bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comprehensive understanding of stroke risk, prognosis, and preventive strategies for type 2 diabetes
Authors: Demidova T. Yu. , Titova V. V. , Ushanova F. O. 
Published: January 2024

Stroke is a serious and disabling disease with a high mortality rate that is becoming increasingly common worldwide, posing a serious threat to the health and quality of life of patients. Type 2 diabetes plays a special role in increasing the risk of stroke, which not only increases the risk of developing a stroke, but also negatively affects the outcome and the possibility of recurrent strokes.In order to prevent stroke, systematic action is necessary, including the correction of risk factors and the use of effective medications. One such drug is pioglitazone. Many studies support its effectiveness in reducing the risk of cardiovascular events, including stroke, for both secondary and primary prevention.Pioglitazone may be particularly beneficial for patients at high risk of cardiovascular disease and those with a history of ischemic brain damage. Despite the known side effects, its benefits in preventing stroke outweigh the possible disadvantages.This review provides important aspects of the role of type 2 diabetes mellitus in increasing the risk of stroke and discusses the prospects for the use of pioglitazone as a drug therapy affecting stroke risk and prognosis.
Successful pregnancy in a patient with acromegaly after somatostatin analogues and cabergoline treatment. therapy with somatostatin analogues and cabergoline
Authors: Knyazeva O. V. , Vorotnikova S. Yu. , Volevodz N. N. , Dzeranova L. K. 
Published: January 2024

The probability of pregnancy in women with acromegaly is relatively low, however modern therapy approaches make it possible to achieve disease compensation and improve reproductive function.World expert’s experience in managing pregnancy in patients with acromegaly is currently insufficient. Pregnancy may be associated with an increased risk for both mother and fetus due to the possible growth of the tumor, the development of metabolic complications (diabetes mellitus, arterial hypertension).This article describes a case of a successful pregnancy in a woman with active acromegaly occurring after somatostatin analogues and cabergoline treatment.
Features of the course of somatolactotrophic tumors of the pituitary gland. Description of clinical case
Authors: Morugova T. V. , Avzaletdinova D. S. , Morugova I. V. 
Published: January 2024

A patient aged 32 with complaints of primary infertility based on additional examination data (increased blood prolactin level, presence of pituitary gland formation according to magnetic resonance imaging of the brain) was diagnosed with prolactin-secreting pituitary microadenoma. At the same time, galactorrhea and menstrual disorders were not noted. Against the background of cabergoline treatment, a pregnancy occurred, which ended with the birth of a full-term healthy child. After delivery, the patient resumed dosing cabergoline 0.5 mg 1 once every two weeks, against the background of which a pronounced decrease in prolactin levels was observed, but there was a progression in the growth of pituitary adenoma (macroadenoma). No acromegaly traits were observed in the patient.Against the background of withdrawal of cabergoline, the patient underwent a study of tropical pituitary hormones, which revealed an increase in the level of growth hormone and insulin-like growth factor-1. During the oral glucose tolerance test with 75 grams of glucose, the somatotropin-producing activity of the pituitary macroadenoma was confirmed. At the age of 43, the patient underwent transsphenoidal adenomectomy, after which she experienced persistent remission for past 6 years.The purpose of this work is to focus the attention of practitioners on the manifestation of possible mixed hormonal activity of pituitary microadenomas.
Developing central diabetes insipidus following neurohypophysitis during the convalescent period after recovering from covid-19: presentation of a clinical case and literature review
Authors: Starostina E. A. , Drachuk E. S. , Przhiyalkovskaya E. G. , Platonova N. M. , Troshina E. A. 
Published: January 2024

Currently, there is a substantial body of research dedicated to exploring the impact of SARS-CoV-2 on the endocrine system. However, information regarding pathological changes in the hypothalamo-pituitary system in the context of COVID-19 remains limited. Hypophysitis is a general term encompassing various inflammatory conditions affecting the pituitary gland, leading to structural alterations in the hypothalamo-pituitary axis and various levels of hormonal deficiencies in the anterior and/or posterior pituitary.This paper presents a clinical case of central diabetes insipidus resulting from neurohypophysitis, manifested two months after recovering from the novel coronavirus infection SARS-CoV-2 (COVID-19). Our study contributes to expanding knowledge about a rare but potentially consequential outcome of the novel coronavirus infection, which holds significance given the global prevalence of COVID-19. The unexpected consequences of SARS-CoV-2 infection contribute to maintaining caution among medical professionals and stimulate interest in scientific research.
Tonic status epilepticus in a centenarian woman
Authors: Fernández‐Torre José L. , Riancho Javier , Martín‐García María , Martínez‐de las Cuevas Gonzalo , Bosque‐Varela Pilar 
Published: January 2024

ABSTRACTGeneralized tonic status epilepticus (TSE) is a rare epileptic condition. It occurs usually in the context of symptomatic generalized epilepsy, in particular, in subjects with a diagnosis of Lennox‐Gastaut syndrome, atypical forms of idiopathic (genetic) generalized epilepsy, or as a paradoxical effect during treatment with diverse antiepileptic drugs. Herein, we describe the case of an elderly woman on chronic treatment with psychotropic drugs who developed an episode of generalized TSE. Motor manifestations were subtle and difficult to recognize as seizures, and a detailed video‐EEG importantly contributed to accurate and prompt diagnosis. TSE was initially refractory to conventional anti‐seizure drug therapy including levetiracetam and valproate but was finally controlled with lacosamide. Our case indicates a potential therapeutic effect of lacosamide on TSE in the elderly after treatment failure with first‐line anti‐seizure drugs. [Published with video sequence onwww.epilepticdisorders.com]
A Rasmussen encephalitis, autoimmune encephalitis, and mitochondrial disease mimicker: expanding the DNM1L‐associated intractable epilepsy and encephalopathy phenotype
Authors: Nolan Danielle A. , Chen Baibing , Michon Anne Marie , Salatka Emily , Arndt Daniel 
Published: January 2024

ABSTRACTDynamin‐1‐like protein (DNM1L) gene variants have been linked to childhood refractory epilepsy, developmental delay, encephalopathy, microcephaly, and progressive diffuse cerebral atrophy. However, only a few cases have been reported in the literature and there is still a limited amount of information about the symptomatology and pathophysiology associated with pathogenic variants of DNM1L. We report a 10‐year‐old girl with a one‐year history of mild learning disorder and absence seizures who presented with new‐onset focal status epilepticus which progressed to severe encephalopathy and asymmetric hemispheric cerebral atrophy. Differential diagnosis included mitochondrial disease, Rasmussen's encephalitis, and autoimmune encephalitis. Disease progressed from one hemisphere to the other despite anti‐seizure medications, hemispherectomy, vagus nerve stimulator, ketogenic diet, and immunomodulators. Continued cerebral atrophy and refractory seizures evolved until death four years after initial presentation. Post‐mortem whole‐exome sequencing revealed a pathogenic DNM1L variant. This paper presents a novel case of adolescent‐onset DNM1L‐related intractable epilepsy and encephalopathy.
Late adult‐onset epilepsy in a patient with hemimegalencephaly
Authors: Climans Seth A. , Mirsattari Seyed M. 
Published: January 2024

ABSTRACTHemimegalencephaly is a malformation of cortical development that normally manifests in childhood with seizures and cognitive impairment. We present a case of hemimegalencephaly in a 55‐year‐old developmentally‐normal woman who developed focal impaired awareness seizures with bilateral tonic‐clonic spread. Her interictal EEG showed left‐sided multifocal spikes, and ictal EEG showed seizures starting in the left hemisphere. Imaging showed hemimegalencephaly. This case may represent the oldest age for a first seizure in a patient with hemimegalencephaly.
Semiology of hyperkinetic seizures of frontalversustemporal lobe origin
Authors: Nitta Naoki , Usui Naotaka , Kondo Akihiko , Tottori Takayasu , Terada Kiyohito , Araki Yasukiyo , Nakaoka Kentaro , Kawaguchi Norihiko , Idebuchi Genichi , Nozaki Kazuhiko , Inoue Yushi 
Published: January 2024

ABSTRACTAims. Hyperkinetic seizures are usually associated with frontal lobe epilepsy. However, some patients have hyperkinetic seizures of temporal lobe origin. The semiological differences in hyperkinetic seizures between frontal and temporal lobe epilepsy have not been well studied. Here, we retrospectively assessed ictal semiology in order to distinguish between hyperkinetic seizures of frontal lobe origin and those of temporal lobe origin.Methods. We retrospectively reviewed data on patients who had undergone surgery for hyperkinetic seizures of temporal or frontal lobe origin and achieved favourable seizure outcomes (Engel Class I) with a minimum postoperative follow‐up of 24 months. We reviewed seizure histories, imaging reports, video‐EEG monitoring data, operative records, and pathological findings. We analysed and compared the hyperkinetic semiology of video‐recorded seizures of temporal lobe origin and those of frontal lobe origin.Results. Forty hyperkinetic seizures in eight patients (seven adult patients and one 12‐year‐old patient) with temporal lobe epilepsy and 45 hyperkinetic seizures in nine patients (eight adult patients and one 16‐year‐old patient) with frontal lobe epilepsy were analysed. Emotional facial expressions (such as fear, laughing, or anger), bilateral forceful elbow flexion, bilateral forceful grasping, facial flushing, and bilateral facial contraction were observed significantly more frequently in seizures of frontal lobe origin. Oroalimentary automatisms, seizures during wakefulness, salivation, and bilateral drop of the corners of the mouth were observed significantly more frequently in seizures of temporal lobe origin.Conclusions. Observation of a number of signs during hyperkinetic manifestations may help to predict whether a seizure originates from the frontal lobe or the temporal lobe.
Encephalopathy with continuous spike‐waves during slow‐wave sleep: evolution and prognosis
Authors: Caraballo Roberto , Pavlidis Elena , Nikanorova Marina , Loddenkemper Tobias 
Published: January 2024

AbstractEncephalopathy with continuous spike‐waves during slow‐wave sleep (CSWS) evolves over time, and three stages can be recognized: before the onset of CSWS, during CSWS, and after the CSWS period. Clinical seizures tend to remit spontaneously around puberty. This pattern is independent of the etiological lesion. The CSWS also disappears in all cases. Focal abnormalities instead, may persist for some time after the disappearance of CSWS. The disappearance of the clinical seizures and CSWS may be simultaneous or seizures may disappear before or after disappearance of the CSWS pattern on the EEG.Electroclinical parameters in the pre‐CSWS period that have been proposed to predict a poor outcome are early‐onset seizures, appearance of new seizures, and a significant increase in seizure frequency. From the electrical point of view, an increase in the frequency of the interictal EEG paroxysms while awake and during sleep and bilateral spike‐and‐wave paroxysms may also be predictive of a poor evolution in CSWS.When CSWS disappears, neurocognitive and behavioral status improve, but in most patients, residual moderate to severe neurocognitive impairments remain. In non‐lesional epilepsy, cognitive recovery after cessation of the CSWS depends on the severity and duration of the initial regression.The duration of the CSWS seems to be the most important predictor of cognitive outcome. Early recognition and effective therapy to reduce the seizures and resolve the CSWS may be crucial to improve long‐term prognosis. Cognitive recovery is observed in patients who respond well to AED treatment and outcome depends on the etiology.
EEG features in Encephalopathy related to Status Epilepticus during slow Sleep
Authors: Gardella Elena , Cantalupo Gaetano , Larsson Pål G. , Fontana Elena , Bernardina Bernardo dalla , Rubboli Guido , Darra Francesca 
Published: January 2024

AbstractEncephalopathy related to Status Epilepticus during slow Sleep (ESES) is a peculiar electro‐clinical condition, with variable etiologies, characterized by an age‐dependent phenomenon of extreme activation of epileptic activity during sleep, i.e. “status epilepticus during sleep”, that is strictly associated with the appearance of cognitive and behavioral disturbances. Even though the peculiar EEG picture is fundamental for the diagnosis of ESES, clear‐cut and shared diagnostic criteria for defining the EEG boundaries of this syndrome are still lacking. The diagnosis of ESES can be further complicated by the variability of the EEG findings, that during the course of the disease can change from diffuse to more or less focal and viceversa, depending both on the spontaneous clinical evolution of this condition and/or on the effects of medications. Given the complexity and the heterogeneity of EEG parameters during the ESES course, it is important to correlate the EEG findings with the concomitant cognitive and behavioral status, possibly taking into account not only the spike‐wave index, but also other parameters, such as for instance the topography of the epileptic abnormalities, their patterns of spread, and their fluctuations over time.Moreover, the epileptiform activity not only during sleep, but also during wakefulness, the presence of focal slowing, the organization of the EEG background and a derangement of the sleep architecture may play a role in determining the clinical picture.
Cognitive impairment and behavioral disorders in Encephalopathy related to Status Epilepticus during slow Sleep: diagnostic assessment and outcome
Authors: Arzimanoglou Alexis , Cross Helen J. 
Published: January 2024

AbstractEncephalopathy related to Status Epilepticus during slow Sleep (ESES) is an age‐dependent phenomenon, with usual spontaneous resolution during teenage years. However, cognitive outcome is often more disappointing, with permanent cognitive deficits in the large majority of children seen in later life. Presuming this to be an epileptic encephalopathy, current treatment practices are almost exclusively guided by the effect of the AEDs used on the degree of EEG abnormality in sleep. However, the major goal of therapy in ESES syndrome should in fact be to prevent or reduce associated cognitive and neurodevelopmental deficits. Whether or not the EEG pattern of ESES should be completely suppressed to improve cognition is unknown. Discussions on both diagnostic assessment and outcome of cognitive impairment and behavioral disorders should systematically take into account the complexity of the disorder; not only in terms of the evolution or fluctuations of the EEG patterns but also in relation to the underlying etiologies (at least lesional versus non‐lesional) and age at diagnosis. We present a common basic assessment protocol, including the minimum technical requirements for polygraphic recording, and a treatment practice protocol that could both be applied in all centres dealing with this rare form of epilepsy. Such an approach would also allow a comprehensive collection of data prospectively, for a better understanding of the natural evolution of the disorder and an evidence‐based evaluation of our practices.
Progressive intellectual impairment in children with Encephalopathy related to Status Epilepticus during slow Sleep
Authors: Dorris Liam , O’Regan Mary , Wilson Margaret , Zuberi Sameer M. 
Published: January 2024

AbstractWe investigated whether Encephalopathy related to Status Epilepticus during slow Sleep (ESES) in childhood was associated with progressive intellectual decline. Participants were identified from the caseload of a single paediatric neurosciences centre and EEG department. A retrospective review of overnight sleep EEG reports (n=2200) over a five‐year period identified twenty‐two children as having the neurophysiological characteristics of ESES. All had repeat neuropsychological assessment using the WISC‐III (UK) and/or WPPSI‐R (UK). There was a statistically significant reduction in Full‐Scale IQ and Performance IQ across a mean and median time interval of two years. Around a third of the participants showed a clinically significant regression in intellectual functioning evidenced by =>12‐point reduction in IQ. These patients were not distinguishable from the rest of the cohort in terms of clinical history, imaging or duration of ESES. The reduction in IQ reflected reduced processing speed, working memory and overall cognitive efficiency. Children with a history of ESES require close monitoring in order to support educational planning and provide families with accurate information about prognosis.
Magnetoencephalogram‐assisted diagnosis of familial focal epilepsy with variable foci in a Chinese family with a novel DEPDC5 mutation
Authors: Li Mingyu , Huang Zhaoyang , Zhang Xiating , Duan Yiran , Jia Yu , Ye Jing , Wang Yuping 
Published: January 2024

ABSTRACTFamilial focal epilepsy with variable foci (FFEVF) is an autosomal dominant disorder characterized by focal seizures arising from different brain lobes in different family members. Currently, the diagnosis of this syndrome mainly depends on the combination of semiology and EEG after exclusion of other types of familial focal epilepsy. Mutations in dishevelled, Egl‐10, and pleckstrin domain‐containing protein 5 (DEPDC5) have been recently identified as a common cause of this syndrome. We studied a Chinese four‐generation FFEVF family with nine affected individuals. Targeted next‐generation sequencing was performed for the proband and the suspected mutation was confirmed by Sanger sequencing. Magnetoencephalography (MEG) was applied to two MRI‐negative patients with refractory epilepsy. We identified a novel splice site mutation in DEPDC5 (c.280‐1 G>A) in this family. The MEG results showed different dipole‐clustered areas in these two patients. This is the first report of the use of MEG to confirm a diagnosis of FFEVF, in a Chinese family with a novel DEPDC5 mutation. Furthermore, the MEG results also revealed the possibility of surgical resection for these two intractable patients.
Ictal cerebral haemodynamic characteristics during typical absence seizures, compared to focal seizures with brief alteration of awareness
Authors: Peng Bingwei , Dai Jin , Li Jialing , Liang Cuifang , Liang Xiuqiong 
Published: January 2024

ABSTRACTAims. To investigate ictal cerebral haemodynamic characteristics during spontaneous typical absence seizures (TAS) and hyperventilation‐evoked absence seizures in paediatric patients, relative to brief complex partial seizures (BCPS).Methods. All children diagnosed with seizures using real‐time transcranial doppler ultrasonography (TCD) and sleep‐deprived video‐EEG (vEEG) from 2015 to 2017 in our hospital were included. The seizures were diagnosed based on the video and EEG findings. Mean cerebral blood flow velocity (CBFVm) of the unilateral middle cerebral artery was measured using TCD. TCD and vEEG data were integrated for a synchronous assessment of CBFVm changes and epileptic status. Baseline and peak CBFVm for TAS and BCPS were compared by T‐test.Results. Six children (two boys and four girls) with TAS and two girls with BCPS were enrolled. A total of 15 spontaneous TAS, 14 hyperventilation‐evoked absence seizures, and six BCPS were recorded using real‐time TCD‐vEEG monitoring. During spontaneous TAS, whether awake or asleep, the CBFVm decreased by 20–40% compared to baseline. During hyperventilation‐evoked absence seizures and BCPS, the CBFVm increased by 50–150% and 20–30% over baseline levels, respectively.Conclusions. The haemodynamic characteristics during TAS and BCPS are distinct, and thus our results may provide a new method to diagnose typical absence seizures using dynamic CBFVm curves. Ictal cerebral haemodynamic characteristics during spontaneous typical absence seizures and hyperventilation‐evoked absence seizures may reflect different pathophysiological mechanisms and networks compared with BCPS.
When the brain hurts the heart: status epilepticus inducing tako‐tsubo cardiomyopathy
Authors: Giovannini Giada , Grassi Laura , Vincenzi Chiara , Mirandola Laura , Meletti Stefano 
Published: January 2024

ABSTRACTAims. Tako‐tsubo cardiomyopathy (TTC) is a transient myocardial dysfunction mainly affecting the left ventricle, mimicking an acute coronary syndrome. This condition can be precipitated either by psychological/physical stressful events or by a number of medical conditions among which are seizures and status epilepticus (SE). The evolution is mostly favourable but sometimes TTC can evolve into life‐threatening conditions.Methods. We searched for cases of TTC among all consecutive SE episodes observed at our department during the period 2013–2018. In addition, we searched MEDLINE (accessed through PubMed from inception to August 31, 2018) to identify reports of patients with TTC associated with an SE episode.Results. Three TTC cases among 392 SE episodes were identified. Adding our cases to those previously reported, overall, we identified 45 cases of TTC induced by SE. The majority were females of around 60 years of age experiencing a first episode of SE with prominent motor phenomena, mostly in the context of remote aetiology. The most frequent presenting symptom was mild hypotension but cases with a severe presentation were also reported. The overall evolution was positive in all cases but some severe complications such as pulmonary oedema, cardiogenic shock, ventricular fibrillation, and a giant apical thrombus were also reported (19%).Conclusions. TTC may be a rare potentially life‐threatening consequence of SE. It is frequently unrecognized, and therefore underdiagnosed. Clinicians dealing with SE should be aware of this entity.
Ictal atrial fibrillation during focal seizures: a case report and literature review
Authors: Basili Luca M. , Morano Alessandra , Fattouch Jinane , Fanella Martina , Albini Mariarita , Avorio Federica , Irelli Emanuele Cerulli , Manfredi Mario , Urani Claudia , Strano Stefano , Giallonardo Anna T. , Di Bonaventura Carlo 
Published: January 2024

ABSTRACTCardiac arrhythmias are a common but often overlooked symptom that occur during or after epileptic seizures. The characterization of seizure‐related heart rhythm disorders could shed light on the functional organization of the so‐called “central autonomic network” and possibly on the pathophysiology of sudden death of epilepsy patients (SUDEP). Indeed, epileptic discharges may affect the heart through the involvement of cortical regions selectively driving autonomic functions. Ictal atrial fibrillation is an exceedingly rare phenomenon, usually associated with generalized tonic‐clonic seizures. Here, we report a case of paroxysmal atrial fibrillation as a core presenting feature of a focal non‐motor seizure in a 68‐year‐old man, at first misdiagnosed and treated for a typical cardiogenic arrhythmia. A brief literature review is included.