifteen patients were positive for aCL, 25 for anti‐β2GPI, and 18 for aPT antibodies. Several patients (12%) displayed more than one specificity in their serum. Only one of these patients had a concurrent positivity for ANAs and ENAs. A predominance of younger patients was found in the antibody‐positive group. All types of epilepsy were represented in the positive group. No relation between antibody positivity and AEDs was found. Diffuse ischemic lesions at computed tomography (CT)/magnetic resonance imaging (MRI) scans were present in higher percentages in patients who were antibody positive. No positive patient had a history of previous thrombosis or other features related to systemic lupus erythematosus (SLE), and no patient was born of a mother with SLE.Conclusions: Our study suggests a relation between epilepsy and aPL in young patients. A pathogenetic role for these autoantibodies cannot be excluded, and their determination might prove useful even from a therapeutic point of view.
Psychostimulants and Epilepsy
Authors: Zagnoni P. G. , Albano C. 
Published: March 2003

Summary: Purpose: The aim of this article is to review the literature on the effects of psychostimulants in epileptic subjects in order to reach a consensus statement regarding the use or abuse of these substances.Methods: Psychostimulant substances have been considered the drugs that share the ability to produce excitation of the CNS leading to convulsions. The stimulation may be at cortical, brainstem, or spinal levels. In this article, the following cortical stimulants are analyzed and discussed: cocaine, amphetamine and related agents, caffeine, cannabinoids, and psychedelic drugs. This review is based on research done using pharmacological textbooks and Medline.Results: The use of cocaine is associated with the occurrence of seizures. The reported frequency varies from 1% to 40% of addicted subjects, based on the typology of the considered study. Amphetamines and related drugs rarely induce epileptic seizures at therapeutic doses, but seizures may occur after the first dosing. Caffeine at high doses may induce epileptic seizures because of its adenosine receptor‐antagonizing properties. Marijuana, at variance with other psychostimulants, owing to its serotonin‐mediated anticonvulsant action, could have a medical use for the treatment of epilepsy. Psychedelic compounds rarely induce epileptic seizures, but the most common clinical CNS complication after ingestion of ecstasy is the occurrence of seizures.Conclusions: The use of psychostimulants, except for marijuana, can induce single or multiple seizures in healthy subjects.
Memory Deficits after Resection from Left or Right Anterior Temporal Lobe in Humans: A Meta‐Analytic Review
Authors: Lee Tatia M. C. , Yip James T. H. , Jones‐Gotman Marilyn 
Published: March 2003

Summary:  Purpose: Memory deficits in epileptic patients have been found in some, but not all studies assessing the effects of side of seizures and resection from a temporal lobe on cognitive performance. The purpose of this study was to provide a quantitative review of previous studies on this issue.Methods: Based on conventional meta‐analytic procedures, we identified 33 studies that assessed verbal and nonverbal memory performance before and after anterior temporal lobectomy. The Logical Memory and Visual Reproduction subtests from the Wechsler Memory Scale were used. These studies were then subjected to two levels of analyses: (a) vote‐counting procedure, and (b) effect‐size calculations and comparisons.Results: Overall, the data confirmed previous findings that verbal memory tasks are sensitive to left hemisphere dysfunction. The efficacy of a “nonverbal” task for tapping function in the nondominant (right) hemisphere was not confirmed, although a trend supporting this speculation was observed. With regard to the comparison of changes in verbal and nonverbal memory before and after resection from a temporal lobe, a clear trend was observed for decline in verbal memory function after resection from the left, especially significant for immediate verbal recall. A trend for contralateral improvement on nonverbal memory also was observed. The pattern of memory change after resection from the right temporal lobe was less clear.Conclusions: The findings of this study suggest that side of epileptic seizure and surgical resection from a temporal lobe affect verbal memory functions. The relations between the laterality of epileptic seizure, surgical resection from the temporal lobe, and nonverbal memory are to be verified by further research.
Effectiveness of Muscimol‐containing Microparticles against Pilocarpine‐induced Focal Seizures
Authors: Kohane Daniel S. , Holmes Gregory L. , Chau Ying , Zurakowski David , Langer Robert , Cha Byung Ho 
Published: March 2003

Summary:  Purpose: To investigate the efficacy of in situ lipid–protein–sugar particles (LPSPs) in mitigating the epileptogenic and histologic effects of intrahippocampal pilocarpine in rats.Methods: LPSPs with and without muscimol were produced by spray‐drying, sized by Coulter counter, and muscimol content determined by high‐pressure liquid chromatography (HLPC). Particles, free muscimol or saline, were injected into the hippocampi of Sprague–Dawley rats before 40 mM pilocarpine, and seizure activity was scored. The trajectories of behavioral scores between groups were compared with two‐way repeated measures analysis of variance. Animals were killed after 2 weeks. Brain sections were stained (Timm and thionin) and scored.Results: LPSPs were 4 to 5 μm in diameter, and contained 0 or 2% (wt/wt) muscimol. In vitro, muscimol was released over a 5‐day period. Intrahippocampal injections of normal saline and blank LPSPs did not deter seizure activity from pilocarpine. The rise of the trajectory in behavior scores in animals given LPSPs containing 5 μg muscimol was significantly slower than in those receiving saline, blank particles, or 5 μg of unencapsulated muscimol. There was less apparent neuronal injury and CA3 and supragranular mossy fiber sprouting in hippocampi of animals receiving muscimol‐containing particles than in animals that did not receive muscimol. Hippocampi of animals that received 5 μg of encapsulated muscimol showed less supragranular sprouting than did those receiving 5 μg of unencapsulated muscimol, but showed no difference in cell loss or CA3 sprouting.Conclusions: Focally delivered biodegradable microparticles loaded with muscimol are effective in reducing seizure activity from pilocarpine in animals and mitigate the histologic effects.
Ictal Pattern of EEG and Muscular Activation in Symptomatic Infantile Spasms: A Videopolygraphic and Computer Analysis
Authors: Bisulli Francesca , Volpi Lilia , Meletti Stefano , Rubboli Guido , Franzoni Emilio , Moscano Milena , D'Orsi Giuseppe , Tassinari Carlo Alberto 
Published: March 2003

Summary: Purpose:To investigate ictal muscular phenomena characterizing symptomatic infantile spasms (ISs) and their relation to ictal EEG.Methods:Four children with severe encephalopathy, neurologic impairment, and refractory ISs related to different dysplastic lesions, underwent videopolygraphic recordings collecting surface electromyogram (EMG) activity from several cranial and limb muscles to evaluate the pattern of muscular recruitment, duration, and side‐to‐side asymmetry of ISs. Acquired data were stored for off‐line analysis by a computerized polygraphic system.Results:Spasms were characterized by a complex pattern of muscular activation. A constant or rostrocaudal propagation pattern was lacking in all patients. Intervals between the onset of EMG activity in different muscles in each spasm were very long: ≤100–200 ms. Two patients, with hemispheric cortical dysplasia and agenesis of the corpus callosum, had asymmetric and asynchronous spasms in which the EMG onset of the muscles contralateral to the affected hemisphere constantly anticipated that of the ipsilateral ones. Backaveraging of EEG activity disclosed a high‐amplitude EEG complex on the same side as the dysplastic lesion, preceding or succeeding the contralateral muscle activity onset. In the other two patients with diffuse cortical dysplasia, no EEG transient was related to EMG activity onset.Conclusions:Despite clinical similarity between spasms in the same patient, our data demonstrate the complexity and heterogeneity of these motor phenomena. Our findings cannot be explained simply in terms of cortical or reticular generators like other motor phenomena such as cortical myoclonus or startle reflex.
Dynamic Variations of Local Cerebral Blood Flow in Maximal Electroshock Seizures in the Rat
Authors: André Véronique , Henry Didier , Nehlig Astrid 
Published: March 2003

Summary:  Purpose: Measurement of cerebral blood flow is routinely used to locate the areas involved in generation and spread of seizures in epilepsy patients. Because the nature of the hyperperfused regions varies with the timing of injection of tracer, in this study, we used a rat model of maximal electroshock seizures to follow up the time‐dependent changes in the distribution of seizure‐induced cerebral blood flow (CBF) changes.Methods: CBF was measured by the quantitative autoradiographic [14C]iodoantipyrine technique over a 30‐s duration. The tracer was injected either at 15 s before seizure induction, simultaneous with the application of the electroshock (tonic phase), at the onset of the clonic phase, or at 3 and 6 min after the seizure (postictal phase).Results: Rates of CBF underwent dynamic changes during the different phases of seizure activity and largely increased over control levels (≤400%) in the 45 regions studied during all phases of the seizure (first 3 times). CBF remained higher than control levels in 35 and 15 areas at 3 and 6 min after the seizure, respectively.Conclusions: The distribution of maximal CBF increases showed a good correlation with their known involvement in the circuits underlying the clinical expression of the different types of seizure activity, tonic versus clonic.
Chromosomal Abnormalities and Epilepsy: A Review for Clinicians and Gene Hunters
Authors: Singh Rita , McKinlay Gardner R. J. , Crossland Kathryn M. , Scheffer Ingrid E. , Berkovic Samuel F. 
Published: March 2003

Summary: Purpose:We analyzed databases on chromosomal anomalies and epilepsy to identify chromosomal regions where abnormalities are associated with clinically recognizable epilepsy syndromes. The expectation was that these regions could then be offered as targets in the search for epilepsy genes.Methods:The cytogenetic program of the Oxford Medical Database, and the PubMed database were used to identify chromosomal aberrations associated with seizures and/or EEG abnormalities. The literature on selected small anomalies thus identified was reviewed from a clinical and electroencephalographic viewpoint, to classify the seizures and syndromes according to the current International League Against Epilepsy (ILAE) classification.Results:There were 400 different chromosomal imbalances described with seizures or EEG abnormalities. Eight chromosomal disorders had a high association with epilepsy. These comprised: the Wolf–Hirschhorn (4p‐) syndrome, Miller–Dieker syndrome (del 17p13.3), Angelman syndrome (del 15q11‐q13), the inversion duplication 15 syndrome, terminal deletions of chromosome 1q and 1p, and ring chromosomes 14 and 20. Many other segments had a weaker association with seizures. The poor quality of description of the epileptology in many reports thwarted an attempt to make precise karyotype–phenotype correlations.Conclusions:We identified certain chromosomal regions where aberrations had an evident association with seizures, and these regions may be useful targets for gene hunters. New correlations with specific epilepsy syndromes were not revealed. Clinicians should continue to search for small chromosomal abnormalities associated with specific epilepsy syndromes that could provide important clues for finding epilepsy genes, and the epileptology should be rigorously characterized.
Independent Component Analysis of Ictal EEG in Medial Temporal Lobe Epilepsy
Authors: Nam Hyunwoo , Yim Tae‐Gyu , Han Seung Kee , Oh Jong‐Bai , Lee Sang Kun 
Published: March 2003

Summary:  Purpose: Application of independent component analysis (ICA) to interictal EEGs and to event‐related potentials has helped noise reduction and source localization. However, ICA has not been used for the analysis of ictal EEGs in partial seizures. In this study, we applied ICA to the ictal EEGs of patients with medial temporal lobe epilepsy (TLE) and investigated whether ictal components can be separated and whether they indicate correct lateralization.Methods: Twenty‐four EEGs from medial TLE patients were analyzed with the extended ICA algorithm. Among the resultant 20 components in each EEG, we selected components with an ictal nature and reviewed their corresponding topographic maps for the lateralization. We then applied quantitative methods for the verification of increased quality of the reconstructed EEGs.Results: All ictal EEGs were successfully decomposed into one or more ictal components and nonictal components. After EEG reconstruction with exclusion of artifacts, the lateralizing power of the ictal EEG was increased from 75 to 96%.Conclusions: ICA can separate successfully the manifold components of ictal rhythms and can improve EEG quality.
Neocortical Seizure Termination by Focal Cooling: Temperature Dependence and Automated Seizure Detection
Authors: Yang Xiao‐Feng , Duffy David W. , Morley Robert E. , Rothman Steven M. 
Published: March 2003

Summary:  Purpose: The therapy for focal neocortical epilepsy remains suboptimal. We have, therefore, worked to develop techniques to cool small regions of the neocortical surface for seizure mapping and, ultimately, for long‐term suppression of focal seizures.Methods: We induced focal neocortical seizures in halothane‐anesthetized rats by the microinjection of 4‐aminopyridine (4‐AP) into the motor cortex. The dura over the injection site was cooled with a Peltier device, and the temperature at the interface between dura and Peltier was measured with a thermocouple. In some experiments, seizures were automatically detected by a computer program that activated the Peltier device.Results: Monopolar EEG indicated that our seizures were focal and suppressed when cooling was applied directly over the injection site. The threshold temperature required to observe any reduction in seizure duration was 24°C. The temperature gradient across the cooled neocortex was sharp, with the temperature increasing to 31°C at 4 mm below the Peltier, which was cooled to 20°C. Automatic seizure detection reduced the total seizure duration from 43.4 ± 33.6 s to 5.6 ± 5.3 s.Conclusions: Cooling terminates neocortical seizures when applied very close to the epileptogenic focus. The threshold for seizure termination (24°C) may be lower than the threshold for termination of normal cortical activity, suggesting that this technique will not dissociate the anticonvulsant effect of cooling from the disruption of normal behavior. However, when coupled with automatic seizure detection, focal cooling remains an attractive option for development as a treatment for focal epilepsy.
Development of Visual Attention in West Syndrome
Authors: Guzzetta Francesco , Frisone Maria Flavia , Ricci Daniela , Randò Teresa , Guzzetta Andrea 
Published: March 2003

Summary:  Purpose: To study prospectively the evolution of visual attention in children with West syndrome to evaluate its development before the onset of spasms, its possible deterioration as a consequence of epileptic disorders, and its outcome at the age of 2 years, and the possible relation between the impairment of visual attention and cognitive development.Methods: Infants with symptomatic West syndrome were examined before the onset of spasms and until age 24 ± 2 months. Visual attention study (through a clinical observation and the fixation‐shift test), cognitive assessment, and complete clinical examination including brain magnetic resonance imaging were performed.Results: A maturation defect of fixation shift skills was generally observed in infants with West syndrome. In some cases, the impaired visual‐attention abilities paralleled a cognitive deterioration, even months before the onset of spasms. During the acute stage of West syndrome, infants lost the previously acquired visual and cognitive abilities, with a typical fluctuation of arousal. Usually at 2 years, there was a persistent defective visual attention detected with the fixation‐shift test.Conclusions: The parallel defect of visual attention and of cognitive competencies is a constant finding in infants with West syndrome; these can precede the clinical onset of epileptic spasms. The severity and persistence of visual inattention might be explained by the age of visual maturation, corresponding to the usual onset of West syndrome.
Olfactory Auras in Patients with Temporal Lobe Epilepsy
Authors: Chen Chien , Shih Yang‐Hsin , Yen Der‐Jen , Lirng Jiing‐Feng , Guo Yuh‐Cherng , Yu Hsiang‐Yu , Yiu Chun‐Hing 
Published: March 2003

Summary:  Purpose: To investigate olfactory auras in patients with temporal lobe epilepsy (TLE).Methods: We reviewed medical records of 217 Chinese patients who underwent temporal lobectomy for medically intractable TLE between 1987 and 1998 in Taiwan. Patients with olfactory auras asked for detailed characteristics of their auras.Results: In all, 12 (5.5%) patients had olfactory auras, seven men and five women. All patients except one described and characterized the unpleasant olfactory auras. Olfactory auras were usually combined with other auras, most frequently sensations of epigastric rising, nausea, and fear. Association with gustatory hallucination was uncommon, in only one patient. On neuroimaging study, 11 patients had structural lesions involving the mesial temporal structures, two exclusively involving the amygdala. Histologic diagnosis included gliosis of the mesial temporal regions in seven (58.3%) patients, neoplasm in four (33.3%) patients, and arteriovenous malformation in one patient. Postoperatively, eight patients were seizure free. Three patients had rare seizures; however, none reported residual olfactory auras.Conclusions: Olfactory auras are infrequent in TLE. In this study, mesial temporal sclerosis is the most common etiology rather than tumors. Mesial temporal structures, especially the amygdala, may play important roles in the genesis of olfactory auras.