bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two Visual Mechanisms of Photosensitivity
Authors: Harding G. F. A. , Fylan F. 
Published: August 2005

Summary: Purpose: Photosensitive epilepsy is the most common of the “reflex” epilepsies. Precipitated by television viewing, flickering light, or specific visual patterns, it is the cause of seizures in 10% of young people with epilepsy. Photosensitivity is associated with two types of EEG abnormalities: photoparoxysmal responses (PPRs) and occipital spikes (OSs). It is unclear whether these abnormalities are mediated by different mechanisms, and furthermore, the clinical significance of OS is unknown. Methods: By using our previously established population of patients with photosensitive epilepsy, all showing EEG abnormalities on intermittent photic stimulation or pattern stimulation, we examined the effects of pattern contrast, spatial and counterphase temporal frequency, and colour on these abnormalities. Results: PPRs and not OSs show linear contrast dependency and are elicited by stationary stimuli and by non‐colour‐opponent isoluminant stimuli. Conclusions: PPRs and OSs are generated independently by the parvocellular and magnocellular visual systems, respectively. The results add support to the hypothesis that only PPRs and not OSs are clinically significant.
Multimodal MR Imaging: Functional, Diffusion Tensor, and Chemical Shift Imaging in a Patient with Localization‐Related Epilepsy
Authors: Krakow K. , Wieshmann U. C. , Woermann F. G. , Symms M. R. , McLean M. A. , Lemieux L. , Allen P. J. , Barker G. J. , Fish D. R. , Duncan J. S. 
Published: August 2005

Summary: Purpose: To demonstrate the integration of complementary functional and structural data acquired with magnetic resonance imaging (MRI) in a patient with localization‐related epilepsy. Methods: We studied a patient with partial and secondarily generalized seizures and a hemiparesis due to a malformation of cortical development (MCD) in the right hemisphere by using EEG‐triggered functional MRI (fMRI), diffusion tensor imaging (DTI), and chemical shift imaging (CSI). Results: fMRI revealed significant changes in regional blood oxygenation associated with interictal epileptiform discharges within the MCD. DTI showed a heterogeneous microstructure of the MCD with reduced fractional anisotropy, a high mean diffusivity, and displacement of myelinated tracts. CSI demonstrated low N‐acetyl aspartate (NAA) concentrations in parts of the MCD. Conclusions: The applied MR methods described functional, microstructural, and biochemical characteristics of the epileptogenic tissue that cannot be obtained with other noninvasive means and thus improve the understanding of the pathophysiology of epilepsy.
Is Schizophrenia a Risk Factor for Epilepsy or Acute Symptomatic Seizures?
Authors: Gelisse RPhilippe , Samuelian Jean‐Claude , Genton Pierre 
Published: August 2005

Summary: Purpose: The precise prevalence of epilepsies and seizures in patients with schizophrenia remains unclear. Methods: To assess the prevalence of epilepsy and of acute symptomatic seizures in schizophrenics, we conducted a survey in a urban sector of Marseilles that includes 56,910 inhabitants, among whom 1,154 had been treated for psychiatric disorders, including 460 for schizophrenia or paranoid disorder (PD) (DSM III‐R 295 and 297.1, respectively; mean age, 41.9 years; range, 17–79 years; 215 men and 245 women). Results: All 460 patients were receiving long‐term neuroleptic drug therapy, and 397 had been hospitalized at least once in the past year, whereas 63 were followed up as outpatients only. Seizures were present in the history of 12 patients: five had various forms of chronic epilepsy (four men, one woman; DSM III‐R 295.1, one case; 295.3, two cases; 295.9, two cases), and three of these experienced seizures only after the onset of their psychiatric condition; five had acute symptomatic seizures (four men, one woman; 295.1, two cases; 295.3, 295.9, and 297.1, one case), and two had only pseudoepileptic events (both 295.3). Conclusions: This survey shows that the prevalence of epilepsy and acute symptomatic seizures is comparatively low in patients with schizophrenia or PD (10.8% each, respectively), and that the prevalence of a history of seizures (21.7% in this study) is not particularly increased in this middle‐aged population. In contrast to childhood‐onset autistic disorders, schizophrenia or PD are not major risk factors for epilepsy or acute symptomatic epileptic seizures.
Electrical Stimulation of the Contralateral Mesial Temporal Structure Induces an Ipsilateral Seizure Pattern in Mesial Temporal Lobe Epilepsy
Authors: Inoue Yushi , Mihara Tadahiro , Tottori Takayasu , Seino Masakazu 
Published: August 2005

Summary: Purpose: We examined the mode of seizure development induced by electrical stimulation in patients with mesial temporal lobe epilepsy. Methods: Of 25 patients undergoing intracranial EEG evaluation and electrical stimulation ipsilateral to the presumed site of habitual seizure origin, 17 patients had additional stimulation studies on the contralateral temporal lobe. Results: Fourteen of the 25 patients had seizures induced with ipsilateral stimulation, and two of the 17 patients had seizures with contralateral stimulation. Seizures induced by ipsilateral stimulation started in the ipsilateral temporal lobe, whereas those induced by contralateral stimulation originated from the ipsilateral temporal lobe structure and were identical to the habitual seizures. Conclusions: Electrical stimulation of the temporal lobe structure opposite the site of habitual seizure origin is said to induce a seizure rarely. However, according to our preliminary results, if contralateral stimulation elicits a habitual seizure in the ipsilateral temporal lobe, it might be considered additional confirmatory evidence of seizure lateralization.
Effect of Theophylline and Trimethobenzamide When Given During Kainate‐Induced Status Epilepticus: An Improved Histopathologic Rat Model of Human Hippocampal Sclerosis
Authors: Katzir Hilli , Mendoza Delia , Mathern Gary W. 
Published: August 2005

Summary: Purpose: The most common pathology in temporal lobe epilepsy (TLE) is hippocampal sclerosis. It is controversial whether status epilepticus (SE) or prolonged seizures plus secondary cerebral injuries are pathogenic mechanisms of hippocampal sclerosis. This study addressed this question in rat models of TLE. Methods: Hippocampal neuron densities and supragranular mossy fiber sprouting were determined in adult rats subjected to systemic kainate‐induced SE (KA‐only) and KA‐induced SE followed 75 minutes later by theophylline (KA/Theo) or trimethobenzamide (KA/Tri). These drugs probably decrease seizure‐induced cerebral hyperemia or hypertension. Results: Compared with controls and KA‐only rats, KA/Tri and KA/Theo rats showed decreased CA3b and CA1 neuron densities (i.e., greater Sommer's sector injury). In addition, KA/Tri rats showed that increased trimethobenzamide dosages were associated with decreased hilar, CA3c, CA3b, CA1, and subiculum neuron densities. There were no significant differences in supragranular mossy fiber sprouting between KA‐only, KA/Tri, and KA/Theo rats. Conclusions: Pharmacologic manipulations during KA‐induced SE are associated with differences in hippocampal pathology, especially in Sommer's sector, and the final pattern of damage and axon sprouting shows histopathologic similarities to that in patients with hippocampal sclerosis. Our findings support the hypothesis that secondary physiologic insults during SE that are likely to decrease seizure‐induced cerebral hyperemia and hypertension may generate greater hippocampal neuronal injury compared with SE alone, and this may be a pathogenic mechanism of human hippocampal sclerosis in patients with TLE.
Use of Cavernous Sinus EEG in the Detection of Seizure Onset and Spread in Mesial Temporal Lobe Epilepsy
Authors: Kunieda Takeharu , Ikeda Akio , Mikuni Nobuhiro , Ohara Shinji , Sadato Akiyo , Taki Waro , Hashimoto Nobuo , Shibasaki Hiroshi 
Published: August 2005

Summary: Purpose: The study goal was to evaluate the clinical usefulness of intravenous EEG recording by placing wire electrodes in the cavernous sinus (CS) and the superior petrosal sinus (SPS) in patients with intractable temporal lobe epilepsy (TLE), with special emphasis on the ictal recording. Methods: We placed Seeker Lite‐ 10 guide wire as electrodes in the bilateral CS, SPS, or both to simultaneously record both ictal and interictal EEGs with the scalp EEG in five patients with TLE. In addition, in one patient, we averaged interictal scalp and intravascular EEG time‐locked to the epileptiform discharge recorded from the CS/SPS‐EEG to further delineate the relationship of the spikes between scalp and intravenous recording. Results: In four of five patients, clinically useful recording was obtained to determine ictal focus. We recorded habitual seizures in three patients, and the detailed characteristics of ictal epileptiform discharges were shown. The averaged waveform of interictal epileptiform discharges clarified the spike distribution in the scalp EEGs, which was otherwise undetectable in the single trace. All of the patients completed the intravenous EEG monitoring without any neurological or psychological problems. Conclusions: The CS/SPS‐EEG is a relatively noninvasive method that is useful for the detection of ictal focus and its spreading pattern and thus for the selection of surgical candidate among patients with intractable TLE. Although the number of seizures detected during the short monitoring period may be limited, due to the advantages of its safety and simplicity, it is worth trying for potential surgical candidates before more invasive examinations are applied. A further study with a larger number of patients is needed to estimate its practical risk.
Spindles‐Inducing Mechanism Modulates Sleep Activation of Interictal Epileptiform Discharges in the Landau—Kleffner Syndrome
Authors: Nobili L. , Baglietto M. G. , Beelke M. , De Carli F. , De Negri E. , Tortorelli S. , Ferrillo F. 
Published: August 2005

Summary: Purpose: Landau–Kleffner syndrome (LKS) is characterized by a marked increase of interictal epileptiform discharges (IEDs) during sleep. During nonrapid eye movement (NREM) sleep, neuronal membrane potential oscillations lead to the appearance of spindles and delta waves in the surface EEG and might develop into paroxysmal synchronization. Spectral analysis allows the quantitative description of the dynamics of delta (slow‐wave activity, SWA, 0.5‐4.5 Hz) and sigma activity (SA, 12.0–16.0 Hz) and can be used to assess the relation between SA, SWA, and IEDs during sleep. Methods: We performed six overnight continuous EEG‐polysomnographic studies in three patients with LKS. The temporal series of SWA and SA were obtained from a spike‐free derivation lead. The IEDs count was performed on the most active lead. Relations between sigma and SWA and time series of lEDs were tested by means of correlation techniques after data normalization. Results: Our results revealed a significantly higher correlation between IEDs and SA with respect to SWA in all the subjects, in total sleep time. The same analysis limited to NREM sleep highlights the better correlation between SA and IEDs. Conclusions: Our data suggest that neural mechanisms involved in the generation of sleep spindles facilitate IEDs production in LKS.
Frequency of Bitemporal Independent Interictal Epileptiform Discharges in Temporal Lobe Epilepsy
Authors: Ergene Erhan , Shih Jerry J. , Blum David E. , So Norman K. 
Published: August 2005

Summary: Purpose: Bitemporal interictal epileptiform discharges (IEDs) occur in ≤42% of scalp EEGs in patients with temporal lobe epilepsy (TLE) studied with routine EEGs or partial analysis of long‐term recordings. Methods: Twenty‐eight patients with TLE demonstrating exclusively unilateral temporal IEDs on routine EEGs underwent 24‐h continuous recording. The entire record was visually in‐spected for epileptiform discharges. We used continuous EEG to assess the significance of long‐term recording in detecting bilateral IEDs. Results: Twenty‐two patients had left temporal IEDs; 21 had right temporal IEDs. Seventeen (61%) patients had IEDs originating from both the right and left temporal lobes. The probability of detecting bilateral independent IEDs was correlated with the duration of continuous EEG recording. There was no correlation between the number of lEDs originating from one side and the probability of detecting independent IEDs on the other side. The frequencies of IEDs were not correlated with the length of time since onset of epilepsy. Conclusions: The findings suggest that when long‐term recordings are performed, the incidence of bilateral discharges in TLE is higher than previously reported in the literature and supports the view that TLE is commonly a bilateral disease.
Independent Occurrence of the CHRNA4 Ser248Phe Mutation in a Norwegian Family with Nocturnal Frontal Lobe Epilepsy
Authors: Steinlein Ortrud K. , Stoodt Jens , Mulley John , Berkovic Sam , Scheffer Ingrid E. , Brodtkorb Eylert 
Published: August 2005

Summary: Purpose: To describe the clinical features of a family from Northern Norway in which autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) is associated with a Ser248Phe amino acid exchange in the second transmembrane domain of the neuronal nicotinic acetylcholine receptor α4 subunit (CHRNA4). We also tested for evidence of a de novo mutation or founder effect by comparing haplotypes with the original Australian family where the Ser248Phe mutation was first described. Methods: Clinical details were obtained from 19 family members. Personal interviews and genetic analysis were carried out in 17. Parts of the coding region of CHRNA4 were sequenced, and two known polymorphisms (bp555/FokI, bp594/CfoI) were typed by restriction analysis. Results: Eleven individuals had ADNFLE. The haplotypes of the mutation‐carrying alleles of affected individuals from the Northern Norwegian and the Australian ADNFLE family are different. The phenotypic expressions are remarkably similar. Conclusions: The Ser248Phe mutation occurred independently in both families. Given the rarity of the disease, this suggests that not only the position of a mutation in the coding sequence but also the type of an amino acid exchange is important for the etiology of ADNFLE. The phenotypic similarity of these two families with different genetic backgrounds suggests that the Ser248Phe mutation largely determines the phenotype, with relatively little influence of other background genes.
Drug‐Induced Changes in Cerebral Glucose Consumption in Bifrontal Epilepsy
Authors: Matheja Peter , Weckesser Matthias , Debus Otfried , Löttgen Jan , Schuierer Gerhard , Schober Otmar , Kurlemann Gerhard 
Published: August 2005

Summary: Purpose: Positron emission tomography (PET) using 18F‐radiolabeled deoxyglucose (18F‐FDG) is a sensitive procedure for detection of epileptogenic foci. Although alterations in glucose consumption are not restricted to the area of seizure generation itself, the magnitude and extent of cerebral metabolic disturbances induced by epileptic discharges can be detected. Despite two decades of epilepsy research using 18F‐FDG‐PET, little is known about the metabolic changes during therapy of focal epilepsy. We report on a child with frontal epilepsy with severe glucose hypometabolism that was nearly completely normalized during drug therapy. Methods: Interictal 18F‐FDG‐PET was performed at the onset of epilepsy and after optimized drug therapy in a 5‐year‐old boy with behavioral abnormalities and repetitive seizures of frontal origin with bifrontal interictal EEG slowing for 8 weeks. Both scans were anatomically matched; initial and intratherapeutic glucose metabolism were compared. Results: In accordance with the epileptogenic focus as identified by EEG and ictal/interictal perfusion single‐photon emission tomography (SPECT), bifrontal hypometabolism was depicted by 18F‐FDG‐PET. Magnetic resonance imaging (MRI) was unremarkable. After dual‐drug therapy (valproate, carbamazepine), the boy became seizure free, and his initial behavioral deficits disappeared. A control PET study after 3 months of therapy showed restored glucose consumption; the frontal EEG slowing was normalized. Conclusions: This case demonstrates that reduction of glucose metabolism in epileptogenic foci may be a result of reversible neuronal dysfunction that correlates with the electroclinical follow‐up.
Lamotrigine in Pregnancy: Pharmacokinetics During Delivery, in the Neonate, and During Lactation
Authors: Ohman Inger , Vitols Sigurd , Tomson Torbjörn 
Published: August 2005

Summary: Purpose: To investigate the pharmacokinetics of lamotrigine (LTG) during delivery, during the neonatal period, and lactation. Methods: High‐performance liquid chromatography was used to determine plasma and milk levels of LTG in nine pregnant women with epilepsy treated with LTG, and plasma levels in their 10 infants. Samples were obtained at delivery, the first 3 days postpartum, and at breast‐feeding 2–3 weeks after delivery. Results: At delivery, maternal plasma LTG concentrations were similar to those from the umbilical cord, indicating extensive placental transfer of LTG. There was a slow decline in the LTG plasma concentration in the newborn. At 72 h postpartum, median LTG plasma levels in the infants were 75% of the cord plasma levels (range, 50–100%). The median milk/maternal plasma concentration ratio was 0.61 (range, 0.47–0.77) 2–3 weeks after delivery, and the nursed infants maintained LTG plasma concentrations of –30% (median, range 23–50%) of the mother's plasma levels. Maternal plasma LTG concentrations increased significantly during the first 2 weeks after parturition, the median increase in plasma concentration/dose ratio being 170%. Conclusions: Our data demonstrate a marked change in maternal LTG kinetics after delivery, possibly reflecting a normalization of an induced metabolism of LTG during pregnancy. LTG is excreted in considerable amounts in breast milk (the dose to the infant can be estimated to 0.2–1 mg/kg/day 2–3 weeks postpartum), which in combination with a slow elimination in the infants, may result in LTG plasma concentrations comparable to what is reported during active LTG therapy. No adverse effects were observed in the infants, however.
Intracarotid Amobarbital Procedure and Prediction of Postoperative Memory in Patients with Left Temporal Lobe Epilepsy and Hippocampal Sclerosis
Authors: Bell Brian D. , Davies Keith G. , Haltiner Alan M. , Walters Gina L. 
Published: August 2005

Summary: Purpose: Although temporal lobe epilepsy (TLE) patients with dominant hemisphere hippocampal sclerosis generally have good cognitive outcome after anterior temporal lobectomy (ATL), a minority of patients experience at least mild post‐ATL decline on one or more standardized measures of episodic and semantic memory. The goal of this investigation was to determine whether memory outcome in this group could be predicted from preoperative intracarotid amobarbital procedure (IAP) recognition memory scores. Methods: Data from 22 left TLE patients were studied retrospectively. All were left hemisphere language dominant and had IAP scores for each hemisphere, a significant degree of pathology‐confirmed left hippocampal sclerosis (HS+), and no positive MRI findings other than atrophy. Cognitive outcome status was represented by the number of pre‐ to post‐ATL declines across three tests, as defined by 90th percentile Reliable Change Index (RCI) criteria. Results: Only 14% of the sample exhibited decline on more than one memory test. Low right IAP (left hemisphere injection) scores and relatively high preoperative cognitive ability and age at surgery predicted a greater risk of post‐ATL memory decline. Conclusions: A minority of left TLE HS+ patients experience at least a mild degree of RCI‐defined decline in episodic or semantic memory after ATL. The right hemisphere IAP memory score, which reflects the functional reserve of the contralateral hemisphere, can help predict the risk of postoperative memory decline for TLE patients in whom HS+ is likely based on the presence of hippocampal atrophy on MRI or early age of seizure onset.
7‐Nitroindazole Differentially Affects the Anticonvulsant Activity of Antiepileptic Drugs Against Amygdala‐Kindled Seizures in Rats
Authors: Borowicz Kinga K. , Kleinrok Zdzislaw , Czuczwar Stanislaw J. 
Published: August 2005

Summary: Purpose: The objective of this study was to evaluate the interaction of the preferential brain nitric oxide synthase (NOS) inhibitor, 7‐nitroindazole (7‐NI), with conventional antiepileptic drugs (AEDs) against amygdala‐kindled seizures in rats. Methods: Experiments were performed on fully kindled rats. Adverse effects were evaluated with the rotorod test, which assesses motor coordination, and the passive‐avoidance task, which assesses memory. Plasma levels of AEDs were measured by immunofluorescence. Results: 7‐NI (up to 100 mg/kg) failed to modify seizure parameters. However, it reduced the severity and duration of kindled seizures when coadministered with otherwise ineffective doses of carbamazepine (CBZ) (10–20 mg/kg) or phenobarbital (PB) (20 mg/kg). Combinations of 7‐NI with valproate (VPA), diphenylhydantoin (DPH), or clonazepam (CLO) were not protective. l‐Arginine (500 mg/kg) did not reverse the seizure‐suppressing interactions between 7‐NI and the conventional AEDs. The combinations of 7‐NI and CBZ or PB did not impair performance in the rotorod test. Coadministration of 7‐NI with CBZ did not affect long‐term memory, and 7‐NI given with PB didn't affect the mnemonic effect of PB. Finally, 7‐NI did not affect the free plasma levels of CBZ or PB. Conclusions: Pharmacokinetic interactions do not seem to account for the anticonvulsant effects of 7‐NI combined with CBZ or PB. Central nitric oxide (NO) is possibly not involved in the synergism between 7‐NI and these AEDs.
Epilepsy Surgery in Children with Tuberous Sclerosis Complex: Presurgical Evaluation and Outcome
Authors: Koh Susan , Jayakar Prasanna , Dunoyer Catalina , Whiting Sharon E. , Resnick Trevor J. , Alvarez Luis A. , Morrison Glenn , Ragheb John , Prats Antonio , Dean Patricia , Antel Samson B. , Gilman Jamie , Duchowny Michael S. 
Published: August 2005

Summary:Purpose: Children with tuberous sclerosis complex (TSC) benefit from excisional surgery if seizures can be localized to a single tuber. We evaluated the role of noninvasive studies to localize the epileptogenic tuber/region (ET/R) and the outcome of focal resection.Methods: We identified 21 children with TSC, ages 3 months to 15 years (mean 4.8 years). All had video‐(electroencephalogram) EEG and magnetic resonance imaging (MRI) scans, and 18 also had ictal single photon emission‐computed tomography (SPECT) studies. An ET/R was localized in 17 patients. Thirteen patients underwent resection guided by intraoperative electrocorticography (n = 7) or subdural monitoring (n = 6).Results: Interictal EEG revealed a principal spike focus (PSF) that corresponded to the ET/R in 14 children. In seven, PSFs occurred in rhythmic runs. PSFs were not observed remote from the ET/R. Focal polymorphic slowing and attenuation occurred in the region of the PSF in 11 patients. Sixteen patients demonstrated an ictal focus corresponding to the ET/R. Ictal SPECT revealed focal hyperperfusion correlating with the ET/R in 10 patients. Although the MRIs in all children revealed multiple tubers, the ET/R corresponded to a large discrete tuber in 8 patients and a calcified tuber in 13 patients. Patchy calcified tubers were also seen elsewhere in six patients. At a mean follow‐up of 26 months, 9 of the 13 children who underwent surgery were seizure‐free, one had greater than 75% reduction in seizures, two were unchanged, and one was lost to follow‐up. New seizures developed in one child from a contralateral tuber.Conclusions: Surgical resection of an ET/R alleviates seizures in most children with TSC and intractable epilepsy. The scalp EEG and MRI help define the ET/R and improve case selection when ictal SPECT is nonlocalizing.