bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential Neuronal and Glial Relations with Parameters of Ictal Discharge in Mesial Temporal Lobe Epilepsy
Authors: Spencer Susan S. , Kim Jung , DeLanerolle Nihal , Spencer Dennis D. 
Published: August 2005

Summary: Purpose: EEG recordings of spontaneous seizures should provide clues to epilepsy pathogenesis and pathology. We examined onset, propagation, and termination characteristics of spontaneous seizures recorded by intracranial EEG in temporal lobe (TL) epilepsy in relation to neuronal, glial, and synaptic changes in the same tissue. Methods: All of our patients with intracranial EEG recordings of spontaneous TL seizure onset, subsequent TL resection, and quantitative pathologic analysis of resected tissue were included. Seizure parameters were mean time to initial propagation, mean total electrical duration, uniformity of seizure‐onset distribution and location, and percentage of seizures with spiking onset per patient. Tissue was analyzed for glial and neuronal density in hippocampal fields and presence of sprouting. Outcome was classified as seizure free or not. Results: All seizures with onset in resected TL in 62 patients were analyzed. The percentage of each patient's seizures with spike onsets was significantly correlated with glial density in CA3 (p < 0.01). Initial propagation time was significantly and inversely correlated with neuronal density in CA4 (p < 0.02). Electrical seizure duration was significantly correlated with glial density in CA2 and CA3 (p < 0.02). Neuronal and glial density were significantly (and inversely) related to one another only in CA1 (p < 0.001). Outcome was most significantly related to uniform hippocampal seizure onset. Presence or absence of sprouting was not significantly related to outcome or any EEG measure. Conclusions: These results suggest both glia and neurons exert independent influences on the expression of ictal discharges in seizures of medial TL onset. Glial density influenced interictal‐ictal transition, whereas neuronal density influenced seizure propagation. These findings may have implications for pathogenesis.
Prospective Population‐Based Study of Intermittent and Continuous Convulsive Status Epilepticus in Richmond, Virginia
Authors: Waterhouse Elizabeth J. , Garnett Linda K. , Towne Alan R. , Morton Lawrence D. , Barnes Thomas , Ko Daijin , DeLorenzo Robert J. 
Published: August 2005

Summary: Purpose: Previous work suggested that there is a lower mortality for convulsive status epilepticus (SE) with intermittent seizures (intermittent SE) as opposed to SE with continuous seizure activity (continuous SE). A plausible hypothesis to explain this difference is that the shorter ictal time in intermittent SE is responsible for the lower mortality in this group. This study investigates the relative contributions of total ictal time and SE duration to the differing mortalities of intermittent and continuous SE. Methods: Six hundred forty‐five cases of prospectively identified convulsive SE were examined. Nonparametric statistical methods were used to compare continuous SE and intermittent SE variables. Multivariate logistic regression analyses were used to determine which factors were most highly associated with mortality. Intermittent SE cases were analyzed to evaluate the relative contributions of ictal time versus SE duration to mortality. Results: Intermittent SE had a significantly lower mortality than continuous SE (19.6 vs. 31.4%; p < 0.001) in adults but not in children. Intermittent and continuous SE durations did not significantly differ in adult cases but did differ in pediatric cases. Ictal time was significantly shorter than SE duration for intermittent SE in both adults and children. After adjusting for age, etiology, and SE duration, SE type (continuous SE vs. intermittent SE) was shown to have an independent effect on mortality in adults. The relative risk of mortality for continuous SE was 1.79 times that of intermittent SE (p = 0.04). After controlling for SE duration, ictal time did not significantly affect mortality in adults. Conclusions: Intermittent and continuous convulsive SE were common in both pediatric and adult populations. Intermittent SE had a significantly lower mortality than did continuous SE. This difference in mortality was not completely explained by differences in SE duration, total ictal time, etiology, or age. Further research is needed to identify the factor(s) contributing to the significant difference in mortality between intermittent SE and continuous SE.
Induction of Ethinylestradiol and Levonorgestrel Metabolism by Oxcarbazepine in Healthy Women
Authors: Fattore C. , Cipolla G. , Gatti G. , Limido G. L. , Sturm Y. , Bernasconi C. , Perucca E. 
Published: August 2005

Summary: Purpose: To evaluate the effect of oxcarbazepine (OCBZ) on the pharmacokinetic profile of steroid oral contraceptives. Methods: Twenty‐two healthy women aged 18–44 years were recruited, and 16 of them completed the study. By using a randomized double‐blind crossover design, each woman was studied in two different menstrual cycles, during which placebo or OCBZ (maintenance dosage, 1,200 mg/day) was given in randomized sequence for 26 consecutive days with a washout of at least one cycle in between. A steroid oral contraceptive containing 50 μg ethinylestradiol (EE) and 250 μg levonorgestrel (LN) was taken for the first 21 days of each cycle. Plasma concentrations of EE and LN were measured by gas chromatography‐mass spectrometry in samples collected at regular intervals on days 21–23 of each cycle. Results: Compared with placebo, areas under the plasma concentration curves (AUC0–24h, geometric means) decreased by 47% for both EE (from 1,677 to 886 pg.h/ml; p < 0.01) and LN (from 137 to 73 ng.h/ml; p < 0.01), during OCBZ treatment. Peak plasma EE concentrations decreased from 180 pg/ml during the placebo cycle to 117 pg/ml during the OCBZ cycle (p < 0.01), whereas peak plasma LN concentrations decreased from 10.2 to 7.7 ng/ml (p < 0.01). The half‐lives of EE and LN also decreased from 13.6 to 7.9 h (p < 0.01) and from 28.8 to 15.8 h, respectively (p < 0.01). Conclusions: OCBZ reduces plasma concentrations of the estrogen and progestagen components of steroid oral contraceptives, presumably by stimulating their CYP3A‐mediated metabolism in the liver or gastrointestinal tract or both. Because this may lead to a decreased efficacy of the contraceptive pill, women treated with OCBZ should receive preferentially a high‐dosage contraceptive and should be monitored for signs of reduced hormonal cover.
The Effect of Tetanus Toxin‐Induced Limbic Epilepsy on the Exploratory Response to Novelty in the Rat
Authors: Mellanby J. , Johansen‐Berg H. , Leyland R. , Milward A. J. 
Published: August 2005

Summary: Purpose: To investigate the exploratory response to novelty in rats that have recovered from experimental limbic epilepsy. Methods: Epilepsy was induced in 12 male rats by injecting a minute amount of tetanus toxin into the ventral hippocampus (and buffer vehicle was injected into 12 controls). Eight weeks after the injection, when the animals appeared behaviourally normal (and previous work would indicate that their electroencephalograms also would have returned to normal), they were tested on the playground maze. In this, their exploratory response to a novel object introduced in the context of seven familiar objects is measured. Simultaneously, their locomotion and investigation of familiar objects is measured. Results: Whereas the control animals showed a significant response to the novel object on both test days, in the toxin‐injected rats the novelty response was not present. There was no difference between the groups on the locomotion measure, but the toxin rats explored the familiar as well as the novel objects less. Conclusions: The exploratory response to a novel object was abolished in the previously epileptic rats.
Posttraumatic Epilepsy Risk Factors: One‐Year Prospective Study After Head Injury
Authors: Angeleri F. , Majkowski J. , Cacchiò G. , Sobieszek A. , D'Acunto S. , Gesuita R. , Bachleda A. , Polonara G. , Królicki L. , Signorino M. , Salvolini U. 
Published: August 2005

Summary:Purpose:Prospective evaluation of risk factors for posttraumatic epilepsy (PTE) by using clinical, EEG, and brain computed tomography (CT) data in four assessments from the head injury (HI) acute phase to 1 year later; and evaluation of the possible epileptogenic role of hemosiderin as shown by brain magnetic resonance imaging (MRI).Methods:Risk factors for PTE were evaluated by using Kaplan‐Meier curves, log‐rank test, and the Cox model in 137 consecutively enrolled adult inpatients. Percentage differences of patients with brain hyperintense and/or hemosiderin areas shown by MRI 1 year after HI were statistically evaluated by univariate tests considering two subgroups [e.g., patients with (PTE) and without (WLS) late seizures].Results:The PTE subgroup included 18 patients with at least two seizures between the second and twelfth months. Kaplan‐Meier curves demonstrated that Glasgow Coma Scale low score, early seizures, and single brain CT lesions are PTE risk factors, as is the development of an EEG focus 1 month after HI. No significant percentage difference was found between PTE and WLS patients with hemosiderin spots shown by MRI 1 year after HI.Conclusions:the Cox model indicates that, for HI patients with early seizures and brain CT single temporal or frontal lesions in the acute phase, the PTE risk is 8.58 and 3.43 times higher, respectively, than for those without. An EEG focus 1 month after HI is a risk factor 3.49 times higher than for patients without such EEG changes. One year after HI, a higher percentage of PTE than WLS patients had cortical MRI hyper‐intense areas including hemosiderin.
Focal Status Epilepticus: Clinical Features and Significance of Different EEG Patterns
Authors: Drislane Frank W. , Blum Andrew S. , Schomer Donald L. 
Published: August 2005

Summary: Purpose: Focal status epilepticus is typically diagnosed by the observation of continuous jerking motor activity, but many other manifestations have been described. EEG evidence of focal status may take several forms, and their interpretation is controversial. We detailed the clinical spectrum of focal status in patients diagnosed by both clinical deficit and EEG criteria and contrasted clinical manifestations in patients with different EEG patterns. Methods: Patients were diagnosed with a neurologic deficit and discrete recurrent focal electrographic seizures or rapid, continuous focal epileptiform discharges on EEG. Clinical findings were determined by chart review. Results: Of 41 patients with focal status, acute vascular disease was the cause in 21; 10 of 41 had exacerbations of prior epilepsy. A variety of clinical seizure types occurred, both before and after the EEG diagnosis, but the diagnosis was not expected in 28 patients before the EEG. Three had no obvious clinical seizures. Focal motor seizures and an abnormal mental status were the most common manifestations at the time of the EEG. With antiepileptic drugs, almost all had control of clinical seizures, and most improved in mental status. Patients with rapid continuous focal epileptiform discharges were nearly identical in presentation, likelihood of diagnosis, subsequent seizures, response to medication, and outcome to those with discrete seizures on EEG. Conclusions: Focal status epilepticus may be seen with a wide variety of clinical seizure types or without obvious clinical seizures. The diagnosis is often delayed or missed and should be considered after strokes or clinical seizures when patients do not stabilize or improve as expected. The diagnosis should be made equally whether patients have discrete electrographic seizures or continuous rapid focal epileptiform discharges on the EEG, and the same response to medications and outcome should be anticipated for the two groups.
Forced Normalization: Clinical and Therapeutic Relevance
Authors: Krishnamoorthy E. S. , Trimble M. R. 
Published: August 2005

Summary:The phenomenon of forced normalization and its clinical counterpart, alternative psychoses, is discussed. The historical origins are briefly noted before the clinical presentation, and some associated clinical findings are given. The main part of the article is devoted to the literature on chemical and electrical kindling, in an attempt to provide some heuristic model to understand the antithetical relationship between seizures and behavior disorders. We conclude that the use of the kindling model may provide further insights into these phenomena, particularly taking into account such key neurotransmitters as glutamate, dopamine, and GABA.
Photosensitive and Nonphotosensitive Electronic Screen Game‐Induced Seizures
Authors: Inoue Yushi , Fukao Kenjiro , Araki Takehisa , Yamamoto Shinobu , Kubota Hidemoto , Watanabe Yutaka 
Published: August 2005

Summary:Purpose: To disclose possible epileptologic differences between photosensitive and nonphotosensitive patients with seizures induced by electronic screen games (ESGs).Methods: In patients with ESG‐induced seizures who showed photo‐ and pattern sensitivity, magnetoencephalography (MEG) and EEG were performed simultaneously during ESG play, and equivalent current dipoles (ECDs) of the MEG spikes were estimated. In patients without ESG‐induced seizures, who were surgical candidates, the intracranial EEG was analyzed for changes in epileptiform spike frequency.Results: Fifteen of 29 patients were photo‐ or pattern sensitive, and they had a posterior predominance of ECDs of the MEG spikes. In contrast, nonphotosensitive patients had an anterior predominance of ECDs. Other seizure‐precipitating factors in the nonphotosensitive patients included hand manipulation or spatial processing. In patients without a history of ESG‐induced seizures who underwent intracranial EEG monitoring for surgical evaluation, ESG playing induced changes in spike frequency in the supplementary motor area, perisylvian region, and medial temporal lobe.Conclusions: In photosensitive patients, interictal MEG spikes arise predominantly from the posterior region of the brain. In nonphotosensitive patients, epileptiform spikes tend to originate in the anterior part of the brain. Thus factors involving functions of the anterior part of the brain other than photo‐ or pattern sensitivity may play a role in the induction of seizures during ESG play. Furthermore, the changes in spike frequency in specific brain areas may correspond to their involvement in praxic activity and emotional changes during ESG play. A chance occurrence of seizures during ESG play also was observed.
Clinical Experience with New Antiepileptic Drugs: Antiepileptic Drugs in Europe
Authors: Loiseau Pierre Jean‐Marie 
Published: August 2005

Summary:The use of antiepileptic drugs (AEDs), singly and in combination, has been marked by variation among European countries and by a slow progress toward a standard of care that is still far from uniform. Phenobarbital, phenytoin, trimethadione, and primidone, given in various combinations, were the predominant agents used in the first half of this century. Prescribing habits differed among the Latin countries, the United Kingdom, and Scandinavia, based on local trends, divergent teaching philosophies of medical schools, and the medical specialty of the prescribing physician. The advent of carbamazepine and valproate, in the early 1960s, changed European prescribing habits. Despite early fears regarding bone marrow toxicity, carbamazepine was found to be superior for treatment of complex partial seizures. Valproate, when the proper therapeutic dosage was belatedly realized, was seen as a superior treatment for generalized and partial epilepsies. Both agents are now considered first‐line treatments for these seizure types. The role of the benzodiazepines as adjunctive anticonvulsant therapy remains controversial because of concerns about neurotoxicity and patient tolerance. The number of AEDs marketed in Europe has grown dramatically in the past decade, with agents such as felbamate, gabapentin, lamotrigine, and tiagabine having been approved as either adjunctive or sole therapy. However, not all new agents are available in each European country, and some variation in prescribing persists.
Environmental Risk Factors for Multifactorial Epilepsy in EL Mice
Authors: Todorova Mariana T. , Burwell Timothy J. , Seyfried Thomas N. 
Published: August 2005

Summary:Purpose:The epileptic EL mouse has been studied extensively as a model of multifactorial epilepsy. Although EL mice have a seizure occasionally during routine handling associated with cage changing, most studies have used vigorous tossing or shaking procedures for seizure induction. A new seizure testing procedure was developed that involved gentle handling and simulated situations associated with emotional stress in rodents. This new testing procedure was used to identify and characterize several environmental risk factors that influence seizure predisposition in EL mice.Methods:Ten adult EL mice were monitored for 7 days under 24‐h light/dark video surveillance to assess the frequency of spontaneous seizures. The development of handling‐induced seizures also was studied in EL mice, in nonepileptic ABP and DDY mice, and in reciprocal ABP × EL F1hybrids from ages 30–180 days.Results:Seizure induction was necessary in EL mice, as spontaneous clinical seizures were not observed. Handling‐induced seizure susceptibility was strongly age and gender dependent in naive EL mice (not previously handled) and peaked ‐90 days, with males significantly more susceptible than females. No seizures were induced by handling in the nonepileptic mouse strains (ABP and DDY) over the testing period. Handling and seizures at young ages in EL and EL × ABP F1hybrid mice significantly enhanced their seizure susceptibility when they were tested again 1 month later. A significant “Gowers effect” was seen also in EL mice. Furthermore, susceptibility was higher in ABP × EL F1hybrids than in their reciprocal EL × ABP F1hybrids at 90–150 days.Conclusions:Seizure susceptibility in EL mice was significantly influenced by a number of environmental factors including age, gender, maternal/paternal effects, prior handling, and seizure history. The emotional stress/fear response is the likely trigger for seizure induction in EL mice. An early life experience stress‐diathesis model, similar to that proposed for major depression in humans, was applicable to the development of seizure susceptibility in EL mice. The new seizure test will be useful for defining gene‐environment interactions and in identifying susceptibility genes for multifactorial epilepsy.
Lamotrigine Concentrations in Human Serum, Brain Tissue, and Tumor Tissue
Authors: Meyer Frank P. , Banditt Peter , Schubert Adrian , Schöche Jochen 
Published: August 2005

Summary: Purpose: Although lamotrigine (LTG) has been used for years as an antiepilepic drug (AED), there are no data on penetration into the brain with the exception of a single case report. It was our aim to determine the LTG content in the brain and the tumor tissue and to bring the same into relation to the serum concentration and protein binding in neurosurgically operated patients. Methods: Neurosurgical intervention was performed on 11 patients with brain tumors. Tumor tissue was removed, and LTG kinetics was carried out for 12 h. LTG was determined by means of (HPLC) and the protein binding by means of ultra‐filtration. Results: At the time of the section of the tumor, the LTG concentrations in the serum were an average of 3.7 μg/ml (range, 1.1–9.8); in the brain, an average of 6.8 μg/g (range, 1.0–14.9); and in the tumor, an average of 4.4 μg/g (range, 2.0–8.3). Brain/serum and tumor/serum ratios of 2.8 and 1.9, respectively, result from these data. The protein binding was on average 68% (range, 46–96). Conclusions: LTG is a lipophile AED with a moderate protein binding that penetrates brain tissue well and can be proven even in the tumor tissue.
Benign Familial Neonatal Convulsions Followed by Benign Epilepsy with Centrotemporal Spikes in Two Siblings
Authors: Maihara Toshiro , Tsuji Masahiro , Higuchi Yoshihisa , Hattori Haruo 
Published: August 2005

Summary: Purpose: To report on sibling cases with benign familial neonatal convulsions (BFNC) followed by benign epilepsy with centrotemporal spikes (BECT). Methods: Case histories and EEGs were obtained for the two siblings with neonatal and subsequent epileptic seizures in one pedigree with BFNC. Results: The family included six affected cases of BFNC in two generations: the proband, the proband's mother and two sisters, and the proband's maternal uncle and his daughter. The proband developed a generalized tonic convulsion 2 days after birth with no apparent cause and normal interictal EEG, and experienced a total of 18 episodes of tonic or clonic seizures or both by age 9 months. In the follow‐up course, an EEG recording showed rolandic discharges at 2 years, and a sylvian seizure occurred at 4 years during sleep. On carbamazepine therapy, the last seizure was recorded at 9 years after a total of 11 episodes of sylvian seizures, with normal EEGs after 12 years. The proband's sister experienced nine episodes of brief tonic seizures between 7 and 9 days after birth, and also developed eight episodes of sylvian seizures from 4 to 7 years, with rolandic discharges on EEG until age 9 years. All of the family members had normal psychomotor development, with no neurologic sequelae. Conclusions: This report of BFNC followed by BECT in sibling cases is significant in view of the genetic analysis and the classification of epilepsies and epileptic syndromes.
Stereotactic Amygdalohippocampotomy for the Treatment of Medial Temporal Lobe Epilepsy
Authors: Parrent Andrew G. , Blume Warren T. 
Published: August 2005

Summary: Purpose: This study was carried out to assess the safety and efficacy of stereotactic ablation of the amygdala and hippocampus for the treatment of medial temporal lobe epilepsy. Methods: Twenty‐two stereotactic amygdalohippocampotomies were performed in 19 patients with unilateral temporal lobe seizures by using magnetic resonance imaging (MRI) localization for target planning and radiofrequency techniques for lesion production. Seizure frequency was assessed at 3‐monthly follow‐up visits. Two lesion groups were defined. In group I, four to 11 (mean, 6.4) discrete lesions were made, encompassing the amygdala and anterior 13–21 mm (mean, 16.8 mm) of the hippocampus. In group II, a large number of confluent lesions were made (mean, 26.0; range, 12–54) encompassing the amygdala and anterior 15–34 mm (mean, 21.5 mm) of the hippocampus. MRI scanning was carried out 24 h and 6–9 months after surgery. Results: In five group I patients, one (20%) experienced a favorable seizure outcome. Of 15 group II patients, one of whom had previously undergone limited lesioning and was also analyzed as part of group I, nine (60%) experienced a favorable seizure outcome, with two seizure free. MRI scans at 6‐ to 9‐months’follow‐up disclosed discrete areas of atrophy in the amygdala and hippocampus, interspersed with preserved brain in the group I patients. More uniform and complete destruction of amygdala and hippocampus was evident in group II patients. All lesions were confined to the amygdala and hippocampus, sparing the parahippocampal gyrus (PHG). Conclusions: The extensive amygdalohippocampal ablation in group II patients improved seizure outcome compared with more limited ablation in group I, but these results were not so good as those from temporal lobectomy in a similar patient group. When considered together with the results of selective amygdalohippocampectomy, and temporal resections that spare hippocampus or amygdala (all producing similar outcomes, and all involving resection of the entorhinal cortex), this study suggests a pivotal role of the entorhinal cortex in temporal epileptogenesis.