bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of D‐Cycloserine on the Anticonvulsant Activity of Phenytoin and Carbamazepine Against Electroconvulsions in Mice
Authors: WlazA Piotr , RolinAski Zbigniew , Czuczwar Stanislaw J. 
Published: August 2005

Summary: Purpose: D‐Cycloserine (DCS) is a high‐efficacy partial agonist at the strychnine‐insensitive glycine modulatory site within the N‐methyl+‐aspartate (NMDA)‐receptor/ionophore complex. Previous studies demonstrated that DCS exhibits anticonvulsant activity in a variety of experimental epilepsy models. In this study, we determined the influence of DCS in subprotective doses on the anticonvulsant action of phenytoin (PHT) and carbamazepine (CBZ) in mice. Methods: Two electroconvulsive tests were used, i.e., determination of seizure threshold and maximal electro‐shock seizures. Antiepileptic drug‐induced motor and long‐term memory deficits were quantified by using the chimney test and the passive‐avoidance test, respectively. In addition, plasma levels of PHT and CBZ were measured by fluorescence polarization immunoassay to exclude any pharmacokinetic interactions. Results: DCS, when used alone in doses of 80 and 160 mg/kg, significantly increased the threshold for electro‐convulsive seizures. DCS in a wide range of doses (1.25–40 mg/kg) was combined with either PHT or CBZ and tested in electroconvulsive tests. DCS, at doses of 2.5 and 10 mg/kg, was the most effective in potentiating the threshold‐increasing action of PHT; higher doses of DCS (20 and 40 mg/kg) were required to achieve a similar effect of CBZ. In maximal electroshock‐induced seizures, DCS (10 mg/kg) augmented the protective action of PHT, but was ineffective at a dose of 40 mg/kg with CBZ. DCS did not potentiate the neurotoxicity produced by PHT and CBZ in the chimney test. Both PHT and CBZ induced impairments of long‐term memory; PHT‐induced memory adverse effects were counteracted by DCS (10 mg/kg). There was no such effect on CBZ‐induced memory impairment, and a worsening influence was observed. Any pharmacokinetic interactions were excluded by measuring total and free plasma levels of both antiepileptic drugs. Conclusion: Our results suggest that combining DCS with PHT and CBZ may be beneficial in treating epileptic seizures.
Interictal 99Tcm HMPAO SPECT and 1H MRS in Children with Temporal Lobe Epilepsy
Authors: Cross J. H. , Gordon I. , Connelly A. , Jackson G. D. , Johnson C. L. , Neville B. G. R. , Gadian D. G. 
Published: August 2005

Summary: Purpose: To understand the pathological basis of focal hypoperfusion seen on interictal 99Tcm hexamethylpropyleneamine oxime (HMPAO) single‐photon‐emission computed tomography (SPECT) in intractable temporal lobe epilepsy, and to determine why the technique may be misleading in the localization and lateralization of the seizure focus in some cases. Methods: Interictal 99Tcm HMPAO SPECT and proton magnetic resonance spectroscopy (1H MRS) of the mesial temporal regions were performed in 14 children with intractable temporal lobe epilepsy not caused by a foreign tissue lesion. Results: Hypoperfusion of one temporal lobe ipsilateral to the seizure focus was demonstrated in 10 (71%) of the children; 1H MRS correctly lateralised in eight of these 10. No asymmetry of perfusion of the anterior temporal regions was seen in the remaining four children; on 1H MRS, three of these were bilaterally abnormal but nonlateralising. Repeated SPECT and 1H MRS in three children demonstrated changes over time, the findings from the two techniques being consistent with each other on both the initial and the repeated scans. Conclusions: Abnormalities demonstrated by 1H MRS correlate well with those seen on interictal SPECT and can help to understand the pathologic basis of these SPECT abnormalities. Furthermore, the presence of bilateral damage can result in an absence of perfusion asymmetry on interictal SPECT.
Seizure Severity in Children with Epilepsy: A Parent‐Completed Scale Compared with Clinical Data
Authors: Carpay J. A. , Vermuelen J. , Stroink H. , Brouwer O. F. , Peters A. C. B. , Aldenkamp A. P. , van Donselaar C. A. , Arts W. F. M. 
Published: August 2005

Summary: Purpose: We wished to compare a parent‐completed scale quantifying seizure severity (SS) in children with various seizure types with the clinicians' impression of SS and other clinical data. Methods: The parents of 117 children with recurrent seizures completed a 13‐item, subjective scale (The Hague Seizure Severity Scale, HASS). Eight treating neurologists quantified SS on a 10‐point Visual Analog Scale (VAS) and supplied other clinical data. Results: Both the HASS and the VAS assessments of SS showed considerable variation within one seizure type. Significant differences were noted between groups with (a) absences and simple partial seizures (SPS), (b) complex partial seizures (CPS), and (c) generalized tonic‐clonic seizures (GTCS). The correlation coefficient between the neurologists' and the parents' scores was 0.45 but did not exceed 0.26 after stratification for seizure type. The parents' score was not substantially influenced by various other clinical variables. The neurologists' score was correlated with resistance to treatment and presence of mental retardation. Conclusions: The SS ratings of the parents and the neurologists were not substantially correlated. The consideration that parents, as eyewitnesses to the seizures, are probably better judges of SS than clinicians may favor the use of a parent‐completed scale to quantify SS. The HASS is a valid and reliable measure of parent‐perceived SS that can be useful as an outcome measure in childhood epilepsy.
Widespread Functional Deficits in Perception‐Related Networks Demonstrated by PET in a Case with Simple Visual Seizures
Authors: Mielke R. , Weber‐Luxenburger G. , Kessler J. , Szelies B. , Heiss W.‐D. 
Published: August 2005

Summary: Purpose: To study benzodiazepine receptor (BZR) density and functional deficits in occipital lobe epilepsy. Methods: A 39‐year‐old man who had simple partial visual seizures after neurosurgical transtentorial extirpation of a pine‐aloma was studied by EEG, magnetic resonance imaging (MRI), and positron emission tomography (PET) of [18F]2‐fluoro‐2‐deoxy‐D‐glucose (FDG) at rest and during visual activation task and [11C]flumazenil (FMZ). Results: Electroencephalographic recordings were nonspecific, and MRI did not reveal any morphologic anomaly in the occipital lobe. Flumazenil‐PET demonstrated a small epileptogenic region in the right visual association cortex and FDG‐PET showed hypometabolism in a corresponding location and thalamic diaschisis. Stimulation of occipital metabolism by a continuous visual recognition task improved significantly the contrast between the dysfunctional zone and its surround. Conclusions: As BZR deficits are restricted to a small region, widespread hypometabolism in networks involved in visual information processing indicates an extensive functional deactivation by the epileptogenic focus.
IgA and IgG2 Deficiency Associated with Zonisamide Therapy: A Case Report
Authors: Maeoka Yukinori , Hara Toshiro , Dejima Sunao , Takeshita Kenzo 
Published: August 2005

Summary: Purpose: To report a previously undescribed adverse effect, IgA/IgG subclass deficiency associated with zonisamide (ZNS) therapy. Methods: Serum IgA and IgG subclass levels were determined by the turbidimetric immunoassay and enzyme‐linked immunosorbent assay, respectively, in a 2–year‐old boy with postmeningitis sequelae who was treated by ZNS. Results: Four months after initiation of ZNS, combined deficiency of IgA and IgG2 was noted. After cessation of ZNS, serum IgA level was promptly increased. IgG2 level was gradually increased, but remained subnormal after 7 months. Conclusions: This case documents, for the first time, the action of ZNS on IgG immune system as well as IgA system. If patients with ZNS therapy showed IgA deficiency and recurrent infections, it is preferable to check serum IgG subclass concentrations as well.
Oral Gabapentin Disposition in Patients with Epilepsy After a High‐Protein Meal
Authors: Benetello P. , Furlanut M. , Fortunato M. , Barldo M. , Pea F. , Togon A. , Testa G. 
Published: August 2005

Summary: Purpose: To study the interaction between gaba‐pentin (GBP) and high‐protein meals, 12 patients with epilepsy were administered this drug both while in a fasting state and after a high‐protein meal. Methods: After having acquired their informed consent, the patients (suffering from partial complex seizures resistant to other anticonvulsants) were randomly assigned to 2 groups of 6 subjects. Each subject was treated in a fasting state with a single 400 (group A) or 800 (group B) mg GBP oral dose. After 24 h, the GBP dose regimen was repeated, but was given after a high‐protein meal. Serum GBP concentrations were measured by LC‐Mass at baseline and 0.5, 1, 2, 3, 5, 7, 9, 12, and 24 h. Saliva GBP concentrations were determined at baseline and 2, 4, 8, and 12 h. GBP urinary excretion was determined at 0–4, 4–8, and 8–12 h intervals. The following kinetic parameters were calculated: area under the concentration time curve from zero time to 24 h after the dose, AUC 0–24 h; maximal serum concentration, Cmax; time to the maximal serum concentration, Tmax; absorption rate constant, ka; elimination rate constant, p; elimination half‐time, t½β. Student's t test for paired data, with significance assigned at P < 0.05, was used. Results: No statistically significant differences were seen in GBP serum or saliva concentrations or in its urinary excretion (both in A or B group) between fasting and after the high‐protein meal. Conclusions: High‐protein meals do not seem to interfere with oral disposition of GBP.
Seizure Semiology of Occipital Lobe Epilepsy in Children
Authors: Van den Hout B. M. , Van der Meij W. , Wieneke G. H. , Van Huffelen A. C. , Van Nieuwenhuizen O. 
Published: August 2005

Summary: Purpose: Occipital lobe epilepsy in children occurs as an idiopathic form, i.e., Benign Epilepsy with Occipital Paroxysms (BEOP), and a symptomatic form. This study attempted to determine whether seizure semiology could distinguish between the two forms. Methods: Fifty children (34 boys, 16 girls) with clinical seizures and interictal EEGs presenting occipital spikes were included consecutively in the study. Seizure onset was between the ages of 2 months and 15 years. Epilepsy was considered symptomatic when psychomotor retardation and/or abnormalities at neurological and/or neuroradiological examination were found: 17 children were classified as idiopathic, and the remaining 33 children were classified as symptomatic. Seizure semiology was assessed by means of a structured interview of the children and their parents, using a detailed questionnaire. Seizure semiology was determined to comprise motor (versive or other movements of the eyes, versive movements of the head, (hemiconvulsions), visual, other signs (e.g. vomiting and headache), and impairment of consciousness. Results: There were no statistically significant differences in seizure semiology between the two groups. Conclusions: Seizure semiology cannot distinguish between different forms of occipital lobe epilepsy: Further clinical examination, clinical neurophysiological investigations, and neuroimaging studies are needed for a correct classification.
Sensitivity of a Seizure Activity Detection Computer in Childhood Video/Electroencephalographic Monitoring
Authors: Kim Heung Dong , Clancy Robert R. 
Published: August 2005

Summary: Purpose: Few data describe the sensitivity of a “Seizure Activity Detection Computer” (SzAC) in childhood video/EEG (VEEG) monitoring, especially for very young children. We examined the accuracy of SzAC in childhood VEEG monitoring in different pediatric age groups. Methods: We visually analyzed VEEG monitoring samples for randomly designated subsets of 56 patients with childhood epilepsy, reviewing 335 visually detected electrographic seizures to analyze the sensitivity of SzAC for each age group as well as the electrographic characteristics affecting the sensitivity of automated computer‐based seizure detection. Results: SzAC was positive in 227 of 335 (67.8%) visually identified electrographic seizures in the entire study group. The SzAC sensitivity for infants (age 2 months to 2 years) was 59.7% (43 of 72 seizures); for young children (age 3–10 years), sensitivity 56.5% (91 of 161 seizures). In adolescents (age 11–18 years), SzAC was positive in 93 of 102 (91.2%) seizures‐ i.e., in a significantly greater number of seizures than in younger age groups. SzAC was significantly less sensitive in detecting electrographic seizures characterized as being of short duration or of low voltage. Conclusions: The overall sensitivity of SzAC in detecting childhood electrographic seizures was 67.8%. The sensitivity was significantly less in younger age groups as compared with that in children aged >11 years. Electrographic seizures of relatively short duration or low voltage were often missed by SzAC.
Identification of Frontal Lobe Epileptic Foci in Children Using Positron Emission Tomography
Authors: da Silva Ednéa A. , Chugani Diane C. , Muzik Otto , Chugani Harry T. 
Published: August 2005

Summary: Purpose: Presurgical evaluation for intractable frontal lobe epilepsy (FLE) is difficult and invasive, partly because anatomic neuroimaging studies with computed tomography (CT) and magnetic resonance imaging (MRI) typically do not show a discrete lesion. In adult patients with FLE, functional neuroimaging of glucose metabolism with positron emission tomography (PET) is less sensitive in detecting focal metabolic abnormalities than in temporal lobe epilepsy (TLE). Comparable data on children with FLE are not available. Methods: We used high‐resolution PET scanning of glucose metabolism to evaluate 13 children (age 17 months to 17 years; mean age 9.5 years) with intractable FLE being considered for surgical treatment. Only children with normal CT and MRI scans were included. Results: Hypometabolism including the frontal lobe was evident in 12 of the 13 children, was unilateral in 11 of 13, and was restricted to the frontal lobe in 8 of 13. One child showed bilateral frontal cortex hypometabolism and another had anictal PET scan demonstrating unilateral frontal cortex hyper‐metabolism surrounded by hypometabolism. Additional hypo–metabolic areas outside the frontal cortex were observed in 5 children in parietal and/or temporal cortex. Localization of seizure onset on scalp EEG was available in 10 children and corresponded to the location of frontal lobe PET abnormality in 8. However, in 4 of the 10 children, the extent of hypometabolism exceeded the epileptogenic region indicated by ictal EEG. In 2 of the 13 children, the abnormality evident on EEG was more extensive than that evident on PET. In the remaining 3 children for whom only interictal EEG data were available, the PET foci did not correspond in location to the interictal EEG abnormalities. In 11 of the 13 children, the presumed region of seizure onset in the frontal lobe, as based on analysis of seizure semiology, corresponded to the locations of frontal lobe glucose metabolism abnormalities. Conclusions: Although high‐resolution PET appears to be very sensitive in localizing frontal lobe glucose metabolic abnormalities in children with intractable FLE and normal CT/ MRI scans, the significance of extrafrontal metabolic disturbances requires further study; these may represent additional epileptogenic areas, effects of diaschisis, seizure propagation sites, or secondary epileptogenic foci.
Disclose or Conceal? Strategies of Information Management in Persons with Epilepsy
Authors: Tröster Heinrich 
Published: August 2005

Summary: Purpose: When handling information about their disease in their social contacts, persons with epilepsy try to avoid or limit stigmatization. We report two basic strategies of information management: general concealment and preventive disclosure. To test whether persons with epilepsy apply a strategy of preventive disclosure, we hypothesized that they would disclose their epilepsy when anticipating that their disease would make them conspicuous in social contacts and when believing that they would be able to forestall stigmatizing attribution processes through disclosure. Methods: One hundred nineteen outpatients at the Bethel Epilepsy Center, Bielefeld, Germany, aged 16–74 years responded to a questionnaire assessing willingness to disclose their epilepsy in various fictitious daily scenarios, the perceived risk that the interaction partner might find out about their epilepsy (risk of detection), as well as the anticipated positive and negative social consequences of disclosure in these social situations. Results: Willingness to disclose varied across the different scenarios, and only a few respondents rejected disclosure categorically. Willingness to disclose depended on the subjectively perceived risk of detection and the anticipated consequences of disclosure: Respondents were more willing to disclose their epilepsy the more they feared that their interaction partner would detect their disease or find out about it in another way and the more they anticipated that disclosure would enable them to exert a favorable impact on their partner's social judgment formation. Conclusions: Many persons with epilepsy appear to apply a strategy of preventive disclosure with which they strive to influence social judgment formation in their environment by purposefully disclosing their disease to forestall possible stigmatization processes.
Factors Associated with Work Outcome After Anterior Temporal Lobectomy for Intractable Epilepsy
Authors: Reeves A. L. , So E. L. , Evans R. W. , Cascino G. D. , Sharbrough F. W. , O'Brien P. C. , Trenerry Max R. 
Published: August 2005

Summary: Purpose: Whereas the effect of anterior temporal lobectomy on seizure frequency is well recognized, less is known about its impact on work status. Methods: One hundred thirty‐four of 190 consecutive patients with temporal lobectomy participated in this study. Eligibility criteria were developed to ensure that only patients with the potential of achieving specific outcomes were included in the corresponding analyses. Results: After surgery, significantly more patients were independent in activities of daily living (p < 0.001) or able to drive (p < 0.001). Income from work also increased (p < 0.01). Nearly one fifth of the patients who were eligible for analysis had either a gain (8%) or a loss (11%) of full‐ or of part‐time work. Univariate analyses revealed the following factors to be associated with full‐time work after surgery: student or full‐time work within a year before surgery, full‐time work experience before surgery, full‐ or part‐time employment experience before surgery, no disability benefits before surgery, low post‐surgical seizure frequency, improved postsurgical seizure control, excellent postsurgical seizure control, driving after surgery, and further education after surgery (p < 0.05). Significant factors on multivariate analysis were being a student or having full‐time work within a year before surgery [odds ratio, 16.2 (95% CI, 4.3–60.5)], driving after surgery [15.2 (3.2–72.0)], and obtaining further education after surgery [9.2 (2.2–53.0)]. Conclusions: Anterior temporal lobectomy for intractable epilepsy improves activities of daily living and the ability to drive. Work outcome of this surgery is influenced by presurgical work experience, successful postsurgical seizure control especially to allow driving, and obtaining further education after surgery.
Safety of Long‐Term Lamotrigine in Epilepsy
Authors: Mackay F. J. , Wilton L. V. , Peace G. L. , Freemantle S. N. , Mann R. D. 
Published: August 2005

Summary: Purpose: To examine the safety of lamotrigine (LTG) used in general practice to treat epilepsy. Methods: Information was collected on 11,316 patients who were included in a noninterventional observational cohort study conducted by means of Prescription‐Event Monitoring (PEM). A follow‐up study provided information on the first 3,994 patients who had taken LTG for 3 6 months. Incidence density (ID) measurements were used to rank the frequency of the reported events. Results: Rash was the most frequently reported nonepileptiform event (ID, 19.7/1,000 patient‐months) in the first month of treatment and resulted in LTG being stopped in 2% of the 11,316 patients. Rash was reported more frequently among children aged 2–12 years (ID, 29.4/1,000 patient‐months) than adults. Other events associated with the use of LTG included headache, drowsiness, nausea, vomiting, malaise, and lassitude. Rare serious events possibly associated with LTG included 12 cases reported as Stevens‐Johnson syndrome, four cases of neutropenia, three cases of thrombocytopenia, and two cases of disseminated intravascular coagulation. There were also individual cases of leucopenia, a meningitic reaction, acute renal failure, hepatotoxicity, and a ‘lupus‐like’reaction possibly associated with the drug. No foetal abnormalities were specifically associated with the use of the drug in pregnancy. No death was attributed to LTG. Conclusions: Patients had severe epilepsy, inadequately controlled by other antiepileptic agents. The results of these two studies suggest that LTG is acceptably safe when used for the treatment of refractory epilepsy.
Movement‐Induced Seizures: A Case Report
Authors: Pierelli F. , Gennaro G. Di , Gherardi M. , Spanedda F. , Marciani M. G. 
Published: August 2005

Summary: Reflex seizures induced by movement are typically evoked by sudden or unattended motor actions. However, tonic seizures may also be triggered by slow movements as observed in nonketotic hyperglycemia or in “praxis‐induced epilepsy.” We report the case of a young, nondiabetic patient affected by recurrent partial tonic postural seizures precipitated by slow movements which were unrelated to cognitive tasks. Ictal EEG did not permit location of the epileptogenic brain region. However, the clinical features suggest possible involvement of the supplementary motor area.
Zonisamide Monotherapy in Newly Diagnosed Infantile Spasms
Authors: Suzuki Yasuhiro , Nagai Toshisaburo , Ono Jiro , Imai Katsumi , Otani Kazumasa , Tagawa Tetsuzo , Abe Jiro , Shiomi Masashi , Okada Shintaro 
Published: August 2005

Summary: Purpose: We determined the short‐term efficacy of zonisamide (ZNS) monotherapy in newly diagnosed patients with infantile spasms (IS). Methods: Eleven hospitals participated in this open, prospective trial. ZNS 3‐10 mg/kg/day was administered as the second‐choice drug to 11 newly diagnosed patients with IS (cryptogenic 3, symptomatic 8) who failed to respond to high‐dose vitamin B6. Results: Four infants with symptomatic IS had cessation of spasms and disappearance of the hypsarrhythmia. In these responders, the spasms ceased after a few days (1–5 days) of treatment at a dose of ZNS 4–5 mg/kg/day which produced plasma ZNS concentrations ranging from 5.2 to 16.3 kg/ml (mean 9.8 pg/ml). There were two relapses (50%) 4–6 weeks after cessation of seizures, however. Relapse was predicted by effects of ZNS on EEG; the 2 infants in whom an abnormal EEG persisted had relapses, whereas the 2 whose EEG normalized remained seizure‐free (follow‐up 20 and 26 months). No adverse reactions were noted. Conclusions: ZNS may be effective in the initial treatment of selected patients with IS.