Sample records for atypical absence seizures

  1. Absence seizure

    MedlinePLUS

    ... or other misbehavior Unexplained difficulties in school and learning difficulties may be the first sign of absence seizures. During the seizure, the person may: Stop walking and start again a few seconds later Stop ...

  2. Common dynamics in temporal lobe seizures and absence seizures.

    PubMed

    Schiff, N D; Labar, D R; Victor, J D

    1999-01-01

    Similarities among the clinical features of complex partial temporal lobe seizures and absence (petit mal) seizures suggest shared underlying mechanisms, but dissimilar electrographic features of the two seizure types have cast doubt on common neuronal substrates. However, visual inspection and traditional approaches to quantitative analysis of the electroencephalogram and electrocorticogram, such as Fourier analysis, may not be appropriate to identify and characterize the highly non-linear mechanisms likely to underlie ictal events. We previously introduced a technique, non-linear autoregressive analysis, that is designed to identify non-linear dynamics in the electroencephalogram [Schiff N. D. et al. (1991) Society of Neuroscience 21st Annual Meeting, 638.6; Schiff N. D. et al. (1995) Biol. Cybern. 72, 519-526, 527-533]. The non-linear autoregressive analysis technique is aimed at describing seizure discharges as a disturbance of synchrony at the level of neuronal circuits. In absence seizures, we showed that non-linear autoregressive analysis revealed a consistent "fingerprint" of these non-linearities in 3/s discharges within and across patients. Here, we investigate the possibility that non-linear autoregressive modeling of seizure records from patients with temporal lobe epilepsy might reveal common circuit mechanisms when compared with the non-linear autoregressive analysis fingerprint of absence seizures. Electrocorticographic records of seizure activity were obtained in four patients who had received subdural grids or strips implanted in preparation for epilepsy surgery. Decomposition of the multichannel data recorded from these patients by principal component analysis revealed that at least three to five independent "generators" were required to model the data from each patient. Non-linear autoregressive analysis of these extracted generators revealed non-linear dynamics in two patients. In both patients, the temporal aspects of these non-linearities were similar to the characteristic non-linearities identified in the non-linear autoregressive analysis fingerprint of absence seizures. In particular, both patients showed a non-linear interaction of signals 90 ms in the past with signals 150 ms in the past. This was the most prominent interaction seen in all patients with absence seizures (typical and atypical). These results suggest that seizures from some patients with temporal lobe epilepsy may share common underlying circuit mechanisms with those of absence seizures. Physiological interpretations of these results are considered and proposed mechanisms are placed into the context of the alterations of consciousness seen in both epilepsies. PMID:10365999

  3. Long-term seizure remission in childhood absence epilepsy: might initial treatment matter?

    PubMed Central

    Berg, Anne T.; Levy, Susan R.; Testa, Francine M.; Blumenfeld, Hal

    2014-01-01

    Objectives: Examine the possible association between long-term seizure outcome in childhood absence epilepsy (CAE) and the initial treatment choice. Methods: Children with CAE were prospectively recruited at initial diagnosis and followed in a community-based cohort study. Children presenting with convulsive seizures, significant imaging abnormalities or who were followed <5 years were excluded. Early outcomes included success of initial medication, early remission, and pharmacoresistance. The primary long-term outcome was complete remission, ?5 years both seizure and medication-free. Survival methods were used for analyses. Results: The first medication was Ethosuximde (ESM ) in 41 (69%) and Valproic acid (VPA) in 18 (31%). Initial success rates were 59% (ESM) and 56% (VPA). Early remission and pharmacoresistance were similar in each group. Apart from atypical EEG features (61% (VPA), 17% (ESM )), no clinical features varied substantially between the treatment groups. Complete remission occurred in 31 (76%) children treated with ESM and 7 (39%) who received VPA (p=0.007). Children with versus without atypical EEG features were less likely to enter complete remission (50% vs. 71%, p=0.03). In a Cox regression, ESM was associated with a higher rate of complete remission than VPA (Hazards ration (HR)=2.5, 95% CI 1.1-6.0, p=0.03). Atypical EEG features did not independently predict outcome (p=0.15). Five- and 10-year remission, regardless of continued treatment, occurred more often in children initially treated with ESM versus VPA . Significance: These findings are congruent with results of studies in genetic absence models in rats and provide preliminary evidence motivating a hypothesis regarding potential disease modifying effects of ESM in childhood absence epilepsy. PMID:24512528

  4. A distinct phenotype of childhood leukodystrophy presenting as absence seizure

    PubMed Central

    Dweikat, Imad Mohammad; Damsah, Nadera; Khalaf, Reham

    2014-01-01

    Leukoencephalopathy refers to any disease of the white matter including hereditary as well as acquired and toxic causes. Inherited leukodystrophies are diseases of myelin including abnormal myelin development, hypomyelination, or degeneration of myelin. We report a 6-year old female who presented with absence seizure at the age of 4 years. Cerebral magnetic resonance imaging (MRI) of the brain showed bilateral periventricular confluent high signal intensity. The seizure responded to anticonvulsant therapy, and the clinical course was characterized by normal development and neurological examination. PMID:24891910

  5. Environmental enrichment improves behavioral outcome in the AY-9944 model of childhood atypical absence epilepsy.

    PubMed

    Stewart, Lee S; Cortez, Miguel A; Snead, O Carter

    2012-08-01

    Atypical absence seizures are drug resistant in the majority of children with Lennox-Gastaut syndrome and herald a poor neurodevelopmental outcome. Here we studied the effects of environmental enrichment, enriched housing conditions designed to stimulate sensory and motor systems in the brain, on behavioral outcome in mice treated with the cholesterol biosynthesis inhibitor AY-9944 (AY), a clinically relevant model of atypical absence epilepsy. Beginning at postnatal day (P) 2, C3H mice were treated with AY (7.5 mg/kg) every 6 days until P20 and then weaned into enriched or standard cages. After 30 days (?P50), AY mice from the enriched housing condition exhibited less behavioral hyperactivity and anxiety, improved olfactory recognition, and spatial learning, but no significant reduction in the number of ictal discharges in comparison with their non-enriched cohorts. The beneficial effects of environmental enrichment in AY model were in some behavioral tests gender-specific in favor of males suggesting that other, possibly hormonally mediated mechanisms, may interact with the therapeutic effects of enrichment. Taken together, these data provide a starting point to derive clinical occupational therapies for improving behavioral outcome in cases of intractable childhood seizures. PMID:22471338

  6. Cellular and network mechanisms of genetically-determined absence seizures

    PubMed Central

    Pinault, Didier; O'Brien, Terence J.

    2005-01-01

    The absence epilepsies are characterized by recurrent episodes of loss of consciousness associated with generalized spike-and-wave discharges, with an abrupt onset and offset, in the thalamocortical system. In the absence of detailed neurophysiological studies in humans, many of the concepts regarding the pathophysiological basis of absence seizures are based on studies in animal models. Each of these models has its particular strengths and limitations, and the validity of findings from these models for the human condition cannot be assumed. Consequently, studies in different models have produced some conflicting findings and conclusions. A long-standing concept, based primarily from studies in vivo in cats and in vitro brain slices, is that these paroxysmal electrical events develop suddenly from sleep-related spindle oscillations. More specifically, it is proposed that the initial mechanisms that underlie absence-related spike-and-wave discharges are located in the thalamus, involving especially the thalamic reticular nucleus. By contrast, more recent studies in well-established, genetic models of absence epilepsy in rats demonstrate that spike-and-wave discharges originate in a cortical focus and develop from a wake-related natural corticothalamic sensorimotor rhythm. In this review we integrate recent findings showing that, in both the thalamus and the neocortex, genetically-determined, absence-related spike-and-wave discharges are the manifestation of hypersynchronized, cellular, rhythmic excitations and inhibitions that result from a combination of complex, intrinsic, synaptic mechanisms. Arguments are put forward supporting the hypothesis that layer VI corticothalamic neurons act as ‘drivers’ in the generation of spike-and-wave discharges in the somatosensory thalamocortical system that result in corticothalamic resonances particularly initially involving the thalamic reticular nucleus. However an important unresolved question is: what are the cellular and network mechanisms responsible for the switch from physiological, wake-related, natural oscillations into pathological spike-and-wave discharges? We speculate on possible answers to this, building particularly on recent findings from genetic models in rats. PMID:21909233

  7. Frontal lobe epilepsy with atypical seizure semiology resembling shuddering attacks or wet dog shake seizures.

    PubMed

    Jahodova, Alena; Krsek, Pavel; Komarek, Vladimir; Kudr, Martin; Kyncl, Martin; Zamecnik, Josef; Tichy, Michal

    2012-03-01

    We report a girl with a drug-resistant frontal lobe epilepsy caused by focal cortical dysplasia, who exhibited uncommon seizures. The seizures consisted of shoulder or whole body shuddering after a short psychic aura and face grimacing. Consciousness was fully preserved. The seizures resembled "wet dog shake" seizures described in rat models of epilepsy or shuddering attacks in infants. EEG findings were inconclusive, however, MRI showed a clear dysplastic lesion in the right frontal mesial and polar structures. The patient underwent an extended lesionectomy guided by neuronavigation and intraoperative electrocorticography. Focal cortical dysplasia type Ib was histologically confirmed and the patient has been seizure-free for the three years following resection. [Published with video sequences]. PMID:22425715

  8. Modulation of absence seizures by branched-chain amino acids: correlation with brain amino acid concentrations

    Microsoft Academic Search

    Franck Dufour; Katarzyna A Nalecz; Maciej J Nalecz; Astrid Nehlig

    2001-01-01

    The occurrence of absence seizures might be due to a disturbance of the balance between excitatory and inhibitory neurotransmissions in the thalamo-cortical loop. In this study, we explored the consequences of buffering the glutamate content of brain cells on the occurrence and duration of seizures in Genetic Absence Epilepsy Rats from Strasbourg (GAERS), a genetic model of generalized non-convulsive epilepsy.

  9. Epileptic activity during early postnatal life in the AY-9944 model of atypical absence epilepsy.

    PubMed

    Jung, Seungmoon; Jeong, Yong; Jeon, Daejong

    2015-05-01

    Atypical absence epilepsy (AAE) is an intractable disorder characterized by slow spike-and-wave discharges in electroencephalograms (EEGs) and accompanied by severe cognitive dysfunction and neurodevelopmental or neurological deficits in humans. Administration of the cholesterol biosynthesis inhibitor AY-9944 (AY) during the postnatal developmental period induces AAE in animals; however, the neural mechanism of seizure development remains largely unknown. In this study, we characterized the cellular manifestations of AY-induced AAE in the mouse. Treatment of brain slices with AY increased membrane excitability of hippocampal CA1 neurons. AY treatment also increased input resistance of CA1 neurons during early postnatal days (PND) 5-10. However, these effects were not observed during late PND (14-21) or in adulthood (7-10 weeks). Notably, AY treatment elicited paroxysmal depolarizing shift (PDS)-like epileptiform discharges during the early postnatal period, but not during late PND or in adults. The PDS-like events were not compromised by application of glutamate or GABA receptor antagonists. However, the PDS-like events were abolished by blockage of voltage-gated Na(+) channels. Hippocampal neurons isolated from an in vivo AY model of AAE showed similar PDS-like epileptiform discharges. Further, AY-treated neurons from T-type Ca(2+) channel ?1G knockout (Cav3.1(-/-)) mice, which do not exhibit typical absence seizures, showed similar PDS-like epileptiform discharges. These results demonstrate that PDS-like epileptiform discharges during the early postnatal period are dependent upon Na(+) channels and are involved in the generation of AY-induced AAE, which is distinct from typical absence epilepsy. Our findings may aid our understanding of the pathophysiological mechanisms of clinical AAE in individuals, such as those with Lennox-Gastaut syndrome. PMID:25890840

  10. Focal frontal epileptiform discharges in a patient with eyelid myoclonia and absence seizures

    PubMed Central

    Takahashi, Satoru; Yamamoto, Shiho; Tanaka, Ryosuke; Okayama, Akie; Araki, Akiko; Azuma, Hiroshi

    2015-01-01

    Eyelid myoclonia with absences is classified as a unique type of generalized seizure. Its pathogenesis is proposed to involve the functional abnormalities in cortical–subcortical networks. Here, we describe the case of a 7-year-old boy who had eyelid myoclonia with absences, along with focal motor seizures. Video-EEG monitoring demonstrated eyelid myoclonia associated with 4- to 5-Hz generalized polyspike–waves preceded by focal frontal discharges. Interictal EEG showed focal epileptiform discharges over the frontal regions. Our case suggests an important role of the frontal lobe in the generation of eyelid myoclonia with absences.

  11. Presynaptic GABA Band ?-hydroxybutyric acid-mediated mechanisms in generalized absence seizures

    Microsoft Academic Search

    O. C. Snead

    1996-01-01

    ?-Hydroxybutyric acid (GHB) is a naturally occurring compound which has the ability to induce generalized absence seizures when given to animals. This effect of GHB may be blocked by either GHB or GABAB receptor antagonists. We sought to test the hypothesis that pre-synaptic GHB- and GABAB-mediated mechanisms in thalamus and cortex are operative in the GHB model of generalized absence

  12. Typical absence seizures in adults: clinical, EEG, video-EEG findings and diagnostic\\/syndromic considerations

    Microsoft Academic Search

    C P Panayiotopoulos; E Chroni; C Daskalopoulos; A Baker; S Rowlinson; P Walsh

    1992-01-01

    Eighteen women and five men had typical absences. These included 10% of a consecutive hospital series of 200 adult patients with epileptic disorders. The absences began between the ages of seven and 46 years and varied in type and severity. Twenty patients also had generalised tonic-clonic seizures, ranging in frequency from one in a lifetime to one per month. Myoclonic

  13. Atypical course in individuals from Spanish families with benign familial infantile seizures and mutations in the PRRT2 gene.

    PubMed

    Guerrero-López, Rosa; Ortega-Moreno, Laura; Giráldez, Beatriz G; Alarcón-Morcillo, Cristina; Sánchez-Martín, Gema; Nieto-Barrera, Manuel; Gutiérrez-Delicado, Eva; Gómez-Garre, Pilar; Martínez-Bermejo, Antonio; García-Peńas, Juan J; Serratosa, José M

    2014-10-01

    A benign prognosis has been claimed in benign familial infantile seizures (BFIS). However, few studies have assessed the long-term evolution of these patients. The objective of this study is to describe atypical courses and presentations in BFIS families with mutations in PRRT2 gene. We studied clinically affected individuals from five BFIS Spanish families. We found mutations in PRRT2 in all 5 families. A non-BFIS phenotype or an atypical BFIS course was found in 9/25 (36%) patients harbouring a PRRT2 mutation. Atypical features included neonatal onset, mild hemiparesis, learning difficulties or mental retardation, and recurrent seizures during adulthood. We also report a novel PRRT2 mutation (c.121_122delGT). In BFIS families an atypical phenotype was present in a high percentage of the patients. These findings expand the clinical spectrum of PRRT2 mutations including non-benign epileptic phenotypes. PMID:25060993

  14. Bidirectional Control of Absence Seizures by the Basal Ganglia: A Computational Evidence

    PubMed Central

    Wang, Tiebin; Jing, Wei; Xia, Yang; Xu, Peng; Luo, Cheng; Valdes-Sosa, Pedro A.; Yao, Dezhong

    2014-01-01

    Absence epilepsy is believed to be associated with the abnormal interactions between the cerebral cortex and thalamus. Besides the direct coupling, anatomical evidence indicates that the cerebral cortex and thalamus also communicate indirectly through an important intermediate bridge–basal ganglia. It has been thus postulated that the basal ganglia might play key roles in the modulation of absence seizures, but the relevant biophysical mechanisms are still not completely established. Using a biophysically based model, we demonstrate here that the typical absence seizure activities can be controlled and modulated by the direct GABAergic projections from the substantia nigra pars reticulata (SNr) to either the thalamic reticular nucleus (TRN) or the specific relay nuclei (SRN) of thalamus, through different biophysical mechanisms. Under certain conditions, these two types of seizure control are observed to coexist in the same network. More importantly, due to the competition between the inhibitory SNr-TRN and SNr-SRN pathways, we find that both decreasing and increasing the activation of SNr neurons from the normal level may considerably suppress the generation of spike-and-slow wave discharges in the coexistence region. Overall, these results highlight the bidirectional functional roles of basal ganglia in controlling and modulating absence seizures, and might provide novel insights into the therapeutic treatments of this brain disorder. PMID:24626189

  15. PROLACTIN-RELEASING PEPTIDE (PrRP) PROMOTES AWAKENING AND SUPPRESSES ABSENCE SEIZURES

    E-print Network

    Huguenard, John R.

    Department of Anatomy and Neurobiology, University of California, Irvine, CA 92697, USA e Department with prominent PrRP receptor expression that is critical for sleep regulation and the formation of non-convulsive absence seizures. Intracerebroventricular injection of PrRP (1^10 nmol) into sleeping animals signi

  16. Regulation of ?-aminobutyric acid (GABA) release in cerebral cortex in the ?-hydroxybutyric acid (GHB) model of absence seizures in rat

    Microsoft Academic Search

    R. Q Hu; P. K Banerjee; O. C Snead III

    2000-01-01

    ?-Hydroxybutyric acid (GHB) has the ability to induce absence seizures. The precise way in which GHB causes seizures remains unclear, but GABAB- and\\/or GHB-mediated presynaptic mechanisms within thalamocortical circuitry may play a role. In the present study, we determined the basal and K+-evoked release of GABA and glutamate in the superficial laminae of frontal cortex during GHB-induced absence seizures. Our

  17. Using Relevance Feedback to Distinguish the Changes in EEG During Different Absence Seizure Phases.

    PubMed

    Li, Jing; Liu, Xianzeng; Ouyang, Gaoxiang

    2014-09-21

    We carried out a series of statistical experiments to explore the utility of using relevance feedback on electroencephalogram (EEG) data to distinguish between different activity states in human absence epilepsy. EEG recordings from 10 patients with absence epilepsy are sampled, filtered, selected, and dissected from seizure-free, preseizure, and seizure phases. A total of 112 two-second 19-channel EEG epochs from 10 patients were selected from each phase. For each epoch, multiscale permutation entropy of the EEG data was calculated. The feature dimensionality was reduced by linear discriminant analysis to obtain a more discriminative and compact representation. Finally, a relevance feedback technique, that is, direct biased discriminant analysis, was applied to 68 randomly selected queries over nine iterations. This study is a first attempt to apply the statistical analysis of relevance feedback to the distinction of different EEG activity states in absence epilepsy. The average precision in the top 10 returned results was 97.5%, and the standard deviation suggested that embedding relevance feedback can effectively distinguish different seizure phases in absence epilepsy. The experimental results indicate that relevance feedback may be an effective tool for the prediction of different activity states in human absence epilepsy. The simultaneous analysis of multichannel EEG signals provides a powerful tool for the exploration of abnormal electrical brain activity in patients with epilepsy. PMID:25245133

  18. Absence-like seizures and their pharmacological profile in tottering-6j mice.

    PubMed

    Kim, Tae Yeon; Maki, Takehiro; Zhou, Ying; Sakai, Keita; Mizuno, Yuri; Ishikawa, Akiyoshi; Tanaka, Ryo; Niimi, Kimie; Li, Weidong; Nagano, Norihiro; Takahashi, Eiki

    2015-07-17

    We previously showed that recessive ataxic tottering-6j mice carried a base substitution (C-to-A) in the consensus splice acceptor sequence linked to exon 5 of the ?1 subunit of the Cav2.1 channel gene (Cacna1a), resulting in the skipping of exon 5 and deletion of part of the S4-S5 linker, S5, and part of the S5-S6 linker in domain I of the ?1 subunit of the Cav2.1 channel. However, the electrophysiological and pharmacological consequences of this mutation have not previously been investigated. Upon whole-cell patch recording of the recombinant Cav2.1 channel in heterologous reconstitution expression systems, the mutant-type channel exhibited a lower recovery time after inactivation of Ca(2+) channel current, without any change in peak current density or the current-voltage relationship. Tottering-6j mice exhibited absence-like seizures, characterized by bilateral and synchronous 5-8 Hz spike-and-wave discharges on cortical and hippocampal electroencephalograms, concomitant with sudden immobility and staring. The pharmacological profile of the seizures was similar to that of human absence epilepsy; the seizures were inhibited by ethosuximide and valproic acid, but not by phenytoin. Thus, the tottering-6j mouse is a useful model for studying Cav2.1 channel functions and Cacna1a-related diseases, including absence epilepsy. PMID:26002462

  19. Insights into the Mechanisms of Absence Seizure Generation Provided by EEG with Functional MRI

    PubMed Central

    Carney, Patrick W.; Jackson, Graeme D.

    2014-01-01

    Absence seizures (AS) are brief epileptic events characterized by loss of awareness with subtle motor features. They may be very frequent, and impact on attention, learning, and memory. A number of pathophysiological models have been developed to explain the mechanism of absence seizure generation, which relies heavily on observations from animal studies. Studying the structural and functional relationships between large-scale brain networks in humans is only practical with non-invasive whole brain techniques. EEG with functional MRI (EEG-fMRI) is one such technique that provides an opportunity to explore the interactions between brain structures involved in AS generation. A number of fMRI techniques including event-related analysis, time-course analysis, and functional connectivity (FC) have identified a common network of structures involved in AS. This network comprises the thalamus, midline, and lateral parietal cortex [the default mode network (DMN)], caudate nuclei, and the reticular structures of the pons. The main component displaying an increase in blood oxygen level dependent (BOLD) signal relative to the resting state, in group studies, is the thalamus while the most consistent cortical change is reduced BOLD signal in the DMN. Time-course analysis shows that, rather than some structures being activated or inactivated during AS, there appears to be increase in activity across components of the network preceding or following the electro-clinical onset of the seizure. The earliest change in BOLD signal occurs in the DMN, prior to the onset of epileptiform events. This region also shows altered FC in patients with AS. Hence, it appears that engagement of this network is central to AS. In this review, we will explore the insights of EEG-fMRI studies into the mechanisms of AS and consider how the DMN is likely to be the major large-scale brain network central to both seizure generation and seizure manifestations. PMID:25225491

  20. Seizures

    MedlinePLUS

    ... defects) Brain tumor (rare) Drug abuse Electric shock Epilepsy Fever (particularly in young children) Head injury Heart ... age. There may be a family history of epilepsy or seizures. If seizures continue repeatedly after the ...

  1. Rebound burst firing in the reticular thalamus is not essential for pharmacological absence seizures in mice

    PubMed Central

    Lee, Seung Eun; Lee, Jaekwang; Latchoumane, Charles; Lee, Boyoung; Oh, Soo-Jin; Saud, Zahangir Alam; Park, Cheongdahm; Sun, Ning; Cheong, Eunji; Chen, Chien-Chang; Choi, Eui-Ju; Lee, C. Justin; Shin, Hee-Sup

    2014-01-01

    Intrinsic burst and rhythmic burst discharges (RBDs) are elicited by activation of T-type Ca2+ channels in the thalamic reticular nucleus (TRN). TRN bursts are believed to be critical for generation and maintenance of thalamocortical oscillations, leading to the spike-and-wave discharges (SWDs), which are the hallmarks of absence seizures. We observed that the RBDs were completely abolished, whereas tonic firing was significantly increased, in TRN neurons from mice in which the gene for the T-type Ca2+ channel, CaV3.3, was deleted (CaV3.3?/?). Contrary to expectations, there was an increased susceptibility to drug-induced SWDs both in CaV3.3?/? mice and in mice in which the CaV3.3 gene was silenced predominantly in the TRN. CaV3.3?/? mice also showed enhanced inhibitory synaptic drive onto TC neurons. Finally, a double knockout of both CaV3.3 and CaV3.2, which showed complete elimination of burst firing and RBDs in TRN neurons, also displayed enhanced drug-induced SWDs and absence seizures. On the other hand, tonic firing in the TRN was increased in these mice, suggesting that increased tonic firing in the TRN may be sufficient for drug-induced SWD generation in the absence of burst firing. These results call into question the role of burst firing in TRN neurons in the genesis of SWDs, calling for a rethinking of the mechanism for absence seizure induction. PMID:25071191

  2. ?-Hydroxybutyric Acid-Induced Electrographic Seizures

    PubMed Central

    Cheung, Joseph; Lucey, Brendan P.; Duntley, Stephen P.; Darken, Rachel S.

    2014-01-01

    We describe a case of absence-like electrographic seizures during NREM sleep in a patient who was taking sodium oxybate, a sodium salt of ?-hydroxybutyric acid (GHB). An overnight full montage electroencephalography (EEG) study revealed numerous frontally predominant rhythmic 1.5-2 Hz sharp waves and spike-wave activity during stage N2 and N3 sleep at the peak dose time for sodium oxybate, resembling atypical absence-like electrographic seizures. The patient was later weaned off sodium oxybate, and a repeat study did not show any such electrographic seizures. Absence-like seizures induced by GHB had previously been described in experimental animal models. We present the first reported human case of absence-like electrographic seizure associated with sodium oxybate. Citation: Cheung J, Lucey BP, Duntley SP, Darken RS. ?-hydroxybutyric acid-induced electrographic seizures. J Clin Sleep Med 2014;10(7):811-812. PMID:25024661

  3. Pathway-Specific Action of-Hydroxybutyric Acid in Sensory Thalamus and Its Relevance to Absence Seizures

    Microsoft Academic Search

    Nicolas Gervasi; Zohreh Monnier; Pierre Vincent; Daniele Paupardin-Tritsch; Stuart W. Hughes; Vincenzo Crunelli; Nathalie Leresche

    2003-01-01

    The systemic injection of-hydroxybutyric acid (GHB) elicits spike and wave discharges (SWDs), the EEG hallmark of absence seizures, and represents a well established, widely used pharmacological model of this nonconvulsive epilepsy. Despite this experimental use of GHB, as well as its therapeutic use in narcolepsy and its increasing abuse, however, the precise cellular mechanisms underlying the different pharmacological actions of

  4. ?-Hydroxybutyric acid-induced electrographic seizures.

    PubMed

    Cheung, Joseph; Lucey, Brendan P; Duntley, Stephen P; Darken, Rachel S

    2014-07-15

    We describe a case of absence-like electrographic seizures during NREM sleep in a patient who was taking sodium oxybate, a sodium salt of ?-hydroxybutyric acid (GHB). An overnight full montage electroencephalography (EEG) study revealed numerous frontally predominant rhythmic 1.5-2 Hz sharp waves and spike-wave activity during stage N2 and N3 sleep at the peak dose time for sodium oxybate, resembling atypical absence-like electrographic seizures. The patient was later weaned off sodium oxybate, and a repeat study did not show any such electrographic seizures. Absence-like seizures induced by GHB had previously been described in experimental animal models. We present the first reported human case of absence-like electrographic seizure associated with sodium oxybate. PMID:25024661

  5. A critical evaluation of the gamma-hydroxybutyrate (GHB) model of absence seizures.

    PubMed

    Venzi, Marcello; Di Giovanni, Giuseppe; Crunelli, Vincenzo

    2015-02-01

    Typical absence seizures (ASs) are nonconvulsive epileptic events which are commonly observed in pediatric and juvenile epilepsies and may be present in adults suffering from other idiopathic generalized epilepsies. Our understanding of the pathophysiological mechanisms of ASs has been greatly advanced by the availability of genetic and pharmacological models, in particular the ?-hydroxybutyrate (GHB) model which, in recent years, has been extensively used in studies in transgenic mice. GHB is an endogenous brain molecule that upon administration to various species, including humans, induces not only ASs but also a state of sedation/hypnosis. Analysis of the available data clearly indicates that only in the rat does there exist a set of GHB-elicited behavioral and EEG events that can be confidently classified as ASs. Other GHB activities, particularly in mice, appear to be mostly of a sedative/hypnotic nature: thus, their relevance to ASs requires further investigation. At the molecular level, GHB acts as a weak GABA-B agonist, while the existence of a GHB receptor remains elusive. The pre- and postsynaptic actions underlying GHB-elicited ASs have been thoroughly elucidated in thalamus, but little is known about the cellular/network effects of GHB in neocortex, the other brain region involved in the generation of ASs. PMID:25403866

  6. Absence of Nails, Deaf-mutism, Seizures, and Intellectual Disability: A Case Report.

    PubMed

    Nair, Lal Devayanivasudevan; Sagayaraj, Benjamin; Kumar, Radha

    2015-04-01

    Seizures coexists in children with intellectual disability and are often attributed to neural dysfunction associated with it. Often a careful clinical examination will unravel many diagnostic pointers as in this 8-year-old child with global development delay, deaf-mutism and moderate intellectual disability (mental retardation) who presented with seizures in the emergency department. General examination revealed dysmorphic features like anonychia, low set ears, long philtrum, large lower lips and abnormal dermatoglyphics with features of osteodystrophy on radiology. She was diagnosed as a case of DOORS syndrome, an extremely rare genetic condition affecting the TCA cycle, with just over 40 cases reported, worldwide till date, since its first description in 1961. Her genetic analysis did not reveal the common TBC1D24 mutation in 16p13.3 resulting often from substitutions affecting the arginine at position 242, in spite of all classical clinical features associated with it, suggesting genetic heterogeneity in DOORS syndrome. Though four year follow-up revealed changes in seizure pattern, there was no optic atrophy, change in IQ or peripheral nerve problem. This probably suggests that children with typical clinical features and TBC1D24 mutations may have more progressive deterioration than those without it and newer molecular techniques may identify unexplained phenotypic expressions. PMID:26023614

  7. Absence of Nails, Deaf-mutism, Seizures, and Intellectual Disability: A Case Report

    PubMed Central

    Sagayaraj, Benjamin; Kumar, Radha

    2015-01-01

    Seizures coexists in children with intellectual disability and are often attributed to neural dysfunction associated with it. Often a careful clinical examination will unravel many diagnostic pointers as in this 8-year-old child with global development delay, deaf-mutism and moderate intellectual disability (mental retardation) who presented with seizures in the emergency department. General examination revealed dysmorphic features like anonychia, low set ears, long philtrum, large lower lips and abnormal dermatoglyphics with features of osteodystrophy on radiology. She was diagnosed as a case of DOORS syndrome, an extremely rare genetic condition affecting the TCA cycle, with just over 40 cases reported, worldwide till date, since its first description in 1961. Her genetic analysis did not reveal the common TBC1D24 mutation in 16p13.3 resulting often from substitutions affecting the arginine at position 242, in spite of all classical clinical features associated with it, suggesting genetic heterogeneity in DOORS syndrome. Though four year follow-up revealed changes in seizure pattern, there was no optic atrophy, change in IQ or peripheral nerve problem. This probably suggests that children with typical clinical features and TBC1D24 mutations may have more progressive deterioration than those without it and newer molecular techniques may identify unexplained phenotypic expressions. PMID:26023614

  8. Antiepileptogenic effects of the selective COX-2 inhibitor etoricoxib, on the development of spontaneous absence seizures in WAG/Rij rats.

    PubMed

    Citraro, Rita; Leo, Antonio; Marra, Rosario; De Sarro, Giovambattista; Russo, Emilio

    2015-04-01

    Different data suggest the involvement of specific inflammatory pathways in the pathogenesis of epilepsy. Cyclooxygenase (COX), which catalyses the production of pro-inflammatory prostaglandins, may play a significant role in seizure-induced neuroinflammation and neuronal hyperexcitability. COX-2 is constitutively expressed in the brain and also increased during/after seizures. COX-2 inhibitors may thus attenuate inflammation associated with brain disorders. We studied whether early long-term treatment (17 consecutive weeks starting from 45 days postnatal age) with the non-steroidal anti-inflammatory drug etoricoxib (10 mg/kg/day per os), a selective COX-2 inhibitor, was able to prevent/reduce the development of absence seizures in WAG/Rij rats, a recognized animal model of absence epilepsy and epileptogenesis. Drug effects on the incidence, duration and properties of absence seizure spike-wave discharges (SWDs) were measured both 1 and 5 months after treatment withdrawal; furthermore, the acute effects of etoricoxib on SWDs in 6-month-old WAG/Rij rats were measured. Early long-term treatment (ELTT) with etoricoxib led to an ?40% long-lasting (5 months) reduction in the development of spontaneous absence seizures in adult WAG/Rij rats thus exhibiting antiepileptogenic effects. Acutely administered etoricoxib (10 and 20mg/kg i.p.) also had anti-absence properties, significantly reducing the number and duration of SWDs by ?50%. These results confirm the antiepileptogenic effects of COX-2 inhibitors and suggest the possible role of COX-2, prostaglandin synthesis and consequent neuroinflammation in the epileptogenic process underlying the development of absence seizures in WAG/Rij rats. PMID:25701797

  9. Kappa opioid receptor agonists suppress absence seizures in WAG\\/Rij rats

    Microsoft Academic Search

    B. Przew?ocka; W. Laso?; H. Machelska; G. van Luijtelaar; A. Coenen; R. Przew?ocki

    1995-01-01

    Involvement of the ? opioid receptor in the regulation of epileptic activity was studied in WAG\\/Rij rats, a genetic model of absence epilepsy. I.c.v. administration of the ? agonists U50,488H {trans-3,4-dichloro-N-methyl-N-[2-(1-pyrrolidynyl)-cyclohexyl]-benzeneacetamide}, U69,593 (5?,7?,8?)-(?)-N-methyl-(1-pyrrolidinyl)-1-oxaspiro(4,5)dec-8-yl)benzeneacetamide) or PD117,302 ((±)-trans-N-methyl-N-[2-(1-pyrrolidinyl)cyclohexyl]benzo[b]thiophene-4-acetamide), 50 and 150 ?g\\/5 ?l each, dose-dependently decreased t the number and mean duration of spike wave discharges (SWD). Peripheral administration of U50,488H (10

  10. Using ictal high-frequency oscillations (80-500Hz) to localize seizure onset zones in childhood absence epilepsy: a MEG study.

    PubMed

    Miao, Ailiang; Xiang, Jing; Tang, Lu; Ge, Huaiting; Liu, Hongxing; Wu, Ting; Chen, Qiqi; Hu, Zheng; Lu, Xiaopeng; Wang, Xiaoshan

    2014-04-30

    This study aimed to use ictal high-frequency oscillations (HFOs) ranging from 80Hz to 500Hz to locate seizure onset zones in childhood absence epilepsy (CAE) using non-invasive magnetoencephalography (MEG). Ten drug-naďve children with CAE were studied using a 275-channel MEG system. MEG data were digitized at a sampling rate of 6000Hz. HFO spectral power in real-time spectrograms was assessed using Morlet continuous wavelet transform. Magnetic sources were volumetrically localized through dynamic magnetic source imaging with a slide window. HFOs were identified in all patients. The total time of fast ripples (250-500Hz) was greater than that of ripples (80-250Hz) during absence seizures. The rate of fast ripples was associated with seizure frequency. HFO duration was significantly longer when co-occurring with spikes than when occurring independently, and the maximum frequency of HFOs co-occurring with spikes was higher than that of HFOs occurring independently. HFOs were predominantly localized in the medial prefrontal cortex (MPFC), whereas spikes were widespread to a variety of regions during the absence seizures. Compared with spikes, HFOs appeared to be more focal. The findings indicate that HFOs in the MPFC have a primary function in initializing epileptic activity in CAE. PMID:24582907

  11. Dynamics of networks during absence seizure's on- and offset in rodents and man

    PubMed Central

    Lüttjohann, Annika; van Luijtelaar, Gilles

    2015-01-01

    Network mechanisms relevant for the generation, maintenance and termination of spike-wave discharges (SWD), the neurophysiological hallmark of absence epilepsy, are still enigmatic and widely discussed. Within the last years, however, improvements in signal analytical techniques, applied to both animal and human fMRI, EEG, MEG, and ECoG data, greatly increased our understanding and challenged several, dogmatic concepts of SWD. This review will summarize these recent data, demonstrating that SWD are not primary generalized, are not sudden and unpredictable events. It will disentangle different functional contributions of structures within the cortico-thalamo-cortical system, relevant for the generation, generalization, maintenance, and termination of SWD and will present a new “network based” scenario for these oscillations. Similarities and differences between rodent and human data are presented demonstrating that in both species a local cortical onset zone of SWD exists, although with different locations; that in both some forms of cortical and thalamic precursor activity can be found, and that SWD occur through repetitive cyclic activity between cortex and thalamus. The focal onset zone in human data could differ between patients with varying spatial and temporal dynamics; in rats the latter is still poorly investigated. PMID:25698972

  12. Atypical evolution in childhood epilepsy with occipital paroxysms (Panayiotopoulos type).

    PubMed

    Caraballo, R H; Astorino, F; Cersósimo, R; Soprano, A M; Fejerman, N

    2001-09-01

    We report, on two, school-age girls with clinical and electroencephalographic features of early onset childhood epilepsy with occipital paroxysms (CEOP) of the "Panayiotopoulos type" that showed atypical evolution. Neurological examination and brain imaging were normal in both. One child presented at age 2.5 years episodes of oculocephalic deviation, and ictal vomiting during nocturnal sleep. The EEG showed left occipital spikes during wakefulness and sleep. One year later, frequent inhibitory seizures appeared in the lower limbs causing, "pseudoataxic gait". At the same time she presented with behavioral disturbances and aphasia. EEG showed bilateral spike-waves while awake and continuous spike-waves during slow sleep (CSWSS). After switching AEDs to benzodiazepines, control of seizures along with improvement of behavior, and partial restoration of cognitive functions were achieved. The CSWSS disappeared and the last EEG at age 8 years only showed only isolated right occipital spikes. The other girl had a personal and familial history of febrile seizures. At 4 years of age she presented the first non-febrile seizures during sleep, with oculocephalic deviation and ictal vomiting, followed by a generalized tonic-clonic seizure. Partial control of seizures was obtained with antiepileptic drugs. At age 7, the child began to have weekly episodes of oculocephalic version, occasionally with secondary generalization. Repeated inhibitory seizures and absences also appeared. EEG showed frequent bilateral spikes occupying predominantly the posterior regions while awake, and CSWSS. At 7.5 years the same electro-clinical picture persisted. Ethosuximide was added to sodium valproate and clobazam. Fifteen days later, the seizures disappeared and the EEG showed less frequent bilateral occipital spikes. She is now 9 years old and she has been seizure-free for 18 months. Her present neuropsychological profile shows mild mental retardation. The two children with typical electroclinical features of "Panayiotopoulos Type" CEOP developed an atypical evolution which, to our knowledge, has not been described previously. PMID:11679309

  13. A-type K+ current can act as a trigger for bursting in the absence of a slow variable

    PubMed Central

    Tabak, Joël; Freeman, Marc E.; Bertram, Richard

    2007-01-01

    Models of bursting in single cells typically include two subsystems with different time scales. Variations in one or more slow variables switch the system between a silent and a spiking state. We have developed a model for bursting in the pituitary lactotroph that does not include any slow variable. The model incorporates fast, non-inactivating calcium and potassium currents (the spike generating mechanism) as well as the fast, inactivating A-type potassium current (IA). IA is only active briefly at the beginning of a burst, but this brief impulse of IA acts as a burst trigger, injecting the spike trajectory close to an unstable steady state. The spiraling of the trajectory away from the steady state produces a period of low amplitude spiking typical of lactotrophs. Increasing the conductance of A-type potassium current brings the trajectory closer to the unstable steady state, increasing burst duration. However, this also increases interburst interval and for larger conductance values all activity stops. To our knowledge, this is the first example of a physiologically based, single-compartmental model of bursting with no slow subsystem. PMID:18047413

  14. Childhood absence epilepsy with tonic-clonic seizures and electroencephalogram 3-4-Hz spike and multispike-slow wave complexes: linkage to chromosome 8q24.

    PubMed Central

    Fong, G C; Shah, P U; Gee, M N; Serratosa, J M; Castroviejo, I P; Khan, S; Ravat, S H; Mani, J; Huang, Y; Zhao, H Z; Medina, M T; Treiman, L J; Pineda, G; Delgado-Escueta, A V

    1998-01-01

    Childhood absence epilepsy (CAE), a common form of idiopathic generalized epilepsy, accounts for 5%-15% of childhood epilepsies. To map the chromosomal locus of persisting CAE, we studied the clinical and electroencephalographic traits of 78 members of a five-generation family from Bombay, India. The model-free affected-pedigree member method was used during initial screening with chromosome 6p, 8q, and 1p microsatellites, and only individuals with absence seizures and/or electroencephalogram 3-4-Hz spike- and multispike-slow wave complexes were considered to be affected. Significant P values of .00000-.02 for several markers on 8q were obtained. Two-point linkage analysis, assuming autosomal dominant inheritance with 50% penetrance, yielded a maximum LOD score (Zmax) of 3.6 for D8S502. No other locus in the genome achieved a significant Zmax. For five smaller multiplex families, summed Zmax was 2.4 for D8S537 and 1.7 for D8S1761. Haplotypes composed of the same 8q24 microsatellites segregated with affected members of the large family from India and with all five smaller families. Recombinations positioned the CAE gene in a 3.2-cM interval. PMID:9758624

  15. Childhood absence epilepsy with tonic-clonic seizures and electroencephalogram 3-4-Hz spike and multispike-slow wave complexes: linkage to chromosome 8q24.

    PubMed

    Fong, G C; Shah, P U; Gee, M N; Serratosa, J M; Castroviejo, I P; Khan, S; Ravat, S H; Mani, J; Huang, Y; Zhao, H Z; Medina, M T; Treiman, L J; Pineda, G; Delgado-Escueta, A V

    1998-10-01

    Childhood absence epilepsy (CAE), a common form of idiopathic generalized epilepsy, accounts for 5%-15% of childhood epilepsies. To map the chromosomal locus of persisting CAE, we studied the clinical and electroencephalographic traits of 78 members of a five-generation family from Bombay, India. The model-free affected-pedigree member method was used during initial screening with chromosome 6p, 8q, and 1p microsatellites, and only individuals with absence seizures and/or electroencephalogram 3-4-Hz spike- and multispike-slow wave complexes were considered to be affected. Significant P values of .00000-.02 for several markers on 8q were obtained. Two-point linkage analysis, assuming autosomal dominant inheritance with 50% penetrance, yielded a maximum LOD score (Zmax) of 3.6 for D8S502. No other locus in the genome achieved a significant Zmax. For five smaller multiplex families, summed Zmax was 2.4 for D8S537 and 1.7 for D8S1761. Haplotypes composed of the same 8q24 microsatellites segregated with affected members of the large family from India and with all five smaller families. Recombinations positioned the CAE gene in a 3.2-cM interval. PMID:9758624

  16. Atypical central pain processing in sensory modulation disorder: absence of temporal summation and higher after-sensation.

    PubMed

    Bar-Shalita, T; Vatine, J-J; Yarnitsky, D; Parush, S; Weissman-Fogel, I

    2014-02-01

    Sensory over-responsivity (SOR), a subtype of the proposed sensory modulation disorder (SMD), is characterized by over-responsiveness to stimuli in several sensory modalities. SMD individuals demonstrate abnormal responses to naturally occurring stimuli in a manner that interferes with daily life participation. Previous psychophysical testing of the somatosensory system revealed that SOR individuals rated pain sensations higher than controls, demonstrating hyperalgesia that can be centrally mediated. Temporal summation (TS) of second pain and after-sensation are manifestations of central sensitization; therefore, this study explored these measures for better characterization of central pain processing in SOR. Twelve SOR adults and 12 healthy controls participated. TS was produced by a train of fifteen repetitive heat pulses, 0.7 s duration each, and 2 s of inter-stimulus interval, applied to the thenar-eminence, while four pain ratings were obtained. An after-sensation was then measured for 5 min, obtaining six pain ratings. No TS of pain was indicated in the SOR group (SOR: p = 0.36; control: p < 0.001). Further, while controls reported a gradual disappearance of pain after-sensation, individuals with SOR continued to report pain for the duration of the 5 min measured (p = 0.002). These results demonstrate an atypical response pattern, suggesting alteration in pain processing and/or modulation at a central level in individuals with SOR. These possible neural changes may manifest themselves as interference with daily functioning as well as shed light on some of the between-subject variability seen in psychophysical testing in non-painful subjects. PMID:24247592

  17. Prolactin and seizure activity.

    PubMed Central

    Bye, A M; Nunn, K P; Wilson, J

    1985-01-01

    Prolactin secretion after tonic-clonic seizures (10 patients), complex partial seizures (five) and non-epileptic attacks (three) was studied in a group of children aged between 0.3 and 14 years. Seven patients with other subcategories of seizure disorders were also studied. Eight children with tonic-clonic seizures exhibited post ictal concentrations of prolactin greater than 500 mU/l. One of the children, who responded on one occasion, did not do so on another. Three children with complex partial seizures had post ictal prolactin concentrations greater than 500 mU/l, while in two the increased values were more modest (390 mU/l and 420 mU/l). The timing of the peak post ictal prolactin concentration varied from less than 20 minutes to a prolonged plateau for three hours. Other seizure types--simple partial with motor signs (2), absence seizure (1), myoclonic seizure (1), minor epileptic status (3) (with one exception), and non-epileptic attacks (3) were not associated with post ictal concentrations greater than 500 mU/l. PMID:3931564

  18. Pachygyria, seizures, hypotonia, and growth retardation in a patient with an atypical 1.33Mb inherited microduplication at 22q11.23.

    PubMed

    Chang, Jiazhen; Zhao, Lijuan; Chen, Chen; Peng, Ying; Xia, Yan; Tang, Guizhi; Bai, Ting; Zhang, Yanghui; Ma, Ruiyu; Guo, Ruolan; Mei, Libin; Liang, Desheng; Cao, Qinying; Wu, Lingqian

    2015-09-10

    22q11.2 microduplication syndrome was recently described as a new disorder with variable clinical features that ranged from normal to mental retardation and with congenital defects. According to published reports, majority of patients with 22q11.2 duplications inherit these from unaffected parents rather than by de novo mutations, which is different from most microduplication/microdeletion syndromes. In this study, we report a patient that carried a paternally inherited atypical 1.33Mb duplication at 22q11.23. The proband (or proposita) presented with hypotonia, feeding difficulties, intractable epilepsy, hearing disability, and pachygyria. A pachygyria phenotype had not been previously reported to be associated with a 22q11 microduplication syndrome. Cytogenetic and molecular genetic analyses based on standard G-banding, SNP array, and fluorescence in situ hybridization were performed for the proband and her parents. An atypical 1.33Mb duplication at 22q11.23 was detected in both the proband and her father. Thus, our findings verify the pathogenicity and diverse phenotypes of 22q11.2 microduplication and expand its phenotypic spectrum. PMID:26099517

  19. Febrile Seizures

    MedlinePLUS

    ... febrile seizures may be treated with the drug diazepam orally or rectally, whenever they have a fever. ... treated with a rectal form of the drug diazepam to stop the seizure and prevent it from ...

  20. Management and Prophylaxis of Seizures in Children

    PubMed Central

    Jacob, J. C.

    1980-01-01

    The National Child Development Study, U.K., provides a perspective of the types of seizures that might be anticipated in a representative childhood population. Management is considered under the broad headings of general and specific considerations. A classification enables a physician to perform a rapid triage of a child experiencing a seizure. Specific management considerations are outlined for status epilepticus, febrile seizures, and recurrent afebrile seizures, particularly of absence and temporal lobe type. Prophylaxis of post traumatic seizures, and the importance of recognizing the group of childhood disorders mimicking seizures, are also discussed. Imagesp1183-a PMID:21293681

  1. Seizure Prediction

    PubMed Central

    Sackellares, J Chris

    2008-01-01

    There is mounting evidence that seizures are preceded by characteristic changes in the EEG that are detectable minutes before seizure onset. Using novel signal analysis techniques, researchers are beginning to characterize the transition from the interictal to the ictal state in quantitative terms. This research has led to the development of automated seizure prediction algorithms. Active debate persists regarding the interpretation of research results, methods of signal analysis, as well as experimental and statistical methods for testing seizure prediction algorithms. Developments in this field have led to new theories on the mechanism of seizure development and resolution. The ability to predict seizures could lead the way to novel diagnostic and therapeutic methods for the treatment of patients with epilepsy. PMID:18488065

  2. Nonepileptic seizures

    Microsoft Academic Search

    Elizabeth S. Bowman

    2000-01-01

    Opinion statement  The primary goal of treatment in nonepileptic seizures (NES) is to improve the patient’s quality of life by terminating seizure\\u000a production or reducing seizure frequency. Initial treatment consists of explaining the diagnosis and its psychological nature\\u000a to patients without judging them or giving the NES excessive attention. Next, help patients identify stresses and refer them\\u000a for mental health treatment.

  3. Febrile Seizures

    MedlinePLUS

    ... febrile seizures face an increased risk of developing epilepsy. These children include those who have cerebral palsy, ... intelligence, behavior, school achievement, and the development of epilepsy. Investigators also continue to explore which drugs can ...

  4. Febrile seizures

    MedlinePLUS

    Seizure - fever induced ... an illness, and may not occur when the fever is highest. Ear infections, a cold or viral ... other than symptoms of the illness causing the fever. Often, the child will not need a full ...

  5. Nonepileptic Seizures.

    PubMed

    Bowman

    2000-11-01

    The primary goal of treatment in nonepileptic seizures (NES) is to improve the patient's quality of life by terminating seizure production or reducing seizure frequency. Initial treatment consists of explaining the diagnosis and its psychological nature to patients without judging them or giving the NES excessive attention. Next, help patients identify stresses and refer them for mental health treatment. Neurologists should continue to see patients intermittently to wean anticonvulsants, and encourage compliance with mental health care. Psychiatric treatment of NES has the following three aims: 1) Help patients identify and eliminate contributing stresses. 2) Teach better coping mechanisms and increased expression of suppressed feelings that are being communicated somatically. 3) Diagnose and treat comorbid psychiatric conditions such as depression, anxiety, dissociation, or post-traumatic symptoms. The mainstay of psychiatric treatment for NES is some kind of individual or family psychotherapy or hypnosis. Selective serotonin reuptake inhibitor antidepressant medications (first-line drugs) or tricyclic antidepressants (second-line drugs) may be needed to treat comorbid depression, panic, or post-traumatic stress disorder (PTSD), but medications should nearly always be combined with psychotherapeutic approaches. Benzodiazepines should be used only with psychotherapy to teach better coping. Families or caregivers may need to learn behavior modification to minimize covert environmental rewards for NES. With proper diagnosis and treatment, about 45% of patients will become seizure-free, and another one third of patients will show reduced seizure frequency. PMID:11096780

  6. Neuronal carbonic anhydrase VII provides GABAergic excitatory drive to exacerbate febrile seizures

    PubMed Central

    Ruusuvuori, Eva; Huebner, Antje K; Kirilkin, Ilya; Yukin, Alexey Y; Blaesse, Peter; Helmy, Mohamed; Jung Kang, Hyo; El Muayed, Malek; Christopher Hennings, J; Voipio, Juha; Šestan, Nenad; Hübner, Christian A; Kaila, Kai

    2013-01-01

    Brain carbonic anhydrases (CAs) are known to modulate neuronal signalling. Using a novel CA VII (Car7) knockout (KO) mouse as well as a CA II (Car2) KO and a CA II/VII double KO, we show that mature hippocampal pyramidal neurons are endowed with two cytosolic isoforms. CA VII is predominantly expressed by neurons starting around postnatal day 10 (P10). The ubiquitous isoform II is expressed in neurons at P20. Both isoforms enhance bicarbonate-driven GABAergic excitation during intense GABAA-receptor activation. P13–14 CA VII KO mice show behavioural manifestations atypical of experimental febrile seizures (eFS) and a complete absence of electrographic seizures. A low dose of diazepam promotes eFS in P13–P14 rat pups, whereas seizures are blocked at higher concentrations that suppress breathing. Thus, the respiratory alkalosis-dependent eFS are exacerbated by GABAergic excitation. We found that CA VII mRNA is expressed in the human cerebral cortex before the age when febrile seizures (FS) occur in children. Our data indicate that CA VII is a key molecule in age-dependent neuronal pH regulation with consequent effects on generation of FS. PMID:23881097

  7. Mutant LGI1 Inhibits Seizure-Induced Trafficking of Kv4.2 Potassium Channels

    PubMed Central

    Smith, Stephen E.P.; Xu, Lin; Kasten, Michael R.; Anderson, Matthew P.

    2012-01-01

    Activity-dependent redistribution of ion channels mediates neuronal circuit plasticity and homeostasis, and could provide pro-epileptic or compensatory anti-epileptic responses to a seizure. Thalamocortical neurons transmit sensory information to the cerebral cortex and through reciprocal corticothalamic connections are intensely activated during a seizure. Therefore, we assessed whether a seizure alters ion channel surface expression and consequent neurophysiologic function of thalamocortical neurons. We report a seizure triggers a rapid (?2 hrs) decrease of EPSC-like current-induced phasic firing associated with increased transient A-type K+ current. Seizures also rapidly redistributed the A-type K+ channel subunit Kv4.2 to the neuronal surface implicating a molecular substrate for the increased K+ current. Glutamate applied in vitro mimicked the effect, suggesting a direct effect of glutamatergic transmission. Importantly, LGI1, a secreted synaptic protein mutated to cause human partial epilepsy, regulated this seizure-induced circuit response. Human epilepsy-associated dominant negative truncated mutant LGI1 inhibited the seizure-induced suppression of phasic firing, increase of A-type K+ current, and recruitment of Kv4.2 surface expression (in vivo and in vitro). The results identify a response of thalamocortical neurons to seizures involving Kv4.2 surface recruitment associated with dampened phasic firing. The results also identify impaired seizure-induced increases of A-type K+ current as an additional defect produced by the autosomal dominant lateral temporal lobe epilepsy gene mutant might contribute to the seizure disorder. PMID:22122031

  8. Febrile seizures

    PubMed Central

    2014-01-01

    Febrile seizure (FS) is the most common seizure disorder of childhood, and occurs in an age-related manner. FS are classified into simple and complex. FS has a multifactorial inheritance, suggesting that both genetic and environmental factors are causative. Various animal models have elucidated the pathophysiological mechanisms of FS. Risk factors for a first FS are a family history of the disorder and a developmental delay. Risk factors for recurrent FS are a family history, age below 18 months at seizure onset, maximum temperature, and duration of fever. Risk factors for subsequent development of epilepsy are neurodevelopmental abnormality and complex FS. Clinicians evaluating children after a simple FS should concentrate on identifying the cause of the child's fever. Meningitis should be considered in the differential diagnosis for any febrile child. A simple FS does not usually require further evaluation such as ordering electroencephalography, neuroimaging, or other studies. Treatment is acute rescue therapy for prolonged FS. Antipyretics are not proven to reduce the recurrence risk for FS. Some evidence shows that both intermittent therapy with oral/rectal diazepam and continuous prophylaxis with oral phenobarbital or valproate are effective in reducing the risk of recurrence, but there is no evidence that these medications reduce the risk of subsequent epilepsy. Vaccine-induced FS is a rare event that does not lead to deleterious outcomes, but could affect patient and physician attitudes toward the safety of vaccination. PMID:25324864

  9. Seizure Disorders in Pregnancy

    MedlinePLUS

    ... in mood, emotions, consciousness, or movement. What is epilepsy? Epilepsy is one kind of seizure disorder. It is ... preterm birth. • What is a seizure? • What is epilepsy? • Can seizures be controlled? • If I have a ...

  10. Early-onset absence epilepsy aggravated by valproic acid: a video-EEG report.

    PubMed

    Belcastro, Vincenzo; Caraballo, Roberto Horacio; Romeo, Antonino; Striano, Pasquale

    2013-12-01

    Early-onset absence epilepsy refers to patients with absence seizures beginning before age 4 and comprises a heterogeneous group of epilepsies. Onset of absence seizures in the first year of life is very rare. We report a boy with absence seizures with onset at age 11 months, whose seizures increased in frequency after the introduction of valproic acid (VPA) treatment and substantially improved upon cessation of treatment. The mechanism of seizure worsening did not involve VPA toxicity, encephalopathy, Glut-1 deficiency or overdosage, and the reason for absence seizure aggravation remained unclear. The patient showed complete control of absence seizures with levetiracetam treatment and the course was benign, both in terms of seizure control and neuropsychological aspects. The similar overall electroclinical picture and outcome between children with early-onset absences and those with CAE support the view that these conditions are a continuum within the wide spectrum of IGE. [Published with video sequences]. PMID:24169439

  11. Epilepsy with myoclonic absences.

    PubMed Central

    Manonmani, V; Wallace, S J

    1994-01-01

    The cases are described of eight children, five of them girls, who had epilepsy with myoclonic absences. The mean age of onset was 4.9 years. Brief episodes of loss of awareness with bilateral clonic jerking of the upper limbs were associated with rhythmic 3 cycles/second spike-wave discharges on electroencephalogram. Generalised tonic-clonic or astatic seizures, or both, also occurred in seven patients. All now have learning difficulties, and seven have behavioural problems. Conventional treatment for absences was effective in only two children. Of six patients treated with lamotrigine, five have improved substantially, but only one is in sustained complete remission. One recently diagnosed patient continues to have frequent myoclonic absences. As the response to treatment and long term outcome are much poorer, it is important to differentiate myoclonic absences from typical childhood absence epilepsy. PMID:8185360

  12. [Concussive convulsions: seizure or no seizure?].

    PubMed

    Nass, R D; Elger, C E; Fink, G R; Burghaus, L

    2011-11-01

    Convulsions following traumatic brain injury (TBI) represent a diagnostic and therapeutic challenge. They can be differentiated into late (> 7 days after TBI), early (1 - 7 days after TBI), immediate (within the first 24 h after TBI), and impact seizures (within seconds after TBI). Some authors suggest that most impact seizures are non-epileptic in origin and hence coined the term "concussive convulsions" for benign impact seizures. Early and late post-traumatic seizures frequently indicate structural brain damage and transition to chronic, post-traumatic epilepsy. The data for impact seizures or concussive convulsions is less clear: only a small percentage of impact seizures is associated with structural brain damage and the development of post-traumatic epilepsy, rather the majority of cases are benign and associated with an excellent prognosis. Here, we present a case report as a starting point for pathophysiological and clinical considerations regarding convulsions that start within seconds after TBI. PMID:22002819

  13. JAMA Patient Page: Seizures

    MedlinePLUS

    ... 1 seizure, you may be diagnosed as having epilepsy , meaning you are prone to seizures. Types of ... Treatment • Medication. If you are diagnosed as having epilepsy, you will likely be prescribed 1 or more ...

  14. Seizure First Aid

    MedlinePLUS

    ... medical I.D. bracelet or necklace that says “epilepsy” or “seizure disorder.” Some individuals wear a medical ... of knowing whether or not the person has epilepsy. The person having a seizure does not have ...

  15. Video game induced seizures

    Microsoft Academic Search

    C D Ferrie; P De Marco; R A Grünewald; S Giannakodimos; C P Panayiotopoulos

    1994-01-01

    Fifteen patients who experienced epileptic seizures while playing video games are described together with a review of 20 cases in the English literature. Nine of the 15 cases and all but two of the reported cases experienced their first seizure while playing video games. Two thirds of patients had idiopathic generalised epilepsy and mainly reported generalised tonic clonic seizures, but

  16. Search and Seizure.

    ERIC Educational Resources Information Center

    Murray, Kenneth T.

    This paper examines the practice of search and seizure from a legal perspective. All issues concerning lawful or unlawful search and seizure, whether in a public school or otherwise, are predicated upon the Fourth Amendment to the United States Constitution. The terms "search,""seizure,""probable cause,""reasonable suspicion," and "exclusionary…

  17. Atypicalseizure-like” activity in cortical reverberating networks in vitro can be caused by LPS-induced inflammation: a multi-electrode array study from a hundred neurons

    PubMed Central

    Gullo, Francesca; Amadeo, Alida; Donvito, Giulia; Lecchi, Marzia; Costa, Barbara; Constanti, Andrew; Wanke, Enzo

    2014-01-01

    We show here that a mild sterile inflammation induced by the endotoxin lipopolysaccharide (LPS), in a neuron/astrocyte/microglial cortical network, modulates neuronal excitability and can initiate long-duration burst events resembling epileptiform seizures, a recognized feature of various central nervous neurodegenerative, neurological and acute systemic diseases associated with neuroinflammation. To study this action, we simultaneously analyzed the reverberating bursting activity of a hundred neurons by using in vitro multi-electrode array methods. ?5 h after LPS application, we observed a net increase in the average number of spikes elicited in engaged cells and within each burst, but no changes neither in spike waveforms nor in burst rate. This effect was characterized by a slow, twofold exponential increase of the burst duration and the appearance of rarely occurring long burst events that were never seen during control recordings. These changes and the time-course of microglia-released proinflammatory cytokine, tumor necrosis factor-alpha (TNF-?), were blocked by pre-treatment with 50 nM minocycline, an established anti-inflammatory agent which was inactive when applied alone. Assay experiments also revealed that application of 60 pM exogenous TNF-? after 12–15 h, produced non-washable changes of neuronal excitability, completely different from those induced by LPS, suggesting that TNF-? release alone was not responsible for our observed findings. Our results indicate that the link between neuroinflammation and hyperexcitability can be unveiled by studying the long-term activity of in vitro neuronal/astrocyte/microglial networks. PMID:25404893

  18. Seizures and electroencephalographic findings in CDKL5 mutations: case report and review.

    PubMed

    Grosso, S; Brogna, A; Bazzotti, S; Renieri, A; Morgese, G; Balestri, P

    2007-05-01

    Mutations in the X-linked gene cyclin-dependent kinase-like 5 (CDKL5) have been detected in patients presenting with seizures in the first few months of life and Rett syndrome features. Twenty-seven cases have been detected to date. Generalized intractable seizures, as infantile spasms, and generalized tonic-clonic seizures and myoclonic seizures characterize the clinical picture of CDKL5 mutations. Here we report on a patient who presented with sleep-related hyperkinetic seizures. Our observation and review of the literature suggest that a broader polymorphic electroclinical pattern with both generalized and focal seizures may occur in patients with CDKL5 mutations. A screen for CDKL5 mutations is useful in patients, mainly females, with a history of early onset intractable seizures and becomes mandatory when idiopathic infantile spasms and/or atypical Rett syndrome features are also present. PMID:17049193

  19. Atypical microglandular adenosis presenting as a breast lump

    Microsoft Academic Search

    Neil Sahasrabudhe; Kathryn Brelsford; Santhi Kumar; Aruna Mene

    2011-01-01

    Microglandular adenosis is a rare, benign, glandular proliferative breast lesion, which also has a more atypical form. It may mimic malignancy clinically, mammographically and pathologically. Histology shows proliferation of glands with an infiltrative pattern and absence of a myoepithelial cell layer, which leads to diagnostic difficulty. We report a case of atypical microglandular adenosis diagnosed in a 78-year-old woman. The

  20. Treatment of neonatal seizures.

    PubMed

    van Rooij, Linda G M; Hellström-Westas, Lena; de Vries, Linda S

    2013-08-01

    Seizures occur more often during the neonatal period than at any other period of life. Precise incidence is difficult to delineate and depends on study population and criteria used for diagnosis of seizures. Controversy exists as to whether neonatal seizures themselves cause damage to the developing brain, or if the damage is primarily due to the underlying cause of the seizures. As a result of this controversy there is an ongoing discussion as to whether all seizures (both clinical and subclinical) should be treated. When (sub)clinical seizures are treated, there is no consensus about the most appropriate treatment for neonatal seizures and how to assess the efficacy of treatment. Current therapeutic options to treat neonatal seizures (i.e. primarily first generation antiepileptics) are relatively ineffective. There is an urgent need for prospective, randomized, controlled trials for efficacy and safety of these second-generation antiepileptic drugs in neonates. The aim of this review is to survey current knowledge regarding treatment of neonatal seizures in both term and preterm infants. PMID:23402893

  1. Generalized tonic-clonic seizure

    MedlinePLUS

    ... grand mal seizure. The terms seizure , convulsion, or epilepsy are most often associated with generalized tonic-clonic ... occur as part of a repeated, chronic illness (epilepsy). Some seizures are due to psychological problems (psychogenic).

  2. Brain mechanisms of altered conscious states during epileptic seizures.

    PubMed

    Cavanna, Andrea Eugenio; Monaco, Francesco

    2009-05-01

    Impaired consciousness has long been considered the hallmark of epileptic seizures. Both generalized seizures and complex partial seizures are characterized by a multifaceted spectrum of altered conscious states, in terms of the general level of awareness and the subjective contents of consciousness. Complete loss of consciousness occurs when epileptic activity involves both cortical and subcortical structures, as in tonic-clonic seizures and absence seizures. Medial temporal lobe discharges can selectively impair experience in complex partial seizures (with affected responsiveness) and certain simple partial seizures (with unaffected responsiveness). Electrical stimulation of temporal lobe structures has been shown to evoke similar subjective experiences. Findings from neurophysiological and brain-imaging studies in epilepsy have now demonstrated that involvement of the bilateral thalamus and upper brainstem leads to selective impairment of frontoparietal association cortices and midline 'default mode' networks, which results in ictal loss of consciousness. The spread of epileptic discharges from the medial temporal lobe to the same subcortical structures can ultimately cause impairment in the level of consciousness in the late ictal and immediate postictal phase of complex partial seizures. This paper reviews novel insights into the brain mechanisms that underlie alterations of consciousness during epileptic seizures and the implications for clinical practice in terms of diagnosis and management. PMID:19488084

  3. Seizures and intracranial hemorrhage.

    PubMed

    Wilson, Karen L; Alexander, James M

    2013-03-01

    Seizures and intracranial hemorrhage are possible medical diseases that any obstetrician may encounter. This article reviews the cause, treatment, and medical management in pregnancy for seizures and intracranial hemorrhage, and how the two can overlap into preeclampsia or eclampsia. This article also highlights some challenging management issues from the obstetrician's perspective. PMID:23466140

  4. Management of provoked seizure

    PubMed Central

    Misra, Usha Kant; Kalita, Jayantee

    2011-01-01

    A provoked seizure may be due to structural damage (resulting from traumatic brain injury, brain tumor, stroke, tuberculosis, or neurocysticercosis) or due to metabolic abnormalities (such as alcohol withdrawal and renal or hepatic failure). This article is a part of the Guidelines for Epilepsy in India. This article reviews the problem of provoked seizure and its management and also provides recommendations based on currently available information. Seizure provoked by metabolic disturbances requires correction of the triggering factors. Benzodiazepines are recommended for treatment of seizure due to alcohol withdrawal; gabapentin for seizure seen in porphyria; and antiepileptic drugs (AED), that are not inducer of hepatic enzymes, in the seizures seen in hepatic dysfunction. In severe traumatic brain injury, with or without seizure, phenytoin (PHT) may be given for 7 days. In ischemic or hemorrhagic stroke one may individualize the AED therapy. In cerebral venous sinus thrombosis (CVST), AED may be prescribed if there is seizure or computed tomographic (CT) abnormalities or focal weakness; the treatment, in these cases, has to be continued for 1 year. Prophylactic AED is not recommended in cases of brain tumor and neurosurgical procedures and if patient is on an AED it can be stopped after 1 week. PMID:21633606

  5. Improving Early Seizure Detection

    PubMed Central

    Jouny, Christophe C.; Franaszczuk, Piotr J.; Bergey, Gregory K.

    2011-01-01

    Over the last decade, the search for a method able to reliably predict seizures hours in advance has been largely replaced by a more realistic goal of very early detection of seizure onset which would allow therapeutic or warning devices to be triggered prior to the onset of disabling clinical symptoms. We explore in this article the steps along the pathway from data acquisition to closed loop applications that can and should be considered to design the most efficient early seizure detection. Microelectrodes, high-frequency oscillations, high sampling rate, high-density arrays, and modern analysis techniques are all elements of the recording and detection process that in combination with modeling studies can provide new insights into the dynamics of seizure onsets. Each of these step needs to be considered if one wants to implement improved detection devices that will favorably impact the quality of life of patients. PMID:22078518

  6. Psychogenic Nonepileptic Seizures

    PubMed Central

    2013-01-01

    Objective: All patients who exhibit seizure-like behavior cannot be evaluated by video-electroencephalography if their routine EEGs are negative, as this would be impractical and cost-prohibitive. The present article reviews a decision-making process that can be used for determining if further neurological evaluation is needed, the differential diagnoses and potential comorbidities involved when making this determination, and an approach to conveying the psychogenic nonepileptic seizure diagnosis to the patient that may help reduce symptom frequency. Design: Literature review. Conclusion: Psychogenic seizures are not caused by abnormal brain electrical activity. The symptoms of psychogenic seizures usually reflect a psychological conflict or a psychiatric disorder. However, psychogenic seizures are not “purposely” produced by the patient, and the patient is not aware that the seizures are non-epileptic, so the patient may become very anxious over having these symptoms. The presentation of the differential diagnosis should be done early in the course of treatment for better patient acceptance, and treatment options should be presented early in the evaluation period. PMID:24563816

  7. Do patients with absence epilepsy respond to ketogenic diets?

    PubMed

    Groomes, Laura B; Pyzik, Paula L; Turner, Zahava; Dorward, Jennifer L; Goode, Victoria H; Kossoff, Eric H

    2011-02-01

    Dietary therapies are established as beneficial for symptomatic generalized epilepsies such as Lennox-Gastaut syndrome; however, the outcome for idiopathic generalized epilepsy has never been specifically reported. The efficacy of the ketogenic and modified Atkins diet for childhood and juvenile absence epilepsy was evaluated from both historical literature review and patients treated at Johns Hopkins Hospital. Upon review of 17 published studies in which absence epilepsy was included as a patient subpopulation, approximately 69% of 133 with clear outcomes patients who received the ketogenic diet had a >50% seizure reduction, and 34% of these patients became seizure free. At Johns Hopkins Hospital, the ketogenic diet (n = 8) and modified Atkins diet (n = 13) led to similar outcomes, with 18 (82%) having a >50% seizure reduction, of which 10 (48%) had a >90% seizure reduction and 4 (19%) were seizure free. Neither age at diet onset, number of anticonvulsants used previously, particular diet used, nor gender correlated with success. PMID:20647578

  8. Seizures and Teens: Sorting Out Seizures--Part Two

    ERIC Educational Resources Information Center

    Devinsky, Orrin

    2006-01-01

    In adolescents, diagnosing seizures can be challenging and can lead to many pitfalls. Because seizures are episodic and unpredictable events, they usually do not occur in the doctor's office. Thus, a diagnosis of epilepsy is usually based on information presented by the person with seizures and their family. Together with results of diagnostic…

  9. Seizures and Epilepsy

    NSDL National Science Digital Library

    Patient Education Institute

    This patient education program discusses different types of seizures including epileptic. The causes, symptoms, diagnosis, and treatment options for epilepsy are reviewed. It also covers what to do when a seizure occurs, how to live with seizures, and preventive measures. This resource is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: This tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.

  10. Dermatoglyphics in seizure disorders.

    PubMed

    Schaumann, B; Johnson, S B; Jantz, R L

    1982-01-01

    A dermatoglyphic study of 197 adult Caucasian males with a confirmed diagnosis of epilepsy was carried out in an attempt to ascertain possible associations between aberrant dermatoglyphic and seizures and to estimate their diagnostic usefulness. Qualitative and quantitative fingertip and palmar dermatoglyphic traits were evaluated. The data were analyzed by etiology seizures. Previous studies and our own earlier data (Schaumann 1979) analyzed by univariate statistical methods indicated the presence of some dermatoglyphic deviations in patients with epilepsy, suggesting the existence of a genetic predisposition to seizures of various etiologies. In the present study, a multivariate analysis was employed on an enlarged patient sample. Three variables were found to be significant: an increased main line index on the right palm (p less than .01) and decreased a-b ridge counts on both left and right palms (p less than .001). Tests of the eigenvalues showed only one value to be significant and accounting for 71.8% of the intergroup variation. PMID:6808522

  11. Neuropsychology of Psychogenic Nonepileptic Seizures

    Microsoft Academic Search

    Daniel L. Drane; Erica L. Coady; David J. Williamson; John W. Miller; Selim Benbadis

    \\u000a Nonepileptic seizures (NES) are operationally defined as episodes of ­involuntary movement, altered responsiveness, or subjective\\u000a experience that resemble epileptic seizures (ES), but are not accompanied by the abnormal electrical discharges in the brain\\u000a that is a seizure. (Lesser, 1996; Reuber and Elger, 2003). When these episodes are caused by psychological processes, they\\u000a are termed psychogenic nonepileptic seizures (PNES). Other terms,

  12. Iopamidol Myelography-Induced Seizures

    PubMed Central

    Singh, Sonal; Rajpal, Chitra; Nannapeneni, Srikanth; Venkatesh, Sundar

    2005-01-01

    Iopamidol, a water-soluble contrast agent, has been rarely associated with seizures. We describe a case of generalized tonic-clonic seizure after cervical myelography with iopamidol in a previously healthy young man. In patients presenting with seizures, a history of recent myelography should be considered as an etiology. Iopamidol myelography may be associated with a risk of seizures. Clinicians need to be aware of this complication and inform their patients about such risk. PMID:16369390

  13. Effect of sodium benzoate in the treatment of atypical nonketotic hyperglycinaemia

    Microsoft Academic Search

    J. M. Neuberger; S. Schweitzer; M.-O. Rolland; R. Burghard

    2000-01-01

    A 6-month-old girl presented with hypotonia and mild psychomotor retardation. Subsequently, an atypical manifestation of a nonketotic hyperglycinaemia was diagnosed, confirmed by significantly reduced activity of the glycine cleavage system in the liver tissue. After the patient developed hypsarrhythmia and had a single cerebral seizure, treatment with both sodium benzoate and dextromethorphan was started. During the following year, the girl

  14. Terminology of psychogenic nonepileptic seizures.

    PubMed

    Brigo, Francesco; Igwe, Stanley C; Ausserer, Harald; Nardone, Raffaele; Tezzon, Frediano; Bongiovanni, Luigi Giuseppe; Tinazzi, Michele; Trinka, Eugen

    2015-03-01

    Several different terms have been used to describe "psychogenic nonepileptic seizures" (PNES) in the literature. In this study, we evaluated the most common English terms used to describe PNES on Google and in PubMed using multiple search terms (https://www.google.com and http://www.ncbi.nlm.nih.gov/pubmed). The information prevalence of the five terms most frequently used to refer to PNES in PubMed were: psychogenic non(-)epileptic seizure(s), followed by pseudo(-)seizure(s), non(-)epileptic seizure(s), psychogenic seizure(s), and non(-)epileptic event(s). The five most frequently adopted terms to describe PNES in Google were: psychogenic non(-)epileptic seizure(s), followed by non(-)epileptic event(s), psychogenic attack(s), non(-)epileptic attack(s), and psychogenic non(-)epileptic attack(s). The broad spectrum of synonyms used to refer to PNES in the medical literature reflects a lack of internationally accepted, uniform terminology for PNES. In addition to "seizure(s)," lay people use the word "attack(s)" to describe PNES. Although considered obsolete, some terms, e.g., pseudoseizure(s), are still used in the recent medical literature. Adopting a uniform terminology to describe PNES could facilitate communication between epileptologists, physicians without specific expertise in epilepsy, and patients. PMID:25631657

  15. Reflex seizures in Rett syndrome.

    PubMed

    Roche Martínez, Ana; Alonso Colmenero, M Itziar; Gomes Pereira, Andreia; Sanmartí Vilaplana, Francesc X; Armstrong Morón, Judith; Pineda Marfa, Mercé

    2011-12-01

    Reflex seizures are a rare phenomenon among epileptic patients, in which an epileptic discharge is triggered by various kinds of stimuli (visual, auditory, tactile or gustatory). Epilepsy is common in Rett syndrome patients (up to 70%), but to the authors' knowledge, no pressure or eating-triggered seizures have yet been reported in Rett children. We describe three epileptic Rett patients with reflex seizures, triggered by food intake or proprioception. One patient with congenital Rett Sd. developed infantile epileptic spasms at around seven months and two patients with classic Rett Sd. presented with generalised tonic-clonic seizures at around five years. Reflex seizures appeared when the patients were teenagers. The congenital-Rett patient presented eating-triggered seizures at the beginning of almost every meal, demonstrated by EEG recording. Both classic Rett patients showed self-provoked pressure -triggered attacks, influenced by stress or excitement. Non-triggered seizures were controlled with carbamazepine or valproate, but reflex seizures did not respond to antiepileptic drugs. Risperidone partially improved self-provoked seizures. When reflex seizures are suspected, reproducing the trigger during EEG recording is fundamental; however, self-provoked seizures depend largely on the patient's will. Optimal therapy (though not always possible) consists of avoiding the trigger. Stress modifiers such as risperidone may help control self-provoked seizures. PMID:22258043

  16. Atypical autoerotic deaths

    SciTech Connect

    Gowitt, G.T.; Hanzlick, R.L. (Fulton County Medical Examiner's Office, Atlanta, GA (United States))

    1992-06-01

    So-called typical' autoerotic fatalities are the result of asphyxia due to mechanical compression of the neck, chest, or abdomen, whereas atypical' autoeroticism involves sexual self-stimulation by other means. The authors present five atypical autoerotic fatalities that involved the use of dichlorodifluoromethane, nitrous oxide, isobutyl nitrite, cocaine, or compounds containing 1-1-1-trichloroethane. Mechanisms of death are discussed in each case and the pertinent literature is reviewed.

  17. Seizure Prediction: Methods

    PubMed Central

    Carney, Paul R.; Myers, Stephen; Geyer, James D.

    2011-01-01

    Epilepsy, one of the most common neurological diseases, affects over 50 million people worldwide. Epilepsy can have a broad spectrum of debilitating medical and social consequences. Although antiepileptic drugs have helped treat millions of patients, roughly a third of all patients have seizures that are refractory to pharmacological intervention. The evolution of our understanding of this dynamic disease leads to new treatment possibilities. There is great interest in the development of devices that incorporate algorithms capable of detecting early onset of seizures or even predicting them hours before they occur. The lead time provided by these new technologies will allow for new types of interventional treatment. In the near future, seizures may be detected and aborted before physical manifestations begin. In this chapter we discuss the algorithms that make these devices possible and how they have been implemented to date. We also compare and contrast these measures, and review their individual strengths and weaknesses. Finally, we illustrate how these techniques can be combined in a closed-loop seizure prevention system. PMID:22078526

  18. Atypical cystic fibrosis

    PubMed Central

    Schram, Carrie A.

    2012-01-01

    Abstract Objective To review the diagnosis of patients with atypical cystic fibrosis (CF). Sources of information A comprehensive search of MEDLINE (1950 to the third week of May 2009), MEDLINE In-Process and Other Non-Indexed Citations and Cases (1950 to the third week of May 2009), and EMBASE (1980 to the fourth week of March 2009). The Cystic Fibrosis Canada website was also reviewed and the most recent patient data registry report was consulted. Main message Atypical CF is a milder form of the CF disorder, which is associated with mutations of the cystic fibrosis transmembrane receptor gene. Instead of having classic symptoms, individuals with atypical CF might only have mild dysfunction in 1 organ system and might or might not have elevated sweat chloride levels. Atypical CF is a very diverse disorder affecting different organ systems to varying degrees. The symptoms patients experience can also fluctuate over time; however, certain clinical signs and symptoms affecting the respiratory, gastrointestinal, endocrine and metabolic, and genitourinary systems should alert physicians to the possibility of CF. Patients with atypical CF often have fewer hospitalizations during childhood than those with classic CF do, and the disorder can remain undiagnosed for many years, at times into adulthood. Conclusion Although patients diagnosed with atypical CF have longer life expectancies than individuals with classic CF, the long-term expected outcome for many individuals with atypical CF is unknown. It is important to counsel patients about the possibility of future illness. Education about CF can help patients understand their symptoms, modify their lifestyles to optimize health, reduce the incidence of complications, and receive family planning counseling when appropriate. PMID:23242890

  19. Absence epilepsy: early prognostic signs.

    PubMed

    Covanis, A; Skiadas, K; Loli, N; Lada, C; Theodorou, V

    1992-12-01

    We have studied 124 children with typical absence epilepsy. The onset of symptoms was in 12% under 4 years, in 51% between 4-8 years and in 37% above 8 years. The F:M ratio was 2:1 in children under 4 years versus 1:1 above 8 years. Absences alone occurred in 82% and absences followed or preceded by generalized tonic-clonic seizures (GTCS) in 6.5% and 11%, respectively. Simple absences were not seen in children under 4 years and were more frequent (14%) in the 4-8 years age group. Family history was positive for epilepsy in 20% and febrile convulsion in 7%. Sixteen percent had a positive past history of febrile convulsions. All patients showed bilateral, synchronous spike-wave discharges from 2.5 to 4 c/s. Lateralized spikes, spike-slow wave complexes were found in 27%. Photosensitivity was present in 18% and was marked in 12%. Monotherapy with sodium valproate or ethosuximide (91% SV) was successful in 85% of patients with absences alone and 68% of the absences with GTCS. Only 2% were not fully controlled either on monotherapy or polytherapy. Treatment was withdrawn in 41 patients and 13 relapsed. We have identified four factors associated with relapses: (a) poor initial response to treatment, (b) lateralized focal EEG abnormality and/or marked photosensitivity, (c) the evolution to myoclonic epilepsy, and (d) early withdrawal of AED (< 3 years). PMID:1344778

  20. Atypical/Nor98 Scrapie Infectivity in Sheep Peripheral Tissues

    PubMed Central

    Andréoletti, Olivier; Orge, Leonor; Benestad, Sylvie L.; Beringue, Vincent; Litaise, Claire; Simon, Stéphanie; Le Dur, Annick; Laude, Hubert; Simmons, Hugh; Lugan, Séverine; Corbičre, Fabien; Costes, Pierrette; Morel, Nathalie; Schelcher, François; Lacroux, Caroline

    2011-01-01

    Atypical/Nor98 scrapie was first identified in 1998 in Norway. It is now considered as a worldwide disease of small ruminants and currently represents a significant part of the detected transmissible spongiform encephalopathies (TSE) cases in Europe. Atypical/Nor98 scrapie cases were reported in ARR/ARR sheep, which are highly resistant to BSE and other small ruminants TSE agents. The biology and pathogenesis of the Atypical/Nor98 scrapie agent in its natural host is still poorly understood. However, based on the absence of detectable abnormal PrP in peripheral tissues of affected individuals, human and animal exposure risk to this specific TSE agent has been considered low. In this study we demonstrate that infectivity can accumulate, even if no abnormal PrP is detectable, in lymphoid tissues, nerves, and muscles from natural and/or experimental Atypical/Nor98 scrapie cases. Evidence is provided that, in comparison to other TSE agents, samples containing Atypical/Nor98 scrapie infectivity could remain PrPSc negative. This feature will impact detection of Atypical/Nor98 scrapie cases in the field, and highlights the need to review current evaluations of the disease prevalence and potential transmissibility. Finally, an estimate is made of the infectivity loads accumulating in peripheral tissues in both Atypical/Nor98 and classical scrapie cases that currently enter the food chain. The results obtained indicate that dietary exposure risk to small ruminants TSE agents may be higher than commonly believed. PMID:21347349

  1. Benign childhood seizure susceptibility syndrome: three case reports.

    PubMed

    Caraballo, Roberto Horacio; Aldao, María del Rosario; Cachia, Pedro

    2011-06-01

    In this study, we describe three patients who each had two different forms of idiopathic focal epilepsiy. Two of these patients had electroclinical features compatible with Panayiotopoulos syndrome and benign childhood epilepsy with centro-temporal spikes (BCECTS), one of whom developed a particular electroclinical picture of atypical benign focal epilepsy and the other an atypical evolution characterized by verbal auditory agnosia and aphasia. The third patient had clinical and electroencephalographic features of BCECTS and of idiopathic childhood occipital epilepsy (Gastaut type) which evolved into electroclinical features of continuous spikes and waves during slow sleep (CSWS). All three patients presented with two focal idiopathic epilepsies with a particular evolution associated with CSWS, supporting the concept of benign childhood seizure susceptibility syndrome as described by Panayiotopoulos (1993). PMID:21628136

  2. Hypersexuality and limbic system seizures

    Microsoft Academic Search

    O. J. Andy

    1977-01-01

    Hypersexual behavior was induced in adult male cats by repeatedly evoked limbic system seizures. Accentuation of Dopaminergic\\u000a activity with drugs was used to facilitate development of the seizure induced hypersexuality. Hypersexuality consisted of\\u000a biting knap of neck, mounting, thrusting and coital intromission. The gradual development and eventual disappearance of hypersexuality\\u000a was correlated with the progressive prolongation of the seizures in

  3. On the Activity of the Corticostriatal Networks during Spike-and-Wave Discharges in a Genetic Model of Absence Epilepsy

    Microsoft Academic Search

    Sean J. Slaght; Tamar Paz; Mario Chavez; Jean-Michel Deniau; Severine Mahon; Stephane Charpier

    2004-01-01

    Absence seizures are characterized by impairment of consciousness associated with widespread bilaterally synchronous spike-and-wave discharges (SWDs) in the electroencephalogram (EEG), which reflect highly synchronized oscillations in thalamocortical networks. Although recent pharmacological studies suggest that the basal ganglia could provide a remote control system for absence seizures, the mechanisms of propagation of epileptic discharges in these subcortical nuclei remain unknown. In

  4. Hypocalcemia-Induced Seizure

    PubMed Central

    Trinidad, Bradley J.; Shi, Jiong

    2015-01-01

    Calcium is essential for both neurotransmitter release and muscle contraction. Given these important physiological processes, it seems reasonable to assume that hypocalcemia may lead to reduced neuromuscular excitability. Counterintuitively, however, clinical observation has frequently documented hypocalcemia’s role in induction of seizures and general excitability processes such as tetany, Chvostek’s sign, and bronchospasm. The mechanism of this calcium paradox remains elusive, and very few pathophysiological studies have addressed this conundrum. Nevertheless, several studies primarily addressing other biophysical issues have provided some clues. In this review, we analyze the data of these studies and propose an integrative model to explain this hypocalcemic paradox. PMID:25810356

  5. Pathology Case Study: Seizures

    NSDL National Science Digital Library

    Dickman, Paul S.

    This is a case study presented by the University of Pittsburgh Department of Pathology in which a 24-day-old baby is failing to thrive and experiencing seizures. Visitors are given the microscopic description, with images, the results of the postmortem examination, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in pediatric pathology.

  6. Vagus Nerve Stimulation for Seizures

    Microsoft Academic Search

    Basim M Uthman

    2000-01-01

    It is agreed that 1% of the general population is afflicted with epilepsy and close to 30% of epilepsy patients are intractable to medications. In spite of a recent increase in the number of new medications that are available on the market, many patients continue to have seizures or their seizures are controlled at the expense of intolerable side effects.

  7. Recurrent seizures after lidocaine ingestion

    PubMed Central

    Aminiahidashti, Hamed; Laali, Abolghasem; Nosrati, Nazanin; Jahani, Fatemeh

    2015-01-01

    Lidocaine has a concentration-dependent effect on seizures. Concentrations above 15 ?g/mL frequently result in seizures in laboratory animals and human. We report a case of central nervous system (CNS) lidocaine toxicity and recurrent seizure after erroneous ingestion of lidocaine solution. A 4-year-old boy presented to the Emergency Department of Imam Hospital of Sari in December 2013 due to tonic-clonic generalized seizures approximately 30 min ago. 3 h before seizure, his mother gave him 2 spoons (amount 20–25 cc) lidocaine hydrochloride 2% solution instead of pediatric gripe by mistake. Seizure with generalized tonic-clonic occurred 3 times in home. Neurological examination was essentially unremarkable except for the depressed level of consciousness. Personal and medical history was unremarkable. There was no evidence of intracranial ischemic or hemorrhagic lesions in computed tomography scan. There were no further seizures, the condition of the patient remained stable, and he was discharged 2 days after admission. The use of viscous lidocaine may result in cardiovascular and CNS toxicity, particularly in children. Conservative management is the best option for treatment of lidocaine induced seizure. PMID:25709968

  8. Predicting Epileptic Seizures in Advance

    PubMed Central

    Moghim, Negin; Corne, David W.

    2014-01-01

    Epilepsy is the second most common neurological disorder, affecting 0.6–0.8% of the world's population. In this neurological disorder, abnormal activity of the brain causes seizures, the nature of which tend to be sudden. Antiepileptic Drugs (AEDs) are used as long-term therapeutic solutions that control the condition. Of those treated with AEDs, 35% become resistant to medication. The unpredictable nature of seizures poses risks for the individual with epilepsy. It is clearly desirable to find more effective ways of preventing seizures for such patients. The automatic detection of oncoming seizures, before their actual onset, can facilitate timely intervention and hence minimize these risks. In addition, advance prediction of seizures can enrich our understanding of the epileptic brain. In this study, drawing on the body of work behind automatic seizure detection and prediction from digitised Invasive Electroencephalography (EEG) data, a prediction algorithm, ASPPR (Advance Seizure Prediction via Pre-ictal Relabeling), is described. ASPPR facilitates the learning of predictive models targeted at recognizing patterns in EEG activity that are in a specific time window in advance of a seizure. It then exploits advanced machine learning coupled with the design and selection of appropriate features from EEG signals. Results, from evaluating ASPPR independently on 21 different patients, suggest that seizures for many patients can be predicted up to 20 minutes in advance of their onset. Compared to benchmark performance represented by a mean S1-Score (harmonic mean of Sensitivity and Specificity) of 90.6% for predicting seizure onset between 0 and 5 minutes in advance, ASPPR achieves mean S1-Scores of: 96.30% for prediction between 1 and 6 minutes in advance, 96.13% for prediction between 8 and 13 minutes in advance, 94.5% for prediction between 14 and 19 minutes in advance, and 94.2% for prediction between 20 and 25 minutes in advance. PMID:24911316

  9. Seizure Treatment in Transplant Patients

    PubMed Central

    Shepard, Paul W.

    2013-01-01

    Opinion statement Solid organ transplantation is frequently complicated by a spectrum of seizure types, including single partial-onset or generalized tonic-clonic seizures, acute repetitive seizures or status epilepticus, and sometimes the evolution of symptomatic epilepsy. There is currently no specific evidence involving the transplant patient population to guide the selection, administration, or duration of antiepileptic drug (AED) therapy, so familiarity with clinical AED pharmacology and application of sound judgment are necessary for successful patient outcomes. An initial detailed search for symptomatic seizure etiologies, including metabolic, infectious, cerebrovascular, and calcineurin inhibitor treatment-related neuro-toxic complications such as posterior reversible encephalopathy syndrome (PRES), is imperative, as underlying central nervous system disorders may impose additional serious risks to cerebral or general health if not promptly detected and appropriately treated. The mainstay for post-transplant seizure management is AED therapy directed toward the suspected seizure type. Unfavorable drug interactions could place the transplanted organ at risk, so choosing an AED with limited interaction potential is also crucial. When the transplanted organ is dysfunctional or vulnerable to rejection, AEDs without substantial hepatic metabolism are favored in post-liver transplant patients, whereas after renal transplantation, AEDs with predominantly renal elimination may require dosage adjustment to prevent adverse effects. Levetiracetam, gabapentin, pregabalin, and lacosamide are drugs of choice for treatment of partial-onset seizures in post-transplant patients given their efficacy spectrum, generally excellent tolerability, and lack of drug interaction potential. Levetiracetam is the drug of choice for primary generalized seizures in post-transplant patients. When intravenous drugs are necessary for acute seizure management, benzodiazepines and fosphenytoin are the traditional and best evidence-based options, although intravenous levetiracetam, valproate, and lacosamide are emerging options. Availability of several newer AEDs has greatly expanded the therapeutic armamentarium for safe and efficacious treatment of post-transplant seizures, but future prospective clinical trials and pharmacokinetic studies within this specific patient population are needed. PMID:22660960

  10. [Atypical human trypanosomoses].

    PubMed

    Truc, P; Nzoumbou-Boko, R; Desquesnes, M; Semballa, S; Vincendeau, P

    2014-01-01

    Trypanosomes are principally responsible for two human diseases: human African trypanosomiasis (HAT) or sleeping sickness (caused by Trypanosoma brucei gambiense and T. b. rhodesiense), and Chagas disease, also called South American trypanosomiasis (T. cruzi). However, some trypanosomes that are natural parasites only of animals can sometimes infect humans and cause the so-called "atypical human trypanosomiases" (aHT). T. evansi, the agent causing surra in camels, horses, dogs, and bovines, and T. lewisi, a cosmopolite rat parasite, are the most frequently involved. These atypical infections involve no or only minor symptoms, but major symptoms are sometimes present. Parasite elimination is generally spontaneous, but can require treatment. Molecular tools, such as polymerase chain reaction, have improved the accuracy of parasite identification. Immunological techniques, mainly immunoenzymatic assays, can detect asymptomatic subjects. Several causes, most often concomitant, have been hypothesized, including immune immaturity, immunodeficiency, and close contact with infected animals. Innate immunity to animal trypanosomes depends on a trypanolytic factor called apolipoprotein L-I, present in human serum. A deficit in both apolipoprotein L-I alleles has been reported in an Indian patient infected by T. evansi. The prevalence of aHT is probably underestimated. Moreover, these trypanosomes might become potential emerging zoonotic pathogens, due to their ability to invade new hosts. An international network has been set up to survey these aHT (NAHIAT: Network on Atypical Human Infections by Animal Trypanosomes). PMID:24918468

  11. Seizures as a manifestation of multiple sclerosis.

    PubMed

    Sponsler, Jeffrey L; Kendrick-Adey, Anastasia C

    2011-12-01

    The incidence of seizures is generally accepted to be greater in patients with multiple sclerosis (MS) than in the general population, and rarely, MS can initially present as seizure. To present a case report of seizure as the initial symptom of MS, to quantify the occurrence of seizures among MS patients, and to classify patients according to when seizures occur relative to onset of MS. The medical history of patients presenting with MS and seizure in our clinic was examined. In addition, 25 scientific papers were reviewed and the number and characteristics of patients with MS and seizure recorded. Data from the literature review and from our own clinical series were combined and examined. Of the MS patients, 1.95% experienced seizures at any time during life. Patients experiencing seizures before MS diagnosis were classified into three categories: (a) 25 (7.3% of patients with MS and seizures) with seizure as the initial presentation of MS; (b) 27 (7.9%) with seizures appearing with other signs and symptoms of MS; and (c) 68 (20%) with seizures occurring years or an unknown period of time before MS onset. Seizure occurring as a symptom of MS relapse was found in 29 patients. The prevalence of seizures among MS patients was higher than that in the general population, indicating a relationship between seizures and MS. Seizures occurred before MS diagnosis in a small percentage of patients. PMID:22258045

  12. Amyloid Imaging in Dementias With Atypical Presentation

    PubMed Central

    Wolk, David A.; Price, Julie C.; Madeira, Charles; Saxton, Judy A.; Snitz, Beth E.; Lopez, Oscar L.; Mathis, Chester A.; Klunk, William E.; DeKosky, Steven T.

    2012-01-01

    We explored the potential value of amyloid imaging in patients with atypical presentations of dementia. Twenty-eight patients with atypical dementia underwent PET imaging with the amyloid imaging tracer Pittsburgh Compound-B (PiB). Twenty-six had [18F]fluoro-2-deoxy-D-glucose (FDG) PET scans. After extensive clinical evaluation, this group of patients generated considerable diagnostic uncertainty and received working diagnoses that included possible AD (pAD), focal dementias [e.g. posterior cortical atrophy (PCA)], or cases in which no clear diagnostic category could be determined (dementia of uncertain etiology; DUE). Patients were classified as PiB-positive, -negative, or -intermediate based on objective criteria. Anterior-posterior (A-P) and left-right (L-R) indices of PiB and FDG uptake were calculated to examine differences in distribution of amyloid pathology and metabolic changes associated with clinical phenotype. Eleven patients (39%) were PiB-positive, 16 were PiB-negative (57%) and one (4%) was intermediate. By diagnostic category, 3/10 patients (30%) with DUE, 1/5 (20%) with primary progressive aphasia (PPA), 3/5 (60%) with posterior cortical atrophy (PCA), and 4/7 (57%) with pAD were PiB-positive. Brain metabolism of both PiB-positive and -negative patients were generally similar by phenotype, but differed from typical AD. PCA patients also appeared to differ in their relative distribution of PiB compared to typical AD, consistent with their atypical phenotype. AD pathology is frequently present in atypical presentations of dementia and can be identified by amyloid imaging. Clinical phenotype is more related to the pattern of cerebral hypometabolism than the presence/absence of amyloid pathology. These findings have diagnostic, prognostic, and therapeutic implications. PMID:22285638

  13. Anterior Plagiocephaly in an Atypical Case of Apert Syndrome

    PubMed Central

    Gupta, Madhumita; Pai, Ashwin Alke; Bhattacharya, Abhimanyu; Ramachandra, Ravi; Sawarappa, Raghavendra; Mohapatra, Subhakanta; Kanoi, Aditya

    2013-01-01

    Apert syndrome is a congenital craniosynostosis syndrome comprising of bilateral coronal synostosis , symmetric syndactyly of hands and feet and midface hypoplasia. We present an atypical phenotype of this syndrome with right sided unilateral coronal synostosis. However, type I apert hand and other clinical and radiological features suggestthe diagnosis. Genetic analysis revealed an absence of the specific missense mutations in the FGFR 2 gene that is found in patients with this syndrome. We conclude that this patient represented a rare atypical variant of Apert syndrome. Further analysis is required to map the associated genotype. PMID:25489515

  14. [Diagnostic significance of sleep EEG in children with febrile seizures].

    PubMed

    Kovelenova, M V; Rozhkov, V P; Guzeva, V I

    2002-01-01

    To obtain effective criteria for febrile seizures (FS) differential diagnosis and prognosis, clinical examination and EEG recorded during wakefulness and daytime sleep were studied in 75 FS children and 15 controls aged from 6 months to 6 years. According to duration, frequency and complications of FS, all patients were divided into three groups: "simple" FS (n = 35), "complex" FS (n = 25) and "afebrile seizures" (AFS), i.e. those who developed non-febrile seizures after febrile ones (n = 15). In waking state EEG, epileptic activity was found in only 60% of AFS patients. During sleep stages I-III, in 84% of the patients with complex FS as well as in all AFS patients generalized discharges of (poly) spike-waves and (or) focal spikes were detected. Paroxysmal changes, atypical scalp distribution, vertex-potentials and sleep spindles generalization as well as insertion of spikes into arousal-rhythms were determined as additional criteria for unfavorable FS course. In the patients with main features of sympathetic-adrenal reaction during febrile paroxysms, complicated FS course was not found. EEG examination during sleep in children with FS increases an efficacy of differential disease diagnosis. Epileptic discharge detection, along with exposure of paroxysmal transformation of physiological sleep EEG transients, that may be earlier sign of epileptic dysfunction, are recommended for proper prevention and treatment of FS. PMID:11915706

  15. Atypical neuroleptics: compulsive disorders.

    PubMed

    2014-02-01

    Compulsive disorders are known adverse effects of dopamine agonists. Atypical neuroleptics (amisulpride, aripiprazole, olanzapine, paliperidone, quetiapine and risperidone) have also been implicated in cases of pathological gambling, hypersexuality, and compulsive eating and shopping, with sometimes serious social and familial consequences. The compulsive disorders improved or ceased when the neuroleptic was withdrawn or replaced. Patients must be informed of these possible adverse effects and monitored for behavioural changes. If such disorders occur, they can be managed by withdrawing the drug, reducing the dosage, or switching to another neuroleptic. PMID:24669386

  16. Occipital seizures imitating migraine aura.

    PubMed Central

    Panayiotopoulos, C P; Sharoqi, I A; Agathonikou, A

    1997-01-01

    Three cases are reported in which symptoms of occipital seizures resembled the visual aura of migraine. Careful recording of the characteristics and timing of such visual effects will often resolve the diagnostic dilemma. PMID:9204019

  17. [Martin Luther's seizure disorder].

    PubMed

    Feldmann, H

    1989-01-01

    Martin Luther's diseases are well documented, because he used to discuss them freely in his letters. There is also a wealth of evidence through reports by his friends. Most of his diseases were common and well known to the contemporary physicians, who accordingly interpreted them correctly: bladder stones, chronic constipation, hemorrhoids. Luther's death obviously was due to a coronary thrombosis. During the last 19 years of his life, in addition to these "natural diseases", Luther also suffered from recurring attacks of a peculiar symptomatology. Luther himself and his friends considered these seizures to be no "natural disease", but Satan punching his flesh, and he compared them to St. Paul's disease (2. Cor. 12). The first of these attacks occurred on July 6, 1527, when Luther was 43 years of age. It began with a roaring tinnitus in his left ear, which increased dramatically and seemed to occupy the left half of his head. Then a state of sickness and collapse followed, however, consciousness was retained throughout the whole period. After a night's rest all the symptoms had subsided, except the tinnitus, which, from that day on, continued for all the following years in varying intensity. Similar attacks with increase of the tinnitus and vertigo as the leading symptoms, seized Luther at irregular intervals and distressed him extremely. Former investigators of Luther's diseases interpreted these attacks as manifestations of a psychiatric disorder and a chronic inflammatory disease of the middle ear. The present detailed study reveals that it was a typical case of Meničre's disease of the left ear manifesting itself more than 330 years before Meničre's classical observation. PMID:2529669

  18. Networks involved in seizure initiation

    PubMed Central

    Vaudano, Anna E.; Carmichael, David W.; Salek-Haddadi, Afraim; Rampp, Stefan; Stefan, Hermann; Lemieux, Louis

    2012-01-01

    Objective: To define the ictal cortical/subcortical network of reading-induced seizures. Methods: We analyzed ictal magnetoencephalography (MEG) and EEG-correlated fMRI (EEG-fMRI) data in a unique patient with reading epilepsy (RE) affected by frequent perioral reflex myocloni triggered by reading silently. Results: Ictal MEG corroborated EEG localization and revealed activity extending precentrally into Brodmann area (BA) 6. fMRI blood oxygen level?dependent (BOLD) signal changes in the left deep piriform cortex (PFC) and left BA6 preceded seizures and occurred before BOLD changes were observed in thalamus and right inferior frontal gyrus (BA44). Dynamic causal modeling provided evidence of a causal link between hemodynamic changes in the left PFC and reading-evoked seizures. Conclusion: Our findings support the important role of deep cortical and subcortical structures, in particular the frontal PFC, as key regions in initiating and modulating seizure activity. In our patient with RE, BA6 appeared to be the area linking cognitive activation and seizure activity. PMID:22764255

  19. Epileptic seizure prediction and control.

    PubMed

    Iasemidis, Leon D

    2003-05-01

    Epileptic seizures are manifestations of epilepsy, a serious brain dynamical disorder second only to strokes. Of the world's approximately 50 million people with epilepsy, fully 1/3 have seizures that are not controlled by anti-convulsant medication. The field of seizure prediction, in which engineering technologies are used to decode brain signals and search for precursors of impending epileptic seizures, holds great promise to elucidate the dynamical mechanisms underlying the disorder, as well as to enable implantable devices to intervene in time to treat epilepsy. There is currently an explosion of interest in this field in academic centers and medical industry with clinical trials underway to test potential prediction and intervention methodology and devices for Food and Drug Administration (FDA) approval. This invited paper presents an overview of the application of signal processing methodologies based upon the theory of nonlinear dynamics to the problem of seizure prediction. Broader application of these developments to a variety of systems requiring monitoring, forecasting and control is a natural outgrowth of this field. PMID:12769431

  20. Early onset seizures and Rett-like features associated with mutations in CDKL5.

    PubMed

    Evans, Julie C; Archer, Hayley L; Colley, James P; Ravn, Kirstine; Nielsen, Jytte Bieber; Kerr, Alison; Williams, Elizabeth; Christodoulou, John; Gécz, Jozef; Jardine, Philip E; Wright, Michael J; Pilz, Daniela T; Lazarou, Lazarus; Cooper, David N; Sampson, Julian R; Butler, Rachel; Whatley, Sharon D; Clarke, Angus J

    2005-10-01

    Mutations in the CDKL5 gene (also known as STK9) have recently been shown to cause early onset epilepsy and severe mental retardation (ISSX or West syndrome). Patients with CDKL5 mutations sometimes also show features similar to those seen in Rett Syndrome (RTT). We have screened the CDKL5 gene in 94 patients with RTT or a RTT-like phenotype who had tested negative for MECP2 mutations (13 classical RTT female subjects, 25 atypical RTT female subjects, 40 RTT-like female and 16 RTT-like male subjects; 33 of the patients had early onset seizures). Novel pathogenic CDKL5 mutations were identified in three girls, two of whom had initially been diagnosed with the early onset seizure variant of RTT and the other with early onset seizures and some features of RTT. In addition, the 33 patients with early seizures were screened for the most common mutations in the ARX gene but none were found. Combining our three new cases with the previously published cases, 13/14 patients with CDKL5 mutations presented with seizures before the age of 3 months. PMID:16015284

  1. [Symptoms and clinical course of epilepsy with myoclonic absences].

    PubMed

    Ikeda, Hiroko; Fujiwara, Tateki; Shigematsu, Hideo; Imai, Katsumi; Kubota, Hidemoto; Kubota, Yuko; Takahashi, Yukitoshi; Inoue, Yushi

    2011-01-01

    There is no comprehensive study so far in Japan on epilepsy with myoclonic absences (EMA), characterized by myoclonic absences (MA) as a specific seizure type. We retrospectively studied 9 patients (4 males and 5 females) with EMA confirmed by ictal video EEG and polygraph (EEG+EMG) recordings. The age at MA onset ranged from 18 to 92 months and the age at the last follow-up ranged from 3 to 39 years. The patients had IQ of 40 to 79. Eight patients had been free from seizures for more than one year at the last follow up. MA was controlled by valproate sodium monotherapy or combination of valproate sodium and ethosuximide with appropriate plasma levels. Generalized tonic clonic seizures and severe mental retardation were not necessarily associated with poor seizure outcome. Patients with long MA duration or MA status epilepticus were prone to be refractory to medication. EMA can be divided into two subgroups based on the seizure outcome, favorable and unfavorable. Further large-scale study is required. PMID:21400926

  2. Cardiorespiratory abnormalities during epileptic seizures.

    PubMed

    Kothare, Sanjeev V; Singh, Kanwaljit

    2014-12-01

    Sudden unexpected death in epilepsy (SUDEP) is a leading cause of death in young and otherwise healthy patients with epilepsy, and sudden death is at least 20 times more common in epilepsy patients as compared to patients without epilepsy. A significant proportion of patients with epilepsy experience cardiac and respiratory complications during seizures. These cardiorespiratory complications are suspected to be a significant risk factor for SUDEP. Sleep physicians are increasingly involved in the care of epilepsy patients and a recognition of these changes in relation to seizures while a patient is under their care may improve their awareness of these potentially life-threatening complications that may occur during sleep studies. This paper details these cardiopulmonary changes that take place in relation to epileptic seizures and how these changes may relate to the occurrence of SUDEP. PMID:25311834

  3. Febrile Seizures and Epilepsy: Possible Outcomes

    MedlinePLUS

    ... BETWEEN FE- BRILE SEIZURES AND LATER DEVELOPMENT OF EPILEPSY? Overall, about 6% of children who experienced febrile ... SEIZURES AND LATER DEVELOPMENT OF SPECIFIC TYPES OF EPILEPSY? Epilepsy that does not respond well to standard ...

  4. Recurrent prolonged fugue states as the sole manifestation of epileptic seizures.

    PubMed

    Khwaja, Geeta A; Duggal, Ashish; Kulkarni, Amit; Chaudhry, Neera; Gupta, Meena; Chowdhury, Debashish; Bohra, Vikram

    2013-10-01

    A fugue state is defined as an altered state of consciousness with varying degrees of motor activity and amnesia for the event. It may last for hours to days and may be psychogenic or organic in nature. Epileptic fugue states can be encountered in patients with absence or complex partial nonconvulsive status epilepticus or may occur as a postictal phenomenon in patients with generalized seizures. "absence status epilepticus" (AS) is rare and seen in only 2.6% of the cases with "childhood absence epilepsy" (CAE). The diagnosis of AS can be elusive, but sudden onset and termination of the fugue state, classical electroencephalogram (EEG) features, and response to a therapeutic trial of benzodiazepines helps in confirming the diagnosis and differentiating it from nonepileptic fugue states. We report a childhood onset case, with a 10 years history of recurrent episodes of prolonged fugue state lasting for up to 24 h, as the sole manifestation of epileptic seizures. The EEG features were suggestive of an AS, but there was no history of typical absences, myoclonus, or generalized tonic clonic seizures. This unusual and rare case cannot be categorized into one of the defined epilepsy syndromes like CAE but belongs to a recently identified syndrome of idiopathic generalized epilepsy known as "Absence status epilepsy" in which AS is the sole or the predominant seizure type. PMID:24339579

  5. Electrolytic entorhinal lesions cause seizures.

    PubMed

    Dasheiff, R M; McNamara, J O

    1982-01-14

    The entorhinal cortex is a key site of interneuronal communication between a variety of cortical and subcortical areas and hippocampal formation. Lesioning the entorhinal cortex is commonly used in studies of the hippocampal formation, animal behavior and neuronal plasticity. We have found that electrolytic destruction of the entorhinal cortex consistently produces limbic seizure activity in rats. The propensity of lesions in this area for producing seizure activity may facilitate insights into the normal function of this network of neural connections. This unexpected phenomenon represents a potential confounding variable for all researchers using this method for making brain lesions. PMID:7055687

  6. Utility of different seizure induction protocols in psychogenic nonepileptic seizures.

    PubMed

    Goyal, Gourav; Kalita, Jayantee; Misra, Usha K

    2014-08-01

    Psychogenic non epileptic seizure (PNES) can be induced by several induction tests but their relative usefulness has not been evaluated. In this study, we report the sensitivity and specificity of various induction tests in the diagnosis of PNES and assess their discomfort level. The induction tests were: (a) compression of temple region (CTR), (b) verbal suggestion (VS), (c) tuning fork application (TFA), (d) moist swab application (MSA), (e) torch light stimulation (TLS) and (f) saline injection (SI). Up to 3 trials were done for each test except for normal saline injection which was given once. For comparison of these tests, patients with epileptic seizures were included as controls. The time to precipitate PNES was recorded and patients' discomfort levels were noted on a 0-10 scale. Video EEG was recorded in the PNES patients. 140 patients with PNES and 50 controls with epileptic seizures were included. The diagnostic yield of CTR was 65.7%, TFA 61.4%, MSA 60.7%, SI 55.6%, VS 54.3% and TLS 40.7%. These tests did not induce seizures in the controls. All these tests had 100% specificity and 100% positive predictive value in the diagnosis of PNES. The maximum discomfort was reported with SI and minimum with MSA. The similarity of efficacy and discomfort with CTR and TFA appear to be the most optimal induction techniques when compared with VS, AMS, TLS, and SI. PMID:24802296

  7. Veterinary Seizure Detector Report Number 1

    E-print Network

    Levi, Anthony F. J.

    Veterinary Seizure Detector Report Number 1 Page 1 of 20 DISTRIBUTION STATEMENT: Distribution authorized to all. Veterinary Seizure Detector Report Number 1 Submitted by Nicolas Roy University) 393 8351 Email nroy@usc.edu Date: April 27, 2010 Work performed at USC #12;Veterinary Seizure Detector

  8. An Incredible Tool for Tracking Seizure Activity

    ERIC Educational Resources Information Center

    Hollingsworth, Jan Carter

    2007-01-01

    Eric Schumacher knows all too well the trials and tribulations of tracking seizures and daily activities in the ongoing attempt to gain seizure control. Diagnosed with epilepsy in his teens, he is now bringing a new and innovative tool to the market that could help countless people with epilepsy gain better control over their seizures and thus…

  9. Atypical hydrops in keratoconus.

    PubMed

    Said, Dalia G; Faraj, Lana; Elalfy, Mohamed S; Miri, Ammar; Maharajan, Senthil V; Dua, Harminder S

    2014-08-01

    To report the clinical presentation, progress and management of atypical acute hydrops. A retrospective case study of three patients with keratoconus, two of whom had previously undergone penetrating keratoplasty. The patients underwent full ophthalmological examination and digital slit-lamp imaging of the cornea throughout the course of the condition. The two patients who had previously undergone keratoplasty had spontaneous hydrops primarily affecting the host bed but in one case extended to the graft inferiorly; however, in the third patient it was traumatic in origin. The Descemet's tear affected the host rim in only one patient, which resolved spontaneously. In another patient, the hydrops was related to an internal dehiscence of the graft-host junction and had to be managed by an endothelial transplant covering the dehisced graft-host junction. In the third patient, hydrops secondary to trauma was also associated with acute haemops. Progression of keratoconus post keratoplasty can occur exclusively in the recipient bed leading to acute hydrops in the host sparing the transplanted cornea. The progressive thinning and ectasia of the recipient bed can also result in internal graft-host dehiscence leading to chronic oedema. Rapid entry of aqueous or blood cells into the corneal stroma following acute rupture of the Descemet's membrane suggests that the abnormal stroma of the eye with keratoconus may have an important role to play in the pathogenesis of acute hydrops/haemops. PMID:24249457

  10. Hyperexcitability and epileptic seizures in a model of frontotemporal dementia.

    PubMed

    García-Cabrero, Ana M; Guerrero-López, Rosa; Giráldez, Beatriz G; Llorens-Martín, María; Avila, Jesús; Serratosa, José M; Sánchez, Marina P

    2013-10-01

    Epileptic seizures are more common in patients with Alzheimer disease than in the general elderly population. Abnormal forms of hyperphosphorylated tau accumulate in Alzheimer disease and other tauopathies. Aggregates of tau are also found in patients with epilepsy and in experimental models of epilepsy. We report here the analysis of epileptic activity and neuropathological correlates of a transgenic line over-expressing human mutant tau, a model of frontotemporal dementia with parkinsonism linked to chromosome 17 (FTDP-17). The FTDP-17 model displays spontaneous epileptic activity and seizures with spike-wave complexes in the EEG, and a higher sensitivity to the GABAA receptor antagonist pentylenetetrazol (PTZ) when compared to age-matched controls, showing a notably increased seizure length and a shorter latency to develop severe seizures. FTDP-17 human tau mutants also display lower convulsive thresholds and higher lethality after PTZ injections. Astrocytosis and activated microglia are prominent in the hippocampus and other brain regions of young FTDP-17 mice where the human mutant tau transgene is expressed, before the appearance of hyperphosphorylated tau aggregates in these structures. FTDP-17 human mutant tau over-expression produces epilepsy and increased GABAA receptor-mediated hyperexcitability in the absence of A? pathology. Although aggregates of hyperphosphorylated tau have been observed in patients with epilepsy and in different chemically and electrically generated models of epilepsy, the FTDP-17 tau mutant analyzed here is the first model of genetically modified tau that presents with epilepsy. This model may represent a valuable tool to assay novel treatments in order to reduce tau pathology, a potential factor which may be involved in the development of epileptic seizures in dementia and other neurodegenerative diseases. PMID:23774255

  11. Selective changes in thalamic and cortical GABAA receptor subunits in a model of acquired absence epilepsy in the rat

    E-print Network

    Huguenard, John R.

    epilepsy in the rat Huifang Li a,*, Alli Kraus a , Jie Wu b , John R. Huguenard a , Robert S. Fisher a role in pathophysiology of absence epilepsy. Ó 2006 Elsevier Ltd. All rights reserved. Keywords; Somatosensory cortex; Absence epilepsy 1. Introduction Absence seizures, previously referred to as petit mal sei

  12. Localizing epileptic seizure onsets with Granger causality

    NASA Astrophysics Data System (ADS)

    Adhikari, Bhim M.; Epstein, Charles M.; Dhamala, Mukesh

    2013-09-01

    Accurate localization of the epileptic seizure onset zones (SOZs) is crucial for successful surgery, which usually depends on the information obtained from intracranial electroencephalography (IEEG) recordings. The visual criteria and univariate methods of analyzing IEEG recordings have not always produced clarity on the SOZs for resection and ultimate seizure freedom for patients. Here, to contribute to improving the localization of the SOZs and to understanding the mechanism of seizure propagation over the brain, we applied spectral interdependency methods to IEEG time series recorded from patients during seizures. We found that the high-frequency (>80 Hz) Granger causality (GC) occurs before the onset of any visible ictal activity and causal relationships involve the recording electrodes where clinically identifiable seizures later develop. These results suggest that high-frequency oscillatory network activities precede and underlie epileptic seizures, and that GC spectral measures derived from IEEG can assist in precise delineation of seizure onset times and SOZs.

  13. Work Absence in Europe

    Microsoft Academic Search

    Lusine Lusinyan; Leo Bonato

    2007-01-01

    Work absence is a part of an individual's decision concerning hours worked. This paper focuses on sickness absence in Europe and builds on an analytical framework in which absence enters both labor supply and demand considerations, with sickness insurance provisions and labor market institutions affecting the costs of absence. The results from a panel of 18 European countries indicate that

  14. Seizure-induced disinhibition of the HPA axis increases seizure susceptibility.

    PubMed

    O'Toole, Kate K; Hooper, Andrew; Wakefield, Seth; Maguire, Jamie

    2014-01-01

    Stress is the most commonly reported precipitating factor for seizures. The proconvulsant actions of stress hormones are thought to mediate the effects of stress on seizure susceptibility. Interestingly, epileptic patients have increased basal levels of stress hormones, including corticotropin-releasing hormone (CRH) and corticosterone, which are further increased following seizures. Given the proconvulsant actions of stress hormones, we proposed that seizure-induced activation of the hypothalamic-pituitary-adrenal (HPA) axis may contribute to future seizure susceptibility. Consistent with this hypothesis, our data demonstrate that pharmacological induction of seizures in mice with kainic acid or pilocarpine increases circulating levels of the stress hormone, corticosterone, and exogenous corticosterone administration is sufficient to increase seizure susceptibility. However, the mechanism(s) whereby seizures activate the HPA axis remain unknown. Here we demonstrate that seizure-induced activation of the HPA axis involves compromised GABAergic control of CRH neurons, which govern HPA axis function. Following seizure activity, there is a collapse of the chloride gradient due to changes in NKCC1 and KCC2 expression, resulting in reduced amplitude of sIPSPs and even depolarizing effects of GABA on CRH neurons. Seizure-induced activation of the HPA axis results in future seizure susceptibility which can be blocked by treatment with an NKCC1 inhibitor, bumetanide, or blocking the CRH signaling with Antalarmin. These data suggest that compromised GABAergic control of CRH neurons following an initial seizure event may cause hyperexcitability of the HPA axis and increase future seizure susceptibility. PMID:24225328

  15. Seizure-induced disinhibition of the HPA axis increases seizure susceptibility

    PubMed Central

    O'Toole, Kate K.; Hooper, Andrew; Wakefield, Seth; Maguire, Jamie

    2013-01-01

    Stress is the most commonly reported precipitating factor for seizures. The proconvulsant actions of stress hormones are thought to mediate the effects of stress on seizure susceptibility. Interestingly, epileptic patients have increased basal levels of stress hormones, including corticotropin-releasing hormone (CRH) and corticosterone, which are further increased following seizures. Given the proconvulsant actions of stress hormones, we proposed that seizure-induced activation of the hypothalamic-pituitary-adrenal (HPA) axis may contribute to future seizure susceptibility. Consistent with this hypothesis, our data demonstrate that pharmacological induction of seizures in mice with kainic acid or pilocarpine increases circulating levels of the stress hormone, corticosterone, and exogenous corticosterone administration is sufficient to increase seizure susceptibility. However, the mechanism(s) whereby seizures activate the HPA axis remain unknown. Here we demonstrate that seizure-induced activation of the HPA axis involves compromised GABAergic control of CRH neurons, which govern HPA axis function. Following seizure activity, there is a collapse of the chloride gradient due to changes in NKCC1 and KCC2 expression, resulting in reduced amplitude of sIPSPs and even depolarizing effects of GABA on CRH neurons. Seizure-induced activation of the HPA axis results in future seizure susceptibility which can be blocked by treatment with an NKCC1 inhibitor, bumetanide, or blocking the CRH signaling with Antalarmin. These data suggest that compromised GABAergic control of CRH neurons following an initial seizure event may cause hyperexcitability of the HPA axis and increase future seizure susceptibility. PMID:24225328

  16. Absence Epilepsy in Tottering Mutant Mice Is Associated with Calcium Channel Defects

    Microsoft Academic Search

    Colin F Fletcher; Cathleen M Lutz; T. Norene O'Sullivan; John D Shaughnessy; Richard Hawkes; Wayne N Frankel; Neal G Copeland; Nancy A Jenkins

    1996-01-01

    Mutations at the mouse tottering (tg) locus cause a delayed-onset, recessive neurological disorder resulting in ataxia, motor seizures, and behavioral absence seizures resembling petit mal epilepsy in humans. A more severe allele, leaner (tgla), also shows a slow, selective degeneration of cerebellar neurons. By positional cloning, we have identified an ?1A voltage-sensitive calcium channel gene that is mutated in tg

  17. Traxoprodil decreases pentylenetetrazol-induced seizures.

    PubMed

    Naspolini, Ana Paula; Cocco, Ariane Rubin; Villa Martignoni, Felipe; Oliveira, Mauro Schneider; Furian, Ana Flávia; Rambo, Leonardo Magno; Rubin, Maribel Antonello; Barron, Susan; Mello, Carlos Fernando

    2012-06-01

    Polyamines, including spermidine, facilitate seizures by positively modulating N-methyl-d-aspartate receptors (NMDAr). Although NMDAr antagonists decrease seizures, it remains to be determined whether traxoprodil, a selective antagonist at the NR2B subunit of the NMDAr, decreases seizures and whether spermidine facilitates pentylenetetrazol (PTZ)-induced seizures. Adult male Wistar rats were injected in the lateral ventricle with 0.9% NaCl (1?l, i.c.v.), spermidine (0.02, 0.2 or 2nmol/site, i.c.v.) or traxoprodil (0.2, 2 or 20nmol, i.c.v.) and with PTZ (35 or 70mg/kg, i.p.). The effect of orally administered traxoprodil (60mg/kg, p.o.) on seizures was also investigated. Latencies to clonic and generalized seizures, as well the total time spent in seizures were recorded by behavioral and electrographic methods (EEG). Spermidine (2nmol/site; i.c.v.) facilitated the seizures induced by a sub-threshold dose of PTZ (35mg/kg; i.p.), but did not alter seizure activity induced by a convulsant dose of PTZ (70mg/kg; i.p.). Traxoprodil (20nmol i.c.v.) increased the latency to generalized tonic-clonic seizures induced by PTZ (70mg/kg; i.p.). Traxoprodil (60mg/kg, p.o.) increased the latency to clonic and generalized seizures, and decreased the total time spent in seizures. These results support the role for the NR2B subunit in PTZ-induced seizures. PMID:22281061

  18. Migrating partial seizures in infancy and 47XYY syndrome: Cause or coincidence?

    PubMed Central

    Iyer, Rajesh Shankar; Thanikasalam; Krishnan, Mugundhan

    2014-01-01

    Migrating partial seizures in infancy (MPSI) is a rare epilepsy syndrome with poor prognosis. The exact etiology of MPSI is still not known. We report a 14-month-old baby with 47XYY karyotype who presented with developmental delay and drug-refractory seizures satisfying the diagnostic criteria for MPSI and discuss the possible association between the 47XYY karyotype and this syndrome. The excess of genes due to an additional Y chromosome could cause disturbance in various stages of formation, migration, or differentiation of neurons. Depending on the degree of disturbance and the resultant cortical excitability, this could result in various epilepsy syndromes. We feel that this association is more likely causal than coincidental. Chromosome studies need to be performed in more individuals with atypical and uncommon epilepsies. Multicenter studies are required to establish the association between epilepsy syndrome and these rare chromosome disorders. PMID:25667867

  19. Primarily generalized seizures are more effective than partial seizures in arousing patients from sleep.

    PubMed

    Dasheiff, Richard M; Kofke, W Andrew

    2003-01-01

    The purpose of this study was to determine the characteristics of generalized and partial seizures which awaken patients from sleep, using a retrospective review of intracranial EEG recordings in 8017 electrographic and 7571 clinical seizures in 172 patients undergoing evaluation for epilepsy brain surgery. Seizure onset during sleep followed by awakening occurred in 99% of 308 seizures in 22 patients during daytime naps. Four events consisted of spontaneous awakening followed by the seizure. In contrast electrographic seizures almost never awakened the patient if they were partial in onset (0.02% temporal, 0% frontal), but did so 26% of the time if they were generalized (p < 0.001). Conversely, generalized clinical seizures awakened the patient only 0.3% of the time (p < 0.001) versus 3% for temporal and 6% for frontal lobe. Partial and generalized seizures differ during sleep. Partial seizures do not awaken until they propagate outside the lobe and evolve into a clinical seizure. Generalized seizures when only electrographic, include wake-regulating structures at their onset (presumably thalamus, hypothalamus, brainstem). Our results suggest that rather than sleep transitions being a facilitatory cause of seizures, seizures awaken us from sleep via endogenous stimulation of the brain's sleep/wake structures. This pathway information may be relevant to planning epilepsy brain surgery. PMID:12564128

  20. [Dacrystic and asystolic epileptic seizures].

    PubMed

    de Sčze, J; Caparros-Lefebvre, D; Girard-Buttaz, I; Carlioz, R; Pruvo, J P; Petit, H

    1995-01-01

    A 33-year-man with an encephalopathy of unknown aetiology, had an history of epilepsia for 30 years. Different types of seizures were seen, including grand mal and frontal attacks. Epilepsia was associated with mental retardation and behavioral disorders. At the age of 33, he was admitted for repetitive general convulsions. Epilepticus status lasted for two weeks and improved with vigabatrin et clonazepam. General seizures, frontal motor convulsions with arms and trunk antepulsion, and dacrystic attacks were seen. The latter seemed to be like normal crying because they were accompanied by lacrimation, contorted and mournful facies, and sobbing sounds. One year later, repetitive cardiac arrests occurred during a new epilepticus status. Cardiac arrests, observed on ECG holter lasted 10 to 24 seconds, without cardiac dysfunction. EEG patterns on ECG holter lasted 10 to 24 seconds, without cardiac dysfunction. EEG patterns included theta and delta activity with rhythmic slow wave epileptic activity, predominating on right side, in temporal areas. CT scan was normal. MRI showed right cerebral atrophy, prevailing in the temporo-mesial region, with right temporal horn enlargement. This case report of dacrystic seizures, the first one with MRI study, suggests that temporo-mesial structures of the non-dominant hemisphere may be involved in dacrystic and asystolic attacks. PMID:7481407

  1. Smartphone applications for seizure management.

    PubMed

    Pandher, Puneet Singh; Bhullar, Karamdeep Kaur

    2014-07-18

    Technological advancements continue to provide innovative ways of enhancing patient care in medicine. In particular, the growing popularity of smartphone technology has seen the recent emergence of a myriad of healthcare applications (or apps) that promise to help shape the way in which health information is delivered to people worldwide. While limited research already exists on a range of such apps, our study is the first to examine the salient features of smartphone applications as they apply to the area of seizure management. For the purposes of this review, we conducted a search of the official online application stores of the five major smartphone platforms: iPhone, Android, Blackberry, Windows Mobile and Nokia-Symbian. Apps were included if they reported to contain some information or tools relating to seizure management and excluded if they were aimed exclusively at health professionals. A total of 28 applications met these criteria. Overall, we found an increasing number of epilepsy apps available on the smartphone market, but with only a minority offering comprehensive educational information alongside tools such as seizure diaries, medication tracking and/or video recording. PMID:25038202

  2. Emergency Management of Seizures in the School Setting

    ERIC Educational Resources Information Center

    O'Dell, Christine; O'Hara, Kathryn; Kiel, Sarah; McCullough, Kathleen

    2007-01-01

    Effective seizure management in the school setting is a critical issue for students with seizures, as well as their parents, classmates, and school personnel. The unpredictable nature of seizures and the potential outcomes of experiencing a seizure in school are sources of anxiety for students with seizures. The ability to respond appropriately to…

  3. Nightmare-Induced Atypical Midventricular Tako-Tsubo Cardiomyopathy

    PubMed Central

    Fibbi, Veronica; Ballo, Piercarlo; Nannini, Marco; Consoli, Lorenzo; Chechi, Tania; Bribani, Andrea; Fiorentino, Francesca; Chiodi, Leandro; Zuppiroli, Alfredo

    2015-01-01

    Tako-Tsubo cardiomyopathy (TTC) is a reversible cardiomyopathy characterized by acute left ventricular segmental dysfunction, whose clinical presentation resembles that of acute myocardial infarction. The syndrome often follows a psychophysical stressful event and is characterized by echocardiographic evidence of akinesia of the left ventricular mid-apical segments. Atypical echocardiographic patterns of TTC have recently been described, often triggered by emotional stressors, rather than physical. In this report, we describe a case of atypical TTC triggered by an unusual stressor (recurrent nightmare) in a 45-year-old woman, with peculiar clinical presentation and evolution characterized by persistent loss of consciousness, neurological deterioration, absence of typical symptoms of TTC, and features suggestive of a hysterical crisis. PMID:25788945

  4. Patterns of seizure occurrence in catamenial epilepsy.

    PubMed

    Herkes, G K; Eadie, M J; Sharbrough, F; Moyer, T

    1993-05-01

    The pattern of seizure occurrence was analysed over 44 menstrual cycles in 12 epileptic women who considered they had menstrually related seizures. Two peaks in the daily seizure rate were apparent. A significant increase in seizures occurred during the days of menstrual flow and the two days preceding it, with a second peak in the four days at midcycle. The lowest seizure rate was in the late phase of the menstrual cycle. Daily salivary progesterone levels were assayed in 11 women, and 12 ovulatory and eight anovulatory cycles were identified on this basis. No increase in seizures occurred at midcycle if ovulation did not occur, but the perimenstrual increase took place irrespective of ovulatory status. PMID:8325277

  5. Breakthrough seizures after starting vilazodone for depression.

    PubMed

    McKean, James; Watts, Hannah; Mokszycki, Robert

    2015-03-01

    Vilazodone is a new selective serotonin reuptake inhibitor (SSRI) and serotonin 5-HT1a partial agonist that is approved by the United States Food and Drug Administration to treat major depression. SSRI-induced seizures are rare and are more likely to be associated with larger doses and severe symptoms such as those present in serotonin syndrome. Several case reports have implicated SSRIs, buspirone, or the combination of these agents as the cause of seizures, but these reports were confounded with either coingestions or doses that exceeded FDA recommendations. We describe a 22-year-old woman with a history of seizure disorder who had been seizure free for the previous 8 years and experienced two breakthrough seizures shortly after starting vilazodone. Her dose of vilazodone had recently been titrated to 40 mg/day when she experienced the first seizure. She was instructed to taper vilazodone over the next several days, then discontinue the drug, and then follow up with her neurologist. Based on the patient's history, physical examination, and recent dose increase, it was plausible that vilazodone was the cause of the seizures. Use of the Naranjo adverse drug reaction probability scale indicated a possible relationship (score of 4) between her development of seizures and vilazodone therapy. The pharmacodynamics of this particular class of SSRI has both proconvulsive and anticonvulsive mechanisms. This is of particular concern in patients with a history of seizure disorder who are starting antidepressive therapy. In persons with epilepsy who are taking vilazodone and experience breakthrough seizures, practitioners should consider this drug as a potential cause of these seizures. Thus, until future research and experience with vilazodone can provide a definitive answer, clinicians should be cautious when prescribing this medication to treat depression in patients with a history of seizure disorder. PMID:25809181

  6. Extreme Hypertension, Eclampsia and Critical Care Seizures

    Microsoft Academic Search

    Errol Gordon; Michel T. Torbey

    \\u000a The association between seizures and blood pressure elevation remains a common medical emergency encountered in an ICU setting.\\u000a Syndromes such as pre-eclampsia or eclampsia, hypertensive encephalopathy, and posterior leukoencephalopathy commonly present\\u000a with seizures. The primary treatment goal is to reduce the arterial blood pressure. In most cases seizure control is thus\\u000a achieved, but unique medications, such as magnesium sulfate, may

  7. Extreme Hypertension, Eclampsia, and Critical Care Seizures

    Microsoft Academic Search

    Errol Gordon; Michel T. Torbey

    The association between seizures and blood pressure elevation remains a common medical emergency encountered in the setting\\u000a of an intensive care unit. Syndromes such as preeclampsia or eclampsia, hypertensive encephalopathy, and posterior leukoencephalopathy\\u000a commonly present with seizures. The primary treatment goal is to reduce the arterial blood pressure. In most cases, seizure\\u000a control is thus achieved, but unique medications, such

  8. Possible causes of seizure after spine surgery

    PubMed Central

    Habibi, Zohreh; Nejat, Farideh; El Khashab, Mostafa

    2010-01-01

    Seizure after laminectomy for spinal procedure is very rare and has not been reported after lipomyelomeningocele surgery beforehand. Here, two cases of seizure following laminectomy for lipomyelomeningocele are reported. The exact etiology of the event is unknown but anesthetic material, pneumocephalus, intracranial hypotension subsequent to cerebrospinal fluid leakage after spinal procedures, spinal-induced seizure and the potential toxic effect of fat molecules could be considered. PMID:21042506

  9. Atypical moles: diagnosis and management.

    PubMed

    Perkins, Allen; Duffy, R Lamar

    2015-06-01

    Atypical moles are benign pigmented lesions. Although they are benign, they exhibit some of the clinical and histologic features of malignant melanoma. They are more common in fair-skinned individuals and in those with high sun exposure. Atypical moles are characterized by size of 6 mm or more at the greatest dimension, color variegation, border irregularity, and pebbled texture. They are associated with an increased risk of melanoma, warranting enhanced surveillance, especially in patients with more than 50 moles and a family history of melanoma. Because an individual lesion is unlikely to display malignant transformation, biopsy of all atypical moles is neither clinically beneficial nor cost-effective. The ABCDE (asymmetry, border irregularity, color unevenness, diameter of 6 mm or more, evolution) mnemonic is a valuable tool for clinicians and patients to identify lesions that could be melanoma. Also, according to the "ugly duckling" concept, benign moles tend to have a similar appearance, whereas an outlier with a different appearance is more likely to be undergoing malignant change. Atypical moles with changes suggestive of malignant melanoma should be biopsied, using an excisional method, if possible. PMID:26034853

  10. Dynamical diseases of brain systems: different routes to epileptic seizures.

    PubMed

    Lopes da Silva, Fernando H; Blanes, Wouter; Kalitzin, Stiliyan N; Parra, Jaime; Suffczynski, Piotr; Velis, Demetrios N

    2003-05-01

    In this overview, we consider epilepsies as dynamical diseases of brain systems since they are manifestations of the property of neuronal networks to display multistable dynamics. To illustrate this concept we may assume that at least two states of the epileptic brain are possible: the interictal state characterized by a normal, apparently random, steady-state electroencephalography (EEG) ongoing activity, and the ictal state, that is characterized by paroxysmal occurrence of synchronous oscillations and is generally called, in neurology, a seizure. The transition between these two states can either occur: 1) as a continuous sequence of phases, like in some cases of mesial temporal lobe epilepsy (MTLE); or 2) as a sudden leap, like in most cases of absence seizures. In the mathematical terminology of nonlinear systems, we can say that in the first case the system's attractor gradually deforms from an interictal to an ictal attractor. The causes for such a deformation can be either endogenous or external. In this type of ictal transition, the seizure possibly may be anticipated in its early, preclinical phases. In the second case, where a sharp critical transition takes place, we can assume that the system has at least two simultaneous interictal and ictal attractors all the time. To which attractor the trajectories converge, depends on the initial conditions and the system's parameters. An essential question in this scenario is how the transition between the normal ongoing and the seizure activity takes place. Such a transition can occur either due to the influence of external or endogenous factors or due to a random perturbation and, thus, it will be unpredictable. These dynamical changes may not be detectable from the analysis of the ongoing EEG, but they may be observable only by measuring the system's response to externally administered stimuli. In the special cases of reflex epilepsy, the leap between the normal ongoing attractor and the ictal attractor is caused by a well-defined external perturbation. Examples from these different scenarios are presented and discussed. PMID:12769430

  11. Infantile hypophosphatasia without bone deformities presenting with severe pyridoxine-resistant seizures.

    PubMed

    de Roo, Marieke G A; Abeling, Nico G G M; Majoie, Charles B; Bosch, Annet M; Koelman, Johannes H T M; Cobben, Jan M; Duran, Marinus; Poll-The, Bwee Tien

    2014-03-01

    An infant carrying a heterozygous c.43_46delACTA and a heterozygous c.668 G>A mutation in the ALPL gene with hypophosphatasia in the absence of bone deformities presented with therapy-resistant seizures. Pyridoxal phosphate was extremely high in CSF and plasma. Pyridoxine treatment had only a transient effect and the severe encephalopathy was fatal. Repeated brain MRIs showed progressive cerebral damage. The precise metabolic cause of the seizures remains unknown and pyridoxine treatment apparently does not cure the epilepsy. PMID:24100244

  12. Levetiracetam in neonatal seizures: a review.

    PubMed

    Mruk, Allison L; Garlitz, Karen L; Leung, Noelle R

    2015-01-01

    Phenobarbital and phenytoin have been the mainstay treatment modalities for neonatal seizures. Studies have revealed these agents control seizures in less than half of neonates, can cause neuronal apoptosis in vitro, and have highly variable pharmacokinetics in neonates. In contrast, there have been no reports of levetiracetam causing these neurotoxic effects. Due to its favorable side effect and pharmacokinetic profiles and positive efficacy outcomes in neonatal studies to date, there is great interest in the use of levetiracetam for neonatal seizures. This article reviews the literature regarding the safety of levetiracetam in neonates and its efficacy in neonatal seizures. PMID:25964725

  13. Importance of cardiological evaluation for first seizures.

    PubMed

    Choong, Ho; Hanna, Ibrahim; Beran, Roy

    2015-04-16

    This paper reports two cases of long QT syndrome (LQTS) which presented with seizures as their initial feature. Case 1, AB was seen in emergency department with post-partum seizure, discharged and re-presented following cardiac arrest associated with LQTS. Case 2, CD presented initially with tonic-clonic seizure and because of experience with AB, CD was assessed for LQTS which was subsequently confirmed. The legal medicine experience re Dobler v Halverson, which involved a young boy with LQTS, who suffered cardiac arrest without prior diagnosis of LQTS, has reinforced the requirement to seriously consider LQTS as an aetiological factor in first seizure presentations. PMID:25879012

  14. 19 CFR 162.63 - Arrests and seizures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) INSPECTION, SEARCH, AND SEIZURE Controlled Substances, Narcotics, and Marihuana § 162.63 Arrests and seizures. Arrests and seizures under the Controlled Substances Act (84...

  15. 19 CFR 162.63 - Arrests and seizures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) INSPECTION, SEARCH, AND SEIZURE Controlled Substances, Narcotics, and Marihuana § 162.63 Arrests and seizures. Arrests and seizures under the Controlled Substances Act (84...

  16. Tardive or Atypical Tourette's Disorder in a Population with Down Syndrome?

    ERIC Educational Resources Information Center

    Myers, Beverly; Pueschel, Siegfried M.

    1995-01-01

    In a population of 425 individuals with Down's syndrome, 5 persons (1.2%) were identified as having Tourette's disorder. The lack of interrelationship between Down's syndrome and Tourette's disorder argues against an atypical Tourette's disorder. Diagnoses of tardive Tourette's disorder were based on absence of family history of Tourette's, late…

  17. Automated identification of multiple seizure-related and interictal epileptiform event types in the EEG of mice

    PubMed Central

    Bergstrom, Rachel A.; Choi, Jee Hyun; Manduca, Armando; Shin, Hee-Sup; Worrell, Greg A.; Howe, Charles L.

    2013-01-01

    Visual scoring of murine EEG signals is time-consuming and subject to low inter-observer reproducibility. The Racine scale for behavioral seizure severity does not provide information about interictal or sub-clinical epileptiform activity. An automated algorithm for murine EEG analysis was developed using total signal variation and wavelet decomposition to identify spike, seizure, and other abnormal signal types in single-channel EEG collected from kainic acid-treated mice. The algorithm was validated on multi-channel EEG collected from ?-butyrolacetone-treated mice experiencing absence seizures. The algorithm identified epileptiform activity with high fidelity compared to visual scoring, correctly classifying spikes and seizures with 99% accuracy and 91% precision. The algorithm correctly identifed a spike-wave discharge focus in an absence-type seizure recorded by 36 cortical electrodes. The algorithm provides a reliable and automated method for quantification of multiple classes of epileptiform activity within the murine EEG and is tunable to a variety of event types and seizure categories. PMID:23514826

  18. Psychogenic nonepileptic seizures: review and update

    Microsoft Academic Search

    Markus Reuber; Christian E. Elger

    2003-01-01

    The population incidence of psychogenic nonepileptic seizures (PNES) may be only 4% that of epilepsy, but many patients with PNES have a tendency to seek medical attention, and PNES make up a larger share of the workload of neurologists and emergency and general physicians. Although a great number of publications describe how PNES can be distinguished from epileptic seizures, it

  19. Lifelong history of injuries related to seizures

    Microsoft Academic Search

    MiriamY Neufeld; Tali Vishne; Vladimir Chistik; AmosD Korczyn

    1999-01-01

    There is meager information in the literature regarding the characteristics and risk factors for injuries caused during epileptic seizures in adults. Previous studies focused mainly on specific types of injuries incurred, and only few explored associated risk factors. A questionnaire regarding lifetime seizures and their traumatic consequences was administered to 298 consecutive epileptic patients and their caretakers or relatives. Ninety-one

  20. Substance P Causes Seizures in Neurocysticercosis

    PubMed Central

    Robinson, Prema; Garza, Armandina; Weinstock, Joel; Serpa, Jose A.; Goodman, Jerry Clay; Eckols, Kristian T.; Firozgary, Bahrom; Tweardy, David J.

    2012-01-01

    Neurocysticercosis (NCC), a helminth infection of the brain, is a major cause of seizures. The mediators responsible for seizures in NCC are unknown, and their management remains controversial. Substance P (SP) is a neuropeptide produced by neurons, endothelial cells and immunocytes. The current studies examined the hypothesis that SP mediates seizures in NCC. We demonstrated by immunostaining that 5 of 5 brain biopsies from NCC patients contained substance P (SP)-positive (+) cells adjacent to but not distant from degenerating worms; no SP+ cells were detected in uninfected brains. In a rodent model of NCC, seizures were induced after intrahippocampal injection of SP alone or after injection of extracts of cysticercosis granuloma obtained from infected wild type (WT), but not from infected SP precursor-deficient mice. Seizure activity correlated with SP levels within WT granuloma extracts and was prevented by intrahippocampal pre-injection of SP receptor antagonist. Furthermore, extracts of granulomas from WT mice caused seizures when injected into the hippocampus of WT mice, but not when injected into SP receptor (NK1R) deficient mice. These findings indicate that SP causes seizures in NCC, and, suggests that seizures in NCC in humans may be prevented and/or treated with SP-receptor antagonists. PMID:22346746

  1. Anticonvulsants for soman-induced seizure activity

    Microsoft Academic Search

    Tsung-Ming Shih; John H. McDonough; Irwin Koplovitz

    1999-01-01

    This report describes studies of anticonvulsants for the organophosphorus (OP) nerve agent soman: a basic research effort to understand how different pharmacological classes of compounds influence the expression of seizure produced by soman in rats, and a drug screening effort to determine whether clinically useful antiepileptics can modulate soman-induced seizures in rats. Electroencephalographic (EEG) recordings were used in these studies.

  2. Focal cooling rapidly terminates experimental neocortical seizures.

    PubMed

    Yang, X F; Rothman, S M

    2001-06-01

    The efficacy of surgical resection for epilepsy is considerably lower for neocortical epilepsy than for temporal lobe epilepsy. We have explored focal cooling with a thermoelectric (Peltier) device as a potential therapy for neocortical epilepsy. After creating a cranial window in anesthetized rats, we induced seizures by injecting artificial cerebrospinal fluid containing 4-aminopyridine (4-AP), a potassium channel blocker. Within 30 minutes of 4-AP injection, animals developed recurrent seizures (duration 85.7 +/- 26.2 seconds; n = 10 rats) that persisted for 2 hours. When a small Peltier device cooled the exposed cortical surface to 20-25 degrees C at seizure onset, the seizure duration was reduced to 8.4 +/- 5.0 seconds (n = 10 rats; p < 0.001). When the Peltier device was placed close to the cortical surface, but not allowed to make physical contact, there was no effect on seizure duration (104.3 +/- 20.7 seconds; p > 0.05 compared to control). Interestingly, the duration of uncooled seizures was reduced after we allowed the cortex to rewarm from prior cooling. Histological examination of the cortex after cooling has shown no evidence of acute or delayed neuronal injury, and blood pressure and temperature remained stable. It may be possible to use Peltier devices for cortical mapping or, when seizure detection algorithms improve, for chronic seizure control. PMID:11409423

  3. Electroencephalographic and seizure manifestations in two patients with folate receptor autoimmune antibody-mediated primary cerebral folate deficiency.

    PubMed

    Steele, Sonya U; Cheah, Sue Mei; Veerapandiyan, Aravindhan; Gallentine, William; Smith, Edward C; Mikati, Mohamad A

    2012-08-01

    Seizure semiology and electroencephalographic (EEG) manifestations of autoimmune-mediated cerebral folate deficiency (CFD) before and after therapy have yet to be fully characterized. Here, we report these findings in two such patients. Our first patient presented with the novel manifestation of infantile spasms at the age of 3months, while the second developed the previously reported initial onset of tonic seizures with static developmental delay, but subsequently manifested the novel finding of electrical status epilepticus in sleep at the age of 15years. Awareness of these new manifestations, together with the previously reported manifestations of developmental delay, seizure onset during the first 2years of life, occurrence of tonic, myoclonic-astatic, absence, and generalized tonic-clonic seizures, with an EEG of generalized spike-slow waves and multifocal spikes, is important to increase the index of suspicion of this treatable disorder. PMID:22749608

  4. Sleep Disorders in Atypical Parkinsonism

    PubMed Central

    Abbott, Sabra M.; Videnovic, Aleksandar

    2014-01-01

    Sleep disorders are commonly seen in atypical parkinsonism, with particular disorders occurring more frequently in specific parkinsonian disorders. Multiple systems atrophy (MSA) is a synucleinopathy often associated with nocturnal stridor which is a serious, but treatable condition highly specific to MSA. In addition, this disorder is strongly associated with rapid eye movement (REM) sleep behavior disorder (RBD), which is also seen in dementia with Lewy bodies (DLB). RBD is far less prevalent in progressive supranuclear palsy (PSP), which is a tauopathy. Insomnia and impaired sleep architecture are the most common sleep abnormalities seen in PSP. Corticobasilar degeneration (CBD) is also a tauopathy, but has far fewer sleep complaints associated with it than PSP. In this manuscript we review the spectrum of sleep dysfunction across the atypical parkinsonian disorders, emphasize the importance of evaluating for sleep disorders in patients with parkinsonian symptoms, and point to sleep characteristics that can provide diagnostic clues to the underlying parkinsonian disorder. PMID:24955381

  5. Atypical histiocytic granuloma of tongue.

    PubMed

    Dominic, Augustine; Sundaresh, K J; Manish, N; Mallikarjuna, Rachappa

    2013-01-01

    A 40-year-old male patient presented with a 3-week history of a painless ulcer on the dorsum of the tongue. He was a chronic smoker since the age of 15 years. The ulcer was well-defined, non-tender and indurated. An incisional biopsy was performed and the diagnosis of atypical histiocytic granuloma was made after histopathological examination. The lesion resolved spontaneously after the incisional biopsy and the patient was on follow-up for 6 months and no recurrences were observed. Here we report a rare case of atypical histiocytic granuloma. Hence, it must be borne in mind in the differential diagnosis of ulcers on the tongue. PMID:23737581

  6. Atypical presentations of falciparum malaria.

    PubMed

    Deb, T; Mohanty, R K; Ravi, K; Bhagat, B M

    1992-06-01

    To identify the uncommon presentations of falciparum malaria in an endemic area and to assess the outcome of treatment, a study was carried out on 35 proved cases whose clinical presentations were either dominated by features other than fever or the history of fever was totally absent. Both urban and rural patients were included. Seventeen cases (48.3%) presented with features of cerebral malaria. Acute abdomen, urticaria, and unexplained shock were the other atypical presentations. Five cases (14.3%) of cerebral malaria died. We conclude that awareness of atypical presentations is important to detect cases of falciparum malaria in an endemic area. Intravenous quinine may need to be given promptly even when cerebral malaria is diagnosed empirically. PMID:1452562

  7. Atypical histiocytic granuloma of tongue

    PubMed Central

    Dominic, Augustine; Sundaresh, KJ; Manish, N; Mallikarjuna, Rachappa

    2013-01-01

    A 40-year-old male patient presented with a 3-week history of a painless ulcer on the dorsum of the tongue. He was a chronic smoker since the age of 15?years. The ulcer was well-defined, non-tender and indurated. An incisional biopsy was performed and the diagnosis of atypical histiocytic granuloma was made after histopathological examination. The lesion resolved spontaneously after the incisional biopsy and the patient was on follow-up for 6?months and no recurrences were observed. Here we report a rare case of atypical histiocytic granuloma. Hence, it must be borne in mind in the differential diagnosis of ulcers on the tongue. PMID:23737581

  8. Helicopter mishap attributed to single seizure.

    PubMed

    Simon, Esan; Watts, Darron; Bohnker, Bruce K

    2008-03-01

    A case report is presented of a 36-year-old U.S. Coast Guard aviator who had a single seizure while operating a helicopter on the ground. His seizure activity produced a loss of consciousness during which he pushed the cyclic to the left anterior quadrant that resulted in a ground mishap. No risk factors were identified in an extensive neurological workup. The current guidance for handling seizures in military aviation personnel is reviewed, along with considerations for treatment. Although the military aviation selection process carefully screens applicants for seizure history and potential, occasional seizures in the aviation population remain possible. Such events may result in military aircraft mishaps despite careful risk factor surveillance, as demonstrated by this case. PMID:18419038

  9. Polarization anatomy of a kainic acid seizure.

    PubMed

    Dasheiff, R M; Sacks, D S

    1997-06-01

    Slow voltage-sensitive dyes work by accumulating in brain tissue and report the average membrane potential of neurons and glia. The voltage-sensitive dye diO-C2-5 was used to monitor the polarization state of 27 brain structures in the rat during a systemically induced, behaviorally mild, kainic acid seizure using a 20 s recording period. The effects of the anesthetic agent used in the experiment were minimized by delaying the dye injection and seizure mapping for one day. Eleven areas were depolarized during the seizure, but 16 other areas did not change their polarization state compared to controls. The effects of pentobarbital appear to have no measurable effect on seizure propagation once the animal has behaviorally recovered from the anesthesia. The technique allows for mapping areas of seizure involvement with a unique combination of spatial and temporal resolution. PMID:9225379

  10. Neuronal Ensemble Synchrony during Human Focal Seizures

    PubMed Central

    Ahmed, Omar J.; Harrison, Matthew T.; Eskandar, Emad N.; Cosgrove, G. Rees; Madsen, Joseph R.; Blum, Andrew S.; Potter, N. Stevenson; Hochberg, Leigh R.; Cash, Sydney S.

    2014-01-01

    Seizures are classically characterized as the expression of hypersynchronous neural activity, yet the true degree of synchrony in neuronal spiking (action potentials) during human seizures remains a fundamental question. We quantified the temporal precision of spike synchrony in ensembles of neocortical neurons during seizures in people with pharmacologically intractable epilepsy. Two seizure types were analyzed: those characterized by sustained gamma (?40–60 Hz) local field potential (LFP) oscillations or by spike-wave complexes (SWCs; ?3 Hz). Fine (<10 ms) temporal synchrony was rarely present during gamma-band seizures, where neuronal spiking remained highly irregular and asynchronous. In SWC seizures, phase locking of neuronal spiking to the SWC spike phase induced synchrony at a coarse 50–100 ms level. In addition, transient fine synchrony occurred primarily during the initial ?20 ms period of the SWC spike phase and varied across subjects and seizures. Sporadic coherence events between neuronal population spike counts and LFPs were observed during SWC seizures in high (?80 Hz) gamma-band and during high-frequency oscillations (?130 Hz). Maximum entropy models of the joint neuronal spiking probability, constrained only on single neurons' nonstationary coarse spiking rates and local network activation, explained most of the fine synchrony in both seizure types. Our findings indicate that fine neuronal ensemble synchrony occurs mostly during SWC, not gamma-band, seizures, and primarily during the initial phase of SWC spikes. Furthermore, these fine synchrony events result mostly from transient increases in overall neuronal network spiking rates, rather than changes in precise spiking correlations between specific pairs of neurons. PMID:25057195

  11. Acute vagus nerve stimulation does not suppress spike and wave discharges in “Genetic Absence Epilepsy Rats from Strasbourg”

    Microsoft Academic Search

    Stefanie Dedeurwaerdere; Kristl Vonck; Pieter Claeys; Peter Van Hese; Michel D’Havé; Thierry Grisar; Dean Naritoku; Paul Boon

    2004-01-01

    We evaluated the efficacy of vagus nerve stimulation (VNS) in Genetic Absence Epilepsy Rats from Strasbourg (GAERS), a validated model for absence epilepsy. In the first experiment, we investigated whether VNS applied at seizure onset can interrupt spike and wave discharges (SWD). In the second experiment, we investigated whether SWD are suppressed or shortened in duration when VNS is applied

  12. Treatment options for atypical optic neuritis

    PubMed Central

    Malik, Amina; Ahmed, Maryam; Golnik, Karl

    2014-01-01

    Context: Optic neuritis (ON) is defined as inflammation of the optic nerve and can have various etiologies. The most common presentation in the US is demyelinating, or “typical” ON, usually associated with multiple sclerosis. This is in contrast to “atypical” causes of ON, which differ in their clinical presentation, management, and prognosis. These atypical cases are characterized by lack of eye pain, exudates, and hemorrhages on exam, very severe, bilateral or progressive visual loss, or with failure to recover vision. Aims: The aim was to describe the clinical presentations of atypical ON and their treatments. Settings and Design: Review article. Materials and Methods: Literature review. Results: Types of atypical ON identified include neuromyelitis optica, autoimmune optic neuropathy, chronic relapsing inflammatory optic neuropathy, idiopathic recurrent neuroretinitis, and optic neuropathy associated with systemic diseases. Atypical ON usually requires corticosteroid treatment and often will require aggressive immunosuppression. Conclusions: Unlike demyelinating ON, atypical ON requires treatment to preserve vision. PMID:25449930

  13. Seizure frequency, patient-perceived seizure severity and the psychosocial consequences of intractable epilepsy.

    PubMed

    Smith, D F; Baker, G A; Dewey, M; Jacoby, A; Chadwick, D W

    1991-09-01

    It is generally recognised that the assessment of treatment effects in epilepsy using seizure frequency as the only outcome measure may lack sensitivity. A patient-based seizure severity scale has been developed and initial results confirm its reliability and validity. As part of the further development of this scale it is important to explore the relationship between seizure severity, seizure frequency and the psychosocial consequences of intractable epilepsy. One hundred patients with medically refractory partial seizures completed a quality of life questionnaire including measures of physical (seizure severity and frequency), social and psychological well-being (anxiety, depression, self-esteem, locus of control and happiness). Multivariate analysis demonstrated that individual psychological variables were best predicted by other psychological variables. However, when these were removed from analysis, seizure severity was the most significant predictor of self-esteem (P = 0.005), locus of control P = 0.039) and anxiety (P = 0.048). Seizure frequency did not contribute significantly to the variance of any of the psychological factors. These results highlight the importance of considering seizure severity when assessing treatment effects in epilepsy and provide further evidence for the construct validity of a novel patient-based seizure severity scale. PMID:1743185

  14. A novel p.Arg970X mutation in the last exon of the CDKL5 gene resulting in late-onset seizure disorder

    Microsoft Academic Search

    Stavroula Psoni; Patrick J. Willems; Emmanuel Kanavakis; Ariadne Mavrou; Helen Frissyra; Joanne Traeger-Synodinos; Christalena Sofokleous; Periklis Makrythanassis; Sophia Kitsiou-Tzeli

    2010-01-01

    Classic Rett Syndrome (RS) is a neurodevelopmental disorder due to mutations in the MECP2 gene in Xq28. Atypical RS with severe early-onset encephalopathy and therapy-resistant epilepsy can be due to mutations in the CDKL5 (Cyclin-Dependent Kinase-like 5) gene in Xp22. We here report a 14-year-old female with a RS-like clinical picture, and well-controlled seizures. MECP2 gene testing was negative, but

  15. Pediatric Stroke Presenting as a Seizure

    PubMed Central

    Ahmadzadeh, Katie L.; Bhardwaj, Vartika; Johnson, Steven A.; Kane, Kathleen E.

    2014-01-01

    Background. Childhood arterial ischemic stroke (AIS) is rare and may be difficult to diagnose. Management of acute stroke in any age group is time sensitive, so awareness of the manifestations and appropriate diagnostic procedures for pediatric AIS is vital to establishing care. We present a pediatric case of arterial ischemic stroke that presented to the emergency department (ED) after two seizures. Case Report. A five-year-old female with an existing seizure disorder presented to a pediatric ED after having two seizures. Postictal upon arrival, she underwent a computed tomography (CT) scan of her head. Family reported that she had complained of a severe headache and vomited; her seizures were described as different from those she had experienced in the past. Loss of grey white matter differentiation on the CT warranted magnetic resonance imaging (MRI), which demonstrated a right-sided stroke. After a complicated course in the hospital, the patient was discharged to a rehabilitation hospital. Why Should an Emergency Physician Be Aware of This? It is important that emergency physicians recognize that a seizure may be the initial symptom of a pediatric stroke regardless of an established seizure history. Pediatric seizures are relatively common; however consideration of the diagnosis of pediatric stroke may prevent unnecessary delays in treatment. PMID:25587467

  16. Seizure circuit analysis with voltage sensitive dye.

    PubMed

    Dasheiff, R M; Sacks, D S

    1992-06-01

    Voltage sensitive dye was used to produce a map of average membrane polarization for the purpose of analysing the circuitry involved in seizures. Dorsal hippocampus, ventral hippocampus, entorhinal cortex, substantia nigra and occipital cortex were selected to calculate the relative changes in polarization. Rats were induced with bicuculline to have convulsive seizures and mild limbic seizures with kainic acid. A 20 second sample of these seizures were recorded using the voltage sensitive dye. Control animals showed a relatively uniform polarization state in the five brain areas. The bicuculline seizure produced hyperpolarization in all five areas. The magnitude of the hyperpolarization varied among the regions to produce a distinctive pattern. The kainic acid seizure produced depolarization in the four limbic areas. The magnitude of the depolarization also varied, producing a different pattern compared with bicuculline or control. Future applications of this technique in animal models could help identify those areas in the brain which regulate seizure propagation, and the anatomical loci in which antiepileptic drugs interfere with this propagation. Ultimately, human applications would include linking voltage sensitive dyes with paramagnetic or positron emitting traces so that epileptic processes could be visualized using magnetic resonance imaging or positron emission computed tomography. PMID:1344333

  17. Advances in management of neonatal seizures.

    PubMed

    Vesoulis, Zachary A; Mathur, Amit M

    2014-06-01

    Seizures are more common in the neonatal period than any other time in the human lifespan. A high index of suspicion for seizures should be maintained for infants who present with encephalopathy soon after birth, have had a stroke, central nervous system (CNS) infection or intracranial hemorrhage or have a genetic or metabolic condition associated with CNS malformations. Complicating the matter, most neonatal seizures lack a clinical correlate with only subtle autonomic changes and often no clinical indication at all. Over the last three decades, several tools have been developed to enhance the detection and treatment of neonatal seizures. The use of electroencephalography (EEG) and the later development of amplitude-integrated EEG (aEEG), allows for Neurologists and non-Neurologists alike, to significantly increase the sensitivity of seizure detection. When applied to the appropriate clinical setting, time to diagnosis and start of therapy is greatly reduced. Phenobarbital maintains the status of first-line therapy in worldwide use. However, newer anti-epileptic agents such as, levetiracetam, bumetanide, and topiramate are increasingly being applied to the neonatal population, offering the potential for seizure treatment with a significantly better side-effect profile. Seizures in premature infants, continue to confound clinicians and researchers alike. Though the apparent seizure burden is significant and there is an association between seizures and adverse outcomes, the two are not cleanly correlated. Compounding the issue, GABA-ergic anti-epileptic drugs are not only less effective in this age group due to reversed neuronal ion gradients but may cause harm. Selecting an appropriate treatment group remains a challenge. PMID:24796413

  18. Epidemiology of seizures in children with brain tumors

    Microsoft Academic Search

    Floyd H. Gilles; Eugene Sobel; Alan Leviton; E. Tessa Hedley-Whyte; C. Jane Tavare; Lester S. Adelman; Raymond A. Sobel

    1992-01-01

    We examined potential clinical and pathologic correlates of seizures among the 3,291 children in the Childhood Brain Tumor Consortium database. Fourteen percent had seizures prior to their hospitalization for a brain tumor. Among children who had a supratentorial tumor, seizures occurred in 22% of those less than 14 years of age. The prevalence of seizures increased to 68% of older

  19. Remote effects of focal hippocampal seizures on the rat neocortex.

    PubMed

    Englot, Dario J; Mishra, Asht M; Mansuripur, Peter K; Herman, Peter; Hyder, Fahmeed; Blumenfeld, Hal

    2008-09-01

    Seizures have both local and remote effects on nervous system function. Whereas propagated seizures are known to disrupt cerebral activity, little work has been done on remote network effects of seizures that do not propagate. Human focal temporal lobe seizures demonstrate remote changes including slow waves on electroencephalography (EEG) and decreased cerebral blood flow (CBF) in the neocortex. Ictal neocortical slow waves have been interpreted as seizure propagation; however, we hypothesize that they reflect a depressed cortical state resembling sleep or coma. To investigate this hypothesis, we performed multimodal studies of partial and secondarily generalized limbic seizures in rats. Video/EEG monitoring of spontaneous seizures revealed slow waves in the frontal cortex during behaviorally mild partial seizures, contrasted with fast polyspike activity during convulsive generalized seizures. Seizures induced by hippocampal stimulation produced a similar pattern, and were used to perform functional magnetic resonance imaging weighted for blood oxygenation and blood volume, demonstrating increased signals in hippocampus, thalamus and septum, but decreases in orbitofrontal, cingulate, and retrosplenial cortex during partial seizures, and increases in all of these regions during propagated seizures. Combining these results with neuronal recordings and CBF measurements, we related neocortical slow waves to reduced neuronal activity and cerebral metabolism during partial seizures, but found increased neuronal activity and metabolism during propagated seizures. These findings suggest that ictal neocortical slow waves represent an altered cortical state of depressed function, not propagated seizure activity. This remote effect of partial seizures may cause impaired cerebral functions, including loss of consciousness. PMID:18768701

  20. Developmental Milestones in Toddlers with Atypical Development

    ERIC Educational Resources Information Center

    Horovitz, Max; Matson, Johnny L.

    2011-01-01

    The attainment of developmental milestones was examined and compared in 162 infants and toddlers with developmental disabilities, including Down Syndrome (n = 26), Cerebral Palsy (n = 19), Global Developmental Delay (n = 22), Premature birth (n = 66), and Seizure Disorder (n = 29). Toddlers in the Seizures Disorder group began crawling at a…

  1. Biotelemetry system for Epilepsy Seizure Control

    SciTech Connect

    Smith, LaCurtise; Bohnert, George W.

    2009-07-02

    The Biotelemetry System for Epilepsy Seizure Control Project developed and tested an automated telemetry system for use in an epileptic seizure prevention device that precisely controls localized brain temperature. This project was a result of a Department of Energy (DOE) Global Initiatives for Proliferation Prevention (GIPP) grant to the Kansas City Plant (KCP), Argonne National Laboratory (ANL), and Pacific Northwest National Laboratory (PNNL) to partner with Flint Hills Scientific, LLC, Lawrence, KS and Biophysical Laboratory Ltd (BIOFIL), Sarov, Russia to develop a method to help control epileptic seizures.

  2. Viscum Album in the Treatment of a Girl With Refractory Childhood Absence Epilepsy.

    PubMed

    von Schoen-Angerer, Tido; Madeleyn, René; Kienle, Gunver; Kiene, Helmut; Vagedes, Jan

    2015-07-01

    Viscum album (European mistletoe) extracts have known immunomodulatory effects but little data exist on anticonvulsant activity despite its usefulness having been reported for centuries. A 4˝-year-old girl with childhood absence epilepsy and global developmental delay was treated with different antiepileptic drugs and ketogenic diet but failed to become seizure free over a 2-year period. She also received different herbal remedies as part of an integrative medicine approach. Initial improvement occurred on valproate-ethosuximide, a further improvement was seen after adding clobazam to valproate. Final cessation of absence activity occurred after a dose increase of V album. She was still seizure free at the 12-month follow-up. V album appears to have been a necessary adjunct treatment for this child to become seizure free. We call on physicians to report their experiences of V album in epilepsy and suggest further study. PMID:25038133

  3. Atypical neuroimaging in Wilson's disease.

    PubMed

    Patell, Rushad; Dosi, Rupal; Joshi, Harshal K; Storz, Dennis

    2014-01-01

    Wilson's disease is a rare metabolic disease involving copper metabolism. Neuroimaging plays an important part in evaluation of patients with a neuropsychiatric presentation. We present a case of a 14-year-old girl with atypical confluent white matter disease and cystic degeneration on MRI, with a rapidly progressive course, who succumbed to complications despite treatment with trientine. Wilson's disease should be considered as a differential for leucoencephalopathy in young patients with progressive neurological disease for its early recognition and optimum outcome. PMID:24907221

  4. Association of a bovine prion gene haplotype with atypical BSE

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Atypical bovine spongiform encephalopathies (BSEs) are recently recognized prion diseases of cattle. Atypical BSEs are rare; approximately 30 cases have been identified worldwide. We tested prion gene (PRNP) haplotypes for an association with atypical BSE. Methodology/Principal Findin...

  5. EEG, CT and neurosonographic findings in patients with postischemic seizures

    Microsoft Academic Search

    Susanna Horner; Xiu-Shi Ni; Margret Duft; Kurt Niederkorn; Helmut Lechner

    1995-01-01

    Seventy-two patients with postischemic seizures were evaluated with electroencephalography (EEG), computerized tomography (CT) and neurosonography. There were 24% early-onset and 76% late-onset initial seizures. Early-onset seizure was more likely to be simple partial (53%), whereas late-onset seizure was more likely to be primarily generalized (56%). 76% early-onset and 80% late-onset seizures were single. Status epilepticus was more frequent in early-onset

  6. Thalamus Relat Syst . Author manuscript Cellular and network mechanisms of genetically-determined absence

    E-print Network

    Boyer, Edmond

    neurophysiological studies in humans, many of the concepts regarding the pathophysiological basis of absence seizures are based on studies in animal models. Each of these models has its particular strengths and limitations, and the validity of findings from these models for the human condition cannot be assumed. Consequently, studies

  7. Genetics Home Reference: Benign familial neonatal seizures

    MedlinePLUS

    ... 15 percent of people with BFNS, recurrent seizures (epilepsy) will come back later in life after the ... with BFNS have gone away. The age that epilepsy begins is variable. How common is BFNS? Benign ...

  8. Automatic Detection of Seizures with Applications

    NASA Technical Reports Server (NTRS)

    Olsen, Dale E.; Harris, John C.; Cutchis, Protagoras N.; Cristion, John A.; Lesser, Ronald P.; Webber, W. Robert S.

    1993-01-01

    There are an estimated two million people with epilepsy in the United States. Many of these people do not respond to anti-epileptic drug therapy. Two devices can be developed to assist in the treatment of epilepsy. The first is a microcomputer-based system designed to process massive amounts of electroencephalogram (EEG) data collected during long-term monitoring of patients for the purpose of diagnosing seizures, assessing the effectiveness of medical therapy, or selecting patients for epilepsy surgery. Such a device would select and display important EEG events. Currently many such events are missed. A second device could be implanted and would detect seizures and initiate therapy. Both of these devices require a reliable seizure detection algorithm. A new algorithm is described. It is believed to represent an improvement over existing seizure detection algorithms because better signal features were selected and better standardization methods were used.

  9. Vagal nerve stimulation does not unkindle seizures.

    PubMed

    Dasheiff, R M; Sandberg, T; Thompson, J; Arrambide, S

    2001-01-01

    The purpose of this study was to investigate a mechanism of action for the effect of vagal nerve stimulation on reducing seizures in patients with complex partial epilepsy. The hypothesis tested was that vagal nerve stimulation has an antikindling effect on epilepsy. The databases of two large clinical trials (E03, E05) were accessed, and statistical methods were applied using logarithmic transforms and regression analysis. Two parameters--duration of a patient's epilepsy before entering the clinical trial and the patient's seizure density before entering the clinical trial--were used as markers of subsequent seizure control during vagal nerve stimulation. In general, there was not a good fit to the regression lines, and the slope of the lines did not conform to the hypothesis. The hypothesis that vagal nerve stimulation may unkindle epileptic seizures was not supported. PMID:11290941

  10. [Vagus nerve stimulation for partial seizures].

    PubMed

    Neufeld, M; Quaknine, G; Korczyn, A

    1995-07-01

    Cerebellar and thalamic stimulation has been known for many years to improve control of epileptic seizures. In the past few years electrical vagus nerve stimulation (VNS) has been introduced and has been effective in controlling seizures in animal models. These encouraging results led to the development of a transcutaneous programmable pulse generator and electrode lead for human use. 2 pilot studies and a multicenter, prospectively-randomized, parallel, double-blind study of patients with refractory partial seizures were performed. In a 3-22 month follow-up, in about 50% of patients seizures were reduced by 30-50%. There were no significant complications of the implant. Side-effects associated with VNS included intermittent hoarseness, coughing and throat pain. Additional controlled clinical trials with many patients and long follow-up are needed. We report 2 patients, the first in Israel, who underwent VNS. PMID:7557711

  11. ASSESSMENT OF A SCALP EEG-BASED AUTOMATED SEIZURE DETECTION SYSTEM

    PubMed Central

    Kelly, K.M.; Shiau, D.S.; Kern, R.T.; Chien, J.H.; Yang, M.C.K.; Yandora, K.A.; Valeriano, J.P.; Halford, J.J.; Sackellares, J.C.

    2010-01-01

    Objective The purpose of this study was to evaluate and validate an offline, automated scalp EEG-based seizure detection system and to compare its performance to commercially available seizure detection software. Methods The test seizure detection system, IdentEvent™, was developed to enhance the efficiency of post-hoc long-term EEG review in epilepsy monitoring units. It translates multi-channel scalp EEG signals into multiple EEG descriptors and recognizes ictal EEG patterns. Detection criteria and thresholds were optimized in 47 long-term scalp EEG recordings selected for training (47 subjects, ~3653 hours with 141 seizures). The detection performance of IdentEvent was evaluated using a separate test dataset consisting of 436 EEG segments obtained from 55 subjects (~1200 hours with 146 seizures). Each of the test EEG segments was reviewed by three independent epileptologists and the presence or absence of seizures in each epoch was determined by majority rule. Seizure detection sensitivity and false detection rate were calculated for IdentEvent as well as for the comparable detection software (Persyst’s Reveal®, version 2008.03.13, with three parameter settings). Bootstrap re-sampling was applied to establish the 95% confidence intervals of the estimates and for the performance comparison between two detection algorithms. Results The overall detection sensitivity of IdentEvent was 79.5% with a false detection rate (FDR) of 2 per 24 hours, whereas the comparison system had 80.8%, 76%, and 74% sensitivity using its three detection thresholds (perception score) with FDRs of 13, 8, and 6 per 24 hours, respectively. Bootstrap 95% confidence intervals of the performance difference revealed that the two detection systems had comparable detection sensitivity, but IdentEvent generated a significantly (p < 0.05) smaller FDR. Conclusions The study validates the performance of the IdentEvent™ .seizure detection system. Significance With comparable detection sensitivity, an improved false detection rate makes the automated seizure detection software more useful in clinical practice. PMID:20471311

  12. Alcohol-Related Seizures in the ICU

    Microsoft Academic Search

    Zachary Webb

    Alcohol abuse is a common cause of seizures resulting in admission to the intensive care unit. The cause of the alcohol-related\\u000a seizures (ARS) is usually abstinence in a chronic alcoholic, although some patients may still have detectable levels of alcohol\\u000a in their blood. ARS generally occur between 7 and 48 h after abstinence. Approximately half of patients presenting with ARS

  13. Progressive facial hemiatrophy after epileptic seizures

    Microsoft Academic Search

    Tamami Yano; Yukio Sawaishi; Miyuki Toyono; Iwao Takaku; Goro Takada

    2000-01-01

    Intractable complex partial seizures developed in a 3-year-old female with normal intracranial findings on computed tomography. Frontal paramedian band-like depression of the skin gradually developed thereafter, and progressive facial hemiatrophy (Parry–Romberg syndrome) was diagnosed. Computed tomography scanning at 5 years of age revealed multiple parenchymal calcifications and low-density areas in the white matter of the frontoparietal lobes. Epileptic seizures, one

  14. Management of typical and atypical intestinal malrotation

    Microsoft Academic Search

    John R. Mehall; John C. Chandler; Rachel L. Mehall; Richard J. Jackson; Charles W. Wagner; Samuel D. Smith

    2002-01-01

    Background: [ldquo ]Atypical Malrotation[rdquo ] has been increasingly diagnosed at the authors' institution. Methods: The authors reviewed retrospectively 201 consecutive operations for malrotation over 5 years to anatomically classify, and describe results of operation for, atypical malrotation. The ligament of Treitz (LOT) was classified as high if left of midline and above the 12th thoracic vertebra, low if left of

  15. Monitor for status epilepticus seizures

    NASA Technical Reports Server (NTRS)

    Johnson, Mark; Simkins, Thomas

    1994-01-01

    This paper describes the sensor technology and associated electronics of a monitor designed to detect the onset of a seizure disorder called status epilepticus. It is a condition that affects approximately 3-5 percent of those individuals suffering from epilepsy. This form of epilepsy does not follow the typical cycle of start-peak-end. The convulsions continue until medically interrupted and are life threatening. The mortality rate is high without prompt medical treatment at a suitable facility. The paper describes the details of a monitor design that provides an inexpensive solution to the needs of those responsible for the care of individuals afflicted with this disorder. The monitor has been designed as a cooperative research and development effort involving the United States Army Armament Research, Development, and Engineering Center's Benet Laboratories (Benet) and the Cerebral Palsy Center for the Disabled (Center), in association with the Department of Neurology at Albany Medical College (AMC). Benet has delivered a working prototype of the device for field testing, in collaboration with Albany Medical College. The Center has identified several children in need of special monitoring and has agreed to pursue commercialization of the device.

  16. Neuroimaging observations in a cohort of elderly manifesting with new onset seizures: Experience from a university hospital

    PubMed Central

    Sinha, Sanjib; Satishchandra, Parthasarathy; Kalband, Balaji Rameshrao; Bharath, Rose Dawn; Thennarasu, Kandavel

    2012-01-01

    Background: The occurrence of epilepsy is higher among elderly patients. The clinical manifestations of seizures, causes of epilepsy, and choice of anti-epileptic drugs (AEDs) are different in elderly people with epilepsy compared to the young. Aim: To evaluate the imaging (CT/MRI) observations in elderly patients manifesting with new-onset seizures. Materials and Methods: Two hundred and one elderly patients with new onset seizures, >60 years (age: 68.0 ± 7.5 years; M:F = 1.8:1) from Jan’ 07 to Jan’ 09, were prospectively recruited. Observations of cranial CT scan (n = 201) and MR imaging (n = 43) were analyzed. Results: The type of seizures included: Simple partial (42%), generalized tonic-clonic (30.3%), and complex partial (27.4%). The pattern of epilepsy syndromes were acute symptomatic (42.3%), remote symptomatic (18.4%), cryptogenic (37.8%), and idiopathic (1.5%). Seizures were controlled with monotherapy in 85%. The CT scan (n = 201) revealed cerebral atrophy (139), mild (79), moderate (43), and severe (18); focal lesions (98), infarcts (45), hemorrhages (18), granuloma (16), tumor (15) and gliosis (4), and hemispheric atrophy (1), white matter changes (75) and diffuse edema (21). An MRI (n = 43) showed variable degree of cerebral atrophy (31); white matter changes (20); focal cerebral lesions (24); - infarct (7); intracranial hemorrhage (6); granuloma (5); tumor (6); gliosis (1); hemispheric atrophy (1); and prominent Virchow-Robin spaces (7); and UBOs (12). Patients with focal lesions in neuroimaging more often had partial seizures, symptomatic epilepsy, past stroke, focal deficit, absence of diffuse atrophy, focal EEG slowing, abnormal CSF, seizure recurrence at follow-up (P < 0.05). Conclusions: Brain imaging observations in elderly patients with new-onset seizures revealed underlying symptomatic nature, hence the etiology and thereby assisted in deciding the specific therapy. PMID:23349592

  17. Seizure Outcomes Following Use of Generic vs. Brand-Name Antiepileptic Drugs: A Systematic Review and Meta-Analysis

    PubMed Central

    Kesselheim, Aaron S.; Stedman, Margaret R.; Bubrick, Ellen J.; Gagne, Joshua J.; Misono, Alexander S.; Lee, Joy L.; Brookhart, M. Alan; Avorn, Jerry; Shrank, William H.

    2011-01-01

    Background The automatic substitution of bioequivalent generic for brand-name antiepileptic drugs (AEDs) has been linked by anecdotal report to loss of seizure control. Objective To evaluate studies comparing brand-name and generic AEDs and determine whether evidence exists of superiority of the brand-name version in maintaining seizure control. Data Sources English-language human studies identified in searches of MEDLINE, EMBASE, and International Pharmaceutical Abstracts (1984 to August 2009). Study Selection Randomized controlled trials (RCTs) and observational studies comparing seizure events or seizure-related outcomes between one brand-name AED and at least one alternate version produced by a distinct manufacturer. Data Extraction We identified 16 articles (9 RCTs, 1 prospective nonrandomized trial, 6 observational studies). We assessed characteristics of the studies and, for RCTs, extracted counts for patients whose seizures were characterized as “controlled” and “uncontrolled.” Data Synthesis Seven RCTs were included in the meta-analysis. The aggregate odds ratio (n=204) was 1.0 (95% confidence interval: 0.7–1.4), indicating no difference in the odds of uncontrolled seizure for patients on generic medications compared to patients on brand-name medications. In contrast, the observational studies identified trends in drug or health services utilization that the authors attributed to changes in seizure control. Conclusions Though most RCTs were short-term evaluations, the available evidence does not suggest an association between loss of seizure control and generic substitution of at least three types of AEDs. The observational study data may be explained by factors such as undue concern from patients or physicians about the effectiveness of generic AEDs after a recent switch. In the absence of better data, physicians may want to consider more intensive monitoring of high-risk patients taking AEDs when any switch occurs. PMID:20329806

  18. Eyelid myoclonia with typical absences: an epilepsy syndrome.

    PubMed Central

    Appleton, R E; Panayiotopoulos, C P; Acomb, B A; Beirne, M

    1993-01-01

    Five unrelated patients are described with the clinical and electrical features of eyelid myoclonia with absences (EMA). In this syndrome brief, typical absences occur with rapid eyelid myoclonia associated with retropulsive movements of the eyeballs and occasionally of the head. The seizures are of shorter duration than in childhood absence epilepsy, and are accompanied by less profound impairment of consciousness. The electroencephalogram demonstrates high amplitude discharges consisting of spikes, multiple spikes and slow waves at a fluctuating frequency of 3-5 Hz and following eye closure, which disappear in darkness. Photosensitivity is also seen. Onset is in early childhood and EMA appears to persist into adult life. Treatment is sodium valproate in combination with either ethosuximide or a benzodiazepine. On the basis of the clinical features, EEG findings, and the response to treatment and prognosis, it is suggested that EMA be classified as a specific epilepsy syndrome. PMID:8270934

  19. Constipation enhances the propensity to seizure in pentylenetetrazole-induced seizure models of mice.

    PubMed

    Moezi, Leila; Pirsalami, Fatema; Inaloo, Soroor

    2015-03-01

    Epilepsy is characterized by spontaneous recurrent seizures and represents one of the most frequent neurological diseases, affecting about 60 million people worldwide. The cellular and neurocircuit bases of epilepsy are poorly understood. Constipation is a common gastrointestinal disorder characterized by symptoms such as straining, hard stool, and infrequent defecation. Population-based studies have shown that the prevalence of constipation is up to 30% of the population in developed countries. The causal link between seizure and constipation is a common belief among patients and physicians, but there are no scientific data to support this association. The current investigation evaluated the effects of constipation induced by loperamide (a peripheral ?-opioid receptor agonist without effect on central nervous system receptors) and clidinium (a quaternary amine antimuscarinic agent with reduced central nervous system effects) on two different seizure models of mice: (1) myoclonic, clonic, and generalized tonic seizures and death induced by intraperitoneal administration of pentylenetetrazole and (2) clonic seizure threshold induced by intravenous infusion of pentylenetetrazole. We demonstrated that the measured intestinal transit (%intestinal transit) decreased after loperamide or clidinium treatment for 3days. Constipation in mice which was induced by loperamide or clonidine caused a decrease in threshold to clonic seizure in the intravenous pentylenetetrazole seizure model. Moreover loperamide- or clidinium-induced constipation decreased latencies to, clonic, and tonic seizures and death in the intraperitoneal pentylenetetrazole model of mice. Serum ammonia levels were slightly elevated in both loperamide- and clidinium-treated mice. In conclusion, loperamide- or clidinium-induced constipated mice are more prone to seizure which might confirm the belief of patients and physicians about constipation as a trigger of seizure. PMID:25745976

  20. Predictors of febrile seizure: a matched case-control study.

    PubMed

    Gururaj, A K; Bener, A; Al-Suweidi, E K; Al-Tatari, H M; Khadir, A E

    2001-12-01

    In a prospective matched case-control study carried out to determine risk factors of febrile seizures among children in the United Arab Emirates, 84 patients with febrile seizure were identified and were matched with 84 control febrile patients without seizure in the same age range, who attended the same hospital during the same period of time. Logistic regression analysis showed that the age at first seizure, family history of febrile seizure, duration of fever, and height of temperature were the only significant predictors for febrile seizures. PMID:11827305

  1. Dynamic time warping based neonatal seizure detection system.

    PubMed

    Ahmed, Rehan; Temko, Andrey; Marnane, William; Boylan, Geraldine; Lighbody, Gordon

    2012-01-01

    Neonatal seizures patterns evolve with changing frequency, morphology and propagation. This study is an initial attempt to incorporate the characteristics of temporal evolution of neonatal seizures into our developed neonatal seizure detector. The previously designed SVM-based neonatal seizure detector is modified by substituting the Gaussian kernel with the Gaussian dynamic time warping kernel, to enable the SVM to classify variable length sequences of feature vectors of neonatal seizures. The preliminary results obtained compare favorably with the conventional SVM. The fusion of the two approaches is expected to improve the current state of the art neonatal seizure detection system. PMID:23367031

  2. Father Absence in Infancy.

    ERIC Educational Resources Information Center

    Pedersen, Frank A.; And Others

    This document reports a study investigating the effects of father absence on measures of cognitive, social, and motivational development in infancy. The sample included 54 black infants, 27 of whom were classified "father-absent." This classification was based on two indices, (1) a dichotomy of father-absent or father-present based on mother's…

  3. [Clinical polymorphism of malignant epilepsy of infancy with migrating multifocal seizures (8 cases)].

    PubMed

    Petrukhin, A S; Kholin, A A; Il'ina, E S; Alikhanov, A A; Voronkova, K V; Lemeshko, I D; Mukhin, K Iu

    2008-01-01

    Malignant migrating partial seizures in infancy are rare epilepsy syndrome that begins in the first 6 months of life and characterized by multiple continuous electroencephalographic and electroclinical focal ictal patterns which involved different independent areas of both hemispheres with arrest of psychomotor development. The present detailed review is based on the personal observation of 8 patients newly diagnosed at the Russian Children Clinical hospital, Moscow, Russia. At least three ictal patterns recorded from different independent areas of both hemispheres were fixed by video-EEG-monitoring in all patients. The high polymorphism and very frequent seizures (not less than five types at every child) were observed. The cases were pharmacoresistant, with the absence of reaction to antiepileptic therapy and progressive deterioration in 4 (50%) patients. Decreasing of seizure frequency by 50% was achieved in 3 (37.5%) patients treated with the combination of valproates, benzodiazepines and barbiturates and by 75% in 1 (12.5%) patient case treated with valproates, benzodiazepines and levetyracetam (keppra). The authors proposed a definition of this epileptic syndrome as: "malignant epilepsy of infancy with migrating multifocal seizures". PMID:19621482

  4. Dictator Perpetuus: Julius Caesar--did he have seizures? If so, what was the etiology?

    PubMed

    Hughes, John R

    2004-10-01

    The "Dictator Perpetuus" of the Roman Empire, the great Julius Caesar, was not the one for whom the well-known cesarean operation was named; instead, this term is derived from a Latin word meaning "to cut." Caesar likely had epilepsy on the basis of four attacks that were probably complex partial seizures: (1) while listening to an oration by Cicero, (2) in the Senate while being offered the Emperor's Crown, and in military campaigns, (3) near Thapsus (North Africa) and (4) Corduba (Spain). Also, it is possible that he had absence attacks as a child and as a teenager. His son, Caesarion, by Queen Cleopatra, likely had seizures as a child, but the evidence is only suggestive. His great-great-great grandnephews Caligula and Britannicus also had seizures. The etiology of these seizures in this Julio-Claudian family was most likely through inheritance, with the possibility of sudden unexpected death in epilepsy (SUDEP) in his great grandfather and also his father. Our best evidence comes from the ancient sources of Suetonius, Plutarch, Pliny, and Appianus. PMID:15380131

  5. Comparison of three nonlinear seizure prediction methods by means of the seizure prediction characteristic

    NASA Astrophysics Data System (ADS)

    Maiwald, Thomas; Winterhalder, Matthias; Aschenbrenner-Scheibe, Richard; Voss, Henning U.; Schulze-Bonhage, Andreas; Timmer, Jens

    2004-07-01

    Epilepsy is characterized by the spontaneous and unforeseeable occurrence of seizures, during which the perception or behavior of patients is disturbed. The predictability of these seizures would render novel therapeutic approaches possible. Several prediction methods have claimed to be able to predict seizures based on EEG recordings minutes in advance. However, the term seizure prediction is not unequivocally defined, different criteria to assess prediction methods exist, and only little attention has been paid to issues of sensitivity and false prediction rate. We introduce an assessment criterion called the seizure prediction characteristic that incorporates the assessment of sensitivity and false prediction rate. Within this framework, three nonlinear seizure prediction methods were evaluated on a large EEG data pool of 21 patients. Altogether, 582 h intracranial EEG data and 88 seizures were examined. With a rate of 1-3.6 false predictions per day, the “dynamical similarity index” achieves a sensitivity between 21 and 42%, which was the best result of the three methods. Sensitivity was between 18 and 31% for the extended, prospective version of the “accumulated energy” and between 13 and 30% for the “effective correlation dimension”. These results still are not sufficient for clinical applications.

  6. Comparable seizure characteristics in magnetic seizure therapy and electroconvulsive therapy for major depression.

    PubMed

    Kayser, Sarah; Bewernick, Bettina H; Hurlemann, René; Soehle, Martin; Schlaepfer, Thomas E

    2013-11-01

    Electroconvulsive therapy (ECT) is highly effective for treatment-resistant depression (TRD); however, its use for less severe forms of depression is somewhat limited by a lack of control over current spreading to medial temporal lobe memory structures, resulting in various cognitive side effects. In contrast, magnetic seizure therapy (MST), which uses high frequency repetitive transcranial magnetic stimulation (rTMS) for local seizure induction, has been associated with reduced cognitive side effects. To assess whether different characteristics of seizures induced by both methods are responsible for the differences in neuropsychological side-effect profile, we studied seven TRD-patients undergoing both MST and ECT in an open-label, within subject, controlled crossover pilot study. Comparison parameters included seizure-related ictal characteristics, including motor activity, electromyogram (EMG), electroencephalogram (EEG), and postictal recovery and reorientation times.Our results showed no differences in motor activity or EMG and EEG characteristics, thus implicating similar electrophysiological processes in seizure induction with MST and ECT. In line with previous studies, we observed shorter postictal recovery and reorientation times following MST.The ictal characteristics of induced seizures were found similar with ECT and MST suggesting that the more focal seizure induction associated with MST may account for the more beneficial neuropsychological side effect profile of MST. PMID:23820052

  7. Propranolol-induced seizures in mice: the role of noradrenaline.

    PubMed

    Amabeoku, G J; Syce, J A

    1997-08-01

    The effects of some noradrenergic agents, phenobarbitone, diazepam and phenytoin on seizures produced by propranolol were investigated in mice. Isoprenaline and DL-threo-3,4-dihydroxyphenylserine (DOPS) effectively antagonized the seizures elicited by propranolol. Pargyline and imipramine significantly attenuated propranolol-induced seizures and also significantly potentiated the protecting effect of DOPS against the seizures. alpha-Methyl-p-tyrosine, disulfiram and reserpine significantly potentiated propranolol-elicited seizures. However, DOPS significantly antagonized the seizure-potentiating effects of alpha-methyl-p-tyrosine, disulfiram and reserpine. Phenylephrine, clonidine, prazosin, idazoxan, phenobarbitone, diazepam and phenytoin did not significantly alter propranolol-induced seizures. These results suggest that propranolol-induced seizures in mice may involve a noradrenergic mechanism mediated via central beta-adrenoceptors. PMID:9351467

  8. Treatment of Seizures in Children (Beyond the Basics)

    MedlinePLUS

    ... table 1 ). (See "Antiepileptic drugs: Mechanism of action, pharmacology, and adverse effects" .) OTHER TREATMENTS Dietary treatment — A ... and clinical features Antiepileptic drugs: Mechanism of action, pharmacology, and adverse effects Treatment of neonatal seizures Seizures ...

  9. Widespread EEG changes precede focal seizures.

    PubMed

    Perucca, Piero; Dubeau, François; Gotman, Jean

    2013-01-01

    The process by which the brain transitions into an epileptic seizure is unknown. In this study, we investigated whether the transition to seizure is associated with changes in brain dynamics detectable in the wideband EEG, and whether differences exist across underlying pathologies. Depth electrode ictal EEG recordings from 40 consecutive patients with pharmacoresistant lesional focal epilepsy were low-pass filtered at 500 Hz and sampled at 2,000 Hz. Predefined EEG sections were selected immediately before (immediate preictal), and 30 seconds before the earliest EEG sign suggestive of seizure activity (baseline). Spectral analysis, visual inspection and discrete wavelet transform were used to detect standard (delta, theta, alpha, beta and gamma) and high-frequency bands (ripples and fast ripples). At the group level, each EEG frequency band activity increased significantly from baseline to the immediate preictal section, mostly in a progressive manner and independently of any modification in the state of vigilance. Preictal increases in each frequency band activity were widespread, being observed in the seizure-onset zone and lesional tissue, as well as in remote regions. These changes occurred in all the investigated pathologies (mesial temporal atrophy/sclerosis, local/regional cortical atrophy, and malformations of cortical development), but were more pronounced in mesial temporal atrophy/sclerosis. Our findings indicate that a brain state change with distinctive features, in the form of unidirectional changes across the entire EEG bandwidth, occurs immediately prior to seizure onset. We postulate that these changes might reflect a facilitating state of the brain which enables a susceptible region to generate seizures. PMID:24260523

  10. Fish oil attenuates methylmalonate-induced seizures.

    PubMed

    Banderó, Cristina Ruedell Reschke; Salvadori, Mirian G S S; Gomes, Anajara Teixeira; Dal Ri, Nadja M K; Furian, Ana Flávia; Oliveira, Mauro Schneider; Rambo, Leonardo Magno; Scorza, Fulvio A; Cysneiros, Roberta M; Emanuelli, Tatiana; Mello, Carlos Fernando

    2013-07-01

    Methylmalonic acidemias are inherited metabolic disorders characterized by methylmalonate (MMA) accumulation and neurological dysfunction, including seizures. Dietary fatty acids are known as an important energy source and reduce seizure activity in selected acute animal models. This study investigated whether chronic treatment with fish oil or with oleic acid attenuates MMA-induced seizures and whether maintenance of Na(+),K(+)-ATPase activity was involved in such an effect. Adult male Wistar rats were given fish oil (85 mg/kg), oleic acid (85 mg/kg) or vehicle (0.42% aqueous Cremophor EL™, 4 mL/kg/body weight/day), p.o., for 75 days. On the 73th day a cannula was implanted in the right lateral ventricle with electrodes over the parietal cortex for EEG recording. On the 76th day the animals were injected with NaCl (2.5 ?mol/2.5 ?L, i.c.v.), or with MMA (2.5 ?mol/2.5 ?L, i.c.v.), and seizure activity was measured by electroencephagraphic (EEG) recording with concomitant behavior monitoring. The effect of prostaglandin E2 (PGE2) on Na(+),K(+)-ATPase activity of slices of cerebral cortex from NaCl-injected animals was determined. Fish oil increased the latency to MMA-induced tonic-clonic seizures, reduced the mean amplitude of ictal EEG recordings, and prevented PGE2-induced decrease of Na(+),K(+)-ATPase activity in cortical slices in vitro. Oleic acid decreased mean amplitude of ictal EEG recordings. The results support that fish oil decreases MMA-induced seizures. The decreased sensitivity of Na(+),K(+)-ATPase to the inhibitory effect of PGE2 in fish oil-treated animals may be related to the currently reported anticonvulsant activity. PMID:23375884

  11. Complex partial seizures of frontal lobe onset statistical analysis of ictal semiology

    Microsoft Academic Search

    P KOTAGAL; G ARUNKUMAR; J HAMMEL; ED MASCHA

    2003-01-01

    Objective: To identify the ictal semiology of complex partial seizures originating from the frontal lobe (FLCPS) and mesial temporal lobe (MTLE) in patients who became seizure free after surgery.Methods: We analysed 149 seizures from 42 patients, 28 with MTLE (75 seizures) and 14 with FLCPS (74 seizures) seizure free for at least 1 year after surgery. Fifty-eight symptoms and signs

  12. Canine and feline epileptic seizures and the lunar cycle: 2,507 seizures (2000-2008).

    PubMed

    Browand-Stainback, Laura; Levesque, Donald; McBee, Matthew

    2011-01-01

    Epileptic seizures in 211 canine and feline patients diagnosed with idiopathic epilepsy were evaluated for temporal significance in relation to the lunar cycle. Seizure counts were compared among each of the eight individual lunar phases, among each of eight exact lunar phase dates, and by percent of lunar illumination using generalized estimating equations. No statistical significance was found in any of these comparisons excluding a relationship between the onset of epileptic seizures and the phases of the moon. Alteration in anticonvulsant treatment or monitoring of canine and feline patients with idiopathic epilepsy at large was not warranted based on the lunar cycle. PMID:21852516

  13. Neural - glial circuits : Can Interneurons stop seizures

    NASA Astrophysics Data System (ADS)

    Nadkarni, Suhita; Jung, Peter

    2004-03-01

    Recent progress in neurobiology suggests that astrocytes - through calcium excitability - are active partners to the neurons by integrating their activity and, in turn, regulating synaptic transmission. In a similar fashion neurons and interneurons are the 'Yin and Yang' of the hippocampus. The dichotomy of excitation and inhibition between pyramidal neurons and interneurons plays a crucial role in the function of the neuronal circuit.We consider a model of a pyramidal cell in contact with one synaptic astrocytes. It has been shown that such a circuit - triggered by transient stimulation - can exhibit sustained oscillations ("seizures") for strong coupling. The question we are considering is, under what conditions synaptic inhibition can stop these seizures?

  14. Emergence of semiology in epileptic seizures.

    PubMed

    Chauvel, Patrick; McGonigal, Aileen

    2014-09-01

    Semiology, the manifestation of epilepsy, is dependent upon electrical activity produced by epileptic seizures that are organized within existing neural pathways. Clinical signs evolve as the epileptic discharge spreads in both time and space. Studying the relation between these, of which the temporal component is at least as important as the spatial one, is possible using anatomo-electro-clinical correlations of stereoelectroencephalography (SEEG) data. The period of semiology production occurs with variable time lag after seizure onset and signs then emerge more or less rapidly depending on seizure type (temporal seizures generally propagating more slowly and frontal seizures more quickly). The subset of structures involved in semiological production, the "early spread network", is tightly linked to those constituting the epileptogenic zone. The level of complexity of semiological features varies according to the degree of involvement of the primary or associative cortex, with the former having a direct relation to peripheral sensory and motor systems with production of hallucinations (visual and auditory) or elementary sensorimotor signs. Depending on propagation pattern, these signs can occur in a "march" fashion as described by Jackson. On the other hand, seizures involving the associative cortex, having a less direct relation with the peripheral nervous system, and necessarily involving more widely distributed networks manifest with altered cognitive and/or behavioral signs whose neural substrate involves a network of cortical structures, as has been observed for normal cognitive processes. Other than the anatomical localization of these structures, the frequency of the discharge is a crucial determinant of semiological effect since a fast (gamma) discharge will tend to deactivate normal function, whereas a slower theta discharge can mimic physiological function. In terms of interaction between structures, the degree of synchronization plays a key role in clinical expression, as evidenced, for example, by studies of ictal fear-related behavior (decorrelation of activity between structures inducing "release" phenomena) and of déjŕ vu (increased synchronization). Studies of functional coupling within networks underlying complex ictal behavior indicate that the clinical semiology of a given seizure depends upon neither the anatomical origin of ictal discharge nor the target areas of its propagation alone but on the dynamic interaction between these. Careful mapping of the ictal network in its full spread offers essential information as to the localization of seizure onset, by deducing that a given network configuration could only be generated by a given area or group of areas. PMID:24424286

  15. Neonatal seizures and therapeutic hypothermia for hypoxic-ischemic encephalopathy

    PubMed Central

    Gano, Dawn; Orbach, Sharon A.; Bonifacio, Sonia L.; Glass, Hannah C.

    2015-01-01

    Neonatal seizures are associated with morbidity and mortality. Hypoxic-ischemic encephalopathy (HIE) is the most common cause of seizures in newborns. Neonatal animal models suggest that therapeutic hypothermia can reduce seizures and epileptiform activity in the setting of hypoxia-ischemia, however data from human studies have conflicting results. In this research highlight, we will discuss the findings of our recent study that demonstrated a decreased seizure burden in term newborns with moderate HIE treated with hypothermia.

  16. Anthrax: a systematic review of atypical presentations.

    PubMed

    Holty, Jon-Erik C; Kim, Rebecca Y; Bravata, Dena M

    2006-08-01

    During the 2001 US anthrax attacks, mortality from inhalational anthrax was significantly lower than had been reported historically, which was attributed in part to early identification and timely treatment. During future attacks, clinicians will rely on published descriptions of the clinical features of inhalational anthrax to rapidly diagnose patients and institute appropriate treatment. Published descriptions of typical inhalation anthrax usually include patients presenting with cough, dyspnea, or chest pain and found to have abnormal lung examination results with pleural effusions or enlarged mediastinum. The purpose of this article is to evaluate whether atypical presentations of inhalational anthrax occur and to describe the features of these presentations. We define atypical presentations as those in patients with confirmed anthrax infection who do not have known cutaneous, gastrointestinal, or inhalational ports of entry. We reviewed the case reports of 42 patients with atypical anthrax (published between 1900 and 2004) that may have had an inhalational source of infection to evaluate whether their clinical presentations differed from the typical findings of inhalational anthrax. Patients with atypical anthrax were less likely to have cough, chest pain, or abnormal lung examination results than patients with typical inhalational anthrax (P<.05 for all comparisons). A previously published screening protocol for patients with suspected anthrax correctly identified 91% of patients with atypical presentations. We conclude that although uncommon, atypical presentations of inhalational anthrax likely occur. Timely diagnosis and treatment of patients with inhalational anthrax require clinical awareness of the full spectrum of signs and symptoms associated with inhalational anthrax. PMID:16857469

  17. Carbon Monoxide Poisoning Presenting as an Isolated Seizure

    Microsoft Academic Search

    Leonard Y Herman

    1998-01-01

    Seizures are generally regarded as a manifestation of extreme, generally near-fatal carbon monoxide poisoning. A case is described in which a seizure attributable to carbon monoxide poisoning occurred in a small child at a level not thought to be associated with serious neurologic toxicity. A literature review of the occurrence of seizures in carbon monoxide poisoning found that no particular

  18. Synaptic reorganization following kainic acid-induced seizures during development

    Microsoft Academic Search

    Yili Yang; Pushpa Tandon; Zhao Liu; Matthew R. Sarkisian; Carl E. Stafstrom; Gregory L. Holmes

    1998-01-01

    Prolonged seizures in the adult brain causes neuronal loss in the hippocampus and aberrant growth (sprouting) of granule cell axons (mossy fibers) in the supragranular zone of the fascia dentata and stratum infrapyramidale of CA3. There is considerable evidence that these changes in neuronal growth following seizures are age related, with younger animals having fewer reactive changes following prolonged seizures

  19. Successful Management of Refractory Neonatal Seizures With Midazolam

    Microsoft Academic Search

    Deepa Sirsi; Srishti Nangia; Jacqueline LaMothe; Barry E. Kosofsky; Gail E. Solomon

    2008-01-01

    Seizures are indicative of underlying neurologic dysfunction in neonates. Repeated seizures may be deleterious to the brain even without disturbances of ventilation or perfusion. First-line antiepileptic drugs such as phenobarbital and phenytoin are not very effective in controlling seizures in neonates. Rapid control of status epilepticus with midazolam has been demonstrated in 2 previous studies with complete clinical and electrographic

  20. Temporal lobe epilepsy: Where do the seizures really begin?

    Microsoft Academic Search

    Edward H. Bertram

    2009-01-01

    Defining precisely the site of seizure onset has important implications for our understanding of the pathophysiology of temporal lobe epilepsy, as well as for the surgical treatment of the disorder. Removal of the limbic areas of the medial temporal lobe has led to a high rate of seizure control, but the relatively large number of patients for whom seizure control

  1. Rhythmic 3-4Hz discharge is insufficient to produce cortical BOLD fMRI decreases in generalized seizures.

    PubMed

    Youngblood, Mark W; Chen, William C; Mishra, Asht M; Enamandram, Sheila; Sanganahalli, Basavaraju G; Motelow, Joshua E; Bai, Harrison X; Frohlich, Flavio; Gribizis, Alexandra; Lighten, Alexis; Hyder, Fahmeed; Blumenfeld, Hal

    2015-04-01

    Absence seizures are transient episodes of impaired consciousness accompanied by 3-4 Hz spike-wave discharge on electroencephalography (EEG). Human functional magnetic resonance imaging (fMRI) studies have demonstrated widespread cortical decreases in the blood oxygen-level dependent (BOLD) signal that may play an important role in the pathophysiology of these seizures. Animal models could provide an opportunity to investigate the fundamental mechanisms of these changes, however they have so far failed to consistently replicate the cortical fMRI decreases observed in human patients. This may be due to important differences between human seizures and animal models, including a lack of cortical development in rodents or differences in the frequencies of rodent (7-8 Hz) and human (3-4 Hz) spike-wave discharges. To examine the possible contributions of these differences, we developed a ferret model that exhibits 3-4 Hz spike-wave seizures in the presence of a sulcated cortex. Measurements of BOLD fMRI and simultaneous EEG demonstrated cortical fMRI increases during and following spike-wave seizures in ferrets. However unlike human patients, significant fMRI decreases were not observed. The lack of fMRI decreases was consistent across seizures of different durations, discharge frequencies, and anesthetic regimes, and using fMRI analysis models similar to human patients. In contrast, generalized tonic-clonic seizures under the same conditions elicited sustained postictal fMRI decreases, verifying that the lack of fMRI decreases with spike-wave was not due to technical factors. These findings demonstrate that 3-4 Hz spike-wave discharge in a sulcated animal model does not necessarily produce fMRI decreases, leaving the mechanism for this phenomenon open for further investigation. PMID:25562830

  2. Febrile temperatures unmask biophysical defects in Nav1.1 epilepsy mutations supportive of seizure initiation

    PubMed Central

    Kahlig, Kristopher M.; Das, Joost H.G.; van Kempen, Marjan J.A.; Lindhout, Dick; Koeleman, Bobby P.C.; Rook, Martin B.

    2013-01-01

    Generalized epilepsy with febrile seizures plus (GEFS+) is an early onset febrile epileptic syndrome with therapeutic responsive (a)febrile seizures continuing later in life. Dravet syndrome (DS) or severe myoclonic epilepsy of infancy has a complex phenotype including febrile generalized or hemiclonic convulsions before the age of 1, followed by intractable myoclonic, complex partial, or absence seizures. Both diseases can result from mutations in the Nav1.1 sodium channel, and initially, seizures are typically triggered by fever. We previously characterized two Nav1.1 mutants—R859H (GEFS+) and R865G (DS)—at room temperature and reported a mixture of biophysical gating defects that could not easily predict the phenotype presentation as either GEFS+ or DS. In this study, we extend the characterization of Nav1.1 wild-type, R859H, and R865G channels to physiological (37°C) and febrile (40°C) temperatures. At physiological temperature, a variety of biophysical defects were detected in both mutants, including a hyperpolarized shift in the voltage dependence of activation and a delayed recovery from fast and slow inactivation. Interestingly, at 40°C we also detected additional gating defects for both R859H and R865G mutants. The GEFS+ mutant R859H showed a loss of function in the voltage dependence of inactivation and an increased channel use-dependency at 40°C with no reduction in peak current density. The DS mutant R865G exhibited reduced peak sodium currents, enhanced entry into slow inactivation, and increased use-dependency at 40°C. Our results suggest that fever-induced temperatures exacerbate the gating defects of R859H or R865G mutants and may predispose mutation carriers to febrile seizures. PMID:24277604

  3. Seizures beget seizures in temporal lobe epilepsies: the boomerang effects of newly formed aberrant kainatergic synapses.

    PubMed

    Ben-Ari, Yehezkel; Crepel, Valérie; Represa, Alfonso

    2008-01-01

    Do temporal lobe epilepsy (TLE) seizures in adults promote further seizures? Clinical and experimental data suggest that new synapses are formed after an initial episode of status epilepticus, however their contribution to the transformation of a naive network to an epileptogenic one has been debated. Recent experimental data show that newly formed aberrant excitatory synapses on the granule cells of the fascia dentate operate by means of kainate receptor-operated signals that are not present on naive granule cells. Therefore, genuine epileptic networks rely on signaling cascades that differentiate them from naive networks. Recurrent limbic seizures generated by the activation of kainate receptors and synapses in naive animals lead to the formation of novel synapses that facilitate the emergence of further seizures. This negative, vicious cycle illustrates the central role of reactive plasticity in neurological disorders. PMID:18488058

  4. Seizures Beget Seizures in Temporal Lobe Epilepsies: The Boomerang Effects of Newly Formed Aberrant Kainatergic Synapses

    PubMed Central

    Ben-Ari, Yehezkel; Crepel, Valérie; Represa, Alfonso

    2008-01-01

    Do temporal lobe epilepsy (TLE) seizures in adults promote further seizures? Clinical and experimental data suggest that new synapses are formed after an initial episode of status epilepticus, however their contribution to the transformation of a naive network to an epileptogenic one has been debated. Recent experimental data show that newly formed aberrant excitatory synapses on the granule cells of the fascia dentate operate by means of kainate receptor-operated signals that are not present on naive granule cells. Therefore, genuine epileptic networks rely on signaling cascades that differentiate them from naive networks. Recurrent limbic seizures generated by the activation of kainate receptors and synapses in naive animals lead to the formation of novel synapses that facilitate the emergence of further seizures. This negative, vicious cycle illustrates the central role of reactive plasticity in neurological disorders. PMID:18488058

  5. Age-dependent seizures of absence epilepsy and sleep spindles dynamics in WAG/Rij rats

    NASA Astrophysics Data System (ADS)

    Grubov, Vadim V.; Sitnikova, Evgenia Y.; Pavlov, Alexey N.; Khramova, Marina V.; Koronovskii, Alexey A.; Hramov, Alexander E.

    2015-03-01

    In the given paper, a relation between time-frequency characteristics of sleep spindles and the age-dependent epileptic activity in WAG/Rij rats is discussed. Analysis of sleep spindles based on the continuous wavelet transform is performed for rats of different ages. It is shown that the epileptic activity affects the time-frequency intrinsic dynamics of sleep spindles.

  6. The Dynamics of Absence Behaviour: Interrelations between Absence from Class and Absence in Class

    ERIC Educational Resources Information Center

    Jonasson, Charlotte

    2011-01-01

    Background: Studies of absence in educational settings have primarily been concerned with the causes for and results of student absence. However, recent research has argued that distinguishing between different forms of absence could be important. In consequence, studying the way in which different forms of absence are interrelated provides…

  7. Pediatric Intracerebral Hemorrhage: Acute Symptomatic Seizures and Epilepsy

    PubMed Central

    Beslow, Lauren A; Abend, Nicholas S; Gindville, Melissa C; Bastian, Rachel A; Licht, Daniel J; Smith, Sabrina E; Hillis, Argye E.; Ichord, Rebecca N; Jordan, Lori C

    2013-01-01

    Objectives To define the incidence of and explore risk factors for seizures and epilepsy in children with spontaneous intracerebral hemorrhage (ICH). Design Prospective cohort study. Setting Three tertiary care pediatric hospitals. Participants Seventy-three pediatric subjects with spontaneous ICH including 20 perinatal (?37 weeks gestation to 28 days) and 53 childhood subjects (>28 days to <18 years at presentation). Main outcome measures Acute symptomatic seizures (clinically evident and electrographic-only within 7 days), remote symptomatic seizures, and epilepsy. Results Acute symptomatic seizures occurred in 35 subjects (48%). Acute symptomatic seizures as a presenting symptom of ICH occurred in 12 (60%) perinatal and 19 (36%) childhood subjects, P=.07. Acute symptomatic seizures after presentation occurred in 7 children. Electrographic-only seizures were present in 9/32 (28%) with continuous EEG monitoring. One-and two-year remote symptomatic seizure-free survival were 82% (95% CI 68%–90%) and 67% (95% CI 46%–82%), respectively. One- and two-year epilepsy-free survival were 96% (95% CI 83%–99%) and 87% (95% CI 65%–95%), respectively. Elevated intracranial pressure requiring acute intervention was a risk factor for acute seizures after presentation, remote symptomatic seizures, and epilepsy (P=.014, P=.025 and P=.0365, respectively log-rank test). Conclusions Presenting seizures are common in perinatal and childhood ICH. Continuous EEG may detect electrographic seizures in some subjects. Single remote symptomatic seizures occur in many, and development of epilepsy is estimated to occur in 13% at two-years. Elevated intracranial pressure requiring acute intervention is a risk factor for acute seizures after presentation, remote symptomatic seizures, and epilepsy. PMID:23392319

  8. Malignant migrating partial seizures in infancy.

    PubMed

    Coppola, Giangennaro

    2013-01-01

    The syndrome of malignant migrating partial seizures in infancy (MMPSI) was first reported in 1995, and is now included among the childhood epileptic syndromes in the revision proposal of the ILAE Commission on classification and terminology. The main clinical features are seizure onset in the first 6 months of life, occurrence of almost continuous migrating polymorphous focal seizures, associated with multifocal ictal EEG discharges, progressive deterioration of psychomotor development combined with frequent evolution of acquired microcephaly, and lack of a significant familial and etiological context. Eventually, children develop major axial hypotonia, pyramidal and extrapyramidal signs with athetotic movements and strabismus. Neuroradiological, biochemical, and genetic investigations thus far have note contributed to our knowledge about this syndrome. Etiology is still unknown, though it appears reasonable to suspect a genetic etiology for MMPSI; a channelopathy may be responsible for the age-dependent cortical neuronal hyperexcitability. Seizures are markedly drug resistant and outcome is generally severe. However, some patients may respond favourably to bromide, stiripentol associated with clonazepam, and, more recently, to levetiracetam. Vagus nerve stimulation and a ketogenic diet have been tried also but with poor or inconclusive results. Based on age at onset, MMPEI may be placed between early epileptic encephalopthies and infantile spasms. PMID:23622207

  9. EEG seizure prediction: Measures and challenges

    Microsoft Academic Search

    A. Aarabi; R. Fazel-Rezai; Y. Aghakhani

    2009-01-01

    Different types of analyses of scalp and intracranial electroencephalography (EEG) recordings using linear and nonlinear time series analysis method have been done. They showed strong evidence of detectable changes in the EEG dynamics from minutes up to several hours in advance of seizure onset. The predictive performance of univariate and bivariate measures, comprising both linear and non-linear approaches have been

  10. Seizures and epilepsy in the elderly.

    PubMed

    Thomas, R J

    1997-03-24

    Seizures and epilepsy in the elderly are an important and increasingly common clinical problem. Major known causes include cerebrovascular disease, brain tumor, degenerative disorders such as Alzheimer disease and cerebral amyloid angiopathy, and toxic-metabolic syndromes such as nonketotic hyperglycemia, postcardiac arrest, and drug-induced seizures. Recognition of seizures may be complicated by relatively unique clinical presentations and differential diagnosis. Nonconvulsive status epilepticus may present as recurrent episodes of confusion. The electroencephalogram is less useful than in the pediatric age group, but has a role in the evaluation of a first seizure and may rarely show characteristic patterns, such as poststroke periodic lateralized epileptiform discharges. Convulsive status, especially that associated with drug toxicity, is associated with increased mortality in the elderly. Pharmacological treatment is complicated by age-related changes in pharmacokinetics and pharmacodynamics and drug-drug and drug-disease interactions. Some of the new antiepileptic drugs may offer advantages for use in the elderly. Oxcarbazepine has fewer drug interactions than carbamazepine, and gabapentin has one, a reduction of felbamate renal elimination. Vigabatrin causes little cognitive dysfunction, while drugs that reduce excitatory amino acid neurotransmission, such as lamotrigine and felbamate, have potentially protective effects in patients with ischemic cerebrovascular disease. The use of barbiturates, primidone, the benzodiazepine clobazam, and the calcium blockers flunarizine and cinnarizine should preferably be avoided in the elderly. PMID:9080915

  11. Seizures and Teens: Maximizing Health and Safety

    ERIC Educational Resources Information Center

    Sundstrom, Diane

    2007-01-01

    As parents and caregivers, their job is to help their children become happy, healthy, and productive members of society. They try to balance the desire to protect their children with their need to become independent young adults. This can be a struggle for parents of teens with seizures, since there are so many challenges they may face. Teenagers…

  12. Brain chirps: spectrographic signatures of epileptic seizures

    Microsoft Academic Search

    Steven J Schiff; David Colella; Gary M Jacyna; Elizabeth Hughes; Joseph W Creekmore; Angela Marshall; Maribeth Bozek-Kuzmicki; George Benke; William D Gaillard; Joan Conry; Steven R Weinstein

    2000-01-01

    Objective: A chirp is a brief signal within which the frequency content changes rapidly. Spectrographic chirps are found in signals produced from many biological and physical phenomena. In radar and sonar engineering, signals with chirps are used to localize direction and range to the signal source. Although characteristic frequency changes during epileptic seizures have long been observed, the correlation with

  13. Levetiracetam seizure prophylaxis in craniotomy patients at high risk for postoperative seizures

    PubMed Central

    Gokhale, Sankalp; Khan, Shariq Ali; Agrawal, Abhishek; Friedman, Allan H.; McDonagh, David L.

    2013-01-01

    Background: The risk of developing immediate postoperative seizures in patients undergoing supratentorial brain tumor surgery without anti-epileptic drug (AED) prophylaxis is 15-20%. Patients who present with pre-operative seizures and patients with supratentorial meningioma or supratentorial low grade gliomas are at significantly higher risk. There is little data on the efficacy of levetiracetam as a prophylactic AED in the immediate postoperative period (within 7 days of surgery) in these patients. Methods: We conducted a retrospective chart review of 165 adult patients classified as higher risk for postoperative seizures who underwent brain tumor resection at Duke University Hospital between time May 2010 and December 2011. All patients had received levetiracetam monotherapy in doses of 1000-3000 mg/day in the immediate postoperative period. Results: We identified 165 patients with following tumor locations: Frontal 83 (50.3%), Temporal 37 (22.4%), Parietal 30 (18.2%), Occipital 2 (1.2%) and 13 (7.8%) with single lesions involving more than one lobe. Histology revealed: Glioma 98 (59.4%), Meningioma 57 (34.5%) and Brain Metastases 6 (3.6%). Preoperatively, 88/165 (53.3%) patients had presented with seizures. 12/165 patients (7.3%) developed clinical seizures (generalized 10, partial 2) in the immediate post-operative period. Other than somnolence in 7 patients (4.2%), no major side-effects were noted. Conclusions: The incidence of seizures was significantly lower in patients treated with levetiracetam (7.3%) when compared with the expected (15-20%) rate without AED prophylaxis based on the previous literature. Levetiracetam appears effective and safe for seizure prevention in patients undergoing brain tumor resection and who are at significantly higher risk of developing post-operative seizures. These findings warrant confirmation in a prospective randomized trial. PMID:24550999

  14. Benzodiazepine receptor declines in hippocampal formation following limbic seizures.

    PubMed

    Kraus, V M; Dasheiff, R M; Fanelli, R J; McNamara, J O

    1983-10-31

    Electrolytic lesions of entorhinal cortex have previously been shown to consistently produce limbic seizures. We report a bilateral and symmetrical decline in benzodiazepine receptor number in dentate gyrus of the hippocampal formation in unilateral entorhinal cortex-lesioned animals. We think this decline is caused by seizures since phenobarbital pretreatment prevented the appearance of limbic seizures and blocked the receptor decline. We postulate that these receptor declines may contribute to decreased endogenous recurrent inhibition (a presumed GABAergic synapse) of dentate granule cells which could lead to their repetitive firing. Thus these benzodiazepine receptor declines may be a consequence of limbic seizures yet increase the likelihood of subsequent seizures. PMID:6315144

  15. T-type Ca˛? channels in absence epilepsy.

    PubMed

    Cheong, Eunji; Shin, Hee-Sup

    2013-07-01

    Low-voltage-activated T-type Ca˛? channels are highly expressed in the thalamocortical circuit, suggesting that they play a role in this brain circuit. Indeed, low-threshold burst firing mediated by T-type Ca˛? channels has long been implicated in the synchronization of the thalamocortical circuit. Over the past few decades, the conventional view has been that rhythmic burst firing mediated by T-type channels in both thalamic reticular nuclie (TRN) and thalamocortical (TC) neurons are equally critical in the generation of thalamocortical oscillations during sleep rhythms and spike-wave-discharges (SWDs). This review broadly investigates recent studies indicating that even though both TRN and TC nuclei are required for thalamocortical oscillations, the contributions of T-type channels to TRN and TC neurons are not equal in the genesis of sleep spindles and SWDs. T-type channels in TC neurons are an essential component of SWD generation, whereas the requirement for TRN T-type channels in SWD generation remains controversial at least in the GBL model of absence seizures. Therefore, a deeper understanding of the functional consequences of modulating each T-type channel subtype could guide the development of therapeutic tools for absence seizures while minimizing side effects on physiological thalamocortical oscillations. This article is part of a Special Issue entitled: Calcium channels. PMID:23416255

  16. Altered resting state functional network connectivity in children absence epilepsy.

    PubMed

    Li, Qifu; Cao, Weifang; Liao, Xiaoping; Chen, Zhibin; Yang, Tianhua; Gong, Qiyong; Zhou, Dong; Luo, Cheng; Yao, Dezhong

    2015-07-15

    Altered functional connectivity has been associated with the influence of epileptic activity. Abnormalities in connectivity, particularly in dorsal attention (DAN), salience (SN) and default mode (DMN) networks, might contribute to the loss of consciousness during seizures and cognitive deficits in patients with children absence epilepsy (CAE). The objective of the present study was to identify whether the functional network connectivity (FNC) is changed between patients with CAE and healthy controls. Using independent component analysis, twelve resting state networks (RSNs) were identified in resting state functional magnetic resonance imaging data sets in eighteen CAE patients and twenty-one healthy controls. Analyses of the group differences in FNC strength were conducted, controlling for age and gender effects. The findings showed that some functional networks were clustered into two subgroups, correlated within subgroups and antagonized with each other. Compared with the controls, patients with CAE demonstrated abnormal FNC strength among three networks: DMN, DAN and SN. In addition, the antagonism of two subgroups was altered. These results might reflect the underlying neuronal functional impairment or altered integration among these RSNs in CAE, suggesting that the abnormal functional connectivity is likely to imply the pathological mechanism associated with the accumulative influence of epileptic activity. These findings contribute to the understanding of the behavior abnormality in CAE, such as disturbed executive and attentional functions and the loss of consciousness during absence seizures. PMID:25982500

  17. Initial evaluation and management of a first seizure in children.

    PubMed

    Chelse, A B; Kelley, Kent; Hageman, Joseph R; Koh, Sookyong

    2013-12-01

    The pediatrician is often the first health professional notified of a child's first seizure. First seizures cause much anxiety for parents and practitioners. Parents are frightened as they witness a paroxysmal event that involves convulsions or altered mental status, and as a result, they seek answers, reassurance, and support. Every pediatrician faces the challenge of determining whether a child who had a paroxysmal event had a seizure. Therefore, it is important for the general pediatrician to have a good understanding of the diagnosis and management of a child's first seizure. This review will discuss the definition of seizures and epilepsy, the critical questions to answer during the initial evaluation of a child's first seizure, guidance for initial management, risk factors for seizure recurrence, and the value of electroencephalography in diagnosis and treatment. PMID:24295157

  18. Metabolic Disruption in Drosophila Bang-Sensitive Seizure Mutants

    PubMed Central

    Fergestad, Tim; Bostwick, Bret; Ganetzky, Barry

    2006-01-01

    We examined a number of Drosophila mutants with increased susceptibility to seizures following mechanical or electrical stimulation to better understand the underlying factors that predispose neurons to aberrant activity. Several mutations in this class have been molecularly identified and suggest metabolic disruption as a possible source for increased seizure susceptibility. We mapped the bang-sensitive seizure mutation knockdown (kdn) to cytological position 5F3 and identified citrate synthase as the affected gene. These results further support a role for mitochondrial metabolism in controlling neuronal activity and seizure susceptibility. Biochemical analysis in bang-sensitive mutants revealed reductions in ATP levels consistent with disruption of mitochondrial energy production in these mutants. Electrophysiological analysis of mutants affecting mitochondrial proteins revealed an increased likelihood for a specific pattern of seizure activity. Our data implicate cellular metabolism in regulating seizure susceptibility and suggest that differential sensitivity of neuronal subtypes to metabolic changes underlies distinct types of seizure activity. PMID:16648587

  19. Seizures down-regulate muscarinic cholinergic receptors in hippocampal formation.

    PubMed

    Dasheiff, R M; Savage, D D; McNamara, J O

    1982-03-11

    Muscarinic cholinergic receptors (MCR) have been previously shown to decline in the hippocampal formation (HPF) of amygdala-kindled rats. Seizures have been proposed as the process responsible for this down-regulation. We now demonstrate similar down-regulation of MCR within HPF in 3 additional methods of inducing seizures: electroconvulsive shock, entorhinal kindling and entorhinal lesion. Two key parameters which causally link the MCR declines with seizures are their time course and reversal with anticonvulsants. The transient decline of MCR induced by entorhinal lesion-induced seizures parallels the time course established in amygdala kindling. Further, phenobarbital could block both these seizures and the MCR declines. Together, this supports the relationship of seizures causing the declines. We postulate that the MCR down-regulation represents an endogenous inhibitory response of neurons that are intensely and repeatedly depolarized during the seizures. PMID:7188331

  20. Lichen sclerosus: a potpourri of misdiagnosed cases based on atypical clinical presentations

    PubMed Central

    Ventolini, Gary; Patel, Ravi; Vasquez, Robert

    2015-01-01

    Objective Lichen sclerosus (LS) is a chronic progressive inflammatory autoimmune-induced disease that primarily affects the epidermis and dermis of the external genital-anal region. Intense and recalcitrant pruritus is the hallmark of LS. Physical exam reveals thinning, hyperkeratosis, and parchment-like appearance. However, the classic symptom and signs of LS may not always be present and patients may be asymptomatic for pruritus. Hence, we describe 15 misdiagnosed cases with atypical clinical presentations. We believe that the absence of pruritus contributed to their initial misdiagnosis. The purpose of this paper is to increase awareness of atypical presentations of LS. Methods Data base review of de-identified clinical case pictures was performed. All patients had histopathology-confirmed diagnoses of LS. The data base file contains 800 cases of vulvovaginal disorders. The Institutional Review Board (IRB) considered that searching a de-identified data base of pictures did not require IRB approval. Results We identified 15 different atypical clinical cases. Patient ages were 18–75 years old. These patients were asymptomatic for pruritus and were misdiagnosed before they presented to the vulvovaginal specialized clinic. Conclusion Fifteen patients asymptomatic for pruritus with histopathology-confirmed diagnosis of LS were identified. They illustrate atypical clinical presentations that LS may have. PMID:26056492

  1. Reduction of adrenergic neurotransmission with clonidine aggravates spike-wave seizures and alters activity in the cortex and the thalamus in WAG\\/Rij rats

    Microsoft Academic Search

    Evgenia Sitnikova; Gilles van Luijtelaar

    2005-01-01

    The alpha-2 adrenoreceptor agonist clonidine in low dose inhibits the release of noradrenaline and aggravates absence seizures. The present study examines properties of two types of spike-wave discharges (SWD) in a genetic model of absence epilepsy, the WAG\\/Rij rats. After reduction of noradrenergic neurotransmission with clonidine (0.00625mg\\/kg, i.p.), the electrical activity was recorded in the neocortex, the ventroposteromedial nucleus (VPM)

  2. Reduction of adrenergic neurotransmission with clonidine aggravates spike-wave seizures and alters activity in the cortex and the thalamus in WAG-Rij rats

    Microsoft Academic Search

    E. Y. Sitnikova

    2004-01-01

    The alpha-2 adrenoreceptor agonist clonidine in low dose inhibits the release of noradrenaline and aggravates absence seizures. The present study examines properties of two types of spike-wave discharges (SWD) in a genetic model of absence epilepsy, the WAG\\/Rij rats. After reduction of noradrenergic neurotransmission with clonidine (0.00625 mg\\/kg, i.p.), the electrical activity was recorded in the neocortex, the ventroposteromedial nucleus

  3. Computer discriminant analysis of atypical urothelial cells.

    PubMed

    Koss, L G; Bartels, P H; Sychra, J J; Wied, G L

    1978-01-01

    Prior computer studies of digitized cell images by the TICAS system have shown that the category of urothelial cells classified visually as atypical may be composed of 2 subgroups, one clustering mainly with benign cells and the other with malignant cells. As a consequence, a visual review of the group of atypical cells was conducted and tested by computer discriminant analysis. The computer classification confirmed the visual reclassification and subdivision of atypical urothelial cells into 2 subgroups, ATY I and ATY II. This is yet another example of feedback from computer diagnosis to visual assessment of cells. The significance of these observations in terms of diagnosis will be the subject of subsequent communications. PMID:364907

  4. The return of dissociation as absence within absence.

    PubMed

    Gurevich, Hayuta

    2014-12-01

    My aim is to translate Ferenczi's central concepts of the intrapsychic impact and imprint of early developmental trauma into both revived and contemporary conceptualizations. The concept of dissociation was renounced by Freud, yet it is returning as a cornerstone of recent trauma theories. Ferenczi used the concept of "repression," but used it in the sense of an intrapsychic imprint of early external trauma that fragments consciousness, that is, as dissociation. Furthermore, early trauma is double: an absence of protection that threatens existence of the self, combined with an absence of attachment and of recognition of this threat and terror; thus it is an absence-within-absence. This contemporary conceptualization entails a widening of the intrapsychic realm to include an intersubjective one, and regards dissociation as a unique and complex intrapsychic absence, which is a negative of the external absence-within-absence in the early environment. PMID:25434884

  5. Signal subspace integration for improved seizure localization.

    PubMed

    Stamoulis, Catherine; Fernández, Iván Sánchez; Chang, Bernard S; Loddenkemper, Tobias

    2012-01-01

    A subspace signal processing approach is proposed for improved scalp EEG-based localization of broad-focus epileptic seizures, and estimation of the directions of source arrivals (DOA). Ictal scalp EEGs from adult and pediatric patients with broad-focus seizures were first decomposed into dominant signal modes, and signal and noise subspaces at each modal frequency, to improve the signal-to-noise ratio while preserving the original data correlation structure. Transformed (focused) modal signals were then resynthesized into wideband signals from which the number of sources and DOA were estimated. These were compared to denoised signals via principal components analysis (PCA). Coherent subspace processing performed better than PCA, significantly improved the localization of ictal EEGs and the estimation of distinct sources and corresponding DOAs. PMID:23366067

  6. Signal subspace integration for improved seizure localization

    PubMed Central

    Stamoulis, Catherine; Fernández, Iván Sánchez; Chang, Bernard S.; Loddenkemper, Tobias

    2012-01-01

    A subspace signal processing approach is proposed for improved scalp EEG-based localization of broad-focus epileptic seizures, and estimation of the directions of source arrivals (DOA). Ictal scalp EEGs from adult and pediatric patients with broad-focus seizures were first decomposed into dominant signal modes, and signal and noise subspaces at each modal frequency, to improve the signal-to-noise ratio while preserving the original data correlation structure. Transformed (focused) modal signals were then resynthesized into wideband signals from which the number of sources and DOA were estimated. These were compared to denoised signals via principal components analysis (PCA). Coherent subspace processing performed better than PCA, significantly improved the localization of ictal EEGs and the estimation of distinct sources and corresponding DOAs. PMID:23366067

  7. Regulation of Kv4.2 A-Type Potassium Channels in HEK-293 Cells by Hypoxia

    PubMed Central

    Liu, Yu-Qiang; Huang, Wen-Xian; Sanchez, Russell M.; Min, Jia-Wei; Hu, Jiang-Jian; He, Xiao-Hua; Peng, Bi-Wen

    2014-01-01

    We previously observed that A-type potassium currents were decreased and membrane excitability increased in hippocampal dentate granule cells after neonatal global hypoxia associated with seizures. Here, we studied the effects of hypoxia on the function and expression of Kv4.2 and Kv4.3 ? subunit channels, which encode rapidly inactivating A-type K currents, in transfected HEK-293 cells to determine if hypoxia alone could regulate IA in vitro. Global hypoxia in neonatal rat pups resulted in early decreased hippocampal expression of Kv4.2 mRNA and protein with 6 or 12?h post-hypoxia. Whole-cell voltage-clamp recordings revealed that similar times after hypoxia (1%) in vitro decreased peak currents mediated by recombinant Kv4.2 but not Kv4.3 channels. Hypoxia had no significant effect on the voltage-dependencies of activation and inactivation of Kv4.2 channels, but increased the time constant of activation. The same result was observed when Kv4.2 and Kv4.3 channels were co-expressed in a 1:1 ratio. These data suggested that hypoxia directly modulates A-type potassium channels of the subfamily typically expressed in principal hippocampal neurons, and does so in a manner to decrease function. Given the role of IA to slow action potential firing, these data are consistent with a direct effect of hypoxia to decrease IA as a mechanism of increased neuronal excitability and promotion of seizures. PMID:25352783

  8. Hyponatremic seizure associated with acute respiratory infection

    Microsoft Academic Search

    Yoshitaka Iwazu; Sumiko Honma; Genro Fujisawa; Kiyoko Uki; Ichiro Yanaka; Yoshiaki Sato; Mitsunobu Murata; Eiji Kusano; Yasushi Asano

    2007-01-01

    A 66-year-old woman was admitted to our hospital because of vomiting and appetite loss. For the 2 days prior to admission,\\u000a she had a cold, which had developed into acute viral bronchitis on admission. Because laboratory data on admission showed\\u000a hyponatremia, intravenous infusion of Ringer's lactate solution was started. However, generalized seizures appeared, and she\\u000a developed a coma on the

  9. Language dysfunction after frontal lobe partial seizures.

    PubMed

    Goldberg-Stern, Hadassa; Gadoth, Nathan; Cahill, William; Privitera, Michael

    2004-05-11

    Postictal language delay (PILD) patterns can lateralize temporal lobe complex partial seizures (CPS). The authors studied PILD in 24 patients with 118 frontal lobe CPS. Prolonged PILD occurred in only 7% of CPS confined to the dominant frontal lobe compared with 91% of CPS that started as frontal and spread to the dominant temporal lobe (p = 0.0001). Postictal language testing provides important information on frontal CPS localization and spread. PMID:15136702

  10. Hypocalcaemic seizures: sign of intestinal disease?

    PubMed

    Van Biervliet, S; Velde, S Vande; Robberecht, E; Van Winckel, M

    2007-01-01

    We describe a baby admitted with convulsions, fever, low protein level and coagulation abnormalities where congenital intestinal lymphangiectasia was confirmed by endoscopy and histology. Treatment with a low fat diet, supplemented with medium chain triglycerides (MCT), resulted in a disappearance of the symptoms and normal growth. When confronted with seizure-like attacks, electrolyte disturbances and hypo-albuminemia one should consider the possibility of protein losing enteropathy. PMID:17715644

  11. Eslicarbazepine acetate for partial-onset seizures.

    PubMed

    Rauchenzauner, Markus; Luef, Gerhard

    2011-12-01

    Eslicarbazepine acetate (ESL), a new voltage-gated sodium channel blocker that is chemically related to carbamazepine and partially metabolized to oxcarbazepine, has attracted attention as results of previous Phase II and III studies demonstrated and confirmed efficacy and tolerability of ESL 800 and 1200 mg once daily as add-on therapy for adult patients with drug-resistant partial-onset seizures. In children, efficacy data point towards a dose-dependent decrease in seizure frequency and tolerability analyses showed a low incidence of mild drug-related adverse effects at 5 and 15 mg/kg/day. The most frequently reported adverse effects were dizziness, somnolence, headache, diplopia, nausea and vomiting. The convenience of once-daily dosing and a short/simple titration regimen in combination with a comparative efficacy and tolerability profile might promote ESL as a valid alternative to the current adjunctive antiepileptic drug therapy armamentarium for drug-resistant partial seizures in adults. Since clinical trials in children and adolescents on ESL efficacy and safety are ongoing and data already published are far from conclusive, the therapeutic value of ESL in this special population has to be established in the near future. PMID:22091592

  12. Ictal alterations of consciousness during ecstatic seizures.

    PubMed

    Picard, Fabienne; Kurth, Florian

    2014-01-01

    Patients with ecstatic epileptic seizures report an altered consciousness, which they describe as a sense of heightened perception of themselves – they “feel very present” – and an increased vividness of sensory perceptions. Recently, the anterior insula has been proposed as the region where these seizures originate, based on the results of ictal nuclear imaging in three patients, the first induction of ecstatic auras by electrical stimulation, and the functional characteristics of the anterior insula in neuroimaging literature. Specifically, the anterior insula is thought to play a key role in integrating information from within the body, the external world, as well as the emotional states. In addition, the anterior insula is thought to convert this integrated information into successive global emotional moments, thus enabling both the construct of a sentient self as well as a mechanism for predictive coding. As part of the salience network, this region is also involved in switching from mind wandering toward attentional and executive processing. In this review, we will summarize previous patient reports and recap how insular functioning may be involved in the phenomenon of ecstatic seizures. Furthermore, we will relate these hypotheses to the results from research on meditation and effects of drug abuse. PMID:24436968

  13. Epileptic Seizure Detection and Warning Device

    SciTech Connect

    Elarton, J.K.; Koepsel, K.L.

    1999-06-21

    Flint Hills Scientific, L.L.C. (FHS) has invented what is believed to be the first real-time epileptic seizure detection and short-term prediction method in the world. They have demonstrated an IBM PC prototype with a multi-channel EEG monitoring configuration. This CRADA effort applied AlliedSignal FM and T hardware design, manufacturing miniaturization, and high quality manufacturing expertise in converting the prototype into a small, portable, self-contained, multi-channel EEG epileptic seizure detection and warning device. The purpose of this project was to design and build a proof-of-concept miniaturized prototype of the FHS-developed PC-based prototype. The resultant DSP prototype, measuring 4'' x 6'' x 2'', seizure detection performance compared favorably with the FHS PC prototype, thus validating the DSP design goals. The very successful completion of this project provided valuable engineering information for FHS for future prototype commercialization as well as providing AS/FM and T engineers DSP design experience.

  14. Uncrossed epileptic seizures in Joubert syndrome.

    PubMed

    López Ruiz, Pedro; García García, Maria Eugenia; Dicapua Sacoto, Daniela; Marcos-Dolado, Alberto

    2015-01-01

    Joubert syndrome and related disorders comprise a subgroup of ciliopathies defined by the presence of the 'molar tooth sign', a midbrain-hindbrain malformation identifiable by neuroimaging. Characteristically, the corticospinal tract and superior cerebellar peduncles do not decussate. Epileptic seizures are uncommon. We present a case of a 28-year-old man with a background of Leber's congenital amaurosis with nephronophthisis, requiring kidney transplantation, and mental retardation, who developed epileptic seizures consisting of a short muffled cry and involuntary shaking movements of the extremities beginning in the left upper limb; these episodes lasted several seconds and occurred in clusters. Simultaneous video-EEG recording showed an ictal pattern in the left frontal lobe. Brain MRI revealed the pathognomonic 'molar tooth sign'; diffusion tensor imaging (DTI)-tractography showed a lack of decussation of both corticospinal tracts. To the best of our knowledge, this is the first time that DTI-tractography has been used to uncover the anatomical substrate underlying the semiology of epileptic seizures. PMID:26002775

  15. A Multi-resolution Approach for Atypical Behaviour Mining

    Microsoft Academic Search

    Alice Marascu; Florent Masseglia

    2009-01-01

    Atypical behaviours are the basis of a valuable knowledge in domains related to security (e.g. fraud detection for credit card (1), cyber security (4) or safety of critical systems (6)). Atypicity generally depends on the isolation level of a (set of) records, compared to the dataset. One possible method for finding atypic records aims to perform two steps. The first

  16. Resetting of Brain Dynamics: Epileptic versus Psychogenic Non-Epileptic Seizures

    PubMed Central

    Krishnan, Balu; Faith, Aaron; Vlachos, Ioannis; Roth, Austin; Williams, Korwyn; Noe, Katie; Drazkowski, Joe; Tapsell, Lisa; Sirven, Joseph; Iasemidis, Leon

    2011-01-01

    In this study, we investigated the possibility of differential diagnosis of patients with epileptic seizures (ES) and patients with psychogenic non-epileptic seizures (PNES) by an advanced analysis of dynamics of the patients' scalp electroencephalograms (EEG). The underlying principle was the presence of resetting of brain's pre-ictal spatiotemporal entrainment following onset of ES and the absence of resetting following PNES. Long-term (days) scalp EEGs recorded from five ES and six PNES patients were analyzed. It was found that: (a) Pre-ictal entrainment of brain sites was reset by epileptic seizures (p<0.05) in 4 out of the 5 patients with ES, and not reset (p=0.28) in the fifth patient. (b) Resetting did not occur (p>0.1) in any of the 6 patients with PNES. These preliminary results in patients with ES are in agreement with our previous findings from intracranial EEG recordings on resetting of brain dynamics at ES and it is expected to constitute the basis for the development of a reliable and supporting tool in the differential diagnosis between ES and PNES. Finally, we believe that these results shed a novel light on the electrophysiology of psychogenic epilepsy by showing that occurrence of PNES does not assist patients to overcome a pathological entrainment of brain dynamics. PMID:22078523

  17. Seizure susceptibility in intact and ovariectomized female rats treated with the convulsant pilocarpine

    PubMed Central

    Scharfman, Helen E.; Goodman, Jeffrey H.; Rigoulot, Marie-Aude; Berger, Russell E.; Walling, Susan G.; Mercurio, Thomas C.; Stormes, Kerry; Maclusky, Neil J.

    2008-01-01

    Despite numerous neuroendocrinological studies of seizures, the influence of estrogen and progesterone on seizures and epilepsy remains unclear. This may be due to the fact that previous studies have not systematically compared distinct endocrine conditions and included all relevant controls. The goal of the present study was to conduct such a study using pilocarpine as chemoconvulsant. Thus, age and weight-matched, intact or ovariectomized rats were tested to determine incidence of status epilepticus and to study events leading to status. Intact female rats were sampled at each cycle stage (proestrus, estrus, metestrus, or diestrus 2). Convulsant was administered at the same time of day, 10:00–10:30 a.m. Statistical analysis showed that there was a significantly lower incidence of status on the morning of estrus, but differences were attenuated in older animals. Ovariectomized rats were distinct in their rapid progression to status. These results show that the incidence of status in female rats following pilocarpine injection, and the progression to pilocarpine-induced status, are influenced by reproductive state as well as age. The hormonal milieu present specifically on the morning of estrus appears to decrease susceptibility to pilocarpine-induced status, particularly at young ages. In contrast, the chronic absence of reproductive steroids that characterizes the ovariectomized rat leads to a more rapid progression to status. This dissociation between incidence vs. progression provides new insight into the influence of estrogen and progesterone on seizures. PMID:16084511

  18. Cysteinyl leukotriene receptor (CysLT) antagonists decrease pentylenetetrazol-induced seizures and blood-brain barrier dysfunction.

    PubMed

    Lenz, Q F; Arroyo, D S; Temp, F R; Poersch, A B; Masson, C J; Jesse, A C; Marafiga, J R; Reschke, C R; Iribarren, P; Mello, C F

    2014-09-26

    Current evidence suggests that inflammation plays a role in the pathophysiology of seizures. In line with this view, selected pro-inflammatory arachidonic acid derivatives have been reported to facilitate seizures. Kainate-induced seizures are accompanied by leukotriene formation, and are reduced by inhibitors of LOX/COX pathway. Moreover, LTD4 receptor blockade and LTD4 synthesis inhibition suppress pentylenetetrazol (PTZ)-induced kindling and pilocarpine-induced recurrent seizures. Although there is convincing evidence supporting that blood-brain-barrier (BBB) dysfunction facilitates seizures, no study has investigated whether the anticonvulsant effect of montelukast is associated with its ability to maintain BBB integrity. In this study we investigated whether montelukast and other CysLT receptor antagonists decrease PTZ-induced seizures, as well as whether these antagonists preserve BBB during PTZ-induced seizures. Adult male albino Swiss mice were stereotaxically implanted with a cannula into the right lateral ventricle, and two electrodes were placed over the parietal cortex along with a ground lead positioned over the nasal sinus for electroencephalography (EEG) recording. The effects of montelukast (0.03 or 0.3 ?mol/1 ?L, i.c.v.), pranlukast (1 or 3 ?mol/1 ?L, i.c.v.), Bay u-9773 (0.3, 3 or 30 nmol/1 ?L, i.c.v.), in the presence or absence of the agonist LTD4 (0.2, 2, 6 or 20 pmol/1 ?L, i.c.v.), on PTZ (1.8 ?mol/2 ?L)-induced seizures and BBB permeability disruption were determined. The animals were injected with the antagonists, agonist or vehicle 30 min before PTZ, and monitored for additional 30 min for the appearance of seizures by electrographic and behavioral methods. BBB permeability was assessed by sodium fluorescein method and by confocal microscopy for CD45 and IgG immunoreactivity. Bay-u9973 (3 and 30 nmol), montelukast (0.03 and 0.3 ?mol) and pranlukast (1 and 3 ?mol), increased the latency to generalized seizures and decreased the mean amplitude of EEG recordings during seizures. LTD4 (0.2 and 2 pmol) reverted the anticonvulsant effect of montelukast (0.3 ?mol). Montelukast (0.03 and 0.3 ?mol) prevented PTZ-induced BBB disruption, an effect that was reversed by LTD4 at the dose of 6 pmol, but not at the doses 0.2 and 2 pmol. Moreover, the doses of LTD4 (0.2 and 2 pmol) that reverted the effect of montelukast on seizures did not alter montelukast-induced protection of BBB, dissociating BBB protection and anticonvulsant activity. Confocal microscopy analysis revealed that 1. PTZ increased the number of CD45+ and double-immunofluorescence staining for CD45 and IgG cells in the cerebral cortex, indicating BBB leakage with leukocyte infiltration; 2. while LTD4 (6 pmol) potentiated, montelukast decreased the effect of PTZ on leukocyte migration and BBB, assessed by double-immunofluorescence staining for CD45 and IgG cells in the cannulated hemisphere. Our data do not allow us ruling out that mechanisms unrelated and related to BBB protection may co-exist, resulting in decreased seizure susceptibility by montelukast. Notwithstanding, they suggest that CysLT1 receptors may be a suitable target for anticonvulsant development. PMID:25090924

  19. Atypical Gifted Learners and Their Characteristics.

    ERIC Educational Resources Information Center

    Diket, Read M., Ed.; Abel, Trudy, Ed.

    This collection of 12 handouts focuses on different categories of atypical gifted learners and their characteristics. The handouts are generally two pages long and present a summary of the literature on the topic, some practical teaching suggestions, and references. The handouts include: (1) "Socioeconomically Disadvantaged Gifted Students" (Pam…

  20. Atypical Visuomotor Performance in Children with PDD

    ERIC Educational Resources Information Center

    Schlooz, Wim A. J. M.; Hulstijn, Wouter

    2012-01-01

    Children with autism spectrum disorders (ASD) frequently encounter difficulties in visuomotor tasks, which are possibly caused by atypical visuoperceptual processing. This was tested in children (aged 9-12 years) with pervasive developmental disorder (PDD; including PDD-NOS and Asperger syndrome), and two same-age control groups (Tourette syndrome…

  1. Identification of atypical scrapie in Canadian sheep

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Scrapie, a transmissible spongiform encephalopathy of sheep and goats, exists in most small ruminant producing countries of the world. An atypical form of this disease, originally termed Nor98, was discovered in large abattoir surveillance of clinically normal, predominantly older sheep and rarely ...

  2. Atypical Alpha Asymmetry in Adults with ADHD

    ERIC Educational Resources Information Center

    Hale, T. Sigi; Smalley, Susan L.; Hanada, Grant; Macion, James; McCracken, James T.; McGough, James J.; Loo, Sandra K.

    2009-01-01

    Introduction: A growing body of literature suggests atypical cerebral asymmetry and interhemispheric interaction in ADHD. A common means of assessing lateralized brain function in clinical populations has been to examine the relative proportion of EEG alpha activity (8-12 Hz) in each hemisphere (i.e., alpha asymmetry). Increased rightward alpha…

  3. Atypical pyoderma gangrenosum mimicking an infectious process.

    PubMed

    To, Derek; Wong, Aaron; Montessori, Valentina

    2014-01-01

    We present a patient with atypical pyoderma gangrenosum (APG), which involved the patient's arm and hand. Hemorrhagic bullae and progressive ulcerations were initially thought to be secondary to an infectious process, but a biopsy revealed PG. Awareness of APG by infectious disease services may prevent unnecessary use of broad-spectrum antibiotics. PMID:25024856

  4. Atypical Neural Self-Representation in Autism

    ERIC Educational Resources Information Center

    Lombardo, Michael V.; Chakrabarti, Bhismadev; Bullmore, Edward T.; Sadek, Susan A.; Pasco, Greg; Wheelwright, Sally J.; Suckling, John; Baron-Cohen, Simon

    2010-01-01

    The "self" is a complex multidimensional construct deeply embedded and in many ways defined by our relations with the social world. Individuals with autism are impaired in both self-referential and other-referential social cognitive processing. Atypical neural representation of the self may be a key to understanding the nature of such impairments.…

  5. Effects of typical and atypical antipsychotics on human glycine transporters.

    PubMed

    Williams, Jacinta B; Mallorga, Pierre J; Conn, P Jeffrey; Pettibone, Douglas J; Sur, Cyrille

    2004-11-01

    Augmentation strategy in the treatment of schizophrenia with the NMDA receptor co-agonist glycine has demonstrated significant improvement in patient symptoms. Interestingly, the therapeutic efficacy of glycine was more consistent among patients that were not co-administered clozapine suggesting that clozapine modulates glycine levels in brain. Since cerebral glycine concentration in the vicinity of NMDA receptors is thought to be controlled by the glia expressed glycine transporter type 1 (GlyT1), the effects of several typical and atypical antipsychotics on glycine uptake were examined in human placenta choriocarcinoma (JAR) cells expressing human GlyT1a. The selectivity of these compounds was investigated by measuring their inhibitory potency at the closely related glycine transporter type 2 (GlyT2). Typical antipsychotics haloperidol, thioridazine and chlorpromazine non-selectively inhibited [(14)C]glycine uptake mediated by GlyT1a and GlyT2 with potency of 9-21 microM. The atypical antipsychotic, clozapine antagonized glycine transport by human GlyT1a with an IC(50) of 100 microM and was weaker at recombinant GlyT2. Its main metabolites, N-desmethylclozapine and clozapine N-oxide were very weak inhibitors at all glycine transporters. Similarly, olanzapine did not potently block GlyT1a- and GlyT2-mediated uptake. Detailed kinetic analysis of hGlyT1a in the presence and absence of haloperidol and clozapine revealed that both drugs were not competitive inhibitors of glycine uptake. Data also indicated that these compounds did not interact with the Na(+) and Cl(-) sites of hGlyT1a. Our results have revealed the existence of an inhibitory interaction between some antipsychotics and hGlyT1a and raise the possibility that these drugs could interact with GlyT1 function at therapeutic doses. PMID:15374578

  6. Familial Atypical Cold Urticaria: Description of a New Hereditary Disease

    PubMed Central

    Gandhi, Chhavi; Healy, Chris; Wanderer, Alan A.; Hoffman, Hal M.

    2009-01-01

    Background Acquired Cold Urticaria (ACU) is usually a self-limited, sporadic, cutaneous disease diagnosed by history and positive cold stimulation time tests (CSTT). We describe three unrelated families (A,B,C) with lifelong atypical cold urticaria, distinguished from ACU and Familial Cold Autoinflammatory Syndrome (FCAS). Objective To describe a new hereditary disease of cold urticaria and study its pathogenesis. Methods Questionnaires, interviews, physical exams, skin testing and biopsies were obtained. Absolute values, means and prevalence percentages of data are reported. Results 35 subjects are described with Familial Atypical Cold Urticaria (FACU) (A:17, B:8, C:10) displaying an autosomal dominant (AD) pattern of inheritance. All tested subjects had negative CSTT. Completed questionnaires from family A and B (35) revealed that all affected subjects had lifelong symptoms that began in early childhood with pruritis, erythema and urticaria after cold exposure. Angioedema (A:23%; B:42%), syncope and/or near-syncope (A:46%; B:86%) were also present. Triggers included cold atmosphere (100%), aquatic activities (A:92%, B:100%), handling cold objects (A:54%, B:71%) and ingestion of cold food or beverage (A:69%, B:100%). Skin biopsies demonstrated a mast cell infiltrate with the appearance of degranulation after cold challenge. Conclusions FACU is a new cold-induced inherited disease that is different than ACU in its natural history, atmospheric cold elicitation, severity of systemic reactions and CSTT results. FACU differs from FCAS in symptom-timing and the absence of fever, chills and joint pain. The etiology is suspected to be mast cell-related. Treatment of reactions is similar to ACU. Further evaluation of pathogenesis and genetics is warranted. PMID:19910034

  7. Low-power CMOS-based epileptic seizure onset detector

    Microsoft Academic Search

    Muhammad Tariqus Salam; Mohamad Sawan; Anas Hamoui; Dang Khoa Nguyen

    2009-01-01

    In this paper, we present an implantable CMOS integrated device that automatically detects epileptic seizure onsets. By recognizing partial-onset seizures, it can improve epilepsy treatment. The circuit consists of a chopper stabilized preamplifier, comprising a modulator, an amplifier, a high-pass filter with low cut-off frequency, and a voltage span detector. The proposed low-power detector extracts seizure onset information from neural

  8. Camphor poisoning: An unusual cause of seizure in children

    PubMed Central

    Patra, Chaitali; Sarkar, Shatanik; Dasgupta, Malay Kumar; Das, Amit

    2015-01-01

    Camphor is a pleasant-smelling cyclic ketone with propensity to cause neurologic side-effect, especially seizures. We report a case of 1˝-year-old child who after inadvertent consumption of camphor, experienced an episode of generalized tonic clonic seizure. This case highlights the importance of enquiring any intake of material (medicinal or otherwise) in every patient presenting with seizure and notifying presence of typical smell, if any. PMID:25878755

  9. Forecasting Seizures in Dogs with Naturally Occurring Epilepsy

    PubMed Central

    Stead, S. Matt; Brinkmann, Ben; Vasoli, Vincent; Crepeau, Daniel; Vite, Charles H.; Sturges, Beverly; Ruedebusch, Vanessa; Mavoori, Jaideep; Leyde, Kent; Sheffield, W. Douglas; Litt, Brian; Worrell, Gregory A.

    2014-01-01

    Seizure forecasting has the potential to create new therapeutic strategies for epilepsy, such as providing patient warnings and delivering preemptive therapy. Progress on seizure forecasting, however, has been hindered by lack of sufficient data to rigorously evaluate the hypothesis that seizures are preceded by physiological changes, and are not simply random events. We investigated seizure forecasting in three dogs with naturally occurring focal epilepsy implanted with a device recording continuous intracranial EEG (iEEG). The iEEG spectral power in six frequency bands: delta (0.1–4 Hz), theta (4–8 Hz), alpha (8–12 Hz), beta (12–30 Hz), low-gamma (30–70 Hz), and high-gamma (70–180 Hz), were used as features. Logistic regression classifiers were trained to discriminate labeled pre-ictal and inter-ictal data segments using combinations of the band spectral power features. Performance was assessed on separate test data sets via 10-fold cross-validation. A total of 125 spontaneous seizures were detected in continuous iEEG recordings spanning 6.5 to 15 months from 3 dogs. When considering all seizures, the seizure forecasting algorithm performed significantly better than a Poisson-model chance predictor constrained to have the same time in warning for all 3 dogs over a range of total warning times. Seizure clusters were observed in all 3 dogs, and when the effect of seizure clusters was decreased by considering the subset of seizures separated by at least 4 hours, the forecasting performance remained better than chance for a subset of algorithm parameters. These results demonstrate that seizures in canine epilepsy are not randomly occurring events, and highlight the feasibility of long-term seizure forecasting using iEEG monitoring. PMID:24416133

  10. Familial form of typical childhood absence epilepsy in a consanguineous context.

    PubMed

    Abouda, Hanen; Hizem, Yosr; Gargouri, Amina; Depienne, Christel; Bouteiller, Delphine; Riant, Florence; Tournier-Lasserve, Elisabeth; Gourfinkel-An, Isabelle; LeGuern, Eric; Gouider, Riadh

    2010-09-01

    Causative genes for childhood absence epilepsy (CAE) are unknown partly because families are small or phenotypically heterogeneous. In five consanguineous Tunisian families with at least two sibs with CAE, 14 patients fulfilled the diagnostic criteria for CAE (Epilepsia 1989; 30:389-399). Linkage analyses or direct sequencing excluded CACNG2, CACNA1A, CACNB4, and CACNA2D2, orthologs of genes responsible for autosomal recessive (AR) absence seizures in mice. These families will help identify (a) gene(s) responsible for CAE. PMID:20561025

  11. Ethosuximide and Phenytoin Dose-Dependently Attenuate Acute Nonconvulsive Seizures after Traumatic Brain Injury in Rats

    PubMed Central

    Shear, Deborah A.; Potter, Brittney; Marcsisin, Sean R.; Sousa, Jason; Melendez, Victor; Tortella, Frank C.; Lu, Xi-Chun M.

    2013-01-01

    Abstract Acute seizures frequently occur following severe traumatic brain injury (TBI) and have been associated with poor patient prognosis. Silent or nonconvulsive seizures (NCS) manifest in the absence of motor convulsion, can only be detected via continuous electroencephalographic (EEG) recordings, and are often unidentified and untreated. Identification of effective anti-epileptic drugs (AED) against post-traumatic NCS remains crucial to improve neurological outcome. Here, we assessed the anti-seizure profile of ethosuximide (ETX, 12.5–187.5?mg/kg) and phenytoin (PHT, 5–30?mg/kg) in a spontaneously occurring NCS model associated with penetrating ballistic-like brain injury (PBBI). Rats were divided between two drug cohorts, PHT or ETX, and randomly assigned to one of four doses or vehicle within each cohort. Following PBBI, NCS were detected by continuous EEG monitoring for 72?h post-injury. Drug efficacy was evaluated on NCS parameters of incidence, frequency, episode duration, total duration, and onset latency. Both PHT and ETX attenuated NCS in a dose-dependent manner. In vehicle-treated animals, 69–73% experienced NCS (averaging 9–10 episodes/rat) with average onset of NCS occurring at 30?h post-injury. Compared with control treatment, the two highest PHT and ETX doses significantly reduced NCS incidence to 13–40%, reduced NCS frequency (1.8–6.2 episodes/rat), and delayed seizure onset: <20% of treated animals exhibited NCS within the first 48?h. NCS durations were also dose-dependently mitigated. For the first time, we demonstrate that ETX and PHT are effective against spontaneously occurring NCS following PBBI, and suggest that these AEDs may be effective at treating post-traumatic NCS. PMID:23822888

  12. Ethosuximide and phenytoin dose-dependently attenuate acute nonconvulsive seizures after traumatic brain injury in rats.

    PubMed

    Mountney, Andrea; Shear, Deborah A; Potter, Brittney; Marcsisin, Sean R; Sousa, Jason; Melendez, Victor; Tortella, Frank C; Lu, Xi-Chun M

    2013-12-01

    Acute seizures frequently occur following severe traumatic brain injury (TBI) and have been associated with poor patient prognosis. Silent or nonconvulsive seizures (NCS) manifest in the absence of motor convulsion, can only be detected via continuous electroencephalographic (EEG) recordings, and are often unidentified and untreated. Identification of effective anti-epileptic drugs (AED) against post-traumatic NCS remains crucial to improve neurological outcome. Here, we assessed the anti-seizure profile of ethosuximide (ETX, 12.5-187.5 mg/kg) and phenytoin (PHT, 5-30 mg/kg) in a spontaneously occurring NCS model associated with penetrating ballistic-like brain injury (PBBI). Rats were divided between two drug cohorts, PHT or ETX, and randomly assigned to one of four doses or vehicle within each cohort. Following PBBI, NCS were detected by continuous EEG monitoring for 72 h post-injury. Drug efficacy was evaluated on NCS parameters of incidence, frequency, episode duration, total duration, and onset latency. Both PHT and ETX attenuated NCS in a dose-dependent manner. In vehicle-treated animals, 69-73% experienced NCS (averaging 9-10 episodes/rat) with average onset of NCS occurring at 30 h post-injury. Compared with control treatment, the two highest PHT and ETX doses significantly reduced NCS incidence to 13-40%, reduced NCS frequency (1.8-6.2 episodes/rat), and delayed seizure onset: <20% of treated animals exhibited NCS within the first 48 h. NCS durations were also dose-dependently mitigated. For the first time, we demonstrate that ETX and PHT are effective against spontaneously occurring NCS following PBBI, and suggest that these AEDs may be effective at treating post-traumatic NCS. PMID:23822888

  13. On the activity of the corticostriatal networks during spike-and-wave discharges in a genetic model of absence epilepsy.

    PubMed

    Slaght, Seán J; Paz, Tamar; Chavez, Mario; Deniau, Jean-Michel; Mahon, Séverine; Charpier, Stéphane

    2004-07-28

    Absence seizures are characterized by impairment of consciousness associated with widespread bilaterally synchronous spike-and-wave discharges (SWDs) in the electroencephalogram (EEG), which reflect highly synchronized oscillations in thalamocortical networks. Although recent pharmacological studies suggest that the basal ganglia could provide a remote control system for absence seizures, the mechanisms of propagation of epileptic discharges in these subcortical nuclei remain unknown. In the present study, we provide the first description of the electrical events in the corticostriatal pathway during spontaneous SWDs in the genetic absence epilepsy rats from Strasbourg (GAERS), a genetic model of absence epilepsy. In corticostriatal neurons, the SWDs were associated with suprathreshold rhythmic depolarizations in-phase with local EEG spikes. Consistent with this synchronized firing in their excitatory cortical afferents, striatal output neurons (SONs) exhibited, during SWDs, large-amplitude rhythmic synaptic depolarizations. However, SONs did not discharge during SWDs. Instead, the rhythmic synaptic excitation of SONs was shunted by a Cl(-)-dependent increase in membrane conductance that was temporally correlated with bursts of action potentials in striatal GABAergic interneurons. The reduced SON excitability accompanying absence seizures may participate in the control of SWDs by affecting the flow of cortical information within the basal ganglia circuits. PMID:15282287

  14. Maternal immune activation increases seizure susceptibility in juvenile rat offspring.

    PubMed

    Yin, Ping; Zhang, Xin-Ting; Li, Jun; Yu, Lin; Wang, Ji-Wen; Lei, Ge-Fei; Sun, Ruo-Peng; Li, Bao-Min

    2015-06-01

    Epidemiological data suggest a relationship between maternal infection and a high incidence of childhood epilepsy in offspring. However, there is little experimental evidence that links maternal infection with later seizure susceptibility in juvenile offspring. Here, we asked whether maternal immune challenge during pregnancy can alter seizure susceptibility and seizure-associated brain damage in adolescence. Pregnant Sprague-Dawley rats were treated with lipopolysaccharide (LPS) or normal saline (NS) on gestational days 15 and 16. At postnatal day 21, seizure susceptibility to kainic acid (KA) was evaluated in male offspring. Four groups were studied, including normal control (NS-NS), prenatal infection (LPS-NS), juvenile seizure (NS-KA), and "two-hit" (LPS-KA) groups. Our results demonstrated that maternal LPS exposure caused long-term reactive astrogliosis and increased seizure susceptibility in juvenile rat offspring. Compared to the juvenile seizure group, animals in the "two-hit" group showed exaggerated astrogliosis, followed by worsened spatial learning ability in adulthood. In addition, prenatal immune challenge alone led to spatial learning impairment in offspring but had no effect on anxiety. These data suggest that prenatal immune challenge causes a long-term increase in juvenile seizure susceptibility and exacerbates seizure-induced brain injury, possibly by priming astroglia. PMID:25982885

  15. Does Naloxone Prevent Seizure in Tramadol Intoxicated Patients?

    PubMed Central

    Eizadi-Mood, Nastaran; Ozcan, Dilek; Sabzghabaee, Ali Mohammad; Mirmoghtadaee, Parisa; Hedaiaty, Mahrang

    2014-01-01

    Background: Tramadol poisoning has increased in recent years. Seizure is one of the side-effects of tramadol toxicity. There is a controversy about possible preventive effect of naloxone in tramadol poisoning induced seizure. Therefore, this study was performed to compare seizure incidence in tramadol poisoning patients who received and did not receive naloxone, as an opioid antagonist. Methods: This study involved prospective data collection followed by retrospective analysis on 104 tramadol poisoning patients who were admitted in a referral poisoning center. The incidences of seizure were compared between patients received naloxone and those did not. Outcome was considered as survived without or with complications and death. Logistic Regression analysis was used to determine the effects of different variables on seizure incidence. Results: 70 (67.3%) of the patients were men. The mean age of the patients was 26.3 ± 9 years old. 18.3% of the patients received naloxone in their treatment period. Seizure incidence was significantly higher among tramadol poisoning patients who did not receive naloxone compare with those received naloxone (14.1% vs. 5.1%). Among different variable studied, age had a significant effect on predicting of seizure (odds ratio = 2.09; 95% of confidence interval: 1.82-2.26; P value, 0.004). Conclusions: Although the seizure incidence was lower in patients with tramadol poisoning who received naloxone, the logistic regression did not support the preventive effect of naloxone on seizure in tramadol poisoning cases. PMID:24829714

  16. The neural correlates of altered consciousness during epileptic seizures.

    PubMed

    Cavanna, Andrea E; Bagshaw, Andrew P; McCorry, Dougall

    2009-06-01

    Epileptic seizures are characterized by a multifaceted spectrum of alterations in the general level of awareness and/or the subjective contents of consciousness. Complete loss of consciousness occurs when epileptic activity involves both cortical and subcortical structures, as in generalized seizures. On the other hand, simple partial seizures can spare both the level and contents of consciousness. Finally, complex partial seizures associated with medial temporal lobe discharges can selectively impair the patient's subjective experiences with variable degrees of responsiveness. The differences in ictal semiology between patients with epilepsy offer unique avenues for understanding the relationship between pathological brain function and altered conscious states. PMID:19772840

  17. Pitfall of bispectral index during intraoperative seizure -a case report-

    PubMed Central

    Kim, Hyungdong

    2013-01-01

    We report a case of a 42-year-old male who developed generalized tonic-clonic seizure with sudden, brief decrease in bispectral index (BIS) value while undergoing emergency kidney transplantation. Few reports have been made on intraoperative pitfall of BIS value associated with seizure. This case report suggests seizure should be taken into account as a reason for such brief fall of BIS, especially while under general anesthesia or in other specific cases in which clinical signs of seizure are unseen. PMID:24363849

  18. Urethane anesthesia blocks the development and expression of kindled seizures

    SciTech Connect

    Cain, D.P.; Raithby, A.; Corcoran, M.E.

    1989-01-01

    The effect of anesthetic and subanesthetic doses of urethane on the development of amygdala kindled seizures and on the expression of previously kindled seizures was studied in hooded rats. An anesthetic dose of urethane almost completely eliminated evoked after discharge and completely eliminated convulsive behavior in both groups. It also eliminated the seizure response to pentylenetetrazol. Subanesthetic doses of urethane strongly attenuated the expression of previously kindled seizures. These results suggest that urethane may not be an appropriate anesthetic for the study of epileptiform phenomena.

  19. Age-dependent long-term structural and functional effects of early-life seizures: evidence for a hippocampal critical period influencing plasticity in adulthood.

    PubMed

    Sayin, U; Hutchinson, E; Meyerand, M E; Sutula, T

    2015-03-12

    Neural activity promotes circuit formation in developing systems and during critical periods permanently modifies circuit organization and functional properties. These observations suggest that excessive neural activity, as occurs during seizures, might influence developing neural circuitry with long-term outcomes that depend on age at the time of seizures. We systematically examined long-term structural and functional consequences of seizures induced in rats by kainic acid, pentylenetetrazol, and hyperthermia across postnatal ages from birth through postnatal day 90 in adulthood (P90). Magnetic resonance imaging (MRI), diffusion tensor imaging (DTI), and electrophysiological methods at ?P95 following seizures induced from P1 to P90 demonstrated consistent patterns of gross atrophy, microstructural abnormalities in the corpus callosum (CC) and hippocampus, and functional alterations in hippocampal circuitry at ?P95 that were independent of the method of seizure induction and varied systematically as a function of age at the time of seizures. Three distinct epochs were observed in which seizures resulted in distinct long-term structural and functional outcomes at ?P95. Seizures prior to P20 resulted in DTI abnormalities in CC and hippocampus in the absence of gross cerebral atrophy, and increased paired-pulse inhibition (PPI) in the dentate gyrus (DG) at ?P95. Seizures after P30 induced a different pattern of DTI abnormalities in the fimbria and hippocampus accompanied by gross cerebral atrophy with increases in lateral ventricular volume, as well as increased PPI in the DG at ?P95. In contrast, seizures between P20 and P30 did not result in cerebral atrophy or significant imaging abnormalities in the hippocampus or white matter, but irreversibly decreased PPI in the DG compared to normal adult controls. These age-specific long-term structural and functional outcomes identify P20-30 as a potential critical period in hippocampal development defined by distinctive long-term structural and functional properties in adult hippocampal circuitry, including loss of capacity for seizure-induced plasticity in adulthood that could influence epileptogenesis and other hippocampal-dependent behaviors and functional properties. PMID:25555928

  20. Quantitative EEG analysis of the maturational changes associated with childhood absence epilepsy

    NASA Astrophysics Data System (ADS)

    Rosso, O. A.; Hyslop, W.; Gerlach, R.; Smith, R. L. L.; Rostas, J. A. P.; Hunter, M.

    2005-10-01

    This study aimed to examine the background electroencephalography (EEG) in children with childhood absence epilepsy, a condition whose presentation has strong developmental links. EEG hallmarks of absence seizure activity are widely accepted and there is recognition that the bulk of inter-ictal EEG in this group is normal to the naked eye. This multidisciplinary study aimed to use the normalized total wavelet entropy (NTWS) (Signal Processing 83 (2003) 1275) to examine the background EEG of those patients demonstrating absence seizure activity, and compare it with children without absence epilepsy. This calculation can be used to define the degree of order in a system, with higher levels of entropy indicating a more disordered (chaotic) system. Results were subjected to further statistical analyses of significance. Entropy values were calculated for patients versus controls. For all channels combined, patients with absence epilepsy showed (statistically significant) lower entropy values than controls. The size of the difference in entropy values was not uniform, with certain EEG electrodes consistently showing greater differences than others.

  1. Effects of JIP3 on epileptic seizures: Evidence from temporal lobe epilepsy patients, kainic-induced acute seizures and pentylenetetrazole-induced kindled seizures.

    PubMed

    Wang, Z; Chen, Y; Lü, Y; Chen, X; Cheng, L; Mi, X; Xu, X; Deng, W; Zhang, Y; Wang, N; Li, J; Li, Y; Wang, X

    2015-08-01

    JNK-interacting protein 3 (JIP3), also known as JNK stress-activated protein kinase-associated protein 1 (JSAP1), is a scaffold protein mainly involved in the regulation of the pro-apoptotic signaling cascade mediated by c-Jun N-terminal kinase (JNK). Overexpression of JIP3 in neurons in vitro has been reported to lead to accelerated activation of JNK and enhanced apoptosis response to cellular stress. However, the occurrence and the functional significance of stress-induced modulations of JIP3 levels in vivo remain elusive. In this study, we investigated the expression of JIP3 in temporal lobe epilepsy (TLE) and in a kainic acid (KA)-induced mouse model of epileptic seizures, and determined whether down-regulation of JIP3 can decrease susceptibility to seizures and neuron damage induced by KA. We found that JIP3 was markedly increased in TLE patients and a mouse model of epileptic seizures; mice underexpressing JIP3 through lentivirus bearing LV-Letm1-RNAi showed decreased susceptibility, delayed first seizure and decreased seizure duration response to the epileptogenic properties of KA. Subsequently, a decreased activation of JNK following seizure induction was observed in mice underexpressing JIP3, which also exhibited less neuronal apoptosis in the CA3 region of the hippocampus, as assessed three days after KA administration. We also found that mice underexpressing JIP3 exhibited a delayed pentylenetetrazole (PTZ)-induced kindling seizure process. PMID:26002316

  2. How to Differentiate Syncope from Seizure.

    PubMed

    Sheldon, Robert

    2015-08-01

    Convulsive syncope is a common cause of misdiagnosis in patients who present with a transient loss of consciousness. This misdiagnosis contributes significantly to the numbers of patients with a questionable diagnosis of epilepsy, and to those with apparently drug-resistant epilepsy. The most important step to an accurate diagnosis is a fastidious history. Inducing syncope with tilt table testing and documenting heart rate changes during events with implantable loop recorders have proved to be useful. These suggest the need for closer and ongoing collaboration among neurologists and cardiologists to provide optimal care for patients with the diagnostic dilemma of syncope or epileptic seizures. PMID:26115824

  3. A micropower support vector machine based seizure detection architecture for embedded medical devices

    E-print Network

    Shoeb, Ali H.

    Implantable neurostimulators for the treatment of epilepsy that are capable of sensing seizures can enable novel therapeutic applications. However, detecting seizures is challenging due to significant intracranial EEG ...

  4. A micropower support vector machine based seizure detection architecture embedded medical devices

    E-print Network

    Denison, Timothy

    Implantable neurostimulators for the treatment of epilepsy that are capable of sensing seizures can enable novel therapeutic applications. However, detecting seizures is challenging due to significant intracranial EEG ...

  5. Atypical Localization of Enchondroma in the Calcaneus.

    PubMed

    Komurcu, Erkam; Kaymaz, Burak; Golge, Umut Hatay; Goksel, Ferdi; Resorlu, Mustafa; K?l?nç, Nihal

    2015-05-01

    A 53-year-old man presented to the orthopedic outpatient clinic with pain and swelling in the right heel without any trauma. On physical examination and radiologic assessment, a lesion with calcification and peripheral sclerosis was detected in the medullary cavity of the calcaneus, and computed tomographic images revealed cortical thinning adjacent to the lesion. Magnetic resonance images showed a 23 × 19-mm lesion. Tru-Cut biopsy, performed to clarify the diagnosis, revealed an enchondroma. As a definitive treatment, curettage of the lesion and grafting of the cavity was performed. Although enchondromas are common pathologic abnormalities of the skeleton and are usually asymptomatic, atypical localization, such as the calcaneus, and atypical clinical manifestations, such as heel pain, should also be kept in mind. PMID:26146974

  6. Cerebral hemodynamic responses to seizure in the mouse brain: simultaneous near-infrared spectroscopy-electroencephalography study

    NASA Astrophysics Data System (ADS)

    Lee, Seungduk; Lee, Mina; Koh, Dalkwon; Kim, Beop-Min; Choi, Jee Hyun

    2010-05-01

    We applied near-infrared spectroscopy (NIRS) and electroencephalography (EEG) simultaneously on the mouse brain and investigated the hemodynamic response to epileptic episodes under pharmacologically driven seizure. ?-butyrolactone (GBL) and 4-aminopyridine (4-AP) were applied to induce absence and tonic-clonic seizures, respectively. The epileptic episodes were identified from the single-channel EEG, and the corresponding hemodynamic changes in different regions of the brain were characterized by multichannel frequency-domain NIRS. Our results are the following: (i) the oxyhemoglobin level increases in the case of GBL-treated mice but not 4-AP-treated mice compared to the predrug state; (ii) the dominant response to each absence seizure is a decrease in deoxyhemolobin; (iii) the phase shift between oxy- and deoxyhemoglobin reduces in GBL-treated mice but no 4-AP-treated mice; and (iv) the spatial correlation of hemodynamics increased significantly in 4-AP-treated mice but not in GBL-treated mice. Our results shows that spatiotemporal tracking of cerebral hemodynamics using NIRS can be successfully applied to the mouse brain in conjunction with electrophysiological recording, which will support the study of molecular, cellular, and network origin of neurovascular coupling in vivo.

  7. Neuropharmacological mechanisms of nerve agent-induced seizure and neuropathology.

    PubMed

    McDonough, J H; Shih, T M

    1997-09-01

    This paper proposes a three phase "model" of the neuropharmacological processes responsible for the seizures and neuropathology produced by nerve agent intoxication. Initiation and early expression of the seizures are cholinergic phenomenon; anticholinergics readily terminate seizures at this stage and no neuropathology is evident. However, if not checked, a transition phase occurs during which the neuronal excitation of the seizure per se perturbs other neurotransmitter systems: excitatory amino acid (EAA) levels increase reinforcing the seizure activity; control with anticholinergics becomes less effective; mild neuropathology is occasionally observed. With prolonged epileptiform activity the seizure enters a predominantly non-cholinergic phase: it becomes refractory to some anticholinergics; benzodiazepines and N-methyl-D-aspartate (NMDA) antagonists remain effective as anticonvulsants, but require anticholinergic co-administration; mild neuropathology is evident in multiple brain regions. Excessive influx of calcium due to repeated seizure-induced depolarization and prolonged stimulation of NMDA receptors is proposed as the ultimate cause of neuropathology. The model and data indicate that rapid and aggressive management of seizures is essential to prevent neuropathology from nerve agent exposure. PMID:9353792

  8. Seizures and brain regulatory systems: consciousness, sleep, and autonomic systems.

    PubMed

    Sedigh-Sarvestani, Madineh; Blumenfeld, Hal; Loddenkemper, Tobias; Bateman, Lisa M

    2015-06-01

    Research into the physiologic underpinnings of epilepsy has revealed reciprocal relationships between seizures and the activity of several regulatory systems in the brain. This review highlights recent progress in understanding and using the relationships between seizures and the arousal or consciousness system, the sleep-wake and associated circadian system, and the central autonomic network. PMID:25233249

  9. Seizures and Epilepsy and Their Relationship to Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Matson, Johnny L.; Neal, Daniene

    2009-01-01

    Autism spectrum disorders (ASD) are serious neurodevelopmental disorders which often co-occur with intellectual disabilities. A disorder which is strongly correlated with both of these disabilities are seizures and epilepsy. The purpose of this review was to provide an overview of available research on seizures and epilepsy in the ASD population…

  10. Electrically Induced Limbic Seizures: Preliminary Findings in a Rodent Model

    PubMed Central

    Kowski, Alexander B; Holtkamp, Martin

    2015-01-01

    In epilepsy, novel pharmacological and nonpharmacological treatment approaches are commonly assessed in model systems of acute motor and often generalized seizures. We developed a rodent model with short-term electrical stimulation of the perforant path resulting in stereotyped limbic seizures. Limbic structures play a major role in human intractable epilepsy. In 10 rats, single electrical 5-second and 20-Hz stimuli to the perforant path reliably produced limbic seizures characterized by resting behavior and subtle motor signs. Electrophysiological recordings from the dentate gyrus demonstrated a seizure pattern with 4-Hz to 5-Hz discharges. Multiple inductions of seizures within 72 hours did not alter behavioral and electrophysiological seizure characteristics. Electrophysiological excitatory and inhibitory parameters assessed by evoked single and paired pulses did not change with increasing number of seizures. We present preliminary findings on a new model of electrically induced limbic seizures of mesiotemporal origin. This model may represent a reliable screening tool for new treatment approaches such as deep brain stimulation. PMID:25861223

  11. Development of spontaneous seizures over extended electrical kindling

    Microsoft Academic Search

    Michalakis Michael; Damian Holsinger; Candace Ikeda-Douglas; Sam Cammisuli; Janina Ferbinteanu; Cheryl DeSouza; Sandra DeSouza; Jillian Fecteau; Ronald J Racine; Norton W Milgram

    1998-01-01

    The present study was aimed at evaluating an extended kindling model of spontaneous epilepsy. Behavioral and electrographic responses to repeated kindling of either the perforant path or amygdala were monitored for up to 300 trials. Kindling initially led to generalized convulsions equivalent to the level 5 seizure on the rating scale developed by Racine. The evoked seizures became progressively more

  12. Neuropeptide FF receptors as novel targets for limbic seizure attenuation.

    PubMed

    Portelli, Jeanelle; Meurs, Alfred; Bihel, Frederic; Hammoud, Hassan; Schmitt, Martine; De Kock, Joery; Utard, Valerie; Humbert, Jean-Paul; Bertin, Isabelle; Buffel, Ine; Coppens, Jessica; Tourwe, Dirk; Maes, Veronique; De Prins, An; Vanhaecke, Tamara; Massie, Ann; Balasubramaniam, Ambikaipakan; Boon, Paul; Bourguignon, Jean-Jacques; Simonin, Frederic; Smolders, Ilse

    2015-08-01

    Neuropeptide Y (NPY) is a well established anticonvulsant and first-in-class antiepileptic neuropeptide. In this study, the controversial role of NPY1 receptors in epilepsy was reassessed by testing two highly selective NPY1 receptor ligands and a mixed NPY1/NPFF receptor antagonist BIBP3226 in a rat model for limbic seizures. While BIBP3226 significantly attenuated the pilocarpine-induced seizures, neither of the highly selective NPY1 receptor ligands altered the seizure severity. Administration of the NPFF1/NPFF2 receptor antagonist RF9 also significantly attenuated limbic seizure activity. To further prove the involvement of NPFF receptors in these seizure-modulating effects, low and high affinity antagonists for the NPFF receptors were tested. We observed that the low affinity ligand failed to exhibit anticonvulsant properties while the two high affinity ligands significantly attenuated the seizures. Continuous NPFF1 receptor agonist administration also inhibited limbic seizures whereas bolus administration of the NPFF1 receptor agonist was without effect. This suggests that continuous agonist perfusion could result in NPFF1 receptor desensitization and mimic NPFF1 receptor antagonist administration. Our data unveil for the first time the involvement of the NPFF system in the management of limbic seizures. PMID:25963417

  13. Detection of early seizures by diffuse optical tomography

    NASA Astrophysics Data System (ADS)

    Zhang, Tao; Hajihashemi, M. Reza; Zhou, Junli; Carney, Paul R.; Jiang, Huabei

    2015-03-01

    In epilepsy it has been challenging to detect early changes in brain activity that occurs prior to seizure onset and to map their origin and evolution for possible intervention. Besides, preclinical seizure experiments need to be conducted in awake animals with images reconstructed and displayed in real-time. We demonstrate using a rat model of generalized epilepsy that diffuse optical tomography (DOT) provides a unique functional neuroimaging modality for noninvasively and continuously tracking brain activities with high spatiotemporal resolution. We developed methods to conduct seizure experiments in fully awake rats using a subject-specific helmet and a restraining mechanism. For the first time, we detected early hemodynamic responses with heterogeneous patterns several minutes preceding the electroencephalographic seizure onset, supporting the presence of a "pre-seizure" state both in anesthetized and awake rats. Using a novel time-series analysis of scattering images, we show that the analysis of scattered diffuse light is a sensitive and reliable modality for detecting changes in neural activity associated with generalized seizure. We found widespread hemodynamic changes evolving from local regions of the bilateral cortex and thalamus to the entire brain, indicating that the onset of generalized seizures may originate locally rather than diffusely. Together, these findings suggest DOT represents a powerful tool for mapping early seizure onset and propagation pathways.

  14. Pathological yawning as an ictal seizure manifestation in the elderly.

    PubMed

    Nicotra, Alessia; Khalil, Nofal M; Owbridge, P; Hakda, Mina; Beitverda, Younatan

    2012-01-01

    Excessive yawning has been reported in the peri-ictal period preceding or following seizures. We describe an exceptional case of an elderly man with impairment of consciousness and paroxysmal excessive yawning. We hypothesise that this can be regarded as an autonomic seizure originating from diencephalic/brainstem structures, manifesting with yawning as an ictal phenomenon. PMID:23076687

  15. Chronic focal seizure disorder as a manifestation of intracranial iophendylate.

    PubMed

    Pascuzzi, R M; Roos, K L; Scott, J A

    1988-01-01

    A 46-year-old woman developed focal seizures 10-15 years following iophendylate myelography. Focal epileptogenic abnormalities on electroencephalogram corresponded to the localization of residual iophendylate in the right sylvian fissure. Intracranial iophendylate may have produced chronic meningeal reaction leading to cortical irritation and a chronic seizure disorder. PMID:3131136

  16. Seizures in Fragile X Syndrome: Characteristics and Comorbid Diagnoses

    ERIC Educational Resources Information Center

    Berry-Kravis, Elizabeth; Raspa, Melissa; Loggin-Hester, Lisa; Bishop, Ellen; Holiday, David; Bailey, Donald B., Jr.

    2010-01-01

    A national survey of caregivers of individuals with fragile X syndrome addressed characteristics of epilepsy and co-occurring conditions. Of the 1,394 individuals (1,090 males and 304 females) with the full mutation, 14% of males and 6% of females reported seizures. Seizures were more often partial, began between ages 4 and 10 years, and were…

  17. Development of seizures in the Mongolian gerbil (Meriones unguiculatus)

    Microsoft Academic Search

    Harriett Kaplan; Charles Miezejeski

    1972-01-01

    Studied the frequency of occurrence of seizures in 102 male and 126 female Mongolian gerbils. Frequency was a function of age but not sex. Seizures lst appeared at 2 mo. of age, and at 6 mo. their frequency was still increasing. The trigger appeared to be increased, possibly stressful, stimulus input. Early stimulation in the form of weekly tests, from

  18. Atypical imaging observations of branchial cleft cysts

    PubMed Central

    HU, SU; HU, CHUN-HONG; YANG, LING; XING, JIAN-MING; CHEN, JIAN-HUA; GE, ZI-LI; LIU, JI-SHENG

    2014-01-01

    The aim of the present study was to assess the atypical imaging manifestations of branchial cleft cysts (BCCs) confirmed by pathology. Computerized tomography (CT) or magnetic resonance imaging (MRI) of 17 BCC cases were reviewed. The imaging features, including laterality, location, border, attenuation and internal architecture, were evaluated. All 17 cases were second BCCs, including 5 cases of Bailey type I classification cysts and 12 cases of type II classification cysts. The atypical imaging features included signal and morphological abnormalities. The abnormal signal intensities were caused by intracapsular bleeding (n=2) or solidification of cystic fluid (n=2). Intracystic hemorrhaging revealed homogeneous hyperintensity on T1-weighted image (T1WI) and T2-weighted image (T2WI). Solidification of cystic fluid revealed slightly homogeneous hyperintensity compared with muscle on T1WI and homogeneous hypointensity on T2WI without enhancement. The aberrant morphology mainly presented as thickening of the cystic wall (n=13). Thickened walls of BCCs with ill- (n=5) or well- (n=8) defined borders were observed in 13 patients. In 3 patients, significant enhancement was identified following intravenous gadolinium administration (n=4). When with atypical CT or MRI features are presented, the typical location of BCCs can help in the diagnosis, as it is located at the lateral portion of the neck adjacent to the anterior border of the mandibular angle or sternocleidomastoid muscle. The atypical observations, including variable signals, imply that the cystic content has changed. Thickened walls indicate inflammation or cancerous tendency and patients with ill-defined margins, vascular involvement or lymphadenopathy atelectasis indicate malignant conversion. PMID:24348852

  19. Spectral atlas of A-type supergiants

    E-print Network

    Klochkova, V G; Chentsov, E L

    2015-01-01

    Based on high-spectral-resolution observations (R=60000) performed with the 6-m BTA telescope in combination with the echelle spectrograph NES, we have studied the optical spectra of three A-type supergiants: a peculiar supergiant 3 Pup, a post-AGB star BD+48 1220, and a massive $\\alpha$ Cyg, which belong to essentially different stages of evolution. A spectral atlas for these stars is prepared in the wavelength interval of 3920 to 6720 \\AA.

  20. An atypical mycobacterial infection of the shoulder

    PubMed Central

    Talbot, Christopher L.; Rhodes, Bryan

    2012-01-01

    Mycobacterium malmoense is an acid-fast non-tuberculous organism that most commonly causes pulmonary infection. Extrapulmonary infection has also been reported. With an increased emphasis being placed on the clinical importance of this organism, especially within Europe, we report the first case of septic arthritis of the shoulder caused by this organism. We also highlight the importance of considering atypical mycobacterium infection in the differential diagnosis of shoulder infection and issues surrounding the management of this entity. PMID:22787336

  1. Atypical melanocytic naevi following melanotan injection.

    PubMed

    Reid, C; Fitzgerald, T; Fabre, A; Kirby, B

    2013-05-01

    Melanotan is a synthetic analogue of alpha melanocyte stimulating hormone (a-MSH) that stimulates melanogenesis. It is sold on the internet and tanning salons as a quick 'tanning jab'. We report a patient who developed multiple new onset atypical naevi within one week of receiving two Melanotan injections. This case highlights the potential risk of Melanotan in stimulating dysplastic naevi or possibly malignant melanoma. PMID:23914578

  2. My approach to atypical melanocytic lesions

    PubMed Central

    Culpepper, K S; Granter, S R; McKee, P H

    2004-01-01

    Histological assessment of melanocytic naevi constitutes a substantial proportion of a dermatopathologist’s daily workload. Although they may be excised for cosmetic reasons, most lesions encountered are clinically atypical and are biopsied or excised to exclude melanoma. Although dysplastic naevi are most often encountered, cytological atypia may be a feature of several other melanocytic lesions, including genital type naevi, acral naevi, recurrent naevi, and neonatal or childhood naevi. With greater emphasis being given to cosmetic results, and because of an ever increasing workload, several “quicker and less traumatising” techniques have been introduced in the treatment and diagnosis of atypical naevi including punch, shave, and scoop shave biopsies. A major limitation to all of these alternatives is that often only part of the lesion is available for histological assessment and therefore all too frequently the pathologist’s report includes a recommendation for complete excision so that the residual lesion can be studied. Complete or large excision of all clinically atypical naevi permits histological assessment of the entire lesion, and in most cases spares the patient the need for further surgical intervention. PMID:15509670

  3. Seizure activity and unresponsiveness after hydroxycut ingestion.

    PubMed

    Kockler, D R; McCarthy, M W; Lawson, C L

    2001-05-01

    A 22-year-old man was hospitalized after unexplained seizure-like activity and unresponsiveness. A urine toxicology screen was negative for salicylates, acetaminophen, alcohol, and drugs of abuse. Medical history was insignificant with the exception of recent (within 2 wks) ingestion of Hydroxycut is a dietary supplement purported to be energy enhancing, muscle building, and fat burning. The agent contains ephedra alkaloids and caffeine, which are both central nervous system stimulants; the etiology of seizure was attributed to their consumption. Due to a significant number of reported adverse events, the United States Food and Drug Administration (FDA) proposed regulations for dietary supplements containing ephedra alkaloids and requested an independent review of case reports linked to these products. Because herbal products are not subject to the same rigorous FDA regulations required for prescription and over-the-counter products, consumers unknowingly risk adverse effects when taking these products. Questioning patients about consumption of herbal products should be part of routine medical visits. PMID:11349754

  4. Management of reflex anoxic seizures in children.

    PubMed

    Iyer, Anand; Appleton, Richard

    2013-09-01

    Reflex anoxic seizures (RAS) are important in the differential diagnosis of non-epileptic paroxysmal events in infants and preschool-aged children. They are classically provoked by a sudden distressing stimulus, which causes loss of consciousness followed by stiffening and brief clonic movements affecting some or all limbs, often misinterpreted as an epileptic seizure. The underlying pathophysiology is a vagal-induced brief cardiac asystole with resultant transient cerebral hypoperfusion. Parents and carers who witness the event are understandably anxious, and the mainstay of management are ensuring the appropriate timely diagnosis of RAS and excluding cardiac arrhythmia. A detailed history from a witness is all that is needed to diagnose this condition and investigations like EEG or neuroimaging should be avoided. Education and reassurance remain the mainstay in the management. Some children benefit from medical treatment with atropine or fluoxetine; however, there is a lack of evidence for pharmacological treatment. Cardiac pacing is the only definitive treatment, and is reserved for frequent, severe cases in joint consultation with the cardiologist. PMID:23814085

  5. Assortative mixing in functional brain networks during epileptic seizures

    NASA Astrophysics Data System (ADS)

    Bialonski, Stephan; Lehnertz, Klaus

    2013-09-01

    We investigate assortativity of functional brain networks before, during, and after one-hundred epileptic seizures with different anatomical onset locations. We construct binary functional networks from multi-channel electroencephalographic data recorded from 60 epilepsy patients; and from time-resolved estimates of the assortativity coefficient, we conclude that positive degree-degree correlations are inherent to seizure dynamics. While seizures evolve, an increasing assortativity indicates a segregation of the underlying functional network into groups of brain regions that are only sparsely interconnected, if at all. Interestingly, assortativity decreases already prior to seizure end. Together with previous observations of characteristic temporal evolutions of global statistical properties and synchronizability of epileptic brain networks, our findings may help to gain deeper insights into the complicated dynamics underlying generation, propagation, and termination of seizures.

  6. Seizure in Pregnancy Following Cerebral Venous Sinus Thrombosis

    PubMed Central

    Farzi, Farnoush; Abdollahzadeh, Mehrsima; Faraji, Roya; Chavoushi, Tahereh

    2015-01-01

    Introduction: Seizure involves less than 1% of pregnancies; however it is associated with increased maternal and fetal complications. Cerebral venous sinus thrombosis is a rare, but potentially life-threatening cause of seizure during pregnancy, presenting primarily as seizure in 12% - 31.9% of cases. Pregnancy and puerperium are known as the risk factors of cerebral venous sinus thrombosis. Case Presentation: Here is presented a case of seizure after delivery by cesarean section in an otherwise healthy woman. The final diagnosis was cerebral venous sinus thrombosis probably due to hypercoagulable state in pregnancy. Conclusions: If seizure occurs during the peripartum period, along with providing complete cardiovascular and respiratory support, advanced diagnostic measures are needed and cerebral venous sinus thrombosis should be considered as a possible diagnosis. PMID:26161329

  7. The piriform, perirhinal, and entorhinal cortex in seizure generation

    PubMed Central

    Vismer, Marta S.; Forcelli, Patrick A.; Skopin, Mark D.; Gale, Karen; Koubeissi, Mohamad Z.

    2015-01-01

    Understanding neural network behavior is essential to shed light on epileptogenesis and seizure propagation. The interconnectivity and plasticity of mammalian limbic and neocortical brain regions provide the substrate for the hypersynchrony and hyperexcitability associated with seizure activity. Recurrent unprovoked seizures are the hallmark of epilepsy, and limbic epilepsy is the most common type of medically-intractable focal epilepsy in adolescents and adults that necessitates surgical evaluation. In this review, we describe the role and relationships among the piriform (PIRC), perirhinal (PRC), and entorhinal cortex (ERC) in seizure-generation and epilepsy. The inherent function, anatomy, and histological composition of these cortical regions are discussed. In addition, the neurotransmitters, intrinsic and extrinsic connections, and the interaction of these regions are described. Furthermore, we provide evidence based on clinical research and animal models that suggest that these cortical regions may act as key seizure-trigger zones and, even, epileptogenesis. PMID:26074779

  8. Pre-seizure state identified by diffuse optical tomography

    PubMed Central

    Zhang, Tao; Zhou, Junli; Jiang, Ruixin; Yang, Hao; Carney, Paul R.; Jiang, Huabei

    2014-01-01

    In epilepsy it has been challenging to detect early changes in brain activity that occurs prior to seizure onset and to map their origin and evolution for possible intervention. Here we demonstrate using a rat model of generalized epilepsy that diffuse optical tomography (DOT) provides a unique functional neuroimaging modality for noninvasively and continuously tracking such brain activities with high spatiotemporal resolution. We detected early hemodynamic responses with heterogeneous patterns, along with intracranial electroencephalogram gamma power changes, several minutes preceding the electroencephalographic seizure onset, supporting the presence of a “pre-seizure” state. We also observed the decoupling between local hemodynamic and neural activities. We found widespread hemodynamic changes evolving from local regions of the bilateral cortex and thalamus to the entire brain, indicating that the onset of generalized seizures may originate locally rather than diffusely. Together, these findings suggest DOT represents a powerful tool for mapping early seizure onset and propagation pathways. PMID:24445927

  9. Pre-seizure state identified by diffuse optical tomography

    NASA Astrophysics Data System (ADS)

    Zhang, Tao; Zhou, Junli; Jiang, Ruixin; Yang, Hao; Carney, Paul R.; Jiang, Huabei

    2014-01-01

    In epilepsy it has been challenging to detect early changes in brain activity that occurs prior to seizure onset and to map their origin and evolution for possible intervention. Here we demonstrate using a rat model of generalized epilepsy that diffuse optical tomography (DOT) provides a unique functional neuroimaging modality for noninvasively and continuously tracking such brain activities with high spatiotemporal resolution. We detected early hemodynamic responses with heterogeneous patterns, along with intracranial electroencephalogram gamma power changes, several minutes preceding the electroencephalographic seizure onset, supporting the presence of a ``pre-seizure'' state. We also observed the decoupling between local hemodynamic and neural activities. We found widespread hemodynamic changes evolving from local regions of the bilateral cortex and thalamus to the entire brain, indicating that the onset of generalized seizures may originate locally rather than diffusely. Together, these findings suggest DOT represents a powerful tool for mapping early seizure onset and propagation pathways.

  10. Regional voltage map of the hippocampus during seizures.

    PubMed

    Dasheiff, R M

    1989-08-01

    The hallmark of brain tissue is its electrical activity. However, few techniques are available to directly monitor voltage changes in neural tissue, especially in whole brain preparation. A technique has been developed using a fluorescent voltage-sensitive dye and digital image analysis to produce a high spatial resolution map of the voltage changes induced by seizures in the hippocampus. Eight different anatomical regions within the septal hippocampus of the rat were analyzed. Seizures were produced in vivo by methods which use entirely different mechanisms and produce electrographically and behaviorally different types of seizures. Kainic acid produced depolarization during the seizure, whereas bicuculline produced hyperpolarization. The results provide experimental evidence that all seizures do not induce a depolarized state in the brain. PMID:2666149

  11. Impaired consciousness in partial seizures is bimodally distributed

    PubMed Central

    Cunningham, Courtney; Chen, William C.; Shorten, Andrew; McClurkin, Michael; Choezom, Tenzin; Schmidt, Christian P.; Chu, Victoria; Bozik, Anne; Best, Cameron; Chapman, Melissa; Furman, Moran; Detyniecki, Kamil; Giacino, Joseph T.

    2014-01-01

    Objective: To investigate whether impaired consciousness in partial seizures can usually be attributed to specific deficits in the content of consciousness or to a more general decrease in the overall level of consciousness. Methods: Prospective testing during partial seizures was performed in patients with epilepsy using the Responsiveness in Epilepsy Scale (n = 83 partial seizures, 30 patients). Results were compared with responsiveness scores in a cohort of patients with severe traumatic brain injury evaluated with the JFK Coma Recovery Scale–Revised (n = 552 test administrations, 184 patients). Results: Standardized testing during partial seizures reveals a bimodal scoring distribution, such that most patients were either fully impaired or relatively spared in their ability to respond on multiple cognitive tests. Seizures with impaired performance on initial test items remained consistently impaired on subsequent items, while other seizures showed spared performance throughout. In the comparison group, we found that scores of patients with brain injury were more evenly distributed across the full range in severity of impairment. Conclusions: Partial seizures can often be cleanly separated into those with vs without overall impaired responsiveness. Results from similar testing in a comparison group of patients with brain injury suggest that the bimodal nature of Responsiveness in Epilepsy Scale scores is not a result of scale bias but may be a finding unique to partial seizures. These findings support a model in which seizures either propagate or do not propagate to key structures that regulate overall arousal and thalamocortical function. Future investigations are needed to relate these behavioral findings to the physiology underlying impaired consciousness in partial seizures. PMID:24727311

  12. Modeling Seizure Self-Prediction: An E-Diary Study

    PubMed Central

    Haut, Sheryl R.; Hall, Charles B.; Borkowski, Thomas; Tennen, Howard; Lipton, Richard B.

    2013-01-01

    Purpose A subset of patients with epilepsy successfully self-predicted seizures in a paper diary study. We conducted an e-diary study to ensure that prediction precedes seizures, and to characterize the prodromal features and time windows that underlie self-prediction. Methods Subjects 18 or older with LRE and ?3 seizures/month maintained an e-diary, reporting AM/PM data daily, including mood, premonitory symptoms, and all seizures. Self-prediction was rated by, “How likely are you to experience a seizure [time frame]”? Five choices ranged from almost certain (>95% chance) to very unlikely. Relative odds of seizure (OR) within time frames was examined using Poisson models with log normal random effects to adjust for multiple observations. Key Findings Nineteen subjects reported 244 eligible seizures. OR for prediction choices within 6hrs was as high as 9.31 (1.92,45.23) for “almost certain”. Prediction was most robust within 6hrs of diary entry, and remained significant up to 12hrs. For 9 best predictors, average sensitivity was 50%. Older age contributed to successful self-prediction, and self-prediction appeared to be driven by mood and premonitory symptoms. In multivariate modeling of seizure occurrence, self-prediction (2.84; 1.68,4.81), favorable change in mood (0.82; 0.67,0.99) and number of premonitory symptoms (1,11; 1.00,1.24) were significant. Significance Some persons with epilepsy can self-predict seizures. In these individuals, the odds of a seizure following a positive prediction are high. Predictions were robust, not attributable to recall bias, and were related to self awareness of mood and premonitory features. The 6-hour prediction window is suitable for the development of pre-emptive therapy. PMID:24111898

  13. Optogenetically Induced Seizure and the Longitudinal Hippocampal Network Dynamics

    PubMed Central

    Osawa, Shin-ichiro; Iwasaki, Masaki; Hosaka, Ryosuke; Matsuzaka, Yoshiya; Tomita, Hiroshi; Ishizuka, Toru; Sugano, Eriko; Okumura, Eiichi; Yawo, Hiromu; Nakasato, Nobukazu; Tominaga, Teiji; Mushiake, Hajime

    2013-01-01

    Epileptic seizure is a paroxysmal and self-limited phenomenon characterized by abnormal hypersynchrony of a large population of neurons. However, our current understanding of seizure dynamics is still limited. Here we propose a novel in vivo model of seizure-like afterdischarges using optogenetics, and report on investigation of directional network dynamics during seizure along the septo-temporal (ST) axis of hippocampus. Repetitive pulse photostimulation was applied to the rodent hippocampus, in which channelrhodopsin-2 (ChR2) was expressed, under simultaneous recording of local field potentials (LFPs). Seizure-like afterdischarges were successfully induced after the stimulation in both W-TChR2V4 transgenic (ChR2V-TG) rats and in wild type rats transfected with adeno-associated virus (AAV) vectors carrying ChR2. Pulse frequency at 10 and 20 Hz, and a 0.05 duty ratio were optimal for afterdischarge induction. Immunohistochemical c-Fos staining after a single induced afterdischarge confirmed neuronal activation of the entire hippocampus. LFPs were recorded during seizure-like afterdischarges with a multi-contact array electrode inserted along the ST axis of hippocampus. Granger causality analysis of the LFPs showed a bidirectional but asymmetric increase in signal flow along the ST direction. State space presentation of the causality and coherence revealed three discrete states of the seizure-like afterdischarge phenomenon: 1) resting state; 2) afterdischarge initiation with moderate coherence and dominant septal-to-temporal causality; and 3) afterdischarge termination with increased coherence and dominant temporal-to-septal causality. A novel in vivo model of seizure-like afterdischarge was developed using optogenetics, which was advantageous in its reproducibility and artifact-free electrophysiological observations. Our results provide additional evidence for the potential role of hippocampal septo-temporal interactions in seizure dynamics in vivo. Bidirectional networks work hierarchically along the ST hippocampus in the genesis and termination of epileptic seizures. PMID:23593349

  14. Seizure, Fit or Attack? The Use of Diagnostic Labels by Patients with Epileptic or Non-Epileptic Seizures

    ERIC Educational Resources Information Center

    Plug, Leendert; Sharrack, Basil; Reuber, Markus

    2010-01-01

    We present an analysis of the use of diagnostic labels such as "seizure", "attack", "fit", and "blackout" by patients who experience seizures. While previous research on patients' preferences for diagnostic terminology has relied on questionnaires, we assess patients' own preferences and their responses to a doctor's use of different labels…

  15. Reduction of Pentylenetetrazole-Induced Seizure Activity in Awake Rats by Seizure-Triggered Trigeminal Nerve Stimulation

    Microsoft Academic Search

    Erika E. Fanselow; Ashlan P. Reid; Miguel A. L. Nicolelis

    2000-01-01

    Stimulation of the vagus nerve has become an effective method for desynchronizing the highly coherent neural activity typically associated with epileptic seizures. This technique has been used in several animal models of seizures as well as in humans suf- fering from epilepsy. However, application of this technique has been limited to unilateral stimulation of the vagus nerve, typically delivered according

  16. Numinous-like auras and spirituality in persons with partial seizures.

    PubMed

    Dolgoff-Kaspar, Rima; Ettinger, Alan B; Golub, Sarit A; Perrine, Kenneth; Harden, Cynthia; Croll, Susan D

    2011-03-01

    This study investigated hyperreligiosity in persons with partial epilepsy by exploring a relationship between aura symptoms and spirituality. It was reasoned that patients with high frequencies of auras that are suggestive of metaphysical phenomena, termed numinous-like auras, would report increased spirituality of an unconventional form, both during their seizures and generally. Numinous-like auras included: dreaminess/feeling of detachment, autoscopy, derealization, depersonalization, time speed alterations, bodily distortions, and pleasure. A high-frequency aura group, low-frequency aura group, and nonseizure reference group were compared on the Expressions of Spirituality-Revised. The High group had significantly greater Experiential/Phenomenological Dimension and Paranormal Beliefs factor scores than the Low group, and significantly greater Experiential/Phenomenological Dimension factor scores than the reference group. There were no differences between the Low group and the reference group. In addition, there were no differences among the three groups on traditional measures of religiosity. The results provide preliminary evidence that epilepsy patients with frequent numinous-like auras have greater ictal and interictal spirituality of an experiential, personalized, and atypical form, which may be distinct from traditional, culturally based religiosity. This form of spirituality may be better described by the term cosmic spirituality than hyperreligiosity. It is speculated that this spirituality is due to an overactivation and subsequent potentiation of the limbic system, with frequent numinous-like auras indicating sufficient activation for this process to occur. It is likely that numinous-like experiences foster cosmic spirituality in a number of circumstances, including seizures, psychosis, near-death experiences, psychedelic drug use, high-elevation exposure, and also normal conditions. PMID:21395568

  17. Atypical enteropathogenic Escherichia coli secretes plasmid encoded toxin.

    PubMed

    Ruiz, Rita C; Melo, Keyde C M; Rossato, Sarita S; Barbosa, Camila M; Corręa, Lívia M; Elias, Waldir P; Piazza, Roxane M F

    2014-01-01

    Plasmid encoded toxin (Pet) is a serine protease originally described in enteroaggregative Escherichia coli (EAEC) prototype strain 042 whose entire characterization was essentially obtained from studies performed with the purified toxin. Here we show that Pet is not exclusive to EAEC. Atypical enteropathogenic Escherichia coli (aEPEC) strains, isolated from diarrhea cases, express Pet and its detection in supernatants of infected HEp-2 cells coincides with the appearance of cell damage, which, in turn, were similar to those described with purified Pet. Pet secretion and the cytotoxic effects are time and culture medium dependent. In presence of DMEM supplemented with tryptone cell rounding and detachment were observed after just 5 h of incubation with the bacteria. In the absence of tryptone, the cytotoxic effects were detected only after 24 h of infection. We also show that, in addition to the prototype EAEC, other pet+ EAEC strains, also isolated from diarrhea cases, induce cellular damage in the same degree as the aEPEC. The cytotoxic effects of EAEC and aEPEC strains were significantly reduced in the presence of a serine protease inhibitor or anti-Pet IgG serum. Our results show a common aspect between the aEPEC and EAEC and provide the first evidence pointing to a role of Pet in aEPEC pathogenesis. PMID:24949475

  18. Atypical Enteropathogenic Escherichia coli Secretes Plasmid Encoded Toxin

    PubMed Central

    Ruiz, Rita C.; Melo, Keyde C. M.; Rossato, Sarita S.; Barbosa, Camila M.; Corręa, Lívia M.; Elias, Waldir P.; Piazza, Roxane M. F.

    2014-01-01

    Plasmid encoded toxin (Pet) is a serine protease originally described in enteroaggregative Escherichia coli (EAEC) prototype strain 042 whose entire characterization was essentially obtained from studies performed with the purified toxin. Here we show that Pet is not exclusive to EAEC. Atypical enteropathogenic Escherichia coli (aEPEC) strains, isolated from diarrhea cases, express Pet and its detection in supernatants of infected HEp-2 cells coincides with the appearance of cell damage, which, in turn, were similar to those described with purified Pet. Pet secretion and the cytotoxic effects are time and culture medium dependent. In presence of DMEM supplemented with tryptone cell rounding and detachment were observed after just 5?h of incubation with the bacteria. In the absence of tryptone, the cytotoxic effects were detected only after 24?h of infection. We also show that, in addition to the prototype EAEC, other pet+ EAEC strains, also isolated from diarrhea cases, induce cellular damage in the same degree as the aEPEC. The cytotoxic effects of EAEC and aEPEC strains were significantly reduced in the presence of a serine protease inhibitor or anti-Pet IgG serum. Our results show a common aspect between the aEPEC and EAEC and provide the first evidence pointing to a role of Pet in aEPEC pathogenesis. PMID:24949475

  19. Atypical Enteropathogenic Escherichia coli Infection and Prolonged Diarrhea in Children

    PubMed Central

    Nguyen, Rang N.; Taylor, Louise S.; Tauschek, Marija

    2006-01-01

    Some clinical isolates of enteropathogenic Escherichia coli (EPEC) lack bundle-forming pili and are termed atypical EPEC. The aim of this study was to determine if atypical EPEC are pathogens by comparing the clinical features of patients infected with atypical EPEC with those of children infected with other causative agents of diarrhea. Fecal samples obtained from children attending the Royal Children's Hospital in Melbourne for investigation of diarrhea were examined for adenovirus, rotavirus, Campylobacter spp., Salmonella spp., protozoa, and pathogenic E. coli. Clinical data were obtained by using a standardized pro forma and analyzed separately. Patients infected with atypical EPEC experienced mild, nondehydrating, and noninflammatory diarrhea that was not particularly associated with fever, vomiting, or abdominal pain. However, the duration of diarrhea in patients infected with atypical EPEC was significantly longer than that caused by the other species or where no pathogens were identified. Infection with atypical EPEC is associated with prolonged diarrhea. PMID:16704807

  20. Epileptic seizure-induced structural and functional changes in rat femur and tibia bone tissues: a Fourier transform infrared imaging study.

    PubMed

    Garip, Sebnem; Sahin, Deniz; Severcan, Feride

    2013-11-01

    The disease- and drug-related bone disorders are rapidly increasing in the population. It is previously reported that anti-epileptic drugs (AEDs) may cause osteopenia, osteoporosis, and fractures in epilepsy patients. However, it cannot be determined whether the bone disorders in epileptic patients are due to AED therapy and/or to epilepsy and epileptic seizures. There is no study in the literature which investigates the sole effects of epilepsy and epileptic seizures on bone tissues. The current study provides the first report on determination of the possible effects of epilepsy and epileptic seizures on long bone tissues. Wistar Albino Glaxo/Rijswijk rats, which are accepted as genetic rat models for human absence epilepsy, were compared with the healthy Wistar rats to get information about the sole effects of epilepsy and epileptic seizures on bones. Cortical regions of tibia and femur bones were studied by Fourier transform infrared microspectroscopy (FTIRM). According to FTIRM parameters, variation on bone mineral and matrix composition, including decreased mineral content, decreased collagen cross-links, increased carbonate substitution, and larger crystals in epileptic group compared to the healthy one, show severe effects of epilepsy and seizures on bone tissues for the first time. PMID:23887385

  1. Atypical magnetic resonance imaging findings in hepatocellular carcinoma.

    PubMed

    Roumanis, Panayota S; Bhargava, Puneet; Kimia Aubin, Golnaz; Choi, Joon-Il; Demirjian, Aram N; Thayer, David A; Lall, Chandana

    2015-01-01

    Magnetic resonance imaging (MRI) is currently the modality of choice to evaluate liver lesions in patients with cirrhosis and hepatitis B and C. Hepatocellular carcinoma demonstrates typical imaging findings on contrast-enhanced MRI, which are usually diagnostic. Unfortunately, a subgroup of hepatocellular carcinoma presents with atypical imaging features, and awareness of these atypical presentations is important in ensuring early diagnosis and optimal patient outcomes. Herein, we review some of the more common atypical presentations with a focus on MRI. PMID:25823550

  2. Molecular Insights Into the Evolutionary Pathway of Vibrio cholerae O1 Atypical El Tor Variants

    PubMed Central

    Kim, Eun Jin; Lee, Dokyung; Moon, Se Hoon; Lee, Chan Hee; Kim, Sang Jun; Lee, Jae Hyun; Kim, Jae Ouk; Song, Manki; Das, Bhabatosh; Clemens, John D.; Pape, Jean William; Nair, G. Balakrish; Kim, Dong Wook

    2014-01-01

    Pandemic V. cholerae strains in the O1 serogroup have 2 biotypes: classical and El Tor. The classical biotype strains of the sixth pandemic, which encode the classical type cholera toxin (CT), have been replaced by El Tor biotype strains of the seventh pandemic. The prototype El Tor strains that produce biotype-specific cholera toxin are being replaced by atypical El Tor variants that harbor classical cholera toxin. Atypical El Tor strains are categorized into 2 groups, Wave 2 and Wave 3 strains, based on genomic variations and the CTX phage that they harbor. Whole-genome analysis of V. cholerae strains in the seventh cholera pandemic has demonstrated gradual changes in the genome of prototype and atypical El Tor strains, indicating that atypical strains arose from the prototype strains by replacing the CTX phages. We examined the molecular mechanisms that effected the emergence of El Tor strains with classical cholera toxin-carrying phage. We isolated an intermediary V. cholerae strain that carried two different CTX phages that encode El Tor and classical cholera toxin, respectively. We show here that the intermediary strain can be converted into various Wave 2 strains and can act as the source of the novel mosaic CTX phages. These results imply that the Wave 2 and Wave 3 strains may have been generated from such intermediary strains in nature. Prototype El Tor strains can become Wave 3 strains by excision of CTX-1 and re-equipping with the new CTX phages. Our data suggest that inter-chromosomal recombination between 2 types of CTX phages is possible when a host bacterial cell is infected by multiple CTX phages. Our study also provides molecular insights into population changes in V. cholerae in the absence of significant changes to the genome but by replacement of the CTX prophage that they harbor. PMID:25233006

  3. Psychogenic nonepileptic seizures in children: a review.

    PubMed

    Reilly, Colin; Menlove, Leanne; Fenton, Virginia; Das, Krishna B

    2013-10-01

    One of the considerations when a child presents with paroxysmal events is psychogenic nonepileptic seizures (PNES). PNES are discernible changes in behavior or consciousness that resemble epileptic seizures but are not accompanied by electrophysiologic changes. They are usually understood as the manifestation of a conversion disorder that reflects underlying psychological distress. There is a lack of population-based data on the prevalence or incidence of PNES in pediatric populations. The prevalence of PNES in children would appear to be lower than that in the adult population, but the prevalence of PNES seems to increase with age, and nonepileptic paroxysmal events are more likely to be PNES in adolescence than earlier in childhood. In terms of manifestation, PNES in childhood have been described using various categorizations and terminology, making comparisons across studies difficult. There is some evidence that events are more likely to involve unresponsiveness in younger children and prominent motor symptoms in older children. The most common precipitating factors would appear to be school-related difficulties and interpersonal conflict within the child's family. In terms of psychopathology, children with PNES are at high risk for symptoms of depression and anxiety. Accurate diagnosis of PNES in children is likely to involve taking a comprehensive description of the episodes, garnering the child's medical/developmental history, video-electroencephalography (video-EEG) to rule out epileptic seizures, and an evaluation of family functioning. The importance of effective and sensitive communication of the diagnosis of PNES has been emphasized and management approaches will typically involve multidisciplinary efforts to safely manage the events at home and at school. Interventions to reduce the effect of precipitating psychosocial stressors and the involvement of a mental health professional to treat comorbid psychopathology will also form part of an effective management plan. Outcome at follow-up is reported to be largely positive, although studies have not been able to follow all children, and few studies have focused on predictors of a good outcome. Future controlled intervention studies using a range of outcome measures are needed to identify efficacious approaches and predictors of best outcome. PMID:23944981

  4. Lipoma in the Corpus Callosum Presenting with Epileptic Seizures Associated with Expanding Perifocal Edema: A Case Report and Literature Review

    PubMed Central

    Fuga, Michiyasu; Yamamoto, Yohei; Hasegawa, Yuzuru; Murayama, Yuichi; Takahashi-Fujigasaki, Junko

    2015-01-01

    This report describes a rare case of a patient with lipoma presenting with epileptic seizures associated with expanding perifocal edema. The patient was a 48-year-old man who presented with loss of consciousness and convulsions. Magnetic resonance imaging (MRI) revealed a calcified mass in the corpus callosum with perifocal edema causing mass effect. An interhemispheric approach was used to biopsy the mass lesion. Histological examination revealed typical adipose cells, along with hamartomatous components. These components contained neurofilament and S-100-positive structures showing marked calcification. Fibrous cells immunoreactive for ?-smooth muscle actin and epithelial membrane antigen proliferated with focal granulomatous inflammatory changes. MIB-1 index was approximately 5% in immature cells observed in granulomatous areas. We thus suspected a coexisting neoplastic component. The residual lesion persisted in a dormant state for 2 years following biopsy. Surgical resection of a lipoma is extremely difficult and potentially dangerous. However, in the present case, the lesion was accompanied by atypical, expanding, and perifocal edema. Surgical treatment was inevitable for the purpose of histological confirmation, considering differential diagnoses such as dermoid, epidermoid, and glioma. In the end, anticonvulsant therapy proved effective for controlling epileptic seizures.

  5. The Role of Resting State Networks in Focal Neocortical Seizures

    PubMed Central

    Bandt, S. Kathleen; Bundy, David T.; Hawasli, Ammar H.; Ayoub, Kareem W.; Sharma, Mohit; Hacker, Carl D.; Pahwa, Mrinal; Leuthardt, Eric C.

    2014-01-01

    Objective The role of resting state functional networks in epilepsy is incompletely understood. While some pathologic diagnoses have been shown to have maintained but altered resting state connectivity, others have implicated resting state connectivity in disease progression. However little is known about how these resting state networks influence the behavior of a focal neocortical seizure. Methods Using data taken from invasively monitored patients with intractable focal neocortical epilepsy, we evaluated network connectivity (as determined by oscillatory covariance of the slow cortical potential (<0.5 Hz)) as it relates to neocortical seizure foci both in the interictal and ictal states. Results Similar to what has been shown in the past for sleep and anesthesia, electophysiologic resting state networks that are defined by this slow cortical potential covariance maintain their topographic correlation structure throughout an ictal event. Moreover, in the context of focal epilepsy in which the seizure has a specific site of onset, seizure propagation is not chaotic or random. Rather, the seizure (reflected by an elevation of high frequency power) preferentially propagates along the network that contains the seizure onset zone. Significance Taken together, these findings further undergird the fundamental role of resting state networks, provide novel insights into the network-influenced behavior of seizures, and potentially identify additional targets for surgical disconnection including informing the location for the completion of multiple subpial transections (MSPTs). PMID:25247680

  6. Optimal control based seizure abatement using patient derived connectivity

    PubMed Central

    Taylor, Peter N.; Thomas, Jijju; Sinha, Nishant; Dauwels, Justin; Kaiser, Marcus; Thesen, Thomas; Ruths, Justin

    2015-01-01

    Epilepsy is a neurological disorder in which patients have recurrent seizures. Seizures occur in conjunction with abnormal electrical brain activity which can be recorded by the electroencephalogram (EEG). Often, this abnormal brain activity consists of high amplitude regular spike-wave oscillations as opposed to low amplitude irregular oscillations in the non-seizure state. Active brain stimulation has been proposed as a method to terminate seizures prematurely, however, a general and widely-applicable approach to optimal stimulation protocols is still lacking. In this study we use a computational model of epileptic spike-wave dynamics to evaluate the effectiveness of a pseudospectral method to simulated seizure abatement. We incorporate brain connectivity derived from magnetic resonance imaging of a subject with idiopathic generalized epilepsy. We find that the pseudospectral method can successfully generate time-varying stimuli that abate simulated seizures, even when including heterogeneous patient specific brain connectivity. The strength of the stimulus required varies in different brain areas. Our results suggest that seizure abatement, modeled as an optimal control problem and solved with the pseudospectral method, offers an attractive approach to treatment for in vivo stimulation techniques. Further, if optimal brain stimulation protocols are to be experimentally successful, then the heterogeneity of cortical connectivity should be accounted for in the development of those protocols and thus more spatially localized solutions may be preferable.

  7. Evidence for Consolidation of Neuronal Assemblies after Seizures in Humans

    PubMed Central

    Stead, Matt; Bower, Regina S.; Kucewicz, Michal T.; Sulc, Vlastimil; Cimbalnik, Jan; Brinkmann, Benjamin H.; Vasoli, Vincent M.; St. Louis, Erik K.; Meyer, Fredric B.; Marsh, W. Richard; Worrell, Gregory A.

    2015-01-01

    The establishment of memories involves reactivation of waking neuronal activity patterns and strengthening of associated neural circuits during slow-wave sleep (SWS), a process known as “cellular consolidation” (Dudai and Morris, 2013). Reactivation of neural activity patterns during waking behaviors that occurs on a timescale of seconds to minutes is thought to constitute memory recall (O'Keefe and Nadel, 1978), whereas consolidation of memory traces may be revealed and served by correlated firing (reactivation) that appears during sleep under conditions suitable for synaptic modification (Buhry et al., 2011). Although reactivation has been observed in human neuronal recordings (Gelbard-Sagiv et al., 2008; Miller et al., 2013), reactivation during sleep has not, likely because data are difficult to obtain and the effect is subtle. Seizures, however, provide intense and synchronous, yet sparse activation (Bower et al., 2012) that could produce a stronger consolidation effect if seizures activate learning-related mechanisms similar to those activated by learned tasks. Continuous wide-bandwidth recordings from patients undergoing intracranial monitoring for drug-resistant epilepsy revealed reactivation of seizure-related neuronal activity during subsequent SWS, but not wakefulness. Those neuronal assemblies that were most strongly activated during seizures showed the largest correlation changes, suggesting that consolidation selectively strengthened neuronal circuits activated by seizures. These results suggest that seizures “hijack” physiological learning mechanisms and also suggest a novel epilepsy therapy targeting neuronal dynamics during post-seizure sleep. PMID:25609617

  8. Stability of Synchronization Clusters and Seizurability in Temporal Lobe Epilepsy

    PubMed Central

    Palmigiano, Agostina; Pastor, Jesús; García de Sola, Rafael; Ortega, Guillermo J.

    2012-01-01

    Purpose Identification of critical areas in presurgical evaluations of patients with temporal lobe epilepsy is the most important step prior to resection. According to the “epileptic focus model”, localization of seizure onset zones is the main task to be accomplished. Nevertheless, a significant minority of epileptic patients continue to experience seizures after surgery (even when the focus is correctly located), an observation that is difficult to explain under this approach. However, if attention is shifted from a specific cortical location toward the network properties themselves, then the epileptic network model does allow us to explain unsuccessful surgical outcomes. Methods The intraoperative electrocorticography records of 20 patients with temporal lobe epilepsy were analyzed in search of interictal synchronization clusters. Synchronization was analyzed, and the stability of highly synchronized areas was quantified. Surrogate data were constructed and used to statistically validate the results. Our results show the existence of highly localized and stable synchronization areas in both the lateral and the mesial areas of the temporal lobe ipsilateral to the clinical seizures. Synchronization areas seem to play a central role in the capacity of the epileptic network to generate clinical seizures. Resection of stable synchronization areas is associated with elimination of seizures; nonresection of synchronization clusters is associated with the persistence of seizures after surgery. Discussion We suggest that synchronization clusters and their stability play a central role in the epileptic network, favoring seizure onset and propagation. We further speculate that the stability distribution of these synchronization areas would differentiate normal from pathologic cases. PMID:22844524

  9. Seizure-like phenomena and propofol: a systematic review.

    PubMed

    Walder, Bernhard; Tramčr, Martin R; Seeck, Margitta

    2002-05-14

    Data on seizure-like phenomena (SLP) in patients receiving propofol were systematically reviewed. Reports had to provide detailed information on SLP in individual patients who received propofol. Phenomena were classified according to the time point of their occurrence during anesthesia or sedation (induction, maintenance, emergence, delayed [>30 minutes after emergence]) and their clinical presentation (generalized tonic-clonic seizures, focal motor seizures, events presented as increased tone with twitching and rhythmic movements not perceived as generalized tonic-clonic seizures, opisthotonos, involuntary movements). In 70 patients without epilepsy, SLP happened during induction in 24 (34%), during maintenance in two (3%), during emergence in 28 (40%), and was delayed in 16 (23%). Most frequent clinical presentations of SLP were generalized tonic-clonic seizures in 30 patients (43%), events presented as increased tone with twitching and rhythmic movements not perceived as generalized tonic-clonic seizures in 20 (36%), and involuntary movements in 11 (16%). Of 11 patients with epilepsy, seven (64%) had generalized tonic-clonic seizure during emergence. Of all 81 patients, 26 (32%) only had an EEG, and 12 (15%) only a neurologic consultation. SLP may happen in patients with or without epilepsy receiving propofol. The time point of the occurrence of SLP suggests that a change in cerebral concentration of propofol may be causal. To confirm this hypothesis, to estimate the prevalence of propofol-related SLP, and to identify patients at risk, data of higher quality are needed. PMID:12017156

  10. Body packing: from seizures to laparotomy.

    PubMed

    Janczak, Joanna M; Beutner, Ulrich; Hasler, Karin

    2015-01-01

    Body packing is a common method for illegal drug trafficking. Complications associated with body packing can be severe and even lead to rapid death. Thus, a timely diagnosis is warranted. As most body packers initially do not show any symptoms, making a correct diagnosis can be rather challenging. We describe a case of a 41-year-old male, who was admitted with an epileptic seizure and who turned out to be a cocaine intoxicated body packer. Due to neurological and cardiovascular deterioration an emergency surgery was performed. Four bags of cocaine could be removed. We discuss the current management regimen in symptomatic and asymptomatic body packers and highlight pearls and pitfalls with diagnosis and treatment. PMID:25883813

  11. Pathology Case Study: Recent Onset Seizures

    NSDL National Science Digital Library

    Biernat, Wojciech

    This neuropathology case study, provided by the University of Pittsburgh Department of Pathology, is an excellent learning tool for students and instructors in the health science fields. In this case, a 12-year-old boy presents with a history of headaches, â??and a recent onset of right-sided seizures followed by the loss of consciousnessâ?ť. Visitors are shown CT scan images of the patientâ??s brain, along with microscopic images. The official diagnosis found in the â??Final Diagnosisâ?ť section is accompanied by a discussion of the contributing doctorâ??s findings and a list of references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose patientâ??s conditions.

  12. Prenatal and Perinatal Determinants of Neonatal Seizures Occurring in the First Week of Life

    Microsoft Academic Search

    Carla Arpino; Sergio Domizio; Maria Patrizia Carrieri; Sonia Brescianini; Giuseppe Sabatino; Paolo Curatolo

    2001-01-01

    To evaluate prenatal and perinatal risk factors for early neonatal seizures, we conducted a case-control study including 100 newborns with neonatal seizures in the first week of life and 204 controls randomly selected from a list of healthy newborns born in the same hospital during the study period. Generalized tonic seizures were the most common seizures observed (29%), although the

  13. Validation of a new automated neonatal seizure detection system: A clinician's perspective

    E-print Network

    is important for detecting seizures in the neonatal intensive care unit (NICU). Our automated algorithmValidation of a new automated neonatal seizure detection system: A clinician's perspective P: Neonatal seizures Automated seizure detection Perinatal asphyxia HIE NICU a b s t r a c t Objective

  14. The epidemiology of clinical neonatal seizures in Newfoundland: A population-based study

    Microsoft Academic Search

    Gabriel M. Ronen; Sharon Penney; Wayne Andrews

    1999-01-01

    Objective: To study the incidence, clinical features, etiologic distribution, and day of seizure onset by etiology in neonates with seizures. Design: Prospective, population-based study involving all the obstetric and neonatal units across the province of Newfoundland, Canada. All units were given educational sessions on neonatal seizure symptomatology. Subjects: Detailed questionnaires were prospectively collected for all infants with probable neonatal seizures

  15. Targeted treatment of migrating partial seizures of infancy with quinidine.

    PubMed

    Bearden, David; Strong, Alanna; Ehnot, Jessica; DiGiovine, Marissa; Dlugos, Dennis; Goldberg, Ethan M

    2014-09-01

    Migrating partial seizures of infancy is an early onset epileptic encephalopathy syndrome that is typically resistant to treatment. The most common cause is a gain of function mutation in the potassium channel KCNT1. The antiarrhythmic drug quinidine is a partial antagonist of KCNT1 and hence may be a candidate drug for treatment of this condition. We report the case of a child with migrating partial seizures of infancy secondary to an activating mutation in KCNT1 treated with quinidine. Treatment with quinidine was correlated with a marked reduction in seizure frequency and improved psychomotor development. PMID:25042079

  16. Seizures Related to Vitamin B6 Deficiency in Adults

    PubMed Central

    Lee, Dong-Gun; Lee, Yeonkyung; Shin, Hyeeun; Kang, Kyusik; Park, Jong-Moo; Kim, Byung-Kun; Kwon, Ohyun; Lee, Jung-Ju

    2015-01-01

    Vitamin B6 is closely associated with functions of the nervous, immune, and endocrine systems. Its deficiency may result in neurological disorders including convulsions and epileptic encephalopathy. Until today, this has only been reported in infants, children, and critically ill adult patients. We report a case of a 36year-old man with chronic alcoholism who presented with seizures after gastrointestinal disturbance. His seizures persisted even after treatment with antiepileptic drugs, but eventually disappeared after administration of pyridoxine. Hence, vitamin B6 deficiency may cause seizures in adult patients with chronic alcoholism. PMID:26157671

  17. Clinical decision making in seizures and status epilepticus.

    PubMed

    Teran, Felipe; Harper-Kirksey, Katrina; Jagoda, Andy

    2015-01-01

    Seizures and status epilepticus are frequent neurologic emergencies in the emergency department, accounting for 1% of all emergency department visits. The management of this time-sensitive and potentially life-threatening condition is challenging for both prehospital providers and emergency clinicians. The approach to seizing patients begins with differentiating seizure activity from mimics and follows with identifying potential secondary etiologies, such as alcohol-related seizures. The approach to the patient in status epilepticus and the patient with nonconvulsive status epilepticus constitutes a special clinical challenge. This review summarizes the best available evidence and recommendations regarding diagnosis and resuscitation of the seizing patient in the emergency setting. PMID:25902572

  18. Automated differentiation between epileptic and nonepileptic convulsive seizures.

    PubMed

    Beniczky, Sándor; Conradsen, Isa; Moldovan, Mihai; Jennum, Poul; Fabricius, Martin; Benedek, Krisztina; Andersen, Noémi; Hjalgrim, Helle; Wolf, Peter

    2015-02-01

    Our objective was the clinical validation of an automated algorithm based on surface electromyography (EMG) for differentiation between convulsive epileptic and psychogenic nonepileptic seizures (PNESs). Forty-four consecutive episodes with convulsive events were automatically analyzed with the algorithm: 25 generalized tonic-clonic seizures (GTCSs) from 11 patients, and 19 episodes of convulsive PNES from 13 patients. The gold standard was the interpretation of the video-electroencephalographic recordings by experts blinded to the EMG results. The algorithm correctly classified 24 GTCSs (96%) and 18 PNESs (95%). The overall diagnostic accuracy was 95%. This algorithm is useful for distinguishing between epileptic and psychogenic convulsive seizures. PMID:25545895

  19. Diagnosis and management of catamenial seizures: a review

    PubMed Central

    Verrotti, Alberto; D’Egidio, Claudia; Agostinelli, Sergio; Verrotti, Carla; Pavone, Piero

    2012-01-01

    Catamenial epilepsy is defined as a pattern of seizures that changes in severity during particular phases of the menstrual cycle, wherein estrogens are proconvulsant, increasing the neuronal excitability; and progesterone is anticonvulsant, enhancing GABA-mediated inhibition. Thus, changes in serum estradiol/progesterone ratio throughout a normal reproductive cycle bring about an increased or decreased risk of seizure occurrence. To date, there are no specific drug treatments for catamenial epilepsy however, non-hormonal and hormonal therapies have been proposed. The aim of this review is to report preclinical and clinical evidences about the relationship between female reproductive steroids and epileptic seizures, and to describe treatment approaches for catamenial epilepsy. PMID:23071424

  20. Genitourinary tuberculosis: an atypical clinical presentation.

    PubMed

    Lim, Pei Shan; Atan, Ixora Kamisan; Naidu, Aruku

    2012-01-01

    Genitourinary tuberculosis is one of the common forms of extrapulmonary tuberculosis. We report a case of atypical genitourinary tuberculosis: massive uterovaginal prolapse with cervical lesion mimicking cervical carcinoma. This particular case highlights the problem of healthcare in most of the developing countries. Lack of patient education, awareness, and access to a healthcare system resulted in a complicated situation. In an endemic area or in an immunocompromised individual, a higher index of suspicion would allow early recognition and treatment institution to minimise its late consequences as well as spreading of the disease. Though anti-TB is the mainstay of treatment, surgical intervention might be needed in selected cases. PMID:23320216

  1. Increased Seizure Latency and Decreased Severity of Pentylenetetrazol-Induced Seizures in Mice after Essential Oil Administration

    PubMed Central

    Koutroumanidou, Eleni; Kimbaris, Athanasios; Kortsaris, Alexandros; Bezirtzoglou, Eugenia; Polissiou, Moschos; Charalabopoulos, Konstantinos

    2013-01-01

    The effect of pretreatment with essential oils (EOs) from eight aromatic plants on the seizure latency and severity of pentylenetetrazol- (PTZ-) induced seizures in mice was evaluated. Weight-dependent doses of Rosmarinus officinalis, Ocimum basilicum, Mentha spicata, Mentha pulegium, Lavandula angustifolia, Mentha piperita, Origanum dictamnus, and Origanum vulgare, isolated from the respective aromatic plants from NE Greece, were administered 60 minutes prior to intraperitoneal (i.p.) injection of a lethal dose of PTZ to eight respective groups of Balb-c mice. Control group received only one i.p. PTZ injection. Motor and behavioral activity of the animals after EOs administration, development of tonic-clonic seizures, seizure latency and severity, and percentage of survival after PTZ administration were determined for each group. All groups of mice treated with the EOs showed reduced activity and stability after the administration of the oil, except for those treated with O. vulgare (100% mortality after the administration of the oil). After PTZ administration, mice from the different groups showed increased latency and reduced severity of seizures (ranging from simple twitches to complete seizures). Mice who had received M. piperita demonstrated no seizures and 100% survival. The different drastic component and its concentration could account for the diversity of anticonvulsant effects. PMID:23819045

  2. Atypical Psychotic Symptoms in a Hispanic Population

    PubMed Central

    Lagomasino, Isabel T; Harmon, Chris

    2005-01-01

    Objective: To better characterize psychotic symptoms and their treatment in Hispanic populations. Design: Chart review. Setting: Chelsea MGH Health Center and Chelsea Counseling Center (both affiliates of the Massachusetts General Hospital). Participants: Forty-four Hispanic patients presenting with psychotic symptoms in the context of mood and anxiety disorders. Measurements: Chart review focussed on diagnosis, description, and cataloguing of psychotic symptoms and review of treatment efficacy. Results: All but two patients described some atypical psychotic symptoms (e.g., doorbells or telephones ringing, voices of children, and visual hallucinations of animals or relatives). Treatment varied; 34 percent received monotherapy (either neuroleptic, antidepressant, or anxiolytic); 61 percent received polypharmacy; of these, 48 percent received a combination of antidepressant and anxiolytic; 19 percent received antidepressant with neuroleptic; 14 percent received antidepressant with neuroleptic and anxiolytic. No regimen was significantly better than any other. Conclusions: Psychotic symptoms in Hispanic patients have been noted anecdotally to present differently from those described in other populations. Our review appears to support this observation. Clinicians who work with Hispanic patients should ask about these atypical psychotic symptoms. We provide speculation on the nature of these symptoms, review approaches to treatment, and make recommendations for further investigation. PMID:21120089

  3. Atypical central neurocytoma with sarcomatous differentiation.

    PubMed

    Vemavarapu, Lakshmi; Czyszczon, Irene; Parker, Joseph C; Wagner, Stephanie; Vitaz, Todd; Parker, John R

    2014-09-01

    We report a case of an intraventricular tumor with features of atypical central neurocytoma with a sarcomatous component in a 44-year-old woman who presented with headaches and vomiting. Magnetic resonance imaging revealed a 3.4-cm lobulated enhancing mass in the occipital horn of the left lateral ventricle, and the patient subsequently underwent a left occipital-parietal craniotomy for debulking. The tumor contained 2 cell populations: round cells with perinuclear halos in a fibrillary background, and spindle cells with oval nuclei arranged in interlacing fascicles with focal necrosis. The round cells had diffuse synaptophysin immunopositivity, while the spindle cells were diffusely immunopositive for vimentin and had intercellular reticulin. The mitotic activity (8 mitotic figures per 10 high-power fields) and the high Ki-67 proliferation index (15.0%) were consistent with atypical central neurocytoma with a sarcomatous component. Although different histologic variants have been described, this is the first reported case, to our knowledge, of central neurocytoma with spindle cell sarcomatous features. PMID:25171707

  4. Atypical inheritance: new horizons for neurology.

    PubMed

    Wilson, G N

    1994-11-01

    Rediscovery of Mendel's laws produced an enthusiastic new discipline at the turn of this century. The eugenics movement had many disciples in the United States, and it should be noted that the term "final solution" was first used by the National Association of Charities and Corrections in the 1920s. American advocates of eugenics accomplished mass sterilization of retarded individuals and the prohibition of Jewish immigration from Germany during World War II. It is interesting that the close of this century has produced a similar revolution in genetics. These newer genetic mechanisms expose the major fallacy of eugenics: traits may be genetic without showing obvious familial transmission. Sanctions against reproduction or immigration thus will have little effect on the gene pool. The clinical implications of atypical inheritance are enormous. Almost every medical disorder must be reinvestigated for evidence of subtle chromosome changes, for worsening in progressive generations, and for influence of parental origin. The classical Mendelian model taught that extreme and rare phenotypes shed light on more frequent ones, hence the definition of genes responsible for hypercholesterolemia, for Alzheimer disease, and for amyotrophic lateral sclerosis. Atypical inheritance mechanisms further enhance this approach, bringing all of neurology under the light of genetic technology. The lure for the practitioner, then, is not the hyperbole of molecular biology; it is the need for a seasoned hand so emphasized by Huntington's disease and the duty to protect the next century from disasters of the current one. PMID:7845336

  5. Association of a bovine prion gene haplotype with atypical BSE

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Transmissible spongiform encephalopathies (TSEs), also known as prion diseases, are a class of fatal neurodegenerative disorders that occur in humans, ruminants, cats, and mink. Three distinct TSEs afflict cattle: classical bovine spongiform encephalopathy (BSE), atypical H-type BSE, and atypical ...

  6. Atypical depression among psychiatric inpatients: clinical features and personality traits

    Microsoft Academic Search

    Celeste N. Derecho; Scott Wetzler; Lata K. McGinn; William C. Sanderson; Gregory M. Asnis

    1996-01-01

    Objective: This study investigates the frequency and characteristics of Atypical Depression (AD) among depressed inpatients. Method: Twenty-one depressed inpatients received DSM-IV diagnoses, were rated on the Hamilton Depression Rating Scale (HAMD), and assessed for AD using the Atypical Depressive Disorder Scale. AD was defined as the presence of mood reactivity and two of four associated features: hyperphagia, hypersomnia, leaden paralysis,

  7. Tramadol and another atypical opioid meperidine have exaggerated serotonin

    E-print Network

    Champagne, Frances A.

    Tramadol and another atypical opioid meperidine have exaggerated serotonin syndrome behavioural-L-tryptophan (5-HTP). As numerous case reports implicate the atypical opioids tramadol and meperidine/x) mice. Comparisons were made with SERT mice treated with either vehicle or morphine, an opioid

  8. Atypical Brain Torque in Boys With Developmental Stuttering

    Microsoft Academic Search

    Jeffrey Ryan Mock; Janet N. Zadina; David M. Corey; Jeremy D. Cohen; Lisa C. Lemen; Anne L. Foundas

    2012-01-01

    The counterclockwise brain torque, defined as a larger right prefrontal and left parietal-occipital lobe, is a consistent brain asymmetry. Reduced or reversed lobar asymmetries are markers of atypical cerebral laterality and have been found in adults who stutter. It was hypothesized that atypical brain torque would be more common in children who stutter. Magnetic resonance imaging-based morphology measures were completed

  9. Atypical lytic lesions of skull: Clinical and radiological correlation

    PubMed Central

    Binit, Sureka; Mittal, Mahesh Kumar; Mittal, Aliza; Thukral, Brij Bhushan

    2015-01-01

    Imaging alone cannot differentiate various isolated atypical lytic lesions involving the skull. Clinical and radiological correlation is mandatory in reaching to a diagnosis. Histopathology remains the gold standard. We describe few atypical cases presenting as isolated lytic lesions of skull with characteristic imaging findings and a brief clinical approach to reach towards the diagnosis. PMID:25745329

  10. Epileptic seizure onset detection prior to clinical manifestation.

    PubMed

    Salam, Muhammad Tariqus; Sawan, Mohamad; Nguyen, Dang Khoa

    2010-01-01

    In this paper, we present the design of an epilepticseizure detector. This circuit is part of an implantable device used to continuously record intracerebral electroencephalographic signals through subdural and depth electrodes. The implemented seizure detector is based on a detection algorithm validated in Matlab tools and the circuits were implemented using CMOS 0.18-microm process. The proposed system was tested using intracerebral EEG recordings from two patients with drug-resistant epilepsy. Four seizures were assessed by the proposed CMOS building blocks and the required delays to detect these seizures were 3, 8, 11, and 11 sec, respectively after electric onset. The simulated total power consumption of the detector was 6.71 microW. Together, these preliminary results indicate the possibility of building implantable ultra-low power seizure-detection devices. PMID:21097161

  11. Prognosis and Outcome Predictors in Psychogenic Nonepileptic Seizures

    PubMed Central

    Durrant, Joseph; Rickards, Hugh; Cavanna, Andrea E.

    2011-01-01

    It is estimated that one in five patients referred to specialist epilepsy clinics for refractory seizures have psychogenic nonepileptic seizures (PNES). Despite the high prevalence, little is known about the prognosis of patients with PNES. In this paper we set out to systematically assess published original studies on the prognosis and outcome predictors of patients with PNES. Our literature search across the databases Medline, PsycINFO, and EMBASE generated 18 original studies meeting the search criteria. Prognosis was found to be poor in adults, but good in children. Predictors of poor outcome included the presence of coexisting epilepsy or psychiatric comorbidities, violent seizure phenomenology, dependent lifestyle, and poor relationships. Overall, too much reliance is placed on seizure remission as an outcome measurement for patients with PNES, and the impact of many of the outcome predictors requires evaluation using larger studies with longer followup. PMID:22937230

  12. Psychogenic non-epileptic seizures in the older adult.

    PubMed

    Yates, Erica

    2014-05-01

    Psychogenic non-epileptic seizures (PNES) are classified in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, as a functional neurological symptom disorder. This disorder is often misdiagnosed as epilepsy, with the consequence that older adults may have been treated for years for epilepsy before they learn their seizures are non-epileptic. Video electroencephalography monitoring, which is the standardized approach for ruling out epilepsy, is often performed in a specialized epilepsy monitoring unit where the patient lies in bed 24 hours per day waiting for a seizure to be recorded. The immobility, loss of independence, and anxiety that occurs during the monitoring process can be difficult for older adults. It is important for all nurses to be aware of PNES and to be sensitive to the unique needs of older adults who are experiencing these seizures. PMID:24815758

  13. Camphor: an herbal medicine causing grand mal seizures.

    PubMed

    MacKinney, Theodore G; Soti, Kamal Raj; Shrestha, Poojan; Basnyat, Buddha

    2015-01-01

    Camphor is usually used in the USA to repel insects, but it is widely used in other countries as an herb. We report the case of a 52-year-old previously healthy Nepali man who ingested approximately 10?g of pure camphor with therapeutic intention. He developed grand mal seizures, and was evaluated in an emergency room. He failed to recall the camphor ingestion initially, and was treated with phenytoin for new-onset idiopathic seizures. Examining physicians only later found out about his camphor ingestion. Finding the cause of new-onset seizures is often challenging for emergency room physicians, internists and neurologists. In addition to other well-reported causes of secondary seizures, herbal medications and supplements must also be explored. PMID:26065546

  14. Effect of Contraceptive Estradiol on Hippocampus Kindling Seizure Activity 

    E-print Network

    Younus, Iyan

    2014-09-15

    by several million women worldwide. The present study was undertaken to investigate the potential adverse effect of EE on epileptogenesis and seizure activity using the hippocampus kindling model in female mice. Animals were stimulated daily without...

  15. Medical Groups Issue Guidelines for Treating First Seizure

    MedlinePLUS

    ... Medical Groups Issue Guidelines for Treating First Seizure Epilepsy medication recommended to help stave off second attack ... the American Academy of Neurology and the American Epilepsy Society. After a review of all available evidence, ...

  16. Appearing and disappearing CT scan abnormalities and seizures

    Microsoft Academic Search

    P K Sethi; B R Kumar; V S Madan; V Mohan

    1985-01-01

    A group of patients presenting with seizures (focal or generalised) and abnormal CT scans who, on follow up, showed complete resolution of the CT scan changes, without any treatment other than anticonvulsants, are described.

  17. Pyridoxine-dependent seizures: magnetic resonance spectroscopy findings.

    PubMed

    Alkan, Alpay; Kutlu, Ramazan; Aslan, Mehmet; Sigirci, Ahmet; Orkan, Ismet; Yakinci, Cengiz

    2004-01-01

    Pyridoxine-dependent seizures are an extremely rare genetic disorder. Early diagnosis and treatment are important for the prevention of permanent brain damage. Elevated levels of glutamate and decreased levels of gamma-aminobutyric acid (GABA) in the frontal and parietal cortices are among the characteristic features of this disorder. These metabolic abnormalities eventually lead to seizures and neuronal loss. In this case report, we present magnetic resonance spectroscopy findings of a 9-year-old girl with pyridoxine-dependent seizures with mental retardation. The N-acetylaspartate-to-creatine ratio was found to be decreased in the frontal and parieto-occipital cortices, which could indicate neuronal loss. Magnetic resonance spectroscopy could be a useful tool in the neuroimaging evaluation for assessment of parenchymal changes despite a normal-appearing brain magnetic resonance image in patients with pyridoxine-dependent seizures. PMID:15032392

  18. Transcutaneous vagus nerve stimulation for partial onset seizure therapy

    Microsoft Academic Search

    Enrique C. G. Ventureyra

    2000-01-01

    A new concept for transcutaneous vagus nerve stimulation for control of partial onset seizures is described. The rationale\\u000a for the application of this innovative noninvasive method is discussed.

  19. Mapping loci for pentylenetetrazol-induced seizure susceptibility in mice

    Microsoft Academic Search

    Thomas N. Ferraro; Gregory T. Golden; George G. Smith; N J Schork; N Mulholland; C Ballas; J Schill; R J Buono; W H Berrettini

    1999-01-01

    DBA\\/2J (D2) and C57BL\\/6J (B6) mice exhibit differential sensitivity to seizures induced by various chemical and physical methods, with D2 mice being relatively sensitive and B6 mice relatively resistant. We conducted studies in mature D2, B6, F1, and F2 intercross mice to investigate behavioral seizure responses to pentylenetetrazol (PTZ) and to map the location of genes that influence this trait.

  20. Seizure control after radiosurgery on cerebral arteriovenous malformations

    Microsoft Academic Search

    Yoshihisa Kida; Tatsuya Kobayashi; Takayuki Tanaka; Yoshimasa Mori; Tosinori Hasegawa; Toshiki Kondoh

    2000-01-01

    Among 462 cases of cerebral arteriovenous malformation (AVM) treated with gamma-radiosurgery, the initial presentations were haemorrhage in 68%, epilepsy in 12.8%, neurological deficits in 3.2%, minor symptoms in 7.6% and asymptomatic in 4.5% respectively. There were 79 cases (17.1%) who had had a convulsive seizure before radiosurgery and they were classified into two groups: 58 cases presented with seizure as

  1. Development of hippocampal sclerosis after a complex febrile seizure

    Microsoft Academic Search

    Andreas Merkenschlager; Horst Todt; Thomas Pfluger; Matthias K. Bernhard

    2009-01-01

    The role of prolonged febrile seizures in the genesis of hippocampal sclerosis is controversial; statistical analysis and\\u000a data from epilepsy surgery suggest a causal relationship. A three-year-old boy had an initial febrile seizure with a transient\\u000a postictal flaccid hemiparesis. Magnetic resonance imaging (MRI) showed no abnormality of the hippocampal areas of both sides.\\u000a At the age of four a prolonged

  2. Wavelet based automatic seizure detection in intracerebral electroencephalogram

    Microsoft Academic Search

    Y. U. Khan; J. Gotman

    2003-01-01

    Background: Automatic seizure detection is often used during long-term monitoring, and is particularly important during intracerebral investigations. Existing methods make many false detections, particularly in intracerebral electroencephalogram (EEG) because of frequent large amplitude rhythmic activity bursts that are non-epileptiform.Objective: To develop a seizure detection method for intracerebral monitoring that is as sensitive as existing methods but has fewer false detections.Methods:

  3. Alcohol-Related Seizures in the Intensive Care Unit

    Microsoft Academic Search

    Zachary Webb; Panayiotis Varelas

    \\u000a Alcohol abuse is a common cause of seizures resulting in admission to the intensive care unit. The cause of the alcohol-related\\u000a seizures (ARS) is usually abstinence in a chronic alcoholic, although some patients may still have detectable levels of alcohol\\u000a in their blood. ARS generally occur between 7 and 48 h after abstinence. Approximately half the patients presenting with ARS

  4. Seizure after flumazenil administration in a pediatric patient.

    PubMed

    McDuffee, A T; Tobias, J D

    1995-06-01

    Flumazenil is a benzodiazepine receptor antagonist used to reverse sedation and respiratory depression induced by benzodiazepines. Seizures and cardiac arrhythmias have complicated its use in adult patients. Overdose patients who have coingested tricyclic antidepressants have a higher risk of these complications. Little information exists concerning adverse effects of flumazenil in children. We report the occurrence of a generalized tonic-clonic seizure in a pediatric patient following the administration of flumazenil. PMID:7651879

  5. Seizure-Induced Alterations in Cerebrovascular Function in the Neonate

    Microsoft Academic Search

    Aliz Zimmermann; Ferenc Domoki; Ferenc Bari

    2008-01-01

    Epileptiform seizures are most common during the neonatal period, affecting at least 0.3% of term neonates and more than 10% of preterm neonates. The adverse impact of neonatal seizures on the long-term neurological outcome has been well documented, but their cerebrovascular consequences are rarely emphasized. The cerebral blood flow is controlled by the interaction of the vascular and parenchymal cells

  6. Vagus nerve stimulation magnet activation for seizures: a critical review.

    PubMed

    Fisher, R S; Eggleston, K S; Wright, C W

    2015-01-01

    Some patients receiving VNS Therapy report benefit from manually activating the generator with a handheld magnet at the time of a seizure. A review of 20 studies comprising 859 subjects identified patients who reported on-demand magnet mode stimulation to be beneficial. Benefit was reported in a weighted average of 45% of patients (range 0-89%) using the magnet, with seizure cessation claimed in a weighted average of 28% (range 15-67%). In addition to seizure termination, patients sometimes reported decreased intensity or duration of seizures or the post-ictal period. One study reported an isolated instance of worsening with magnet stimulation (Arch Pediatr Adolesc Med, 157, 2003 and 560). All of the reviewed studies assessed adjunctive magnet use. No studies were designed to provide Level I evidence of efficacy of magnet-induced stimulation. Retrospective analysis of one pivotal randomized trial of VNS therapy showed significantly more seizures terminated or improved in the active stimulation group vs the control group. Prospective, controlled studies would be required to isolate the effect and benefit of magnet mode stimulation and to document that the magnet-induced stimulation is the proximate cause of seizure reduction. Manual application of the magnet to initiate stimulation is not always practical because many patients are immobilized or unaware of their seizures, asleep or not in reach of the magnet. Algorithms based on changes in heart rate at or near the onset of the seizure provide a methodology for automated responsive stimulation. Because literature indicates additional benefits from on-demand magnet mode stimulation, a potential role exists for automatic activation of stimulation. PMID:25145652

  7. Severe new seizures after initiation of vagus nerve stimulation therapy

    Microsoft Academic Search

    Najib I. Murr; Nabil J. Azar

    2011-01-01

    Vagus nerve stimulation is considered to be a safe and effective adjunctive therapy for patients with drug-resistant epilepsy. Contrary to some antiepileptic drugs, vagus nerve stimulation is not known to precipitate or aggravate new or preexisting seizures. We describe the emergence of a new type of disabling, recurrent partial seizure immediately after initiation of vagus nerve stimulation in a 51-year-old

  8. The effectiveness of atypical antipsychotic medications in depressive disorders.

    PubMed

    Ishak, Waguih William; Rapaport, Mark H; Gotto, Jennifer G

    2004-12-01

    Clinical evidence supporting the use of atypical antipsychotic medication (broad-spectrum psychotropic agents) in the treatment of depressive disorders is increasing rapidly. Animal models suggest that when atypical antipsychotic medications are used in combination with a selective serotonin reuptake inhibitor there is additional activation of frontal dopaminergic and noradrenergic neurotransmitter systems. This stimulated the initiation of several clinical trials that showed the efficacy of atypical antipsychotic medication augmentation of selective serotonin reuptake inhibitors for patients with treatment-resistant depression. There also are few case reports of successful treatment of depression with atypical antipsychotic medication alone. When a clinician is treating a depressed patient who did not achieve relief after trials with two different antidepressant regimens, one option to consider is augmentation with an atypical antipsychotic medication to ameliorate depressive symptoms. PMID:15538989

  9. Head-up tilting is a useful provocative test for psychogenic non-epileptic seizures.

    PubMed

    Zaidi, A; Crampton, S; Clough, P; Fitzpatrick, A; Scheepers, B

    1999-09-01

    Differentiating psychogenic non-epileptic attack disorder (NEAD) from true epilepsy is difficult. This often results in a misdiagnosis and unnecessary and ineffective treatment. Prolonged EEG/video recording is the most sensitive tool for differentiating NEAD from epilepsy, but is costly and therefore limited in availability. Provocative tests, particularly the use of saline injection, can reduce the length of monitoring but give rise to ethical dilemmas. This study assesses the value of head-up tilt testing as a provocative test for NEAD. Twenty-one patients (17 female, mean age 34.6 +/- 11.5 years) with recurrent seizure-like episodes and a clinical diagnosis of NEAD were studied. Patients were tilted to 80( composite function )on an electric tilt table with footplate support for up to 45 minutes during continuous ECG, EEG and blood pressure monitoring. Seventeen patients (81%) experienced typical symptoms (non-epileptiform limb shaking in 15 patients, absence in one patient, myoclonic jerking in one patient) during head-up tilt without significant EEG abnormalities or haemodynamic changes. The mean time to onset of seizure-like activity was 13.2 +/- 11 minutes (range 0-31 minutes). No patients suffered injury or any other significant side-effect. Provocative testing using suggestion and head-up tilt is a sensitive tool for diagnosing NEAD and represents a safe, simple and inexpensive outpatient technique for investigating patients with suspected NEAD. PMID:10512777

  10. Cerebrospinal fluid from a 7-month-old dog with seizure-like episodes.

    PubMed

    Amude, Alexandre M; Alfieri, Amauri A; Balarin, Mara R S; dos Reis, Antônio C F; Alfieri, Alice F

    2006-03-01

    A 7-month-old dog was presented to the Veterinary Teaching Hospital of the Universidade Estadual de Londrina, Paraná, Brazil with a 1-week history of seizure-like activity and compulsive walking. Neurological deficits included seizures, nystagmus, absence of a menace reaction, depressed postural reactions, spastic tetraparesis, opisthotonos, and spasticity of the thoracic limbs. Cerebrospinal fluid (CSF) evaluation showed severe lymphocytic pleocytosis (554 cells/microL, with 70% lymphocytes) and a protein concentration of 17 mg/dL. The histopathologic findings in cerebrum, cerebellum, and brainstem obtained at necropsy were compatible with acute encephalomyelitis caused by canine distemper virus (CDV). Using reverse transcription-polymerase chain reaction (RT-PCR), CDV RNA was detected in both CSF and fragments of fresh brain tissue. The results indicated that CDV was the agent responsible for the clinical and laboratory presentation. Severe pleocytosis with lymphocyte predominance is an unusual finding in canine distemper and must be differentiated from granulomatous meningoencephalitis. RT-PCR on CSF is a useful, fast, and specific method to diagnose CDV infection in dogs. PMID:16511803

  11. 38 CFR 21.350 - Unauthorized absences.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31 Leaves of Absence § 21.350 Unauthorized absences. A veteran who is unable to obtain an authorized leave of absence in...

  12. 38 CFR 21.350 - Unauthorized absences.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31 Leaves of Absence § 21.350 Unauthorized absences. A veteran who is unable to obtain an authorized leave of absence in...

  13. 38 CFR 21.350 - Unauthorized absences.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31 Leaves of Absence § 21.350 Unauthorized absences. A veteran who is unable to obtain an authorized leave of absence in...

  14. Father Absence and Conscience Development

    ERIC Educational Resources Information Center

    Hoffman, Martin L.

    1971-01-01

    Father-absent and father-present seveth graders were compared on moral attributes and overt aggression. Some evidence suggests that some but not all of the effects of father absence are attributable to the lack of a paternal model. Effects may be mediated in part by changes in the mother's child-rearing pattern. (NH)

  15. Role of Organochlorine Pesticides in Children with Idiopathic Seizures

    PubMed Central

    Arora, Shilpa Khanna; Sharma, Tusha; Banerjee, Basu Dev; Gupta, Sushan

    2013-01-01

    Background. Organochlorine pesticides (OCP) are persistent organic pollutants that have been implicated in causing several deleterious effects in humans. These are known neurotoxins in high doses, but the role of environmentally acquired OCPs in the body to induce seizures in children has not been investigated yet. Objectives. To assess the serum levels of OCPs in children aged 2–12 with idiopathic seizure and to find out any association between the two are our objectives. Methods. It was a cross-sectional pilot study. Twenty developmentally normal children aged 2–12, presenting with idiopathic generalized seizures, were recruited. Twenty age-matched controls without any history of seizures were also taken. Their serum levels of ?, ?, and ? hexachlorocyclohexane (HCH); and aldrin; dieldrin; p,p-dichlorodiphenyltrichloroethane (DDT), o,p-DDT, and p,p dichlorodiphenyldichloroethylene (DDE); and ? and ? endosulfan were analysed using gas chromatography (GC). Mann-Whitney U test was used to compare OCP levels between the groups. Spearman correlation was used to find the correlation between individual pesticide levels with age and seizure duration. Results. Levels of ?, ?, and total HCH were significantly higher among cases as compared to the control group (P ? 0.05). Conclusion. There exists a possible association between idiopathic seizures and high serum levels of OCPs, especially HCH. PMID:24368944

  16. A low computation cost method for seizure prediction.

    PubMed

    Zhang, Yanli; Zhou, Weidong; Yuan, Qi; Wu, Qi

    2014-10-01

    The dynamic changes of electroencephalograph (EEG) signals in the period prior to epileptic seizures play a major role in the seizure prediction. This paper proposes a low computation seizure prediction algorithm that combines a fractal dimension with a machine learning algorithm. The presented seizure prediction algorithm extracts the Higuchi fractal dimension (HFD) of EEG signals as features to classify the patient's preictal or interictal state with Bayesian linear discriminant analysis (BLDA) as a classifier. The outputs of BLDA are smoothed by a Kalman filter for reducing possible sporadic and isolated false alarms and then the final prediction results are produced using a thresholding procedure. The algorithm was evaluated on the intracranial EEG recordings of 21 patients in the Freiburg EEG database. For seizure occurrence period of 30 min and 50 min, our algorithm obtained an average sensitivity of 86.95% and 89.33%, an average false prediction rate of 0.20/h, and an average prediction time of 24.47 min and 39.39 min, respectively. The results confirm that the changes of HFD can serve as a precursor of ictal activities and be used for distinguishing between interictal and preictal epochs. Both HFD and BLDA classifier have a low computational complexity. All of these make the proposed algorithm suitable for real-time seizure prediction. PMID:25062892

  17. Automated seizure detection using a self-organizing neural network.

    PubMed

    Gabor, A J; Leach, R R; Dowla, F U

    1996-09-01

    An algorithm for automated seizure detection using the self-organizing map (SOM) neural network (NN), with unsupervised training, was used to detect seizures in 24 long-term EEG recordings. The detection paradigm was tested on a constant 8 channel subset of 18 channel scalp EEG recordings. The NN was trained to recognize seizures using 98 training examples. A strategy was devised using wavelet transform to construct a filter that was 'matched' to the frequency features of examples used to train the NN. Four second epochs of training examples and EEGs being tested were transformed into time-independent representations of spectrograms resulting in a time-frequency representation of the time-series. Rule-based long and short term contextual features were used for detection in association with the NN. Fifty-six seizures were detected from a possible 62 (90%) associated with an average 0.71 +/- 0.79 false-positive errors per hour using the same 'population' detection parameters. When the sensitivity for detection was increased, all but one of the 62 seizures were detected (98%). Less than 1.0 false-positive error per hour occurred in all but 5 records when using the 'population' parameters. The combination of rule-based detection criteria employing contextual parameters and unsupervised training of NNs to recognize time-frequency patterns is a promising direction for automated seizure detection. PMID:8862115

  18. Behaviors induced or disrupted by complex partial seizures.

    PubMed

    Leung, L S; Ma, J; McLachlan, R S

    2000-09-01

    We reviewed the neural mechanisms underlying some postictal behaviors that are induced or disrupted by temporal lobe seizures in humans and animals. It is proposed that the psychomotor behaviors and automatisms induced by temporal lobe seizures are mediated by the nucleus accumbens. A non-convulsive hippocampal afterdischarge in rats induced an increase in locomotor activity, which was suppressed by the injection of dopamine D(2) receptor antagonist in the nucleus accumbens, and blocked by inactivation of the medial septum. In contrast, a convulsive hippocampal or amygdala seizure induced behavioral hypoactivity, perhaps by the spread of the seizure into the frontal cortex and opiate-mediated postictal depression. Mechanisms underlying postictal psychosis, memory disruption and other long-term behavioral alterations after temporal lobe seizures, are discussed. In conclusion, many of the changes of postictal behaviors observed after temporal lobe seizures in humans may be found in animals, and the basis of the behavioral change may be explained as a change in neural processing in the temporal lobe and the connecting subcortical structures. PMID:10974356

  19. Rapid arrest of seizures with an inhalation aerosol containing diazepam.

    PubMed

    Xi, L Y; Zheng, W M; Zhen, S M; Xian, N S

    1994-01-01

    Diazepam (DZP) and a mixture of Chinese herbs customarily used to treat epilepsy were prepared as an aerosol under the trade name Aerosolum Diaiepami Compositae or Flvalscop (FVS). FVS was studied in a single-blind trial in 101 patients with seizures preceded by an aura and in 19 without an aura to whom was administered by another person. FVS or a control preparation was administered. In 16-22 s, (average 18.5 s), the aura was interrupted and no seizure ensued in 90% of the cases treated with FVS and in 26% of cases treated with the control preparation. Of the 120 patients, 8 had elementary partial seizures with Jacksonian march, 18 had complex partial seizures (CPS), 7 had simple partial seizures with autonomic symptoms, and 87 had secondarily generalized tonic-clonic seizures. Eleven patients have now received FVS for 2 years (400 ml each). Forty patients for 1 year (150-200 ml each); none of these patients have shown any side effects or abnormal laboratory findings. An aerosol-administered drug may be a valuable adjunct to the antiepileptic drug (AED) arsenal and merits more extensive evaluation. PMID:8156957

  20. Post-traumatic seizure susceptibility is attenuated by hypothermia therapy

    PubMed Central

    Atkins, Coleen M.; Truettner, Jessie S.; Lotocki, George; Sanchez-Molano, Juliana; Kang, Yuan; Alonso, Ofelia F.; Sick, Thomas J.; Dietrich, W. Dalton; Bramlett, Helen M.

    2010-01-01

    Traumatic brain injury (TBI) is a major risk factor for the subsequent development of epilepsy. Currently, chronic seizures after brain injury are often poorly controlled by available anti-epileptic drugs. Hypothermia treatment, a modest reduction in brain temperature, reduces inflammation, activates pro-survival signaling pathways, and improves cognitive outcome after TBI. Given the well-known effect of therapeutic hypothermia to ameliorate pathological changes in the brain after TBI, we hypothesized that hypothermia therapy may attenuate the development of post-traumatic epilepsy and some of the pathomechanisms that underlie seizure formation. To test this hypothesis, adult male Sprague Dawley rats received moderate parasagittal fluid-percussion brain injury, and then were maintained at normothermic or moderate hypothermic temperatures for 4 hr. At 12 weeks after recovery, seizure susceptibility was assessed by challenging the animals with pentylenetetrazole (PTZ), a GABAA receptor antagonist. PTZ elicited a significant increase in seizure frequency in TBI normothermic animals as compared to sham surgery animals and this was significantly reduced in TBI hypothermic animals. Early hypothermia treatment did not rescue chronic dentate hilar neuronal loss, nor did it improve loss of doublecortin-labeled cells in the dentate gyrus post-seizure. However, mossy fiber sprouting was significantly attenuated by hypothermia therapy. These findings demonstrate that reductions in seizure susceptibility after TBI are improved with post-traumatic hypothermia and provide a new therapeutic avenue for the treatment of post-traumatic epilepsy. PMID:21044182

  1. Cannabidiol Rescues Acute Hepatic Toxicity and Seizure Induced by Cocaine

    PubMed Central

    Vilela, Luciano Rezende; Gomides, Lindisley Ferreira; David, Bruna Araújo; Antunes, Maísa Mota; Diniz, Ariane Barros; Moreira, Fabrício de Araújo; Menezes, Gustavo Batista

    2015-01-01

    Cocaine is a commonly abused illicit drug that causes significant morbidity and mortality. The most severe and common complications are seizures, ischemic strokes, myocardial infarction, and acute liver injury. Here, we demonstrated that acute cocaine intoxication promoted seizure along with acute liver damage in mice, with intense inflammatory infiltrate. Considering the protective role of the endocannabinoid system against cell toxicity, we hypothesized that treatment with an anandamide hydrolysis inhibitor, URB597, or with a phytocannabinoid, cannabidiol (CBD), protects against cocaine toxicity. URB597 (1.0?mg/kg) abolished cocaine-induced seizure, yet it did not protect against acute liver injury. Using confocal liver intravital microscopy, we observed that CBD (30?mg/kg) reduced acute liver inflammation and damage induced by cocaine and prevented associated seizure. Additionally, we showed that previous liver damage induced by another hepatotoxic drug (acetaminophen) increased seizure and lethality induced by cocaine intoxication, linking hepatotoxicity to seizure dynamics. These findings suggest that activation of cannabinoid system may have protective actions on both liver and brain induced by cocaine, minimizing inflammatory injury promoted by cocaine, supporting its further clinical application in the treatment of cocaine abuse. PMID:25999668

  2. Sturge-Weber syndrome: a favourable surgical outcome in a case with contralateral seizure onset and myoclonic-astatic seizures.

    PubMed

    Jiruska, Premysl; Marusic, Petr; Jefferys, John G R; Krsek, Pavel; Cmejla, Roman; Sebronova, Vera; Komarek, Vladimir

    2011-03-01

    Sturge-Weber syndrome is a neurocutaneous disorder classically characterized by the presence of facial port-wine stain and ipsilateral leptomeningeal angiomatosis. It is often associated with refractory epilepsy which requires surgical treatment. We present a case of a patient who initially presented with partial seizures of temporo-occipital origin, ipsilateral to the pial angiomatosis. During the course of the disease, the patient developed medically refractory epilepsy with partial seizures originating predominantly from the contralateral temporo-occipital area as well as myoclonic and myoclonic-astatic seizures. Resection of the occipital and temporal lobe affected by the pial angioma resulted in favourable outcome. Bilateral dysfunction observed in Sturge-Weber syndrome may result in an increased capability of focal discharges to generate synchronous epileptiform activity leading to an increased incidence of generalised seizures, most probably via a mechanism of secondary bilateral synchrony. [Published with video sequences]. PMID:21393095

  3. From treatment to cure: stopping seizures, preventing seizures, and reducing brain propensity to seize.

    PubMed

    Pavlov, Ivan; Schorge, Stephanie

    2014-01-01

    Current antiepileptic treatments are aimed at stopping or preventing seizures rather than curing epilepsy. Here, we discuss how recent advances in genetics and neurophysiological research may not only help us better understand the pathophysiology of different epilepsies, but may also drive the development of novel approaches, including treatments that can modify the underlying disease. Although these new therapeutic strategies are still in the very early stages, rapid progress in this direction means that the ability to stop or even to reverse changes caused by epileptogenesis may not be that far away. PMID:25078506

  4. Seizure-induced reduction in PIP3 levels contributes to seizure-activity and is rescued by valproic acid?

    PubMed Central

    Chang, Pishan; Walker, Matthew C.; Williams, Robin S.B.

    2014-01-01

    Phosphatidylinositol (3–5) trisphosphate (PIP3) is a central regulator of diverse neuronal functions that are critical for seizure progression, however its role in seizures is unclear. We have recently hypothesised that valproic acid (VPA), one of the most commonly used drugs for the treatment of epilepsy, may target PIP3 signalling as a therapeutic mode of action. Here, we show that seizure induction using kainic acid in a rat in vivo epilepsy model resulted in a decrease in hippocampal PIP3 levels and reduced protein kinase B (PKB/AKT) phosphorylation, measured using ELISA mass assays and Western blot analysis, and both changes were restored following VPA treatment. These finding were reproduced in cultured rat hippocampal primary neurons and entorhinal cortex–hippocampal slices during exposure to the GABA(A) receptor antagonist pentylenetetrazol (PTZ), which is widely used to generate seizures and seizure-like (paroxysmal) activity. Moreover, VPA's effect on paroxysmal activity in the PTZ slice model is blocked by phosphatidylinositol 3-kinase (PI3K) inhibition or PIP2 sequestration by neomycin, indicating that VPA's efficacy is dependent upon PIP3 signalling. PIP3 depletion following PTZ treatment may also provide a positive feedback loop, since enhancing PIP3 depletion increases, and conversely, reducing PIP3 dephosphorylation reduces paroxysmal activity and this effect is dependent upon AMPA receptor activation. Our results therefore indicate that PIP3 depletion occurs with seizure activity, and that VPA functions to reverse these effects, providing a novel mechanism for VPA in epilepsy treatment. PMID:24148856

  5. Atypical presentation of cerebral schistosomiasis four years after exposure to Schistosoma mansoni.

    PubMed

    Rose, Matthew F; Zimmerman, Eli E; Hsu, Liangge; Golby, Alexandra J; Saleh, Emam; Folkerth, Rebecca D; Santagata, Sandro S; Milner, Danny A; Ramkissoon, Shakti H

    2014-01-01

    Schistosomiasis is the second most socioeconomically devastating parasitic disease worldwide, affecting over 240 million people in 77 countries on 5 continents and killing 300,000 people annually in sub-Saharan Africa alone. Neuroschistosomiasis is caused by granuloma formation around eggs that lodge in the CNS, with Schistosoma mansoni and Schistosoma haematobium usually affecting the spinal cord and Schistosoma japonicum causing most reported cerebral disease. We report a case of a previously healthy 25-year-old woman native to the United States who presented with a single generalized tonic-clonic seizure without other neurologic symptoms four years after spending a semester in Ghana where she went swimming once in a river. Brain MRI showed areas of signal abnormality and mottled nodular linear enhancement in the left temporal and right posterior temporal/parietal lobes and right cerebellum without mass effect. A biopsy of the left temporal lesion showed prominent granulomas with dense mixed inflammatory infiltrates composed of eosinophils, plasma cells, and lymphocytes surrounding refractile egg shells containing characteristic embryonal cells and von Lichtenberg's envelope and displaying the pathognomonic spine shape of S. mansoni. Serum ELISA and antibody immunoblots confirmed exposure to S. mansoni. In summary, we describe the atypical combination of cerebral schistosomiasis due to S. mansoni, after a prolonged interval of four years, from a single known exposure. PMID:25667876

  6. Atypical presentation of cerebral schistosomiasis four years after exposure to Schistosoma mansoni?

    PubMed Central

    Rose, Matthew F.; Zimmerman, Eli E.; Hsu, Liangge; Golby, Alexandra J.; Saleh, Emam; Folkerth, Rebecca D.; Santagata, Sandro S.; Milner, Danny A.; Ramkissoon, Shakti H.

    2014-01-01

    Schistosomiasis is the second most socioeconomically devastating parasitic disease worldwide, affecting over 240 million people in 77 countries on 5 continents and killing 300,000 people annually in sub-Saharan Africa alone. Neuroschistosomiasis is caused by granuloma formation around eggs that lodge in the CNS, with Schistosoma mansoni and Schistosoma haematobium usually affecting the spinal cord and Schistosoma japonicum causing most reported cerebral disease. We report a case of a previously healthy 25-year-old woman native to the United States who presented with a single generalized tonic–clonic seizure without other neurologic symptoms four years after spending a semester in Ghana where she went swimming once in a river. Brain MRI showed areas of signal abnormality and mottled nodular linear enhancement in the left temporal and right posterior temporal/parietal lobes and right cerebellum without mass effect. A biopsy of the left temporal lesion showed prominent granulomas with dense mixed inflammatory infiltrates composed of eosinophils, plasma cells, and lymphocytes surrounding refractile egg shells containing characteristic embryonal cells and von Lichtenberg's envelope and displaying the pathognomonic spine shape of S. mansoni. Serum ELISA and antibody immunoblots confirmed exposure to S. mansoni. In summary, we describe the atypical combination of cerebral schistosomiasis due to S. mansoni, after a prolonged interval of four years, from a single known exposure. PMID:25667876

  7. Benign childhood seizure susceptibility syndrome: three case reports

    Microsoft Academic Search

    Roberto Horacio Caraballo; María del Rosario Aldao; Pedro Cachia

    2011-01-01

    In this study, we describe three patients who each had two different forms of idiopathic focal epilepsiy. Two of these patients\\u000a had electroclinical features compatible with Panayiotopoulos syndrome and benign childhood epilepsy with centro-temporal spikes\\u000a (BCECTS), one of whom developed a particular electroclinical picture of atypical benign focal epilepsy and the other an atypical\\u000a evolution characterized by verbal auditory agnosia

  8. [Treatment of atypical and neurotic depression].

    PubMed

    Leitner, P; Umann, E; Kulawik, H

    1986-10-01

    Hitherto it has not been usual to talk in the German language about the therapy-oriented concept of two forms of the progress of atypical depression (Type A and Type V). The characteristic symptom of Type A is angst, together with phobias, physical complaints, etc. In Type V there are vegetative symptoms, often towards evening (Hypersomnia, difficulty in getting to sleep, increased appetite, increased weight, increased libido), accompanied by hysterical extrovert personality traits, and of intermittent occurrence. These clinical pictures are amenable to psychopharmalogical therapy. In conformity with the assumption of "somatic accommodation" treatment with antidepressives is recommended in the case neurotic depression, too, at least in the initial stages of treatment. PMID:3809300

  9. Extensive Hypertrophic Lupus Erythematosus: Atypical Presentation

    PubMed Central

    Narang, Tarun; Sharma, Meghna; Gulati, Nigabh; Kaur, Anureet

    2012-01-01

    Lupus erythematosus (LE) is a disease with a wide spectrum of cutaneous and systemic manifestations. Clinical features of patients with LE show a great variation, and for this reason it is difficult to develop a unifying concept of this disease. Our objective is to present a case of hypertrophic LE with atypical morphology and extensive involvement, who responded favorably to isotretinoin. Diagnosis of hypertrophic lupus erythematosus (HLE) was confirmed by characteristic histopathological findings. Combination therapy with isotretinoin and hydroxychloroquine resulted in flattening and repression of previously refractory skin lesions. Sometimes, HLE lesions may present a diagnostic and therapeutic dilemma. In long standing lesions, squamous cell carcinoma may arise. Therefore, HLE requires adequate therapy with clinical and histopathological follow up. PMID:23248382

  10. Atypical Development in Plant and Soil Nematodes

    PubMed Central

    Ferris, Howard; Robbins, Robert; Yeates, Gregor

    2012-01-01

    Observations of atypical developmental and anatomical characteristics have been recorded for many taxa of soil nematodes. They include the unusual occurrence of extra feeding structures, aberrant configuration of features of both male and female reproductive systems, and the occurrence of intersexes assumed to be functionally female, functionally male, or non-functional. In many cases, hypotheses have been advanced regarding the genetic or developmental mechanisms and environmental stimuli that control, regulate, or facilitate abnormalities, but many are quite speculative and lack experimental verification. Further, the fitness costs or advantages, and the heritability of aberrant characters are largely unknown, except where they clearly preclude reproduction, either apomictic or amphimictic. Underlying mechanisms and ecological consequences may be difficult to study in organisms that are not readily cultured under axenic or sterile laboratory conditions, however information on developmental processes in Caenorhabditis elegans represents an important resource in which to seek homologies. PMID:23483848

  11. Atypical ?-Catenin Activated Child Hepatocellular Tumor

    PubMed Central

    Unlu, Havva Akmaz; Karakus, Esra; Yazal Erdem, Arzu; Yakut, Zeynep Ilerisoy

    2015-01-01

    Hepatocellular adenomas are a benign, focal, hepatic neoplasm that have been divided into four subtypes according to the genetic and pathological features. The ?-catenin activated subtype accounts for 10-15% of all hepatocellular adenomas and specific magnetic resonance imaging features have been defined for different hepatocellular adenomas subtypes. The current study aimed to report the magnetic resonance imaging features of a well differentiated hepatocellular carcinoma that developed on the basis of ?-catenin activated hepatocellular adenomas in a child. In this case, atypical diffuse steatosis was determined in the lesion. In the literature, diffuse steatosis, which is defined as a feature of the hepatocyte nuclear factor-1?-inactivated hepatocellular adenomas subtype, has not been previously reported in any ?-catenin activated hepatocellular adenomas case. Interlacing magnetic resonance imaging findings between subtypes show that there are still many mysteries about this topic and larger studies are warranted. PMID:26157702

  12. Linguistic recycling in typical and atypical interaction.

    PubMed

    Perkins, Michael R

    2014-01-01

    I present evidence that linguistic "recycling" - i.e., the redeployment of linguistic material from prior utterances during conversation - is a striking and prevalent feature not only of interaction between typical speakers, but also, and notably, of interaction involving the communication impaired. In the latter case, recycling may sometimes be used as a compensatory communicative resource when linguistic ability is compromised. Despite its prevalence, however, recycling has largely been ignored by clinical linguists. In addition to providing illustrations of linguistic recycling across a range of communication disorders, I also examine how it is subserved by phenomena such as priming, short-term memory and alignment. I subsequently argue for a shift in perspective that puts recycling at the heart of our perception of how typical and atypical interaction works, and suggest a number of potential benefits for clinical linguistics, ranging from the way we understand and analyse communication disorders to how we assess and treat them. PMID:25000380

  13. Indications of atypical antipsychotics in the elderly.

    PubMed

    McKean, Andrew; Monasterio, Erik

    2015-01-01

    Atypical antipsychotics (AAP) have become some of the most commonly prescribed medications in primary and specialist care settings. Off-label prescribing accounts for much of the expanded use of AAPs. This has become common in the elderly. Marketing by pharmaceutical companies appears to have contributed to the off-label use of AAPs, in situations where their safety and efficacy is far from established. Although evidence provides varying degrees of support for their use for behavioural and psychological symptoms of dementia, augmentation of antidepressants in depression, anxiety, insomnia and in the management of psychosis in Parkinson's Disease, there are a number of potential problems with their expanded use in the elderly. These include weight gain, type two diabetes mellitus, sudden cardiac death and increased mortality rates in the elderly with dementia. It is recommended that whenever AAPs are used off-label, a review date is identified, informed consent is obtained and treatment and side-effects are closely monitored. PMID:25354148

  14. Father Absence and Youth Incarceration

    Microsoft Academic Search

    Cynthia C. Harper; Sara S. McLanahan

    2004-01-01

    This studymeasuredthe likelihoodofyouthincarcerationamongadolescent males from father-absent households, using data from the National Longi- tudinal Survey of Youth (N 534,031 person-years). At baseline, the adoles- cents ranged from 14 to 17 years, and the incarceration outcome measure spanned ages 15 to 30 years. This study tested whether risk factors concen- trated in father-absent households explained the apparent effects of father absence.

  15. Postnatal Inflammation Increases Seizure Susceptibility in Adult Rats

    PubMed Central

    Galic, Michael A.; Riazi, Kiarash; Heida, James G.; Mouihate, Abdeslam; Fournier, Neil M.; Spencer, Sarah J.; Kalynchuk, Lisa E.; Teskey, G. Campbell; Pittman, Quentin J.

    2012-01-01

    There are critical postnatal periods during which even subtle interventions can have long-lasting effects on adult physiology. We asked whether an immune challenge during early postnatal development can alter neuronal excitability and seizure susceptibility in adults. Postnatal day 14 (P14) male Sprague Dawley rats were injected with the bacterial endotoxin lipopolysaccharide (LPS), and control animals received sterile saline. Three weeks later, extracellular recordings from hippocampal slices revealed enhanced field EPSP slopes after Schaffer collateral stimulation and increased epileptiform burst-firing activity in CA1 after 4-aminopyridine application. Six to 8 weeks after postnatal LPS injection, seizure susceptibility was assessed in response to lithium–pilocarpine, kainic acid, and pentylenetetrazol. Rats treated with LPS showed significantly greater adult seizure susceptibility to all convulsants, as well as increased cytokine release and enhanced neuronal degeneration within the hippocampus after limbic seizures. These persistent increases in seizure susceptibility occurred only when LPS was given during a critical postnatal period (P7 and P14) and not before (P1) or after (P20). This early effect of LPS on adult seizures was blocked by concurrent intracerebroventricular administration of a tumor necrosis factor ? (TNF?) antibody and mimicked by intracerebroventricular injection of rat recombinant TNF?. Postnatal LPS injection did not result in permanent changes in microglial (Iba1) activity or hippocampal cytokine [IL-1?(interleukin-1?) and TNF?] levels, but caused a slight increase in astrocyte (GFAP) numbers. These novel results indicate that a single LPS injection during a critical postnatal period causes a long-lasting increase in seizure susceptibility that is strongly dependent on TNF?. PMID:18596165

  16. Seizure protection by intrapulmonary delivery of midazolam in mice.

    PubMed

    Dhir, Ashish; Zolkowska, Dorota; Rogawski, Michael A

    2013-10-01

    The lung provides a portal of entry that could be used to rapidly deliver anticonvulsant substances to the brain to treat seizures. In the present study, we demonstrate that midazolam, a water-soluble anticonvulsant benzodiazepine, confers potent seizure protection when administered via the intrapulmonary route. High dose (100 mg/kg) intraperitoneal midazolam induced loss-of-righting reflex in mice. Lower doses of midazolam (100-1000 ?g/kg) when administered intraperitoneally did not induce loss-of-righting reflex but protected animals against pentylenetetrazol (PTZ)-induced seizures. Intrapulmonary administration of midazolam via a tracheal cannula protected against intraperitoneal PTZ seizures at lower doses. The minimal intraperitoneal and intravenous doses of midazolam required to elevate the threshold for seizure signs induced by intravenous PTZ were 500 and 100 ?g/kg, respectively, whereas the minimal intrapulmonary midazolam dose was 12.5 ?g/kg. Intratracheal midazolam caused a large increase in intravenous PTZ threshold 5 min after administration but the effect declined rapidly over 60 min and no antiseizure activity was evident at 120 min. The minimal intraperitoneal doses of midazolam required to elevate the threshold for seizure signs induced by intravenous picrotoxin and kainic acid were 100 and 2000 ?g/kg, respectively; the corresponding values for intratracheal midazolam were 25 and 100 ?g/kg, respectively. We conclude that midazolam is a highly effective anticonvulsant when administered by the intrapulmonary route. Midazolam is substantially more potent when delivered into the lung than when administered intraperitoneally or intravenously. Inhalation could be an alternative to other routes of administration for the delivery of midazolam to rapidly abort acute seizures. PMID:23774136

  17. Malignant migrating partial seizures of infancy controlled by stiripentol and clonazepam.

    PubMed

    Merdariu, Dana; Delanoë, Catherine; Mahfoufi, Nora; Bellavoine, Vanina; Auvin, Stéphane

    2013-02-01

    The syndrome of malignant migrating partial seizures of infancy (MMPSI) is characterized by early onset of multiple seizure types and overall poor prognosis. Seizures are markedly drug resistant and few reports have suggested the efficacy of some antiepileptic drugs. We report one case of MMPSI in which prolonged seizure control is obtained with an association of clonazepam, levetiracetam and stiripentol, confirming thus the possibility of complete sustained seizure control in this epileptic syndrome. Of more than 60 cases reported to date, ours is the forth in which sustained complete control of seizures was obtained. PMID:22521903

  18. Metformin Hydrochloride in Patients With Atypical Hyperplasia or In Situ Breast Cancer to Placebo in Decreasing Atypical Cells in Patients With Atypical Hyperplasia or in Situ Breast Cancer | Division of Cancer Prevention

    Cancer.gov

    This randomized phase III trial studies metformin hydrochloride to see how well it works compared to placebo in decreasing atypical cells in patients with atypical hyperplasia or in situ breast cancer.

  19. Cognitive-behavioral therapy for psychogenic nonepileptic seizures

    PubMed Central

    Goldstein, L.H.; Chalder, T.; Chigwedere, C.; Khondoker, M.R.; Moriarty, J.; Toone, B.K.; Mellers, J.D.C.

    2010-01-01

    Objective: To compare cognitive-behavioral therapy (CBT) and standard medical care (SMC) as treatments for psychogenic nonepileptic seizures (PNES). Methods: Our randomized controlled trial (RCT) compared CBT with SMC in an outpatient neuropsychiatric setting. Sixty-six PNES patients were randomized to either CBT (plus SMC) or SMC alone, scheduled to occur over 4 months. PNES diagnosis was established by video-EEG telemetry for most patients. Exclusion criteria included comorbid history of epilepsy, <2 PNES/month, and IQ <70. The primary outcome was seizure frequency at end of treatment and at 6-month follow-up. Secondary outcomes included 3 months of seizure freedom at 6-month follow-up, measures of psychosocial functioning, health service use, and employment. Results: In an intention-to-treat analysis, seizure reduction following CBT was superior at treatment end (group × time interaction p < 0.0001; large to medium effect sizes). At follow-up, the CBT group tended to be more likely to have experienced 3 months of seizure freedom (odds ratio 3.125, p = 0.086). Both groups improved in some health service use measures and on the Work and Social Adjustment Scale. Mood and employment status showed no change. Conclusions: Our findings suggest that cognitive-behavioral therapy is more effective than standard medical care alone in reducing seizure frequency in PNES patients. Classification of evidence: This study provides Class III evidence that CBT in addition to SMC, as compared to SMC alone, significantly reduces seizure frequency in patients with PNES (change in median monthly seizure frequency: baseline to 6 months follow-up, CBT group, 12 to 1.5; SMC alone group, 8 to 5). GLOSSARY AED = antiepileptic drug; CBT = cognitive-behavioral therapy; CI = confidence interval; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, 4th edition; HADS = Hospital Anxiety and Depression Scale; IQR = interquartile range; ITT = intention-to-treat; OR = odds ratio; PNES = psychogenic nonepileptic seizures; RCT = randomized controlled trial; SMC = standard medical care; WASAS = Work and Social Adjustment Scale. PMID:20548043

  20. Zonisamide – a review of experience and use in partial seizures

    PubMed Central

    Wilfong, Angus A; Willmore, L James

    2006-01-01

    Zonisamide is a modern antiepileptic drug (AED) that is distinguished from other AEDs by its unique structure and broad mechanistic profile. Preclinical studies have reported a range of potential mechanisms of action for zonisamide, such as blocking voltage-gated sodium channels, reduction of T-type calcium channel currents, and enhancement of gamma-aminobutyric acid (GABA)-mediated inhibition, which are indicative of its broad antiseizure effects. Zonisamide has a favorable linear pharmacokinetic profile, a long half-life, and a low incidence of protein-binding interactions with other AEDs. Hepatically metabolized through the cytochrome P450 pathway, zonisamide does not induce its own metabolism or liver enzymes. For more than 2 decades, zonisamide has been extensively used as monotherapy and adjunctive therapy for the treatment of partial and generalized seizures in pediatric and adult patients in Japan. Zonisamide was approved in the USA in 2000 as adjunctive therapy for partial seizures in adults. With over 2 million patient-years of exposure internationally, zonisamide has demonstrated safety and efficacy against a multitude of epilepsy and seizure types, including both partial and generalized seizures. This review focuses on the experience and use of zonisamide in partial seizures, as well as possible new uses for zonisamide. PMID:19412474

  1. A patient with atonic seizures mimicking transient ischemic attacks?

    PubMed Central

    Kang, Min-Ju; Choi, Jun Young; An, Young-Sil; Park, Ki-Hyung; Park, Hyeon-Mi; Lee, Yeong-Bae; Shin, Dong-Jin; Sung, Young Hee; Shin, Dong Hoon

    2015-01-01

    A focal atonic seizure is a partial seizure in which the ictal manifestation consists of paresis of the extremities or muscles on one side of the body, and this phenomenon can easily be misdiagnosed as a transient ischemic attack. An 86-year-old woman visited our hospital complaining of transient right upper extremity weakness lasting for 10 min following an unusual sensation in her chest accompanied by palpitations. On the third hospital day, she again complained of right arm weakness, which progressed to jerky movements of her right extremity accompanied by facial twitching and then generalized into a tonic–clonic seizure. The EEG displayed several interictal spikes in the contralateral temporal area, and the ictal SPECT, analyzed using the SISCOM system, showed an increased signal in both the contralateral superior parietal area and the mesial frontal area. In this case, the patient was diagnosed with focal atonic seizures as the cause of the monolimb weakness, which had been initially misdiagnosed aas transient ischemic attacks. In cases in which a patient presents with monolimb paresis, physicians should consider the possibility of an atonic seizure as the cause. PMID:25870790

  2. The effects of inferior olive lesion on strychnine seizure

    SciTech Connect

    Anderson, M.C.; Chung, E.Y.; Van Woert, M.H. (Mount Sinai School of Medicine, New York, NY (USA))

    1990-10-01

    Bilateral inferior olive lesions, produced by systemic administration of the neurotoxin 3-acetylpyridine (3AP) produce a proconvulsant state specific for strychnine-induced seizures and myoclonus. We have proposed that these phenomena are mediated through increased excitation of cerebellar Purkinje cells, through activation of glutamate receptors, in response to climbing fiber deafferentation. An increase in quisqualic acid (QA)-displaceable ({sup 3}H)AMPA ((RS)-alpha-amino-3-hydroxy-5-methyl-isoxazole-4-propionic acid) binding in cerebella from inferior olive-lesioned rats was observed, but no difference in ({sup 3}H)AMPA binding displaced by glutamate, kainic acid (KA) or glutamate diethylester (GDEE) was seen. The excitatory amino acid antagonists GDEE and MK-801 ((+)-5-methyl-10,11-dihydro-5H-dibenzo(a,d)cyclo-hepten-5,10 imine) were tested as anticonvulsants for strychnine-induced seizures in 3AP inferior olive-lesioned and control rats. Neither drug effected seizures in control rats, however, both GDEE and MK-801 produced a leftward shift in the strychnine-seizure dose-response curve in 3AP inferior olive-lesioned rats. GDEE also inhibited strychnine-induced myoclonus in the lesioned group, while MK-801 had no effect on myoclonus. The decreased threshold for strychnine-induced seizures and myoclonus in the 3AP-inferior olive-lesioned rats may be due to an increase in glutamate receptors as suggested by the ({sup 3}H)AMPA binding data.

  3. Cross Sectional Imaging of Post Partum Headache and Seizures

    PubMed Central

    Mundaganur, Praveen; Sonwalkar, Pradeep; N S, Vishal; G S, Narendra; P, Sanjay

    2014-01-01

    Objectives: To evaluate spectrum of causes & their characteristic findings in peripartum head ache and seizures on computed tomography & magnetic resonance imaging. Materials and Methods: Forty patients with complaints of peripartum headache and seizures underwent cross sectional imaging with computed tomography and magnetic resonance imaging during period of June 2011 to May 2012. Age group of subjects in this study was 18 to 38 y. Out of 40 patients 15 had history of eclampsia and remaining 25 patients were normotensive. Subjects with complaints of headache and seizures after six weeks of delivery were excluded from the study. Intravenous contrast was administered in cases with diagnostic dilemma. All results were reported and informed to the referring physicians on priority bases. Results: Nine patients with peripartum headache and seizures revealed no brain parenchymal or cerebral vascular abnormalities on imaging. Eleven patients with a history of eclampsia showed features of eclamptic encephalopathy. Out 40 patients, 17 patients revealed cortical venous thrombosis with 14 patients showing parenchymal changes. One patient each showed features of meningoencephalitis, ischemic watershed territory infarct & region of gliosis. All results were analysed & tabulated. Conclusion: Eclamptic encephalopathy and cortical venous thrombosis are the major causes for post partum headache and seizures. Rational use of CT & MRI in the early course of the disease helps in characterizing the lesion and providing the appropriate treatment. PMID:25654004

  4. Clinical implementation of a neonatal seizure detection algorithm

    PubMed Central

    Temko, Andriy; Marnane, William; Boylan, Geraldine; Lightbody, Gordon

    2015-01-01

    Technologies for automated detection of neonatal seizures are gradually moving towards cot-side implementation. The aim of this paper is to present different ways to visualize the output of a neonatal seizure detection system and analyse their influence on performance in a clinical environment. Three different ways to visualize the detector output are considered: a binary output, a probabilistic trace, and a spatio-temporal colormap of seizure observability. As an alternative to visual aids, audified neonatal EEG is also considered. Additionally, a survey on the usefulness and accuracy of the presented methods has been performed among clinical personnel. The main advantages and disadvantages of the presented methods are discussed. The connection between information visualization and different methods to compute conventional metrics is established. The results of the visualization methods along with the system validation results indicate that the developed neonatal seizure detector with its current level of performance would unambiguously be of benefit to clinicians as a decision support system. The results of the survey suggest that a suitable way to visualize the output of neonatal seizure detection systems in a clinical environment is a combination of a binary output and a probabilistic trace. The main healthcare benefits of the tool are outlined. The decision support system with the chosen visualization interface is currently undergoing pre-market European multi-centre clinical investigation to support its regulatory approval and clinical adoption. PMID:25892834

  5. EEG seizure detection and prediction algorithms: a survey

    NASA Astrophysics Data System (ADS)

    Alotaiby, Turkey N.; Alshebeili, Saleh A.; Alshawi, Tariq; Ahmad, Ishtiaq; Abd El-Samie, Fathi E.

    2014-12-01

    Epilepsy patients experience challenges in daily life due to precautions they have to take in order to cope with this condition. When a seizure occurs, it might cause injuries or endanger the life of the patients or others, especially when they are using heavy machinery, e.g., deriving cars. Studies of epilepsy often rely on electroencephalogram (EEG) signals in order to analyze the behavior of the brain during seizures. Locating the seizure period in EEG recordings manually is difficult and time consuming; one often needs to skim through tens or even hundreds of hours of EEG recordings. Therefore, automatic detection of such an activity is of great importance. Another potential usage of EEG signal analysis is in the prediction of epileptic activities before they occur, as this will enable the patients (and caregivers) to take appropriate precautions. In this paper, we first present an overview of seizure detection and prediction problem and provide insights on the challenges in this area. Second, we cover some of the state-of-the-art seizure detection and prediction algorithms and provide comparison between these algorithms. Finally, we conclude with future research directions and open problems in this topic.

  6. Risk factors for EEG seizures in neonates treated with hypothermia

    PubMed Central

    Wusthoff, Courtney J.; Shellhaas, Renée A.; Tsuchida, Tammy N.; Bonifacio, Sonia Lomeli; Cordeiro, Malaika; Sullivan, Joseph; Abend, Nicholas S.; Chang, Taeun

    2014-01-01

    Objective: To assess the risk factors for electrographic seizures among neonates treated with therapeutic hypothermia for hypoxic-ischemic encephalopathy (HIE). Methods: Three-center observational cohort study of 90 term neonates treated with hypothermia, monitored with continuous video-EEG (cEEG) within the first day of life (median age at onset of recording 9.5 hours, interquartile range 6.3–14.5), and continued for >24 hours (total recording 93.3 hours, interquartile range 80.1–112.8 among survivors). A pediatric electroencephalographer at each site reviewed cEEGs for electrographic seizures and initial EEG background category. Results: A total of 43 (48%) had electrographic seizures, including 9 (10%) with electrographic status epilepticus. Abnormal initial EEG background classification (excessively discontinuous, depressed and undifferentiated, burst suppression, or extremely low voltage), but not clinical variables (including pH <6.8, base excess ??20, or 10-minute Apgar ?3), was strongly associated with seizures. Conclusions: Electrographic seizures are common among neonates with HIE undergoing hypothermia and are difficult to predict based on clinical features. These results justify the recommendation for cEEG monitoring in neonates treated with hypothermia. PMID:24610326

  7. Seizures in public places in New York City.

    PubMed Central

    Neugebauer, R; Oppenheimer, G; Susser, M

    1986-01-01

    The frequency of police aid to persons experiencing seizures in public in New York City in 1977 was examined as an index of uncontrolled seizure disorders, and as a pointer to variations in seizure frequencies by age, sex, and ethnicity. The overall rate of assistance to persons with public seizures was 5.4 per 10,000 person years. For Blacks the rate was more than double that for Whites and "Hispanics" (10, 4.7, and 4 per 10,000 person years, respectively). Males were assisted about 2.5 times more often than females (8.2 vs 3.3 per 10,000 person years). Among Black males, young adults and those of late middle age had the most pronounced excess over White males of the same ages (26.1 and 23.1 vs 7.8 and 4.0, respectively, per 10,000 person years). These variations underscore an unmet need for medical care for seizures that is especially marked in particular ethnic, sex, and age groups. PMID:3740336

  8. Predictors of Seizure Outcomes in Children with Tuberous Sclerosis Complex and Intractable Epilepsy Undergoing Resective Epilepsy Surgery: An Individual Participant Data Meta-Analysis

    PubMed Central

    Fallah, Aria; Guyatt, Gordon H.; Snead, O. Carter; Ebrahim, Shanil; Ibrahim, George M.; Mansouri, Alireza; Reddy, Deven; Walter, Stephen D.; Kulkarni, Abhaya V.; Bhandari, Mohit; Banfield, Laura; Bhatnagar, Neera; Liang, Shuli; Teutonico, Federica; Liao, Jianxiang; Rutka, James T.

    2013-01-01

    Objective To perform a systematic review and individual participant data meta-analysis to identify preoperative factors associated with a good seizure outcome in children with Tuberous Sclerosis Complex undergoing resective epilepsy surgery. Data Sources Electronic databases (MEDLINE, EMBASE, CINAHL and Web of Science), archives of major epilepsy and neurosurgery meetings, and bibliographies of relevant articles, with no language or date restrictions. Study Selection We included case-control or cohort studies of consecutive participants undergoing resective epilepsy surgery that reported seizure outcomes. We performed title and abstract and full text screening independently and in duplicate. We resolved disagreements through discussion. Data Extraction One author performed data extraction which was verified by a second author using predefined data fields including study quality assessment using a risk of bias instrument we developed. We recorded all preoperative factors that may plausibly predict seizure outcomes. Data Synthesis To identify predictors of a good seizure outcome (i.e. Engel Class I or II) we used logistic regression adjusting for length of follow-up for each preoperative variable. Results Of 9863 citations, 20 articles reporting on 181 participants were eligible. Good seizure outcomes were observed in 126 (69%) participants (Engel Class I: 102(56%); Engel class II: 24(13%)). In univariable analyses, absence of generalized seizure semiology (OR?=?3.1, 95%CI?=?1.2–8.2, p?=?0.022), no or mild developmental delay (OR?=?7.3, 95%CI?=?2.1–24.7, p?=?0.001), unifocal ictal scalp electroencephalographic (EEG) abnormality (OR?=?3.2, 95%CI?=?1.4–7.6, p?=?0.008) and EEG/Magnetic resonance imaging concordance (OR?=?4.9, 95%CI?=?1.8–13.5, p?=?0.002) were associated with a good postoperative seizure outcome. Conclusions Small retrospective cohort studies are inherently prone to bias, some of which are overcome using individual participant data. The best available evidence suggests four preoperative factors predictive of good seizure outcomes following resective epilepsy surgery. Large long-term prospective multicenter observational studies are required to further evaluate the risk factors identified in this review. PMID:23405072

  9. Distribution of seizures across the menstrual cycle in women with epilepsy.

    PubMed

    Herzog, Andrew G; Fowler, Kristen M; Sperling, Michael R; Massaro, Joseph M

    2015-05-01

    The purpose of this study was to determine whether seizure frequency and cycle days with seizure occurrence vary across the menstrual cycle. The subjects were the first 100 women with intractable focal onset seizures, 13-45 years old, who completed the baseline phase of the National Institutes of Health (NIH) Progesterone Trial. Each subject recorded seizures and menses during a 3-month baseline phase. Data consisted of (1) seizure numbers for each cycle day and (2) cycle days with seizure occurrence. Statistical comparisons of seizure frequency and days with seizures were performed using generalized estimating equation one-way analysis of variance (ANOVA) and logistic regression followed by pairwise multiple comparisons of days based on the least square means. Seizure numbers and cycle days with seizure occurrence varied across the menstrual cycle. There was an approximately twofold difference between the highest (day 1) and lowest (day -8) values for both seizure frequency and days with occurrence. The demonstration of variation in seizure frequency and cycle days with seizure occurrence across the menstrual cycle, as well as identification of specific days that have substantially higher or lower frequencies than other days, supports the existence of catamenial epilepsy. PMID:25823700

  10. EFFECTIVE SAMPLING TECHNIQUES FOR PARTICULATE EMISSIONS FROM ATYPICAL STATIONARY SOURCES

    EPA Science Inventory

    Sampling techniques for measuring particulate emissions from four 'atypical' stationary source categories were developed and evaluated. The categories include low effluent velocity streams, extended dimensions, partially or totally unconfined flow, and saturated gas streams or ga...

  11. BRAINA JOURNAL OF NEUROLOGY Atypical activation during the Embedded Figures

    E-print Network

    Cambridge, University of

    BRAINA JOURNAL OF NEUROLOGY Atypical activation during the Embedded Figures Task as a functional Neurological Institute doi:10.1093/brain/aws229 Brain 2012: 0; 1­12 | 1 Received February 16, 2012. Revised

  12. The Use of Electroconvulsive Therapy in Atypical Psychotic Presentations

    PubMed Central

    Vasu, Devi

    2007-01-01

    Convulsive therapy and its progeny, electroconvulsive therapy (ECT), were originally used for the treatment of catatonic schizophrenia, and there is little doubt that ECT remains an effective intervention for the treatment of schizophrenia. However, current practice tends to favor the use of ECT in severe or treatment refractory affective disorders, and its use in schizophrenia and other nonaffective (atypical) psychotic disorders has become controversial. Case reports have suggested a role for ECT in two specific atypical psychotic disorders: Cotard's syndrome and cycloid psychosis. In this article, we review the atypical psychotic disorders and report a series of five case examples that signify the role of ECT in atypical psychotic presentations, particularly when the symptoms resemble those found in Cotard's syndrome and cycloid psychosis. PMID:20428309

  13. SHORT REPORT Atypical Diffusion Tensor Hemispheric Asymmetry in Autism

    E-print Network

    Utah, University of

    SHORT REPORT Atypical Diffusion Tensor Hemispheric Asymmetry in Autism Nicholas Lange, Molly B. Du: Biological measurements that distinguish individuals with autism from typically developing individuals a useful combination of classification features and further understand autism neuropathology. Methods: WMM

  14. Atypical presentation of a middle age male with severe hypertriglyceridaemia: a case report

    PubMed Central

    Albahrani, Ali I; Usher J, Jannette; Marks, Eileen; Ranganath, L; Shenkin, Alan

    2007-01-01

    Background Severe hypertriglyceridaemia (HTG) is uncommon but most prevalent in subjects with type 2 diabetes mellitus (T2DM) and excess ethanol intake. Case presentation We describe a case of a middle age male (53 y) presenting to the emergency room with acute atypical central chest pain and severe HTG in the absence of evidence of overt ischaemic heart disease (IHD). Admission ECG and EET (exercise tolerance test) were negative for reversible ischaemic changes. His admission glucose was 12.2 mmol/l, triglycerides (TG) were 103 mmol/l, total cholesterol 37 mmol/l. Cardiac Troponin T could not be measured on three occasions but CK MB mass was normal at 3 ?g/l. The patient was started on Bezafibrate 400 mg OD, Simvastatin 20 mg nocte, Omacor (Omega-3 fish oil) 1 gm bd and Metformin 500 mg tds. Four weeks after admission, lipid and liver profiles showed remarkable improvement, TG 2.9 mmol/l, Tchol 6.3 mmol/l and HDLc 1.5 mmol/l, ALAT and GGT were normal. Conclusion A case report of severe hypertriglyceridaemia with atypical presentation demonstrate the role of combined lipid modifying agents in lowering triglycerides and cholesterol as well as improving liver enzymes. PMID:17629933

  15. Atypical antipsychotics and mood stabilization in bipolar disorder

    Microsoft Academic Search

    Paolo Brambilla; Francesco Barale; Jair C. Soares

    2003-01-01

      \\u000a The available literature on the use of atypical antipsychotics for the treatment of bipolar disorder was reviewed. All uncontrolled\\u000a and controlled reports were identified through a comprehensive Medline search. Based on the available evidence, olanzapine\\u000a was found to be the most appropriate atypical antipsychotic agent utilized for the treatment of manic bipolar patients, although\\u000a there is also preliminary data

  16. Treatment of Bipolar Disorder: The Evolving Role of Atypical Antipsychotics

    Microsoft Academic Search

    Roy H. Perlis

    Management of bipolar disorder (BPD) may require multiple medications, including lithi- um, anticonvulsants, and antipsychotics (both conventional and atypical). Updated treatment guidelines reflect an expanded role for atypical antipsychotics (AAPs) in BPD treatment. Five AAPs—olanzapine, risperidone, quetiapine, ziprasidone, and aripiprazole—are approved by the US Food and Drug Administration (FDA) as monotherapy for first-line treatment of acute manic and (except for

  17. Psychogenic Nonepileptic Seizures after Head Injury: A Case Report

    PubMed Central

    Scévola, Laura; D'Alessio, Luciana; Saferstein, Dario; Centurión, Estela; Consalvo, Damián; Kochen, Silvia

    2009-01-01

    Psychogenic nonepileptic seizures (PNESs) are diagnosed when disruptive changes in behaviour, thinking, or emotion resemble epileptic seizures (ESs), but no paroxysmal discharges are seen on electroencephalogram (EEG) and do not originate from another medical illness. The gold standard for PNES diagnosis is video electroencephalogram (Video-EEG). PNESs are defined by modern psychiatry as conversion and dissociative disorders but these disorders may coexist with many others psychiatric disorders, including depression, posttraumatic stress disorder, and personality disorders. It is well known that epileptic seizures are a frequent and well-studied complication of traumatic head injury (THI). However, THI may also generate psychic symptoms including PNES. In this paper we describe a patient who developed PNES after THI in a bus accident and received a diagnosis of refractory epilepsy for 24 years until she underwent Video-EEG. PMID:19859582

  18. Issues related to development of new anti-seizure treatments

    PubMed Central

    Wilcox, Karen S.; Dixon-Salazar, Tracy; Sills, Graeme J.; Ben-Menachem, Elinor; White, H. Steve; Porter, Roger J.; Dichter, Marc A.; Moshé, Solomon L.; Noebels, Jeffery L.; Privitera, Michael D.; Rogawski, Michael A.

    2013-01-01

    Summary This report represents a summary of the discussions led by the anti-seizure treatment working group of the ILAE/AES Working Groups joint meeting in London (London Meeting). We review here what is currently known about the pharmacological characteristics of current models of refractory seizures, both for adult and pediatric epilepsy. In addition, we address how the NINDS-funded Anticonvulsant Screening Program (ASP) is evolving to incorporate appropriate animal models in the search for molecules that might be sufficiently novel to warrant further pharmacological development. We also briefly address what we believe is necessary, going forward, to achieve the goal of stopping seizures in all patients, with a call to arms for funding agencies, the pharmaceutical industry, and basic researchers. PMID:23909851

  19. A case of Hashimoto's encephalopathy presenting with seizures and psychosis.

    PubMed

    Lee, Min-Joo; Lee, Hae-Sang; Hwang, Jin-Soon; Jung, Da-Eun

    2012-03-01

    Hashimoto's encephalopathy (HE) is a rare, poorly understood, autoimmune disease characterized by symptoms of acute or subacute encephalopathy associated with increased anti-thyroid antibody levels. Here, we report a case of a 14-year-old girl with HE and briefly review the literature. The patient presented with acute mental changes and seizures, but no evidence of infectious encephalitis. In the acute stage, the seizures did not respond to conventional antiepileptic drugs, including valproic acid, phenytoin, and topiramate. The clinical course was complicated by the development of acute psychosis, including bipolar mood, insomnia, agitation, and hallucinations. The diagnosis of HE was supported by positive results for antithyroperoxidase and antithyroglobulin antibodies. Treatment with methylprednisolone was effective; her psychosis improved and the number of seizures decreased. HE is a serious but curable, condition, which might be underdiagnosed if not suspected. Anti-thyroid antibodies must be measured for the diagnosis. HE should be considered in patients with diverse neuropsychiatric manifestations. PMID:22474467

  20. Quinolones potentiate cefazolin-induced seizures in DBA/2 mice.

    PubMed

    De Sarro, A; Zappalá, M; Chimirri, A; Grasso, S; De Sarro, G B

    1993-07-01

    The behavioral and convulsant effects of cefazolin, a beta-lactam derivative, were studied after intraperitoneal administration to DBA/2 mice, a strain genetically susceptible to sound-induced seizures, and Swiss mice. DBA/2 mice were more susceptible to seizures induced by cefazolin than were Swiss mice. The proconvulsant effects of some quinolones on seizures evoked by intraperitoneal administration of cefazolin were also evaluated in DBA/2 mice. Our study also demonstrated that the order of proconvulsant activity in our epileptic model was pefloxacin > enoxacin > ofloxacin > rufloxacin > norfloxacin > cinoxacin > ciprofloxacin > nalidixic acid. The relationships between the chemical structures and proconvulsant activities of quinolone derivatives were studied. The relationship between lipophilicity and proconvulsant activity was also investigated. PMID:8395790

  1. Quinolones potentiate cefazolin-induced seizures in DBA/2 mice.

    PubMed Central

    De Sarro, A; Zappalá, M; Chimirri, A; Grasso, S; De Sarro, G B

    1993-01-01

    The behavioral and convulsant effects of cefazolin, a beta-lactam derivative, were studied after intraperitoneal administration to DBA/2 mice, a strain genetically susceptible to sound-induced seizures, and Swiss mice. DBA/2 mice were more susceptible to seizures induced by cefazolin than were Swiss mice. The proconvulsant effects of some quinolones on seizures evoked by intraperitoneal administration of cefazolin were also evaluated in DBA/2 mice. Our study also demonstrated that the order of proconvulsant activity in our epileptic model was pefloxacin > enoxacin > ofloxacin > rufloxacin > norfloxacin > cinoxacin > ciprofloxacin > nalidixic acid. The relationships between the chemical structures and proconvulsant activities of quinolone derivatives were studied. The relationship between lipophilicity and proconvulsant activity was also investigated. PMID:8395790

  2. Canonical Decomposition of scalp EEG in epileptic seizure localisation Maarten De Vos 1,

    E-print Network

    the seizures. The electroencephalogram (EEG) is then recorded over several days as it is the direct measurement of seizure onset zone is recording of ictal scalp electroencephalogram (EEG) [10]. The EEG measures electric

  3. Assessment of a scalp EEG-based automated seizure detection system

    Microsoft Academic Search

    K. M. Kelly; D. S. Shiau; R. T. Kern; J. H. Chien; M. C. K. Yang; K. A. Yandora; J. P. Valeriano; J. J. Halford; J. C. Sackellares

    2010-01-01

    ObjectiveThe purpose of this study was to evaluate and validate an offline, automated scalp EEG-based seizure detection system and to compare its performance to commercially available seizure detection software.

  4. Automatic detection of epileptic seizure onset and termination using intracranial EEG

    E-print Network

    Kharbouch, Alaa Amin

    2012-01-01

    This thesis addresses the problem of real-time epileptic seizure detection from intracranial EEG (IEEG). One difficulty in creating an approach that can be used for many patients is the heterogeneity of seizure IEEG patterns ...

  5. Electroacupuncture Reduces Cocaine-Induced Seizures and Mortality in Mice

    PubMed Central

    Chen, Yi-Hung; Chuang, Chieh-Min; Lu, Dah-Yuu; Lin, Jaung-Geng

    2013-01-01

    The aims of this study were to characterize the protective profile of electroacupuncture (EA) on cocaine-induced seizures and mortality in mice. Mice were treated with EA (2?Hz, 50?Hz, and 100?Hz), or they underwent needle insertion without anesthesia at the Dazhui (GV14) and Baihui (GV20) acupoints before cocaine administration. EA at 50 Hz applied to GV14 and GV20 significantly reduced the seizure severity induced by a single dose of cocaine (75?mg/kg; i.p.). Furthermore, needle insertion into GV14 and GV20 and EA at 2 Hz and 50 Hz at both acupoints significantly reduced the mortality rate induced by a single lethal dose of cocaine (125?mg/kg; i.p.). In the sham control group, EA at 50?Hz applied to bilateral Tianzong (SI11) acupoints had no protective effects against cocaine. In addition, EA at 50?Hz applied to GV14 and GV20 failed to reduce the incidence of seizures and mortality induced by the local anesthetic procaine. In an immunohistochemistry study, EA (50 Hz) pretreatment at GV14 and GV20 decreased cocaine (75?mg/kg; i.p.)-induced c-Fos expression in the paraventricular thalamus. While the dopamine D3 receptor antagonist, SB-277011-A (30?mg/kg; s.c), did not by itself affect cocaine-induced seizure severity, it prevented the effects of EA on cocaine-induced seizures. These results suggest that EA alleviates cocaine-induced seizures and mortality and that the dopamine D3 receptor is involved, at least in part, in the anticonvulsant effects of EA in mice. PMID:23690833

  6. A Review of Pharmacologic Strategies for Switching to Atypical Antipsychotics

    PubMed Central

    Masand, Prakash S.

    2005-01-01

    Background: In daily clinical practice, frequent switching of antipsychotic medications is widespread. There are various reasons for switching, including a partial or complete lack of efficacy, adverse side effects, and partial or noncompliance with medication. Patients switched from conventional drugs to oral atypical antipsychotic drugs have been shown to benefit from significant improvements in clinical response and tolerability. This review examines the strategies for switching patients from conventional antipsychotic drugs to both oral and long-acting formulations of atypical antipsychotic drugs that are the recommended treatment in the majority of patients with schizophrenia. Data Sources and Study Selection: An electronic literature search of relevant studies using MEDLINE (January 1994–June 2004) was performed using the search terms antipsychotic, atypical, conventional, schizophrenia, and switching. English-language articles, references from bibliographies of reviews, original research articles, and other articles of interest were reviewed. Data Extraction and Synthesis: Data quality was determined by publication in the peer-reviewed literature and the most important information identified. Data from clinical trials suggest that switching to an atypical antipsychotic drug is beneficial for the patient with schizophrenia. Conclusions: If initiated appropriately, switching to atypical antipsychotic medications should not compromise patient functioning; indeed, individualized strategies have been shown to provide continuous treatment efficacy. Switching to atypical antipsychotic therapy should, therefore, be employed as a pharmacologic strategy to maximize patient outcomes. PMID:16027767

  7. Enflurane-Induced Grand Mal Seizures During Otic Microsurgery

    PubMed Central

    DeWolf, Andre M.; Chang, Juei-Ling; Larson, Christopher E.; Caparosa, Ralph J.

    1984-01-01

    Abnormal electroencephalographic seizure-like activity and myoclonic movements have been recognized during enflurane anesthesia. This is most commonly seen in the presence of respiratory alkalosis and high concentrations of enflurane. Immediate and delayed postoperative generalized tonic-clonic convulsions have also been reported after enflurane anesthesia. Experimental studies have shown that auditory stimuli could facilitate seizure activity during deep enflurane anesthesia. Here we report a case of intraoperative generalized tonic-clonic convulsion during low concentrations of enflurane without evidence of hyperventilation and the presence of auditory stimulation. PMID:6591846

  8. Susceptibility of immature rats to seizures induced by unsymmetrical dimethylhydrazine 

    E-print Network

    Boyd, Dale Duaine

    1963-01-01

    of convulsions in male and female rats was also compared and no significant difference was found. Interval Between In ection of UDMH and Onset of Seizures The effect of age on the time interval between injection of UDMH and the onset of seizures is shown... and decreases steadily as age increased (with the exception of the 24-day-old group), when analyzed by the analysis of regression method the relationship between age and interval of time between in)ection and onset of convulsions proved not to be a strictly...

  9. Seizure susceptibility decreases with enhancement of rapid eye movement sleep.

    PubMed

    Kumar, P; Raju, T R

    2001-12-20

    The study examined the effect of enhanced rapid eye movement (REM) sleep duration on the seizure threshold determined by electrical stimulation of the amygdala in rats. The duration of REM sleep was specifically increased by the microinjection of a cholinergic agonist, carbachol, into the pontine reticular formation. This was accompanied by a significant increase in the threshold current required to elicit an afterdischarge in the amygdala. The results suggest that an increase in REM sleep decreases the likelihood of cortical seizure activity, an effect that is manifest even in other stages of the sleep-wakefulness cycle and not only in the REM state, per se. PMID:11743963

  10. Atypical presentation of cauda equina syndrome

    PubMed Central

    Caputo, Lisa A; Cusimano, Michael D

    2002-01-01

    Cauda equina syndrome (CES) has been described in the literature as a clinical entity consisting of low back pain, bilateral leg pain with motor and sensory deficits, genitourinary dysfunction with overflow incontinence or retention, and faecal incontinence. CES has been recognised as a rare complication of spinal manipulative therapy, and is an absolute contraindication to this type of therapy. A case of CES that presented in an atypical manner is presented, highlighting the lack of leg symptomatology, but with the presence of painless urinary retention. A definition of CES as a condition presenting with bladder dysfunction and possible motor and/or sensory loss in the region of sacral and/or lumbar dermatomes is discussed. Evaluation of patients with lumbar disc pathology who are suspected of suffering from CES should include questioning regarding urinary difficulty and neurologic examination of the sacral plexus, including sensation; and may include advanced imaging such as contrast computerized tomography (CT) scan or magnetic resonance imaging (MRI). Immediate referral for consideration of decompression surgery is recommended for optimal recovery of neurologic function. Clinicians should be knowledgeable of the various forms CES can present in, and maintain a high index of suspicion for this condition in patients with suspected lumbar disc herniation or urinary dysfunction. ImagesFigure 1AFigure 1BFigure 2Figure 3AFigure 3B

  11. The Neurogenetics of Atypical Parkinsonian Disorders

    PubMed Central

    Fogel, Brent L.; Clark, Mary C.; Geschwind, Daniel H.

    2015-01-01

    Although classic Parkinson disease is the disorder most commonly associated with the clinical feature of parkinsonism, there is in fact a broader spectrum of disease represented by a collection of phenotypically similar neurodegenerative conditions which mimic many of its core features. These atypical parkinsonian disorders most commonly include progressive supranuclear palsy and corticobasal degeneration, disorders both associated with frontotemporal dementia, as well as multiple system atrophy, and dementia with Lewy bodies. While clinical distinction of these disorders still remains a challenge to physicians, recent advances in genetics are poised to tease apart the differences. Insights into the molecular etiologies underlying these conditions will improve diagnosis, yield better understanding of the underlying disease pathology, and ultimately lend stimulation to the development of potential treatments. At the same time, the wide range of phenotypes observed from mutations in a single gene warrants broad testing facilitated by advances in DNA sequencing. These expanding genomic approaches, ranging from the use of next-generation sequencing to identify causative or risk-associated gene variations to the study of epigenetic modification linking human genetics to environmental factors, are poised to lead the field into a new age of discovery. PMID:24963681

  12. Podocyte dysfunction in atypical haemolytic uraemic syndrome.

    PubMed

    Noris, Marina; Mele, Caterina; Remuzzi, Giuseppe

    2015-04-01

    Genetic or autoimmune defects that lead to dysregulation of the alternative pathway of complement have been associated with the development of atypical haemolytic uraemic syndrome (aHUS), which is characterized by thrombocytopenia, haemolytic anaemia and acute kidney injury. The relationship between aHUS, podocyte dysfunction and the resultant proteinuria has not been adequately investigated. However, the report of mutations in diacylglycerol kinase ? (DGKE) as a cause of recessive infantile aHUS characterized by proteinuria, highlighted podocyte dysfunction as a potential complication of aHUS. DGKE deficiency was originally thought to trigger aHUS through pathogenetic mechanisms distinct from complement dysregulation; however, emerging findings suggest an interplay between DGKE and complement systems. Podocyte dysfunction with nephrotic-range proteinuria can also occur in forms of aHUS associated with genetic or autoimmune complement dysregulation without evidence of DGKE mutations. Furthermore, proteinuric glomerulonephritides can be complicated by aHUS, possibly as a consequence of podocyte dysfunction inducing endothelial injury and prothrombotic abnormalities. PMID:25599621

  13. Similar semiology of epileptic and psychogenic nonepileptic seizures recorded during stereo-EEG.

    PubMed

    Ostrowsky-Coste, Karine; Montavont, Alexandra; Keo-Kosal, Pascale; Guenot, Marc; Chatillon, Claude-Edouard; Ryvlin, Philippe

    2013-12-01

    We report two adolescents with refractory seizure disorders in whom both epileptic and psychogenic nonepileptic seizures (PNES) were recorded with intracerebral EEG. The ictal phenomenology of epileptic seizures (ES) and PNES, consisting of hypermotor attacks in the first patient and left-sided painful episodes in the second patient, proved remarkably similar in both cases, highlighting the difficulties which can arise with the distinction of epileptic seizures and PNES based on ictal phenomenology alone. PMID:23972997

  14. Nonlinear dynamics in EEG from epileptic patients: Is it possible to predict seizures?

    NASA Astrophysics Data System (ADS)

    Winterhalder, M.; Schelter, B.; Maiwald, T.; Aschenbrenner-Scheibe, R.; Brandt, A.; Schulze-Bonhage, A.; Timmer, J.

    2004-12-01

    Several concepts and analysis techniques originating from Nonlinear Dynamics have been applied to electroencephalography recordings of epilepsy patients to predict seizures. An early prediction of an upcoming seizure would dramatically increase the therapeutic possibilities for this common neurological disease. We suggest standards to assess seizure prediction performance of time series analysis techniques. We present assessment of three methods originating from Nonlinear Dynamics with respect to their ability in predicting epileptic seizures.

  15. Seizures and electroencephalographic findings in CDKL5 mutations: Case report and review

    Microsoft Academic Search

    S. Grosso; A. Brogna; S. Bazzotti; A. Renieri; G. Morgese; P. Balestri

    2007-01-01

    Mutations in the X-linked gene cyclin-dependent kinase-like 5 (CDKL5) have been detected in patients presenting with seizures in the first few months of life and Rett syndrome features. Twenty-seven cases have been detected to date. Generalized intractable seizures, as infantile spasms, and generalized tonic–clonic seizures and myoclonic seizures characterize the clinical picture of CDKL5 mutations. Here we report on a

  16. Ictal analgesia in temporal lobe epilepsy - The mechanism of seizure-related burns.

    PubMed

    Sz?cs, Anna; Horváth, András; Rásonyi, György; Fabó, Dániel; Szabó, Géza; Sákovics, Anna; Kamondi, Anita

    2015-08-01

    Seizure-related injuries have major impact in the excess mortality and morbidity of epilepsy patients. Experimental data suggest that analgesia may develop during seizures contributing to the severity of seizure-related accidents, especially burns. We aimed to identify those seizure-types that may lead to burn-injuries by seizure-related analgesia. In our tertiary epilepsy centre, we asked 100 epilepsy patients having a history of seizure-related injury, to complete our burn-and-pain questionnaire. Fifty-one patients completed the survey; their epileptology data were collected and those with a seizure-related burn were interviewed. Forty-two out of the 51 patients (82%) had partial epilepsy and 9 (18%) had idiopathic generalised epilepsy. Twenty-six persons (51%) reported decreased pain perception during or after seizures in general. Twelve patients (23%) had suffered one or more seizure-related burn. Five of them fell onto a hot surface or fire accidentally, during generalized tonic-clonic seizures. Seven out of the 12 burnt patients (58%) grasped a hot object or reached into boiling fluid during complex partial seizures; without experiencing-, or reacting in response to pain. These patients had temporal lobe epilepsy, 5 of them had left temporal seizure onset. Our hypothesis based on the circumstantial analysis of our patients' burn-injuries; is that temporal lobe seizures may cause ictal/postictal analgesia. It may be caused by the seizure-related epileptic facilitation of the periaqueductal gray matter; the central pain-inhibiting structure of the brain. Seizure-related endogenous opioid-release my have a contributory role in inhibiting pain-perception. Ictal analgesia warrants better burn-prevention in temporal lobe epilepsy patients. Understanding the mechanism of ictal analgesia and specifying those seizures-types prone to cause it; may help indentifying human pain-inhibiting pathways. PMID:25953092

  17. A crossover, add-on trial of talampanel in patients with refractory partial seizures.

    PubMed

    Chappell, A S; Sander, J W; Brodie, M J; Chadwick, D; Lledo, A; Zhang, D; Bjerke, J; Kiesler, G M; Arroyo, S

    2002-06-11

    The authors report a double-blind, placebo-controlled, crossover study of talampanel in 49 patients with refractory partial seizures. Three doses of talampanel were investigated based on differences in patients' concomitant antiepileptic drug usage. Talampanel showed efficacy in reducing seizure frequency (p = 0.001) with a median seizure reduction of 21%. Eighty percent of patients had fewer seizures on talampanel than on placebo. Dizziness (52%) and ataxia (26%) were the only significant adverse events. PMID:12058100

  18. The Atypical OmpR/PhoB Response Regulator ChxR from Chlamydia trachomatis Forms Homodimers In Vivo and Binds a Direct Repeat of Nucleotide Sequences ? †

    PubMed Central

    Hickey, John M.; Weldon, Lindsey; Hefty, P. Scott

    2011-01-01

    Two-component signal transduction systems are widespread in bacteria and are essential regulatory mechanisms for many biological processes. These systems predominantly rely on a sensor kinase to phosphorylate a response regulator for controlling activity, which is frequently transcriptional regulation. In recent years, an increasing number of atypical response regulators have been discovered in phylogenetically diverse bacteria. These atypical response regulators are not controlled by phosphorylation and exhibit transcriptional activity in their wild-type form. Relatively little is known regarding the mechanisms utilized by these atypical response regulators and the conserved characteristics of these atypical response regulators. Chlamydia spp. are medically important bacteria and encode an atypical OmpR/PhoB subfamily response regulator termed ChxR. In this study, protein expression analysis supports that ChxR is likely exerting its effect during the middle and late stages of the chlamydial developmental cycle, stages that include the formation of infectious elementary bodies. In the absence of detectable phosphorylation, ChxR formed homodimers in vitro and in vivo, similar to a phosphorylated OmpR/PhoB subfamily response regulator. ChxR was demonstrated to bind to its own promoter in vivo, supporting the role of ChxR as an autoactivator. Detailed analysis of the ChxR binding sites within its own promoter revealed a conserved cis-acting motif that includes a tandem repeat sequence. ChxR binds specifically to each of the individual sites and exhibits a relatively large spectrum of differential affinity. Taken together, these observations support the conclusion that ChxR, in the absence of phosphorylation, exhibits many of the characteristics of a phosphorylated (active) OmpR/PhoB subfamily response regulator. PMID:21057008

  19. Absence seizures in C3H/HeJ and knockout mice caused by mutation of the AMPA receptor

    E-print Network

    Huguenard, John R.

    epilepsy, characterized by spike­wave discharges (SWD) in the electroencephalogram, arises from aberrations) in the electroencephalogram (EEG) and are characterized by a brief loss of consciousness while the patient remains still. SWD

  20. A novel p.Arg970X mutation in the last exon of the CDKL5 gene resulting in late-onset seizure disorder.

    PubMed

    Psoni, Stavroula; Willems, Patrick J; Kanavakis, Emmanuel; Mavrou, Ariadne; Frissyra, Helen; Traeger-Synodinos, Joanne; Sofokleous, Christalena; Makrythanassis, Periklis; Kitsiou-Tzeli, Sophia

    2010-03-01

    Classic Rett Syndrome (RS) is a neurodevelopmental disorder due to mutations in the MECP2 gene in Xq28. Atypical RS with severe early-onset encephalopathy and therapy-resistant epilepsy can be due to mutations in the CDKL5 (Cyclin-Dependent Kinase-like 5) gene in Xp22. We here report a 14-year-old female with a RS-like clinical picture, and well-controlled seizures. MECP2 gene testing was negative, but subsequent sequencing of the CDKL5 gene revealed the c. 2908 C>T nonsense mutation (p.Arg970X) in the last exon, not previously described in other patients or controls. The less severe phenotype might be due to the position of the mutation in the last exon of the CDKL5 gene. PMID:19428276

  1. Subacute encephalopathy and seizures in alcoholics (SESA) presenting with non-convulsive status epilepticus

    Microsoft Academic Search

    Suzette M. LaRoche; Rosita Shivdat-Nanhoe

    2011-01-01

    Subacute encephalopathy with seizures in chronic alcoholism (SESA) was first described in 1981 by Niedermeyer who reported alcoholic patients presenting with confusion, seizures and focal neurological deficits and is quite distinct from patients presenting with typical alcohol withdrawal seizures. EEG often reveals periodic discharges and spikes, but SESA presenting with non-convulsive status epilepticus has rarely been described.We report a case

  2. Synergistic GABA-Enhancing Therapy against Seizures in a Mouse Model of Dravet Syndrome

    PubMed Central

    Oakley, John C.; Cho, Alvin R.; Cheah, Christine S.; Scheuer, Todd

    2013-01-01

    Seizures remain uncontrolled in 30% of patients with epilepsy, even with concurrent use of multiple drugs, and uncontrolled seizures result in increased morbidity and mortality. An extreme example is Dravet syndrome (DS), an infantile-onset severe epilepsy caused by heterozygous loss of function mutations in SCN1A, the gene encoding the brain type-I voltage-gated sodium channel NaV1.1. Studies in Scn1a heterozygous knockout mice demonstrate reduced excitability of GABAergic interneurons, suggesting that enhancement of GABA signaling may improve seizure control and comorbidities. We studied the efficacy of two GABA-enhancing drugs, clonazepam and tiagabine, alone and in combination, against thermally evoked myoclonic and generalized tonic-clonic seizures. Clonazepam, a positive allosteric modulator of GABA-A receptors, protected against myoclonic and generalized tonic-clonic seizures. Tiagabine, a presynaptic GABA reuptake inhibitor, was protective against generalized tonic-clonic seizures but only minimally protective against myoclonic seizures and enhanced myoclonic seizure susceptibility at high doses. Combined therapy with clonazepam and tiagabine was synergistic against generalized tonic-clonic seizures but was additive against myoclonic seizures. Toxicity determined by rotorod testing was additive for combination therapy. The synergistic actions of clonazepam and tiagabine gave enhanced seizure protection and reduced toxicity, suggesting that combination therapy may be well tolerated and effective for seizures in DS. PMID:23424217

  3. Diagnosis of neonatal seizure by continuous recording and rapid analysis of the electroencephalogram

    Microsoft Academic Search

    J A Eyre; R C Oozeer; A R Wilkinson

    1983-01-01

    Clinical diagnosis of neonatal seizure is difficult and repeated seizures may be unrecognised. To assist in early diagnosis we recorded continuously the electroencephalogram (EEG) of very sick newborns while intensive care continued. In 25 babies at high risk of seizure a continuous record of two channels of EEG, ECG, and respiration was made for periods varying from 11 hours to

  4. Clinical features of seizures in patients with human immunodeficiency virus infection.

    PubMed

    Kim, Hyun Kyung; Chin, Bum Sik; Shin, Hyoung-Shik

    2015-06-01

    Patients with human immunodeficiency virus (HIV) infection have a higher burden of seizures, but few studies have examined seizures in HIV-infected individuals in Korea. A retrospective study was conducted to determine the epidemiology and clinical characteristics of seizures in patients with HIV infection. Among a total of 1,141 patients, 34 (3%) had seizures or epilepsy; 4 of these individuals had epilepsy before HIV infection, and the others showed new-onset seizures. Most patients exhibited moderate (200 to 500, n = 13) or low (below 200, n = 16) CD4 counts. The most common seizure etiology was progressive multifocal leukoencephalopathy (n = 14), followed by other HIV-associated central nervous system (CNS) complications (n = 6). Imaging studies revealed brain lesions in 21 patients. A total of 9 patients experienced only one seizure during the follow-up period, and 25 patients experienced multiple seizures or status epilepticus (n = 2). Multiple seizures were more common in patients with brain etiologies (P = 0.019) or epileptiform discharges on EEG (P = 0.032). Most seizures were controlled without anticonvulsants (n = 12) or with a single anticonvulsant (n = 12). Among patients with HIV infection, seizures are significantly more prevalent than in the general population. Most seizures, with the exception of status epilepticus, have a benign clinical course and few complications. PMID:26028919

  5. The Effects of Seizures on the Connectivity and Circuitry of the Developing Brain

    ERIC Educational Resources Information Center

    Swann, John W.

    2004-01-01

    Recurring seizures in infants and children are often associated with cognitive deficits, but the reason for the learning difficulties is unclear. Recent studies in several animal models suggest that seizures themselves may contribute in important ways to these deficits. Other studies in animals have shown that recurring seizures result in…

  6. Psychomotor seizures of temporal lobe onset: Analysis of symptom clusters and sequences

    Microsoft Academic Search

    Prakash Kotagal; Hans Otto Lüders; George Williams; Thom R. Nichols; Joseph McPherson

    1995-01-01

    We analyzed 91 psychomotor seizures from 31 patients seizure free at least one year after temporal lobectomy (implying temporal lobe onset). Fifty symptoms were looked for in every seizure and their time of onset and ending noted. Statistical analysis was used to define symptom clusters and the order of appearance of symptoms. Of the eighteen most common symptoms examined, all

  7. Case Report Shared vulnerability between seizures and psychosis in cocaine addiction?

    E-print Network

    Hayar, Abdallah

    Case Report Shared vulnerability between seizures and psychosis in cocaine addiction? Benjamin Available online 15 September 2011 Keywords: Cocaine Seizures Psychosis N-methyl-D-aspartate Dopamine Kindling effect Cocaine-induced seizures (CIS) and cocaine-induced psychosis (CIP) may be complications

  8. Risk of seizures and neurocysticercosis in household family contacts of children with single enhancing lesions

    Microsoft Academic Search

    Gagandeep Singh; S Ram; V Kaushal; Sheel Kumar; R. C Bhatia; N Raizada; R. K Kaushal

    2000-01-01

    A small, single enhancing lesion (SEL) is often noted upon computed tomography (CT) in children and young adults with recent focal or generalized seizures. A high frequency of seizures has been reported in family members of persons with SEL. We studied the prevalence of seizures and cysticercus electro-immuno-transfer blot (EITB) based seropositivity among family members, specifically household family contacts of

  9. A computational environment for long-term multi-feature and multi-algorithm seizure prediction

    Microsoft Academic Search

    C. A. Teixeira; B. Direito; R. P. Costa; M. Valderrama; H. Feldwisch-Drentrup; S. Nikolopoulos; M. Le Van Quyen; B. Schelter; A. Dourado

    2010-01-01

    The daily life of epilepsy patients is constrained by the possibility of occurrence of seizures. Until now, seizures cannot be predicted with sufficient sensitivity and specificity. Most of the seizure prediction studies have been focused on a small number of patients, and frequently assuming unrealistic hypothesis. This paper adopts the view that for an appropriate development of reliable predictors one

  10. Downregulated GABA and BDNF-TrkB Pathway in Chronic Cyclothiazide Seizure Model

    PubMed Central

    2014-01-01

    Cyclothiazide (CTZ) has been reported to simultaneously enhance glutamate receptor excitation and inhibit GABAA receptor inhibition, and in turn it evokes epileptiform activities in hippocampal neurons. It has also been shown to acutely induce epileptic seizure behavior in freely moving rats. However, whether CTZ induced seizure rats could develop to have recurrent seizure still remains unknown. In the current study, we demonstrated that 46% of the CTZ induced seizure rats developed to have recurrent seizure behavior as well as epileptic EEG with a starting latency between 2 weeks and several months. In those chronic seizure rats 6 months after the seizure induction by the CTZ, our immunohistochemistry results showed that both GAD and GAT-1 were significantly decreased across CA1, CA3, and dentate gyrus area of the hippocampus studied. In addition, both BDNF and its receptor TrkB were also decreased in hippocampus of the chronic CTZ seizure rats. Our results indicate that CTZ induced seizure is capable of developing to have recurrent seizure, and the decreased GABA synthesis and transport as well as the impaired BDNF-TrkB signaling pathway may contribute to the development of the recurrent seizure. Thus, CTZ seizure rats may provide a novel animal model for epilepsy study and anticonvulsant drug testing in the future. PMID:24757570

  11. Patients with coexistent psychogenic pseudoepileptic and epileptic seizures: a psychological profile

    Microsoft Academic Search

    Krzysztof Owczarek; Joanna J?drzejczak

    2001-01-01

    Despite significant advances in epileptology, the differential diagnosis of epileptic and pseudoepileptic seizures continues to be a considerable challenge. The problem becomes even more complicated when epileptic and psychogenic pseudoepileptic seizures coexist in the same patient . Appropriate psychological measures may be helpful in the diagnosis and may improve knowledge about aetiological factors which can provoke psychogenic pseudoepileptic seizures. The

  12. First Japanese case of atypical progeroid syndrome/atypical Werner syndrome with heterozygous LMNA mutation.

    PubMed

    Motegi, Sei-ichiro; Yokoyama, Yoko; Uchiyama, Akihiko; Ogino, Sachiko; Takeuchi, Yuko; Yamada, Kazuya; Hattori, Tomoyasu; Hashizume, Hiroaki; Ishikawa, Yuichi; Goto, Makoto; Ishikawa, Osamu

    2014-12-01

    Atypical progeroid syndrome (APS), including atypical Werner syndrome (AWS), is a progeroid syndrome involving heterozygous mutations in the LMNA gene encoding the nuclear protein lamin A/C. We report the first Japanese case of APS/AWS with a LMNA mutation (p.D300N). A 53-year-old Japanese man had a history of recurrent severe cardiovascular diseases as well as brain infarction and hemorrhages. Although our APS/AWS patient had overlapping features with Werner syndrome (WS), such as high-pitched voice, scleroderma, lipoatrophy and atherosclerosis, several cardinal features of WS, including short stature, premature graying/alopecia, cataract, bird-like face, flat feet, hyperkeratosis on the soles and diabetes mellitus, were absent. In immunofluorescence staining and electron microscopic analyses of the patient's cultured fibroblasts, abnormal nuclear morphology, an increase in small aggregation of heterochromatin and a decrease in interchromatin granules in nuclei of fibroblasts were observed, suggesting that abnormal nuclear morphology and chromatin disorganization may be associated with the pathogenesis of APS/AWS. PMID:25327215

  13. CFTR gene variant for patients with congenital absence of vas deferens

    SciTech Connect

    Zielenski, J.; Markiewicz, D.; Corey, M. [Univ. of Toronto (Canada)] [and others

    1995-10-01

    Obstructive azoospermia due to congenital absence of vas deferens is a prominent clinical feature among male patients with cystic fibrosis (CF). A similar autosomal recessive condition with no other CF manifestations is classified as congenital bilateral absence of vas deferens (CBAVD). Since 50%-64% of CBAVD patients have been found to be positive for at least one known CFTR mutation, it is believed that at least part of the CBAVD population represents an atypical form of CF affecting only the male reproductive system. This explanation is not completely satisfactory, however, because only {approximately}10% of CBAVD patients are found to carry known CF mutations on both chromosomes, even after exhaustive screening of the entire CFTR coding region. Here we present data to show that a previously known sequence variant in intron 8 of the CFTR gene is a specific and frequent mutation associated with CBAVD. 20 refs., 1 tab.

  14. Childhood Learning Disabilities and Atypical Dementia: A Retrospective Chart Review

    PubMed Central

    Seifan, Alon

    2015-01-01

    Objective To further our understanding of the association between self-reported childhood learning disabilities (LDs) and atypical dementia phenotypes (Atypical Dementia), including logopenic primary progressive aphasia (L-PPA), Posterior Cortical Atrophy (PCA), and Dysexecutive-type Alzheimer’s Disease (AD). Methods This retrospective case series analysis of 678 comprehensive neuropsychological assessments compared rates of self-reported LD between dementia patients diagnosed with Typical AD and those diagnosed with Atypical Dementia. 105 cases with neuroimaging or CSF data available and at least one neurology follow-up were identified as having been diagnosed by the neuropsychologist with any form of neurodegenerative dementia. These cases were subject to a consensus diagnostic process among three dementia experts using validated clinical criteria for AD and PPA. LD was considered Probable if two or more statements consistent with prior LD were documented within the Social & Developmental History of the initial neuropsychological evaluation. Results 85 subjects (Typical AD n=68, Atypical AD n=17) were included in the final analysis. In logistic regression models adjusted for age, gender, handedness, education and symptom duration, patients with Probable LD, compared to patients without Probable LD, were significantly more likely to be diagnosed with Atypical Dementia vs. Typical AD (OR 13.1, 95% CI 1.3-128.4). All three of the L-PPA cases reporting a childhood LD endorsed childhood difficulty with language. By contrast, both PCA cases reporting Probable childhood LD endorsed difficulty with attention and/or math. Conclusions In people who develop dementia, childhood LD may predispose to atypical phenotypes. Future studies are required to confirm whether atypical neurodevelopment predisposes to regional-specific neuropathology in AD and other dementias. PMID:26106899

  15. Seizures after Onyx embolization for the treatment of cerebral arteriovenous malformation.

    PubMed

    de Los Reyes, K; Patel, A; Doshi, A; Egorova, N; Panov, F; Bederson, J B; Frontera, J A

    2011-09-01

    Onyx embolization of cerebral arteriovenous malformations (AVM) has become increasingly common. We explored the risk of seizures after Onyx use.A retrospective review was conducted of 20 patients with supratentorial brain arteriovenous malformation (AVM) who received Onyx embolization between 2006 and 2009. Baseline demographics, clinical history, seizure history, AVM characteristics and treatment were compared between those who developed post-onyx seizure and those who did not. MRIs were reviewed for edema following Onyx treatment.Of 20 patients who underwent Onyx embolization, the initial AVM presentation was hemorrhage in 40% (N=8). The median number of embolizations was two (range 1-4) and the median final obliteration amount was 90% (range 50-100%). A history of seizure was present in 50% (N=10) of patients pre-embolization and 12 (60%) patients received seizure medications (treatment or prophylaxis) prior to embolization. Seizur post-Onyx embolization occurred in 45% (N=9). The median time to seizur post-Onyx was seven days (range 0.3-210). Four patients (20%) with seizures post-Onyx had no seizure history. Two of these patients (10%) had no other identifiable cause for seizure other than recent Onyx embolization. Seizures in these two patients occurred within 24 hours of Onyx administration. Among patients with post-Onyx seizures, there was a trend toward larger AVM size (P=0.091) and lower percent obliteration (P=0.062). Peri-AVM edema was present in 75% of MRIs performed within one month of Onyx treatment and may represent a possible etiology for seizures.New onset seizures post-Onyx embolization are not uncommon. Further study of seizure prevention is warranted. PMID:22005695

  16. Early Postnatal EEG Features of Perinatal Arterial Ischaemic Stroke with Seizures

    PubMed Central

    Low, Evonne; Mathieson, Sean R.; Stevenson, Nathan J.; Livingstone, Vicki; Ryan, C. Anthony; Bogue, Conor O.; Rennie, Janet M.; Boylan, Geraldine B.

    2014-01-01

    Background Stroke is the second most common cause of seizures in term neonates and is associated with abnormal long-term neurodevelopmental outcome in some cases. Objective To aid diagnosis earlier in the postnatal period, our aim was to describe the characteristic EEG patterns in term neonates with perinatal arterial ischaemic stroke (PAIS) seizures. Design Retrospective observational study. Patients Neonates >37 weeks born between 2003 and 2011 in two hospitals. Method Continuous multichannel video-EEG was used to analyze the background patterns and characteristics of seizures. Each EEG was assessed for continuity, symmetry, characteristic features and sleep cycling; morphology of electrographic seizures was also examined. Each seizure was categorized as electrographic-only or electroclinical; the percentage of seizure events for each seizure type was also summarized. Results Nine neonates with PAIS seizures and EEG monitoring were identified. While EEG continuity was present in all cases, the background pattern showed suppression over the infarcted side; this was quite marked (>50% amplitude reduction) when the lesion was large. Characteristic unilateral bursts of theta activity with sharp or spike waves intermixed were seen in all cases. Sleep cycling was generally present but was more disturbed over the infarcted side. Seizures demonstrated a characteristic pattern; focal sharp waves/spike-polyspikes were seen at frequency of 1–2 Hz and phase reversal over the central region was common. Electrographic-only seizure events were more frequent compared to electroclinical seizure events (78 vs 22%). Conclusions Focal electrographic and electroclinical seizures with ipsilateral suppression of the background activity and focal sharp waves are strong indicators of PAIS. Approximately 80% of seizure events were the result of clinically unsuspected seizures in neonates with PAIS. Prolonged and continuous multichannel video-EEG monitoring is advocated for adequate seizure surveillance. PMID:25051161

  17. Does the teddy bear sign predict psychogenic nonepileptic seizures?

    PubMed

    Cervenka, Mackenzie C; Lesser, Ronald; Tran, Tung T; Fortuné, Taryn; Muthugovindan, Deivasumathy; Miglioretti, Diana L

    2013-08-01

    This study evaluated whether adults and older teenagers who bring toy stuffed animals to an epilepsy monitoring unit (EMU), i.e., the "teddy bear sign," were more likely to be diagnosed to have psychogenic nonepileptic seizures (PNES) than to have epilepsy. We prospectively evaluated 335 patients, aged 15 years and older, admitted to our EMU over a 19-month period, assessing age at seizure onset, duration of seizures, gender, seizure diagnosis, presence of intellectual disabilities, presence of psychiatric illness, and possession of a toy stuffed animal in the EMU. Among all ages, patients who brought toy stuffed animals were not more likely to have PNES or both PNES and epilepsy than to have epilepsy alone. For those 18 and over, there was a significant difference but only after adjusting for all other patient characteristics, and absolute differences were small. Patients 18 and older with stuffed animals had a 3.21 (95% confidence interval = 1.58, 8.90) times greater odds of being diagnosed to have PNES or both PNES and epilepsy than to have epilepsy alone after adjusting for other patient characteristics (p = 0.022). We conclude that patient possession of toy stuffed animals in the EMU is not a reliable sign of PNES. PMID:23770681

  18. Search and Seizure: What Your School's Rights Are.

    ERIC Educational Resources Information Center

    Stefkovich, Jacqueline A.; O'Brien, G. Michaele

    1996-01-01

    Unlike most school-security strategies, search and seizure procedures can be largely determined by studying landmark court cases. The U.S. Supreme Court set standards for conducting school searches in "New Jersey v. T.L.O." (1985) and for drug testing student athletes in "Vernonia School District v. Acton" (1995). School officials should also be…

  19. Pharmacotherapeutic targeting of cation-chloride cotransporters in neonatal seizures.

    PubMed

    Puskarjov, Martin; Kahle, Kristopher T; Ruusuvuori, Eva; Kaila, Kai

    2014-06-01

    Seizures are a common manifestation of acute neurologic insults in neonates and are often resistant to the standard antiepileptic drugs that are efficacious in children and adults. The paucity of evidence-based treatment guidelines, coupled with a rudimentary understanding of disease pathogenesis, has made the current treatment of neonatal seizures empiric and often ineffective, highlighting the need for novel therapies. Key developmental differences in ?-aminobutyric acid (GABA)ergic neurotransmission between the immature and mature brain, and trauma-induced alterations in the function of the cation-chloride cotransporters (CCCs) NKCC1 and KCC2, probably contribute to the poor efficacy of standard antiepileptic drugs used in the treatment of neonatal seizures. Although CCCs are attractive drug targets, bumetanide and other existing CCC inhibitors are suboptimal because of pharmacokinetic constraints and lack of target specificity. Newer approaches including isoform-specific NKCC1 inhibitors with increased central nervous system penetration, and direct and indirect strategies to enhance KCC2-mediated neuronal chloride extrusion, might allow therapeutic modulation of the GABAergic system for neonatal seizure treatment. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here. PMID:24802699

  20. Pharmacotherapeutic targeting of cation-chloride cotransporters in neonatal seizures

    PubMed Central

    Puskarjov, Martin; Kahle, Kristopher T; Ruusuvuori, Eva; Kaila, Kai

    2014-01-01

    Seizures are a common manifestation of acute neurologic insults in neonates and are often resistant to the standard antiepileptic drugs that are efficacious in children and adults. The paucity of evidence-based treatment guidelines, coupled with a rudimentary understanding of disease pathogenesis, has made the current treatment of neonatal seizures empiric and often ineffective, highlighting the need for novel therapies. Key developmental differences in ?-aminobutyric acid (GABA)ergic neurotransmission between the immature and mature brain, and trauma-induced alterations in the function of the cation-chloride cotransporters (CCCs) NKCC1 and KCC2, probably contribute to the poor efficacy of standard antiepileptic drugs used in the treatment of neonatal seizures. Although CCCs are attractive drug targets, bumetanide and other existing CCC inhibitors are suboptimal because of pharmacokinetic constraints and lack of target specificity. Newer approaches including isoform-specific NKCC1 inhibitors with increased central nervous system penetration, and direct and indirect strategies to enhance KCC2-mediated neuronal chloride extrusion, might allow therapeutic modulation of the GABAergic system for neonatal seizure treatment. PMID:24802699

  1. Community Use of Intranasal Midazolam for Managing Prolonged Seizures

    ERIC Educational Resources Information Center

    Kyrkou, Margaret; Harbord, Michael; Kyrkou, Nicole; Kay, Debra; Coulthard, Kingsley

    2006-01-01

    Background: Until a few years ago, rectal diazepam (RD) was the only option available to parents and carers managing prolonged seizures. However, its use in the community was limited due to the requirement for privacy, and because education staff in South Australia are not permitted to carry out invasive procedures. Method: Following a literature…

  2. Search and Seizure: The Meaning of the Fourth Amendment Today.

    ERIC Educational Resources Information Center

    Arbetman, Lee; Perry, Michelle

    1997-01-01

    Traces the application of the constitutional protection from "unreasonable searches and seizures" as it has evolved in response to public attitudes and changes in technology. Includes a synopsis of relevant cases and two lesson plans. The cases concern a police search through trash bags and drug testing for athletes. (MJP)

  3. Vagus Nerve Stimulation for Control of Intractable Seizures in Childhood

    Microsoft Academic Search

    Arun Paul Amar; Michael L. Levy; J. Gordon McComb; Michael L. J. Apuzzo

    2001-01-01

    Vagus nerve stimulation (VNS) is gaining increasing popularity and credibility as a treatment option for children with intractable epilepsy. VNS offers several advantages over extant treatments. Its efficacy is maintained during prolonged stimulation, and seizure control actually improves with time. There is no associated cognitive impairment and no adverse drug interactions. Unlike cerebral surgery, VNS is a potentially reversible form

  4. Moonstruck? The effect of the lunar cycle on seizures

    Microsoft Academic Search

    Sallie Baxendale; Jennifer Fisher

    2008-01-01

    Recent reports on the effects of the lunar cycle on seizure occurrence have yielded mixed results. If the moon phase is influential, we hypothesized that this would be due to the moon’s contribution to nocturnal illumination, rather than its waxing or waning state, and that significant correlations would not be apparent if local cloud cover were controlled for. We found

  5. Real-time seizure monitoring and spectral analysis microsystem

    Microsoft Academic Search

    J. N. Y. Aziz; Rafal Karakiewicz; Roman Genov; B. L. Bardakjian; M. Derchansky; P. L. Carlen

    2006-01-01

    SPECTRAL Abstract- Wepresent aneural recording andspectral analysis RECORDING ANALYSIS integrated microsystem. Itistheinstrumentational andcomputa- INTERACE PROCESSOR tional coreofanenvisioned miniature implantable brain implant forautomated epileptic seizure therapy. Themicrosystem com- WAVELET bines twofunctional blocks: theneural recording interface and TRANSFORM thespectral analysis processor. Theneural interface contains 256 signal acquisition channels recording neural field potentials from anarrayof16x16electrodes simultaneously, ina distributed \\\\ fashion. Thespectral analysis processor

  6. On the proper selection of preictal period for seizure prediction.

    PubMed

    Bandarabadi, Mojtaba; Rasekhi, Jalil; Teixeira, César A; Karami, Mohammad R; Dourado, António

    2015-05-01

    Supervised machine learning-based seizure prediction methods consider preictal period as an important prerequisite parameter during training. However, the exact length of the preictal state is unclear and varies from seizure to seizure. We propose a novel statistical approach for proper selection of the preictal period, which can also be considered either as a measure of predictability of a seizure or as the prediction capability of an understudy feature. The optimal preictal periods (OPPs) obtained from the training samples can be used for building a more accurate classifier model. The proposed method uses amplitude distribution histograms of features extracted from electroencephalogram (EEG) recordings. To evaluate this method, we extract spectral power features in different frequency bands from monopolar and space-differential EEG signals of 18 patients suffering from pharmacoresistant epilepsy. Furthermore, comparisons among monopolar channels with space-differential channels, as well as intracranial EEG (iEEG) and surface EEG (sEEG) signals, indicate that while monopolar signals perform better in iEEG recordings, no significant difference is noticeable in sEEG recordings. PMID:25944112

  7. Medical image. Reflex anoxic seizures in a toddler.

    PubMed

    de Almeida, Tilak; Pennock, Victoria; Skinner, Jonathan R

    2013-02-15

    We report a toddler with frequent pallid type breath-holding or reflex anoxic seizure episodes successfully treated with pacemaker implantation. A rhythm strip (from an ambulatory ECG monitor that shows an 18-second period of asystole) is shown. PMID:23463115

  8. ROBUST NEONATAL EEG SEIZURE DETECTION THROUGH ADAPTIVE BACKGROUND MODELLING

    PubMed Central

    TEMKO, ANDRIY; BOYLAN, GERALDINE; MARNANE, WILLIAM; LIGHTBODY, GORDON

    2014-01-01

    Adaptive probabilistic modelling of the EEG background is proposed for seizure detection in neonates with hypoxic ischemic encephalopathy. The decision is made based on the temporal derivative of the seizure probability with respect to the adaptively modeled level of background activity. The robustness of the system to long duration ‘seizure-like’ artifacts, in particular those due to respiration, is improved. The system was developed using statistical leave-one-patient-out performance assessment, on a large clinical dataset, comprising 38 patients of 1479 hours total duration. The developed technique was then validated by a single test on a separate totally unseen randomized prospective dataset of 51 neonates totaling 2540 hours of duration. By exploiting the proposed adaptation, the ROC area is increased from 93.4% to 96.1% (41% relative improvement). The number of false detections per hour is decreased from 0.42 to 0.24, while maintaining the correct detection of seizure burden at 70%. These results on the unseen data were predicted from the rigorous leave-one-patient-out validation and confirm the validity of our algorithm development process. PMID:23746291

  9. Current treatment of atypical hemolytic uremic syndrome

    PubMed Central

    Kaplan, Bernard S.; Ruebner, Rebecca L.; Spinale, Joann M.; Copelovitch, Lawrence

    2014-01-01

    Summary Tremendous advances have been made in understanding the pathogenesis of atypical Hemolytic Uremic Syndrome (aHUS), an extremely rare disease. Insights into the molecular biology of aHUS resulted in rapid advances in treatment with eculizumab (Soliris®, Alexion Pharmaceuticals Inc.). Historically, aHUS was associated with very high rates of mortality and morbidity. Prior therapies included plasma therapy and/or liver transplantation. Although often life saving, these were imperfect and had many complications. We review the conditions included under the rubric of aHUS: S. pneumoniae HUS (SpHUS), inborn errors of metabolism, and disorders of complement regulation, emphasizing their differences and similarities. We focus on the clinical features, diagnosis, and pathogenesis, and treatment of aHUS that results from mutations in genes encoding alternative complement regulators, SpHUS and HUS associated with inborn errors of metabolism. Mutations in complement genes, or antibodies to their protein products, result in unregulated activity of the alternate complement pathway, endothelial injury, and thrombotic microangiopathy (TMA). Eculizumab is a humanized monoclonal antibody that inhibits the production of the terminal complement components C5a and the membrane attack complex (C5b-9) by binding to complement protein C5a. This blocks the proinflammatory and cytolytic effects of terminal complement activation. Eculizumab use has been reported in many case reports, and retrospective and prospective clinical trials in aHUS. There have been few serious side effects and no reports of tachphylaxis or drug resistance. The results are very encouraging and eculizumab is now recognized as the treatment of choice for aHUS. PMID:25343125

  10. Olanzapine versus other atypical antipsychotics for schizophrenia

    PubMed Central

    Komossa, Katja; Rummel-Kluge, Christine; Hunger, Heike; Schmid, Franziska; Schwarz, Sandra; Duggan, Lorna; Kissling, Werner; Leucht, Stefan

    2014-01-01

    Background In many countries of the industrialised world second generation (“atypical”) antipsychotics have become the first line drug treatment for people with schizophrenia. The question as to whether, and if so how much, the effects of the various second generation antipsychotics differ is a matter of debate. In this review we examined how the efficacy and tolerability of olanzapine differs from that of other second generation antipsychotics. Objectives To evaluate the effects of olanzapine compared to other atypical antipsychotics for people with schizophrenia and schizophrenia-like psychosis. Search methods 1. Electronic searching We searched the Cochrane Schizophrenia Group Trials Register (April 2007) which is based on regular searches of BIOSIS, CENTRAL, CINAHL, EMBASE, MEDLINE and PsycINFO. 2. Reference searching We inspected the reference of all identified studies for more trials. 3. Personal contact We contacted the first author of each included study for missing information. 4. Drug companies We contacted the manufacturers of all atypical antipsychotics included for additional data. Selection criteria We included all randomised trials that used at least single-blind (rater-blind) design, comparing oral olanzapine with oral forms of amisulpride, aripiprazole, clozapine, quetiapine, risperidone, sertindole, ziprasidone or zotepine in people with schizophrenia or schizophrenia-like psychosis. Data collection and analysis We extracted data independently. For dichotomous data we calculated relative risks (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis based on a random effects model. We calculated numbers needed to treat/harm (NNT/NNH) where appropriate. For continuous data, we calculated weighted mean differences (WMD) again based on a random effects model. Main results The review currently includes 50 studies and 9476 participants which provided data for six comparisons (olanzapine compared to amisulpride, aripiprazole, clozapine, quetiapine, risperidone or ziprasidone). The overall attrition from the included studies was considerable (49.2%) leaving the interpretation of results problematic. Olanzapine improved the general mental state (PANSS total score) more than aripiprazole (2 RCTs, n=794, WMD ?4.96 CI ?8.06 to ?1.85), quetiapine (10 RCTs, n=1449, WMD ?3.66 CI ?5.39 to ?1.93), risperidone (15 RCTs, n=2390, WMD ?1.94 CI ?3.31 to ?0.58) and ziprasidone (4 RCTs, n=1291, WMD ?8.32 CI ?10.99 to ?5.64), but not more than amisulpride or clozapine. This somewhat better efficacy was confirmed by fewer participants in the olanzapine groups leaving the studies early due to inefficacy of treatment compared to quetiapine (8 RCTs, n=1563, RR 0.56 CI 0.44 to 0.70, NNT 11 CI 6 to 50), risperidone (14 RCTs, n=2744, RR 0.78 CI 0.62 to 0.98, NNT 50 CI 17 to 100) and ziprasidone (5 RCTs, n=1937, RR 0.64 CI 0.51 to 0.79, NNT 17, CI 11 to 33). Fewer participants in the olanzapine group than in the quetiapine (2 RCTs, n=876, RR 0.56 CI 0.41 to 0.77, NNT 11 CI 7 to 25) and ziprasidone (2 RCTs, n=766, RR 0.65 CI 0.45 to 0.93, NNT 17 CI 9 to 100) treatment groups, but not in the clozapine group (1 RCT, n=980, RR 1.28 CI 1.02 to 1.61, NNH not estimable), had to be re-hospitalised in the trials. Except for clozapine, all comparators induced less weight gain than olanzapine (olanzapine compared to amisulpride: 3 RCTs, n=671, WMD 2.11kg CI 1.29kg to 2.94kg; aripiprazole: 1 RCT, n=90, WMD 5.60kg CI 2.15kg to 9.05kg; quetiapine: 7 RCTs, n=1173, WMD 2.68kg CI 1.10kg to 4.26kg; risperidone: 13 RCTs, n=2116, WMD 2.61kg CI 1.48kg to 3.74kg; ziprasidone: 5 RCTs, n=1659, WMD 3.82kg CI 2.96kg to 4.69kg). Associated problems such as glucose and cholesterol increase were usually also more frequent in the olanzapine group. Other differences in adverse effects were less well documented. Nevertheless, olanzapine may be associated with slightly more extrapyramidal side effects than quetiapine (use of antiparkinson medication (6

  11. Progressive, Seizure-Like, Spike-Wave Discharges Are Common in Both Injured and Uninjured Sprague-Dawley Rats: Implications for the Fluid Percussion Injury Model of Post-Traumatic Epilepsy.

    PubMed

    Rodgers, Krista M; Dudek, F Edward; Barth, Daniel S

    2015-06-17

    Variable-duration oscillations and repetitive, high-voltage spikes have been recorded in the electrocorticogram (ECoG) of rats weeks and months after fluid percussion injury (FPI), a model of traumatic brain injury. These ECoG events, which have many similarities to spike-wave-discharges (SWDs) and absence seizures, have been proposed to represent nonconvulsive seizures characteristic of post-traumatic epilepsy (PTE). The present study quantified features of SWD episodes in rats at different time points after moderate to severe FPI, and compared them with age-matched control rats. Control and FPI-injured rats at 1 year of age displayed large-amplitude and frequent SWD events at frontal and parietal recording sites. At 3-6 months, SWDs were shorter in duration and less frequent; extremely brief SWDs (i.e., "larval") were detected as early as 1 month. The onset of the SWDs was nearly always synchronous across electrodes and of larger amplitude in frontal regions. A sensory stimulus, such as a click, immediately and consistently stopped the occurrence of the SWDs. SWDs were consistently accompanied by behavioral arrest. All features of SWDs in control and experimental (FPI) rats were indistinguishable. None of the FPI-treated rats developed nonconvulsive or convulsive seizures that could be distinguished electrographically or behaviorally from SWDs. Because SWDs have features similar to genetic absence seizures, these results challenge the hypothesis that SWDs after FPI reflect PTE. PMID:26085641

  12. In vivo effects of bumetanide at brain concentrations incompatible with NKCC1 inhibition on newborn DGC structure and spontaneous EEG seizures following hypoxia-induced neonatal seizures.

    PubMed

    Wang, S; Zhang, X Q; Song, C G; Xiao, T; Zhao, M; Zhu, G; Zhao, C S

    2015-02-12

    Neonatal seizures caused by perinatal asphyxia and hypoxic-ischemic encephalopathy can be refractory to conventional anticonvulsants. This may be due to the depolarizing effects of gamma-aminobutyric acid (GABA) achieved by the activity of the Na(+)-K(+)-2Cl(-) cotransporter (NKCC1). The aim of this study is to evaluate the long-term effects of bumetanide, a NKCC1 inhibitor, on hippocampal neurogenesis and seizure susceptibility in hypoxia-induced neonatal seizure model. Wistar rats were subjected to hypoxia-induced neonatal seizures at postnatal day 10 (P10). Following acute seizures, the rats were treated with intraperitoneal injection (i.p.) of bumetanide at a dose of 0.5mg/kg for 3 weeks. In later adulthood, hypoxia-induced seizures increased the number of newborn dentate gyrus cells (DGCs), promoted mossy fiber sprouting (MFS) and reduced the apical dendritic complexity of newborn DGCs 1 month after the insults. In addition, these seizures resulted in long-lasting consequences, such as spontaneous electroencephalography (EEG) seizures, though spatial learning impairments were not seen. Bumetanide treatments significantly enhanced cell proliferation and dendritic development of newborn DGCs after neonatal seizures, accompanied by the decreased seizure activity. However, systemic administration of bumetanide resulted in much lower brain concentrations, and was incompatible with NKCC1 inhibition in blood-brain barrier (BBB)-protected brain tissue. Our results suggested that bumetanide might have long-term effects in suppressing seizure activity, and altering the neurogenesis after neonatal seizures. These effects of bumetanide may be mediated by the targets outside the BBB-protected central nerve system (CNS) or CNS-located target(s) other than NKCC1. PMID:25463517

  13. Dissociated multimodal hubs and seizures in temporal lobe epilepsy

    PubMed Central

    Douw, Linda; DeSalvo, Matthew N; Tanaka, Naoaki; Cole, Andrew J; Liu, Hesheng; Reinsberger, Claus; Stufflebeam, Steven M

    2015-01-01

    Objective Brain connectivity at rest is altered in temporal lobe epilepsy (TLE), particularly in “hub” areas such as the posterior default mode network (DMN). Although both functional and anatomical connectivity are disturbed in TLE, the relationships between measures as well as to seizure frequency remain unclear. We aim to clarify these associations using connectivity measures specifically sensitive to hubs. Methods Connectivity between 1000 cortical surface parcels was determined in 49 TLE patients and 23 controls with diffusion and resting-state functional magnetic resonance imaging. Two types of hub connectivity were investigated across multiple brain modules (the DMN, motor system, etcetera): (1) within-module connectivity (a measure of local importance that assesses a parcel's communication level within its own subnetwork) and (2) between-module connectivity (a measure that assesses connections across multiple modules). Results In TLE patients, there was lower overall functional integrity of the DMN as well as an increase in posterior hub connections with other modules. Anatomical between-module connectivity was globally decreased. Higher DMN disintegration (DD) coincided with higher anatomical between-module connectivity, whereas both were associated with increased seizure frequency. DD related to seizure frequency through mediating effects of anatomical connectivity, but seizure frequency also correlated with anatomical connectivity through DD, indicating a complex interaction between multimodal networks and symptoms. Interpretation We provide evidence for dissociated anatomical and functional hub connectivity in TLE. Moreover, shifts in functional hub connections from within to outside the DMN, an overall loss of integrative anatomical communication, and the interaction between the two increase seizure frequency. PMID:25909080

  14. Symptomatic atypical femoral fractures are related to underlying hip geometry.

    PubMed

    Taormina, David P; Marcano, Alejandro I; Karia, Raj; Egol, Kenneth A; Tejwani, Nirmal C

    2014-06-01

    The benefits of bisphosphonates are well documented, but prolonged use has been associated with atypical femur fractures. Radiographic markers for fracture predisposition could potentially aid in safer medication use. In this case-control designed study, we compared hip radiographic parameters and the demographic characteristics of chronic bisphosphonate users who sustained an atypical femoral fracture with a group of chronic bisphosphonate users who did not sustain an atypical femur fracture and also a group who sustained an intertrochanteric hip fracture. Radiographic parameters included were neck-shaft angle (NSA), hip-axis length (HAL) and center-edge angle (CE). Multivariate regression was used to evaluate the relationship between radiographic measures and femur fracture. Receiver-operating characteristic analysis determined cut-off points for neck-shaft angle and risk of atypical femur fracture. Ultimately, pre-fracture radiographs of 53 bisphosphonate users who developed atypical fracture were compared with 43 asymptomatic chronic bisphosphonate users and 64 intertrochanteric fracture patients. Duration of bisphosphonate use did not statistically differ between users sustaining atypical fracture and those without fracture (7.9 [±3.5] vs. 7.7 [±3.3] years, p=0.7). Bisphosphonate users who fractured had acute/varus pre-fracture neck-shaft angles (p<0.001), shorter hip-axis length (p<0.01), and narrower center-edge angles (p<0.01). Regression analysis revealed associations between neck-shaft angle (OR=0.89 [95% CI=0.81-0.97; p=0.01), center edge angle (OR=0.89 [95% CI=0.80-0.99]; p=0.03), and BMI (OR=1.15 [95% CI=1.02-1.31; p=0.03) with fracture development. ROC curve analysis (AUC=0.67 [95% CI=0.56-0.79]) determined that a cut-off point for neck-shaft angle <128.3° yielded 69% sensitivity and 63% specificity for development of atypical femoral fracture. Ultimately, an acute/varus angle of the femoral neck, high BMI, and narrow center-edge angle were associated with development of atypical femur fracture in long-term bisphosphonate users. Patients on long-term bisphosphonates should be regularly radiographically evaluated in order to assess for potential risk of atypical fracture. PMID:24565751

  15. Population dose-response analysis of daily seizure count following vigabatrin therapy in adult and pediatric patients with refractory complex partial seizures.

    PubMed

    Nielsen, Jace C; Hutmacher, Matthew M; Wesche, David L; Tolbert, Dwain; Patel, Mahlaqa; Kowalski, Kenneth G

    2015-01-01

    Vigabatrin is an irreversible inhibitor of ?-aminobutyric acid transaminase (GABA-T) and is used as an adjunctive therapy for adult patients with refractory complex partial seizures (rCPS). The purpose of this investigation was to describe the relationship between vigabatrin dosage and daily seizure rate for adults and children with rCPS and identify relevant covariates that might impact seizure frequency. This population dose-response analysis used seizure-count data from three pediatric and two adult randomized controlled studies of rCPS patients. A negative binomial distribution model adequately described daily seizure data. Mean seizure rate decreased with time after first dose and was described using an asymptotic model. Vigabatrin drug effects were best characterized by a quadratic model using normalized dosage as the exposure metric. Normalized dosage was an estimated parameter that allowed for individualized changes in vigabatrin exposure based on body weight. Baseline seizure rate increased with decreasing age, but age had no impact on vigabatrin drug effects after dosage was normalized for body weight differences. Posterior predictive checks indicated the final model was capable of simulating data consistent with observed daily seizure counts. Total normalized vigabatrin dosages of 1, 3, and 6?g/day were predicted to reduce seizure rates 23.2%, 45.6%, and 48.5%, respectively. PMID:25117853

  16. Association of a Bovine Prion Gene Haplotype with Atypical BSE

    PubMed Central

    Clawson, Michael L.; Richt, Juergen A.; Baron, Thierry; Biacabe, Anne-Gaëlle; Czub, Stefanie; Heaton, Michael P.; Smith, Timothy P. L.; Laegreid, William W.

    2008-01-01

    Background Atypical bovine spongiform encephalopathies (BSEs) are recently recognized prion diseases of cattle. Atypical BSEs are rare; approximately 30 cases have been identified worldwide. We tested prion gene (PRNP) haplotypes for an association with atypical BSE. Methodology/Principle Findings Haplotype tagging polymorphisms that characterize PRNP haplotypes from the promoter region through the three prime untranslated region of exon 3 (25.2 kb) were used to determine PRNP haplotypes of six available atypical BSE cases from Canada, France and the United States. One or two copies of a distinct PRNP haplotype were identified in five of the six cases (p?=?1.3×10?4, two-tailed Fisher's exact test; CI95% 0.263–0.901, difference between proportions). The haplotype spans a portion of PRNP that includes part of intron 2, the entire coding region of exon 3 and part of the three prime untranslated region of exon 3 (13 kb). Conclusions/Significance This result suggests that a genetic determinant in or near PRNP may influence susceptibility of cattle to atypical BSE. PMID:18350166

  17. Diurnal rhythms in seizures detected by intracranial electrocorticographic monitoring: an observational study.

    PubMed

    Hofstra, Wytske A; Spetgens, Willy P J; Leijten, Frans S S; van Rijen, Peter C; Gosselaar, Peter; van der Palen, Job; de Weerd, Al W

    2009-04-01

    Few studies have evaluated human seizure occurrence over the 24-hour day, and only one group has employed intracranial electrocorticography monitoring to record seizures. Circadian patterns in seizures may have important implications in diagnosis and therapy and provide opportunities in research. We have analyzed spontaneous seizures in 33 consecutive patients with long-term intracranial EEG and video monitoring. Several aspects of seizures were noted, including time of day, origin, type, and behavioral state (sleeping/awake). We recorded 450 seizures that showed an uneven distribution over the day, depending on lobe of origin: temporal lobe seizures occurred preferentially between 1100 and 1700 hours, frontal seizures between 2300 and 0500 hours, and parietal seizures between 1700 and 2300 hours. In the awake state, larger proportions of clinical seizures were seen from 0500 to 1100 hours and from 1700 to 2300 hours. During sleep, larger proportions occurred from 1100 to 1700 hours and from 2300 to 0500 hours. Our results suggest that seizures from different brain regions have a strong tendency to occur in different diurnal patterns. PMID:19435581

  18. Functional and anatomic correlates of two frequently observed temporal lobe seizure-onset patterns.

    PubMed

    Velasco, A L; Wilson, C L; Babb, T L; Engel, J

    2000-01-01

    Intracranial depth electrode EEG records of 478 seizures, recorded in 68 patients undergoing diagnostic monitoring with depth electrodes, were evaluated to investigate the correlates of electrographic onset patterns in patients with temporal lobe seizures. The seizure onsets in 78% of these patients were identified as either hypersynchronous onsets, beginning with low-frequency, high-amplitude spikes, or low-voltage fast (LVF) onsets, increasing in amplitude as the seizure progressed. The number of patients (35) having hypersynchronous seizure onsets was nearly twice that of patients (18) having LVF onsets. Three major differences were seen among patients with the two seizure-onset patterns. When compared with patients having LVF onsets, patients with hypersynchronous seizure onsets had a significantly greater probability of having (1) focal rather than regional seizure onsets (p < 0.01), (2) seizures spreading more slowly to the contralateral mesial temporal lobe (p < 0.003), and (3) cell counts in resected hippocampal tissue showing greater neuronal loss (p < 0.001). The results provide evidence that the most frequent electrographic abnormality associated with mesial temporal seizures is local hypersynchrony, a condition associated with major neuronal loss in the hippocampus. The results also indicate that LVF seizure onsets more frequently represent widely distributed discharges, which interact with and spread more rapidly to surrounding neocortical areas. PMID:10709214

  19. Pyridoxine does not prevent hyperbaric oxygen-induced seizures in rats.

    PubMed

    Walter, Frank G; Chase, Peter B; Fernandez, Miguel C; Cameron, Diane; Roe, Denise J; Wolfson, Mark

    2006-08-01

    Normobaric supplemental oxygen can prolong seizures not caused by hyperbaric oxygen therapy. In addition, hyperbaric oxygen therapy can cause seizures. The mechanism of hyperbaric oxygen-induced seizures is unknown. We hypothesized that pretreatment with pyridoxine may delay the onset of hyperbaric oxygen-induced seizures, recognizing that pyridoxine is already an antidote for some epileptogenic poisons such as isoniazid and monomethylhydrazine. Therefore, rats were pretreated with intraperitoneal injections of pyridoxine at 48, 24, and 2 h before undergoing hyperbaric oxygen (HBO) treatment at 3 atmospheres absolute with 100% oxygen and were compared to a control group of HBO-treated rats for time to onset of seizures. There was no difference in onset of seizure time between the pyridoxine-treated group of rats and the control rats. Supplemental pyridoxine pretreatment did not alter the time to onset of seizures during HBO treatment in this study. PMID:17044573

  20. Cytidine 5'-diphosphocholine (CDP-choline) adversely effects on pilocarpine seizure-induced hippocampal neuronal death.

    PubMed

    Kim, Jin Hee; Lee, Dong Won; Choi, Bo Young; Sohn, Min; Lee, Song Hee; Choi, Hui Chul; Song, Hong Ki; Suh, Sang Won

    2015-01-21

    Citicoline (CDP-choline; cytidine 5'-diphosphocholine) is an important intermediate in the biosynthesis of cell membrane phospholipids. Citicoline serves as a choline donor in the biosynthetic pathways of acetylcholine and neuronal membrane phospholipids, mainly phosphatidylcholine. The ability of citicoline to reverse neuronal injury has been tested in animal models of cerebral ischemia and clinical trials have been performed in stroke patients. However, no studies have examined the effect of citicoline on seizure-induced neuronal death. To clarify the potential therapeutic effects of citicoline on seizure-induced neuronal death, we used an animal model of pilocarpine-induced epilepsy. Temporal lobe epilepsy (TLE) was induced by intraperitoneal injection of pilocarpine (25mg/kg) in adult male rats. Citicoline (100 or 300 mg/kg) was injected into the intraperitoneal space two hours after seizure onset and a second injection was performed 24h after the seizure. Citicoline was injected once per day for one week after pilocarpine- or kainate-induced seizure. Neuronal injury and microglial activation were evaluated at 1 week post-seizure. Surprisingly, rather than offering protection, citicoline treatment actually enhanced seizure-induced neuronal death and microglial activation in the hippocampus compared to vehicle treated controls. Citicoline administration after seizure-induction increased immunoglobulin leakage via BBB disruption in the hippocampus compared with the vehicle-only group. To clarify if this adverse effect of citicoline is generalizable across alternative seizure models, we induced seizure by kainate injection (10mg/kg, i.p.) and then injected citicoline as in pilocarpine-induced seizure. We found that citicoline did not modulate kainate seizure-induced neuronal death, BBB disruption or microglial activation. These results suggest that citicoline may not have neuroprotective effects after seizure and that clinical application of citicoline after seizure needs careful consideration. PMID:25446447

  1. Atypical Craniosynostosis with Torticollis and Neurological Symptoms: A Rhombencephalosynapsis Sequence

    PubMed Central

    Koljonen, Virve; Leikola, Junnu; Valanne, Leena; Hukki, Jyri

    2009-01-01

    Purpose. We describe a case of 3-year-old girl with rhombencephalosynapsis, a rare cerebellar anomaly. Patient. A 3-year-old girl was admitted to our hospital due to congenital torticollis and asymmetry of face, skull and trunk. Craniosynostosis was suspected due to abnormal head shape. 3D-CT revealed closure of the sagittal suture without scaphocephalic skull. Due to atypical craniosynostosis with neurological symptoms, brain-MRI was performed revealing rhombencephalosynapsis. Results. Our patient presented with atypical craniosynostosis and balance problems, not typical for scaphocephaly. Operative treatment for craniosynotosis was not carried out because the cause of the problems was the cerebellum instead of the brain. Conclusions. Therefore, we conclude that patients with atypical craniosynostosis should be examined with brain-MRI to exclude the intracranial malformations, which 3D-CT does not reveal. Without brain-MRI, decision (not) to perform surgery could have been different. PMID:20029674

  2. Cutaneous location of atypical teratoid/rhabdoid tumour.

    PubMed

    Bellon, Nathalia; Fraitag, Sylvie; Miquel, Catherine; Salomon, Laurent J; Bourdeaut, Franck; Bodemer, Christine; Roujeau, Thomas; Zerah, Michel; Hadj-Rabia, Smail

    2014-07-01

    Atypical teratoid/rhabdoid tumour is a rare and highly malignant tumour of the posterior fossae nervous system that occurs in children especially in the first few years of life. Cutaneous location is not previously reported. A newborn boy was referred for both aqueductal stenosis detected antenatally and skin tags mimicking hamartoma. The cerebral tumour increased in size during a few months leading to both skin and cerebral biopsies. Integrase Interactor-1 (INI-1) immunostaining and tumoural and leukocytes INI-1 gene sequencing confirmed the atypical teratoid/rhabdoid tumour nature of the cerebral tumour. INI-1 immunostaining in skin biopsy confirmed the dermal location of rhabdoid tumour. Thus, unusual cutaneous lesions may be part of atypical teratoid/rhabdoid tumour. The loss of Integrase INI-1 on immunohistochemical staining is characteristic. PMID:24284868

  3. Ethosuximide, Valproic Acid, and Lamotrigine in Childhood Absence Epilepsy

    PubMed Central

    Glauser, Tracy A.; Cnaan, Avital; Shinnar, Shlomo; Hirtz, Deborah G.; Dlugos, Dennis; Masur, David; Clark, Peggy O.; Capparelli, Edmund V.; Adamson, Peter C.

    2010-01-01

    BACKGROUND Childhood absence epilepsy, the most common pediatric epilepsy syndrome, is usually treated with ethosuximide, valproic acid, or lamotrigine. The most efficacious and tolerable initial empirical treatment has not been defined. METHODS In a double-blind, randomized, controlled clinical trial, we compared the efficacy, tolerability, and neuropsychological effects of ethosuximide, valproic acid, and lamotrigine in children with newly diagnosed childhood absence epilepsy. Drug doses were incrementally increased until the child was free of seizures, the maximal allowable or highest tolerable dose was reached, or a criterion indicating treatment failure was met. The primary outcome was freedom from treatment failure after 16 weeks of therapy; the secondary outcome was attentional dysfunction. Differential drug effects were determined by means of pairwise comparisons. RESULTS The 453 children who were randomly assigned to treatment with ethosuximide (156), lamotrigine (149), or valproic acid (148) were similar with respect to their demographic characteristics. After 16 weeks of therapy, the freedom-from-failure rates for ethosuximide and valproic acid were similar (53% and 58%, respectively; odds ratio with valproic acid vs. ethosuximide, 1.26; 95% confidence interval [CI], 0.80 to 1.98; P = 0.35) and were higher than the rate for lamotrigine (29%; odds ratio with ethosuximide vs. lamotrigine, 2.66; 95% CI, 1.65 to 4.28; odds ratio with valproic acid vs. lamotrigine, 3.34; 95% CI, 2.06 to 5.42; P<0.001 for both comparisons). There were no significant differences among the three drugs with regard to discontinuation because of adverse events. Attentional dysfunction was more common with valproic acid than with ethosuximide (in 49% of the children vs. 33%; odds ratio, 1.95; 95% CI, 1.12 to 3.41; P = 0.03). CONCLUSIONS Ethosuximide and valproic acid are more effective than lamotrigine in the treatment of childhood absence epilepsy. Ethosuximide is associated with fewer adverse attentional effects. (ClinicalTrials.gov number, NCT00088452.) PMID:20200383

  4. Time-frequency characteristics and dynamics of sleep spindles in WAG/Rij rats with absence epilepsy.

    PubMed

    Sitnikova, Evgenia; Hramov, Alexander E; Grubov, Vadim; Koronovsky, Alexey A

    2014-01-16

    In rat models of absence epilepsy, epileptic spike-wave discharges appeared in EEG spontaneously, and the incidence of epileptic activity increases with age. Spike-wave discharges and sleep spindles are known to share common thalamo-cortical mechanism, suggesting that absence seizures might affect some intrinsic properties of sleep spindles. This paper examines time-frequency EEG characteristics of anterior sleep spindles in non-epileptic Wistar and epileptic WAG/Rij rats at the age of 7 and 9 months. Considering non-stationary features of sleep spindles, EEG analysis was performed using Morlet-based continuous wavelet transform. It was found, first, that the average frequency of sleep spindles in non-epileptic Wistar rats was higher than in WAG/Rij (13.2 vs 11.2 Hz). Second, the instantaneous frequency ascended during a spindle event in Wistar rats, but it was constant in WAG/Rij. Third, in WAG/Rij rats, the number and duration of epileptic discharges increased in a period between 7 and 9 months of age, but duration and mean value of intra-spindle frequency did not change. In general, age-dependent aggravation of absence seizures in WAG/Rij rats did not affect EEG properties of sleep spindles; it was suggested that pro-epileptic changes in thalamo-cortical network in WAG/Rij rats might prevent dynamic changes of sleep spindles that were detected in Wistar. PMID:24231550

  5. Atypical Intracranial Epidermoid Cysts: Rare Anomalies with Unique Radiological Features

    PubMed Central

    Law, Eric K. C.; Lee, Ryan K. L.; Ng, Alex W. H.; Siu, Deyond Y. W.; Ng, Ho-Keung

    2015-01-01

    Epidermoid cysts are benign slow growing extra-axial tumours that insinuate between brain structures, while their occurrences in intra-axial or intradiploic locations are exceptionally rare. We present the clinical, imaging, and pathological findings in two patients with atypical epidermoid cysts. CT and MRI findings for the first case revealed an intraparenchymal epidermoid cyst that demonstrated no restricted diffusion. The second case demonstrated an aggressive epidermoid cyst that invaded into the intradiploic spaces, transverse sinus, and the calvarium. The timing of ectodermal tissue sequestration during fetal development may account for the occurrence of atypical epidermoid cysts. PMID:25667778

  6. Recurrent Sinus Pauses: An Atypical Presentation of Temporal Lobe Epilepsy

    PubMed Central

    Eltawansy, Sherif Ali; Osofsky, Jeffrey; Holland, Neil

    2014-01-01

    Autonomic dysfunction related to seizures may give rise to a broad spectrum of cardiovascular abnormalities. Among these, ictal bradycardia and conduction delays may be encountered. Failure to recognize these abnormalities may contribute to sudden, unexplained death in epilepsy patients. We report a case of a Haitian female with temporal lobe epilepsy associated with recurrent sinus pauses. PMID:25328719

  7. Hyperventilation and photic stimulation are useful additions to a placebo-based suggestive seizure induction protocol in patients with psychogenic nonepileptic seizures.

    PubMed

    Popkirov, Stoyan; Grönheit, Wenke; Wellmer, Jörg

    2015-05-01

    The early and definitive diagnosis of psychogenic nonepileptic seizures is a common challenge in epileptology practice. Suggestive seizure induction is a valuable tool to aid the differentiation between epileptic and psychogenic nonepileptic seizures, especially when long-term video-EEG monitoring is inconclusive or unavailable. In this retrospective analysis, we compared the diagnostic yield of a classical, placebo-based induction protocol with that of an extended protocol that includes hyperventilation and photic stimulation as means of suggestion while also implementing more open, standardized patient information. We investigated whether the diversification of suggestive seizure induction has an effect on diagnostic yield and whether it preempts the administration of placebo. Data from 52 patients with confirmed psychogenic nonepileptic seizures were analyzed. While suggestive seizure induction using only placebo-based suggestion provoked a typical event in 13 of 20 patients (65%), the extended protocol was positive in 27 of 34 cases (84%); this improvement was not significant (p=0.11). Noninvasive suggestion techniques accounted for 78% of inductions, avoiding placebo administration in a majority of patients. Still, placebo remains an important part of suggestive seizure induction, responsible for 22% (6 out of 27) of successful inductions using our extended protocol. Our study demonstrates that the diversification of suggestive seizure induction is feasible and beneficial for both patients and diagnosticians. PMID:25934586

  8. Depression and symptoms affect quality of life in psychogenic nonepileptic seizures

    PubMed Central

    LaFrance, W Curt; Syc, Stephanie

    2009-01-01

    Background: In patients with active epilepsy, adverse medication effects and severity of depression are correlated with health-related quality of life, but seizure frequency is not. We sought to examine if the same pattern exists in patients with psychogenic nonepileptic seizures (PNES). Methods: We administered seizure calendars, quality of life (QOL) scales, depression scales, and symptom checklists to 49 patients with video EEG–confirmed PNES. Data analysis consisted of performing Pearson correlation coefficients, scatter plots, and t tests. Results: Depression and symptom scores significantly increased as health-related QOL scores decreased (partial correlation coefficient r = ?0.73 for both comparisons), whereas seizure count was nonsignificant (partial correlation coefficient r = ?0.19). Conclusions: As is seen in epilepsy, patients with psychogenic nonepileptic seizures demonstrate that higher depressive symptoms and somatic symptoms are independently related to worsening quality of life (QOL); however, seizure frequency is not. Seizure frequency is an important focus in patient care and treatment trials. The findings underscore the importance of, along with seizure counts, also examining QOL, depression, and somatic symptoms in patients with seizures. GLOSSARY AED = antiepileptic drug; AEP = Adverse Events Profile; BDI = Beck Depression Inventory; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, 4th edition; HRQOL = health-related QOL; NPE = neuropsychiatric examination; PNES = psychogenic nonepileptic seizures; QOL = quality of life; QOLIE-31 = Quality of Life in Epilepsy–31; RIH = Rhode Island Hospital; SCL-90 = Symptom Checklist–90; vEEG = video EEG. PMID:19652140

  9. Slow Spatial Recruitment of Neocortex during Secondarily Generalized Seizures and Its Relation to Surgical Outcome.

    PubMed

    Martinet, Louis-Emmanuel; Ahmed, Omar J; Lepage, Kyle Q; Cash, Sydney S; Kramer, Mark A

    2015-06-24

    Understanding the spatiotemporal dynamics of brain activity is crucial for inferring the underlying synaptic and nonsynaptic mechanisms of brain dysfunction. Focal seizures with secondary generalization are traditionally considered to begin in a limited spatial region and spread to connected areas, which can include both pathological and normal brain tissue. The mechanisms underlying this spread are important to our understanding of seizures and to improve therapies for surgical intervention. Here we study the properties of seizure recruitment-how electrical brain activity transitions to large voltage fluctuations characteristic of spike-and-wave seizures. We do so using invasive subdural electrode arrays from a population of 16 patients with pharmacoresistant epilepsy. We find an average delay of ?30 s for a broad area of cortex (8 × 8 cm) to be recruited into the seizure, at an estimated speed of ?4 mm/s. The spatiotemporal characteristics of recruitment reveal two categories of patients: one in which seizure recruitment of neighboring cortical regions follows a spatially organized pattern consistent from seizure to seizure, and a second group without consistent spatial organization of activity during recruitment. The consistent, organized recruitment correlates with a more regular, compared with small-world, connectivity pattern in simulation and successful surgical treatment of epilepsy. We propose that an improved understanding of how the seizure recruits brain regions into large amplitude voltage fluctuations provides novel information to improve surgical treatment of epilepsy and highlights the slow spread of massive local activity across a vast extent of cortex during seizure. PMID:26109670

  10. A fully-asynchronous low-power implantable seizure detector for self-triggering treatment.

    PubMed

    Mirzaei, Marjan; Salam, Muhammad Tariqus; Nguyen, Dang K; Sawan, Mohamad

    2013-10-01

    In this paper, we present a new asynchronous seizure detector that is part of an implantable integrated device intended to identify electrographic seizure onset and trigger a focal treatment to block the seizure progression. The proposed system has a low-power front-end bioamplifier and a seizure detector with intelligent mechanism to reduce power dissipation. This system eliminates the unnecessary clock gating during normal neural activity monitoring mode and reduces power dissipation in the seizure detector; as a result, this device is suitable for long-term implantable applications. The proposed system includes analog and digital building blocks with programmable parameters for extracting electrographic seizure onset information from real-time EEG recordings. Sensitivity of the detector is enhanced by optimizing the variable parameters based on specific electrographic seizure onset activities of each patient. The detection algorithm was validated using Matlab tools and implemented in standard 0.13 ?m CMOS process with total die area of 1.5 × 1.5 mm˛. The fabricated chip is validated offline using intracranial EEG recordings from two patients with refractory epilepsy. Total power consumption of the chip is 9 ?W and average detection delay is 13.7 s after seizure onset, well before the onset of clinical manifestation. The proposed system achieves an accurate detection performance with 100% sensitivity and no false alarms during the analyses of 15 seizures and 19 non-seizure datasets. PMID:24232623

  11. Early seizure detection in an animal model of temporal lobe epilepsy

    NASA Astrophysics Data System (ADS)

    Talathi, Sachin S.; Hwang, Dong-Uk; Ditto, William; Carney, Paul R.

    2007-11-01

    The performance of five seizure detection schemes, i.e., Nonlinear embedding delay, Hurst scaling, Wavelet Scale, autocorrelation and gradient of accumulated energy, in their ability to detect EEG seizures close to the seizure onset time were evaluated to determine the feasibility of their application in the development of a real time closed loop seizure intervention program (RCLSIP). The criteria chosen for the performance evaluation were, high statistical robustness as determined through the predictability index, the sensitivity and the specificity of a given measure to detect an EEG seizure, the lag in seizure detection with respect to the EEG seizure onset time, as determined through visual inspection and the computational efficiency for each detection measure. An optimality function was designed to evaluate the overall performance of each measure dependent on the criteria chosen. While each of the above measures analyzed for seizure detection performed very well in terms of the statistical parameters, the nonlinear embedding delay measure was found to have the highest optimality index due to its ability to detect seizure very close to the EEG seizure onset time, thereby making it the most suitable dynamical measure in the development of RCLSIP in rat model with chronic limbic epilepsy.

  12. Perilesional brain edema and seizure activity in patients with calcified neurocysticercosis

    PubMed Central

    Nash, Theodore E.; Pretell, E. Javier; Lescano, Andres. G.; Bustos, Javier A.; Gilman, Robert H.; Gonzalez, Armando E.; Garcia, Héctor H.

    2013-01-01

    Background Cysticercosis due to Taenia solium is a leading cause of adult acquired seizures and epilepsy that frequently occurs in patients with only calcified larval cysts. Transient episodes of perilesional brain edema occur around calcified foci but its importance, association with seizures, incidence, and pathophysiology are unknown. Methods One hundred and ten persons with only calcified lesions and a history of seizures or severe headaches were followed prospectively in a cohort design to assess the incidence of seizure relapses. In a nested case-control sub study, perilesional edema was assessed by MRI at the time a seizure occurred in the symptomatic patient and in a matched asymptomatic control, amongst the 110 followed. Results Median follow up was 32.33 months (SD 19.99). Twenty-nine people had an incident seizure with an estimated 5 year seizure incidence of 36%. Twenty-four patients of the 29 with seizure relapse had an MRI evaluation within five days of the event. Perilesional edema was found in 12 (50.0%) compared to 2 of 23 asymptomatic matched controls (8.7%). Conclusions Perilesional edema occurs frequently and is associated with episodic seizure activity in calcified neurocysticercosis. Our findings are likely representative of symptomatic patients in endemic regions and suggest a unique and possibly preventable cause of seizures in this population. PMID:18986841

  13. Novel HCN2 mutation contributes to febrile seizures by shifting the channel's kinetics in a temperature-dependent manner.

    PubMed

    Nakamura, Yuki; Shi, Xiuyu; Numata, Tomohiro; Mori, Yasuo; Inoue, Ryuji; Lossin, Christoph; Baram, Tallie Z; Hirose, Shinichi

    2013-01-01

    Hyperpolarization-activated cyclic nucleotide-gated (HCN) channel-mediated currents, known as I h, are involved in the control of rhythmic activity in neuronal circuits and in determining neuronal properties including the resting membrane potential. Recent studies have shown that HCN channels play a role in seizure susceptibility and in absence and limbic epilepsy including temporal lobe epilepsy following long febrile seizures (FS). This study focused on the potential contributions of abnormalities in the HCN2 isoform and their role in FS. A novel heterozygous missense mutation in HCN2 exon 1 leading to p.S126L was identified in two unrelated patients with FS. The mutation was inherited from the mother who had suffered from FS in a pedigree. To determine the effect of this substitution we conducted whole-cell patch clamp electrophysiology. We found that mutant channels had elevated sensitivity to temperature. More specifically, they displayed faster kinetics at higher temperature. Kinetic shift by change of temperature sensitivity rather than the shift of voltage dependence led to increased availability of I h in conditions promoting FS. Responses to cyclic AMP did not differ between wildtype and mutant channels. Thus, mutant HCN2 channels cause significant cAMP-independent enhanced availability of I h during high temperatures, which may contribute to hyperthermia-induced neuronal hyperexcitability in some individuals with FS. PMID:24324597

  14. Father Absence and Children's Cognitive Development

    ERIC Educational Resources Information Center

    Shinn, Marybeth

    1978-01-01

    Reviews literature indicating detrimental effects of father absence on children's cognitive development as assessed by standardized IQ tests, standardized achievement tests, and school performance. (BD)

  15. Complex partial seizures: cerebral structure and cerebral function.

    PubMed

    Theodore, W H; Holmes, M D; Dorwart, R H; Porter, R J; Di Chiro, G; Sato, S; Rose, D

    1986-01-01

    We studied the relationships between cerebral structure and function in 10 patients with complex partial seizures who had major cerebral lesions, including porencephalic cysts, tuberose sclerosis, agenesis of the corpus callosum, and cerebral hemiatrophy. Evaluation included computed tomography (CT) and magnetic resonance imaging (MRI) scanning, EEG, and positron emission tomography (PET) using [18F]-2-deoxyglucose. Surface EEG usually showed widespread, bilateral epileptiform discharges even if pathology was clearly restricted to one hemisphere. In several cases, interictal PET hypometabolism was more widespread than structural changes seen on CT and MRI, extending to involve the ipsilateral temporal lobe in patients with extratemporal lesions. This study shows that patterns of metabolic and electrophysiologic dysfunction may not be predicted by structural lesions in patients with partial seizure disorders. PMID:3489612

  16. Seizures in the life and works of Edgar Allan Poe.

    PubMed

    Bazil, C W

    1999-06-01

    Edgar Allan Poe, one of the most celebrated of American storytellers, lived through and wrote descriptions of episodic unconsciousness, confusion, and paranoia. These symptoms have been attributed to alcohol or drug abuse but also could represent complex partial seizures, prolonged postictal states, or postictal psychosis. Complex partial seizures were not well described in Poe's time, which could explain a misdiagnosis. Alternatively, he may have suffered from complex partial epilepsy that was complicated or caused by substance abuse. Even today, persons who have epilepsy are mistaken for substance abusers and occasionally are arrested during postictal confusional states. Poe was able to use creative genius and experiences from illness to create memorable tales and poignant poems. PMID:10369317

  17. Intermittent prophylaxis of recurrent febrile seizures with clobazam versus diazepam.

    PubMed

    Sattar, S; Saha, S K; Parveen, F; Banu, L A; Momen, A; Ahmed, A U; Quddush, M R; Karim, M M; Begum, S A; Haque, M A; Hoque, M R

    2014-10-01

    Febrile seizures are the most common type of seizure among children that can be prevented by using prophylactic drugs like Clobazam and Diazepam. The present prospective study was conducted in the Department of Pediatrics, Mymensingh Medical College Hospital and Community Based Medical College Hospital, Bangladesh over a period of 1 year from July 2012 to June 2013 to compare the effectiveness of intermittent Clobazam versus Diazepam therapy in preventing the recurrence of febrile seizures and assessed adverse effects of each drug. A total of 65 patients (32 children administered Clobazam and rest 33 children received Diazepam) of simple and complex febrile seizures aged 6 months to 5 years of both sexes were the study population. Data were collected by interview of the patients, clinical examination and laboratory investigations using the research instrument. Data were analyzed by using Chi-square (?2) Test, Student's 't' Test and Fisher's Exact Test. For all analytical tests, the level of significance was set at 0.05 and p<0.05 was considered significant. The proportion of patients was higher between age 12-36 months and male was predominant in the both Clobazam and Diazepam groups. Over 31% of patients in Clobazam group who experienced episode of fever within 3 months, 40.6% within 6 months and 9.4% within 9 months compared to 36.4% in Diazepam group within 3 months, 45.5% within 6 months & 12.1% within 9 months after discharge from the hospital. Three (9.4%) patients in Clobazam group and 7(21.3%) in Diazepam group who experienced febrile convulsion during the follow up period. From the data adverse effects within 3 and 6 months experienced by the patient's drowsiness, sedation and ataxia were higher in Diazepam group than those in Clobazam group. However, within 9 months lethargy and irritability were somewhat higher in Clobazam group than those in Diazepam group. The mean duration of hospitalization was significantly higher in Diazepam group compared to Clobazam group (6.0±1.0 vs. 4.6±0.08 days, P<0.001). Seven (21.2%) out of 33 children with febrile seizures in Diazepam group had a history of recurrent seizures, whereas 3(9.4%) of 32 children in the Clobazam group. The risks of recurrent febrile seizure in the Diazepam group was 2.6 times greater compared to those in the Clobazam group (P=0.186). The result indicates that Clobazam is safe, efficacious, requires less frequent dosing and has less adverse effects such as drowsiness, sedation, ataxia and irritability as compared to Diazepam. So, Clobazam may be an alternative to Diazepam given intermittently for prevention of recurrent febrile seizures. PMID:25481585

  18. The adolescent or adult with generalized tonic–clonic seizures

    PubMed Central

    Gursahani, Roop; Gupta, Namit

    2012-01-01

    Primary and secondary generalized tonic–clonic seizures (GTCs) together constitute up to 50% of adolescent and adult patients with epilepsy as diagnosed by history and EEG. Syncope and psychogenic nonepileptic seizures are major differential diagnoses and must be carefully excluded in therapy-resistant cases. Individual episodes can have up to seven phases in secondarily generalized GTCs. The distinction between primary and secondary GTCs depends mainly on history and EEG, and yield can be improved with sleep deprivation or overnight recording. Epilepsies with primary or unclassified GTCs can respond to any one of the five broad-spectrum antiepileptic drugs (AEDs): valproate, lamotrigine, levetiracetam, topiramate and zonisamide. Unless a focal onset is clearly confirmed, a sodium-channel blocking AED should not be used in the initial treatment of these conditions. PMID:22566718

  19. The serotonin axis: Shared mechanisms in seizures, depression and SUDEP

    PubMed Central

    Richerson, George B.; Buchanan, Gordon F.

    2010-01-01

    Summary There is a growing appreciation that patients with seizures are also affected by a number of co-morbid conditions, including an increase in prevalence of depression (Kanner, 2009), sleep apnea (Chihorek et al, 2007), and sudden death (Ryvlin et al, 2006; Tomson et al, 2008). The mechanisms responsible for these associations are unclear. Here we discuss the possibility that underlying pathology in the serotonin (5-HT) system of epilepsy patients lowers the threshold for seizures, while also increasing the risk of depression and sudden death. We propose that post-ictal dysfunction of 5-HT neurons causes depression of breathing and arousal in some epilepsy patients, and this can lead to sudden unexpected death in epilepsy (SUDEP). We further draw parallels between SUDEP and sudden infant death syndrome (SIDS), which may share pathophysiological mechanisms, and which have both been linked to defects in the 5-HT system. PMID:21214537

  20. Optical triggered seizures using a caged 4-Aminopyridine

    PubMed Central

    Zhao, Mingrui; McGarry, Laura M.; Ma, Hongtao; Harris, Samuel; Berwick, Jason; Yuste, Rafael; Schwartz, Theodore H.

    2015-01-01

    Animal models of epilepsy are critical not only for understanding the fundamental mechanism of epilepsy but also for testing the efficacy of new antiepileptic drugs and novel therapeutic interventions. Photorelease of caged molecules is widely used in biological research to control pharmacologic events with high spatio-temporal resolution. We developed a technique for in vivo optical triggering of neocortical seizures using a novel caged compound based on ruthenium photochemistry (RuBi-4AP). Epileptiform events in mouse cortex were induced with blue light in both whole brain and focal illumination. Multi-electrode array recording and optical techniques were used to characterize the propagation of these epileptic events, including interictal spikes, polyspikes, and ictal discharges. These results demonstrate a novel optically-triggered seizure model, with high spatio-temporal control, that could have widespread application in the investigation of ictal onset, propagation and to develop novel light-based therapeutic interventions. PMID:25698919

  1. Zotepine versus other atypical antipsychotics for schizophrenia

    PubMed Central

    Subramanian, Selvizhi; Rummel-Kluge, Christine; Hunger, Heike; Schmid, Franziska; Schwarz, Sandra; Kissling, Werner; Leucht, Stefan; Komossa, Katja

    2014-01-01

    Background In many parts of the world, particularly in industrialised countries, second generation (atypical) antipsychotic drugs have become first line treatment for people suffering from schizophrenia. The question as to whether the effects of various second generation antipsychotic drugs differ is a matter of debate. Objectives To evaluate the effects of zotepine compared with other second generation antipsychotic drugs for people suffering from schizophrenia and schizophrenia-like psychoses. Search methods We searched the Cochrane Schizophrenia Group Trials Register (November 2009), inspected references of all identified studies for further trials and contacted authors of trials for additional information. Selection criteria We included only randomised clinical controlled trials that compared zotepine with any forms of amisulpride, aripiprazole, clozapine, olanzapine, risperidone, sertindole or ziprasidone in people suffering from only schizophrenia or schizophrenia-like psychoses. Data collection and analysis SS and KK extracted data independently. For dichotomous data we calculated relative risks (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis based on a random-effects model. For continuous data, we calculated weighted mean differences (MD) again based on a random-effects model. Main results We included three studies (total n=289; 2 RCTs zotepine vs clozapine; 1 RCT zotepine vs clozapine vs risperidone (at 4 mg, 8 mg doses) vs remoxipride. All studies were of limited methodological quality. When zotepine was compared with clozapine, it was clozapine that was found to be more effective in terms of global state (n=59, 1 RCT, RR No clinically significant response 8.23 CI 1.14 to 59.17). Mental state scores also favoured clozapine (n=59, 1 RCT, MD average score (BPRS total, high = poor) 6.00 CI 2.17 to 9.83) and there was less use of antiparkinson medication in the clozapine group (n=116, 2 RCTs, RR 20.96 CI 2.89 to 151.90). In the comparison of zotepine and risperidone, mental state scoring found no significant difference between the groups (vs 4 mg: n=40, 1 RCT, MD average endpoint score (BPRS total, high=poor) 1.40 CI -9.82 to 12.62; vs 8 mg: n=40, 1 RCT, MD -1.30 CI -12.95 to 10.35) and use of antiparkinson medication was equivocal (vs 4 mg: n=40, 1 RCT, MD 1.80 CI -0.64 to 4.24; vs 8 mg: n=40, 1 RCT, MD 2.50 CI -0.05 to 5.05). Finally, when zotepine was compared with remoxipride, again no effect was found for mental state (n=58, 1 RCT, MD average endpoint score (BPRS total, high=poor) 5.70 CI -4.13 to 15.53) and there was no significant difference between the two groups in terms of use of antiparkinson medication (n=49, 1 RCT, RR 0.97 CI 0.41 to 2.29). Data on important other outcomes such as other adverse events, service use or satisfaction with care, quality of life were not available. Authors’ conclusions The evidence base around zotepine is insufficient to provide firm conclusions on its absolute or relative effects. This is despite it being in use in Austria, France, Germany, Japan and the UK. PMID:20927748

  2. Masculine Girls and Feminine Boys: Genetic and Environmental Contributions to Atypical Gender Development in Early Childhood

    Microsoft Academic Search

    Ariel Knafo; Alessandra C. Iervolino; Robert Plomin

    2005-01-01

    In this genetic study of atypical gender role development, parents of 5,799 twin pairs, ages 3 and 4, rated their twin children's masculinity and femininity. Boys were selected as gender atypical if they were highly feminine (top 5%, 10%, or 15%) relative to other boys, and girls were selected if they were highly masculine relative to other girls. Gender-atypical boys

  3. Depressive symptoms and atypical jobs in France, from the 2003 Decennial health survey

    E-print Network

    Paris-Sud XI, Université de

    1 Depressive symptoms and atypical jobs in France, from the 2003 Decennial health survey Gaëlle is to study the relations between depressive symptoms and atypical jobs in the working population in France by the CES-D scale. Atypical jobs were defined by employment status (fixed-term or temporary job contract

  4. Molecular and phenotypic methods for the characterization of atypical Aeromonas salmonicida

    Microsoft Academic Search

    Marja-Liisa Hänninen; Varpu Hirvelä-Koski

    1997-01-01

    Atypical Aeromonas salmonicida form a taxonomically diverse group among the psychrophilic A. salmonicida. Characteristics of 53 atypical A. salmonicida strains originating from Finland, Denmark, Norway and Sweden were studied using 60 phenotypic tests. Ribopattern analysis and plasmid profiles were used as genetic methods. The production of brown pigment on the furunculosis agar containing l-tyrosine divided the atypical oxidase-positive strains into

  5. Clinical significance of recurrent psychogenic nonepileptic seizure status

    Microsoft Academic Search

    Markus Reuber; Ralf Pukrop; Alex J. Mitchell; Jürgen Bauer; Christian E. Elger

    2003-01-01

    To explore the clinical significance of a history of recurrent psychogenic nonepileptic seizure status (PNES-status), this study describes the frequency of PNES-status in 85 consecutive PNES patients and examines whether there are relevant differences between patients with a history of recurrent PNES-status and other PNES-patients. PNES patients were also compared with 64 patients with epilepsy. Data were extracted from hospital

  6. Networking Property During Epileptic Seizure with Multichannel EEG Recordings

    Microsoft Academic Search

    Huihua Wu; Xiaoli Li; Xinping Guan

    2006-01-01

    \\u000a EEG recordings are widely used in epilepsy research. We intend to address a question whether small world network property\\u000a exists in neural networks when epileptic seizures occur. In this paper, we introduce a bispectrum analysis to calculate the\\u000a interaction between two EEG recordings; then, a suitable threshold is chosen to convert the interaction of the six channels\\u000a at five frequency

  7. Bicoherence of intracranial EEG in sleep, wakefulness and seizures

    Microsoft Academic Search

    T. H. Bullock; J. Z. Achimowicz; R. B. Duckrow; S. S. Spencer; V. J. Iragui-Madoz

    1997-01-01

    The hypothesis that the intracranial EEG has local structure and short-term non-stationarity is tested with a little-studied measure of nonlinear phase coupling, the bicoherence in human subdural and deep temporal lobe probe data from 11 subjects during sleeping, waking and seizure states. This measure of cooperativity estimates the proportion of energy in every possible pair of frequency components, F1, F2

  8. Inability of Lyapunov Exponents to Predict Epileptic Seizures

    NASA Astrophysics Data System (ADS)

    Lai, Ying-Cheng; Harrison, Mary Ann F.; Frei, Mark G.; Osorio, Ivan

    2003-08-01

    It has been claimed that Lyapunov exponents computed from electroencephalogram or electrocorticogram (ECoG) time series are useful for early prediction of epileptic seizures. We show, by utilizing a paradigmatic chaotic system, that there are two major obstacles that can fundamentally hinder the predictive power of Lyapunov exponents computed from time series: finite-time statistical fluctuations and noise. A case study with an ECoG signal recorded from a patient with epilepsy is presented.

  9. Risk factors for complications of drug-induced seizures.

    PubMed

    Thundiyil, Josef G; Rowley, Freda; Papa, Linda; Olson, Kent R; Kearney, Thomas E

    2011-03-01

    The purpose of this study is to determine clinical factors associated with complications of drug-induced seizures. This prospective observational study was conducted at an American Association of Poison Control Centers-certified regional poison control center (PCC) over a 1-year period. All consecutive cases reported to a PCC involving seizures were forwarded to investigators, who obtained standardized information including the specific drug or medication exposure, dose, reason for exposure, vital signs, laboratory data, treatment, and outcome. Patients were monitored by daily telephone follow-up until death or discharge. Subjects were excluded if the seizure was deemed to be unrelated to exposure. Odds ratios were used to analyze variables for associations with admission to the hospital for >72 h, endotracheal intubation, status epilepticus, anoxic brain injury, or death. One hundred twenty-one cases met inclusion criteria. Sixty-three (52%) were male, and the mean age was 30 (SD14) years. Common exposures included: antidepressants (33%), stimulants (15%), and anticholinergics (10%). One hundred and three (85%) of the exposures were intentional, of which 74 were suicide attempts and 16 were drug abuse or misuse. Forty-nine (40%) patients required endotracheal intubation, 12(10%) had status epilepticus, 50(41%) were hospitalized for more than 72 h, and one patient died. Median hospital stay was 3 days. Variables significantly associated with complications included stimulant exposure (odds ratios, OR=11 [95% confidence intervals (CI) 1.9-52]), suicide attempt (OR=2.2 [95% CI 1.02-4.7]), initial hypotension (OR=11.2 [95% CI 1.4-89.3]), admission glucose >130 mg/dL (OR=5.4 [95% CI 1.6-18.1]), and admission HCO(3)?<20 mEq/L (OR=4.0 [95% CI 1.4-11.3]). Significant clinical factors associated with complications of drug-related seizures include stimulant exposure, suicide attempt, initial hypotension, and admission acidosis or hyperglycemia. PMID:20661684

  10. Seizure and coma following Kratom (Mitragynina speciosa Korth) exposure.

    PubMed

    Nelsen, Jamie L; Lapoint, Jeff; Hodgman, Michael J; Aldous, Kenneth M

    2010-12-01

    Reports of toxicity secondary to Kratom are rare and lack of diagnostic testing in human specimens has prevented confirmatory explanation of observed clinical effects. We present a novel case of serious human toxicity following Kratom use confirmed via quantitative analysis of urine by high performance liquid chromatography coupled to electrospray tandem mass spectrometry. A 64 year-old male was witnessed to have a seizure at home following kratom consumption. Upon arrival to the emergency department (ED), the patient was unresponsive. While in the ED, the patient sustained a second seizure. He was intubated to protect his airway. The remainder of his hospital course was uneventful. A urine specimen was collected shortly after admission and sent for analysis. The mitragynine concentration in the urine was 167?±?15 ng/ml. We report a rare case of Kratom toxicity characterized by a seizure and coma confirmed by urinary analysis of mitragynine by high performance liquid chromatography coupled to electrospray tandem mass spectrometry. The proposed mechanism for this reaction is unclear but suggested mechanisms include adenosine binding or stimulation of adrenergic and/or serotonergic receptors similar to tramadol. PMID:20411370

  11. New developments in electroconvulsive therapy and magnetic seizure therapy.

    PubMed

    Lisanby, Sarah H; Morales, Oscar; Payne, Nancy; Kwon, Edward; Fitzsimons, Linda; Luber, Bruce; Nobler, Mitchell S; Sackeim, Harold A

    2003-07-01

    New findings regarding the mechanisms of action of electro-convulsive therapy (ECT) have led to novel developments in treatment technique to further improve this highly effective treatment for major depression. These new approaches include novel placements, optimization of electrical stimulus parameters, and new methods for inducing more targeted seizures(eg, magnetic seizure therapy [MST]). MST is the use of transcranial magnetic stimulation to induce a seizure. Magnetic fields pass through tissue unimpeded, providing more control over the site and extent of stimulation than can be achieved with ECT. This enhanced control represents a means of focusing the treatment on target cortical structures thought to be essential to antidepressant response and reducing spread to medial temporal regions implicated in the cognitive side effects of ECT. MST is at an early stage of development. Preliminary results suggest that MST may have some advantages over ECT in terms of subjective side effects and acute cognitive functioning. Studies designed to address the antidepressant efficacy of MST are underway. As with all attempts to improve convulsive therapy technique, the clinical value of MST will need to be established through controlled clinical trials. This article reviews the experience to date with MST, and places this work in the broader context of other means of optimizing convulsive therapy in the treatment of depression. PMID:12894034

  12. Terminology and classification of seizures and epilepsy in veterinary patients.

    PubMed

    Mariani, Christopher L

    2013-05-01

    The classification of epileptic seizures and epilepsy is a controversial and dynamic topic that has undergone many iterations in human medicine. The International League against Epilepsy is a multinational organization that has formed a number of task forces and subcommittees to study this issue, and has ratified several reports outlining recommended terminology and classification schemes for human patients. Veterinary publications on this issue have generally adapted these schemes to fit small animal patients, but a formally endorsed system to classify seizures and epilepsy has never been developed for veterinary patients. This review outlines the classification systems that have been published for human patients and summarizes previous efforts by veterinary authors to utilize these methods. Finally, a set of definitions and terminology for use in veterinary patients is proposed, which includes a glossary of descriptive terminology for ictal semiology and a diagnostic scheme for classification of individual patients. This document is intended as a starting point of discussion, which will hopefully eventually result in a formally ratified document that will be useful for communication between health professionals, the design of clinical trials and for guiding treatment decisions and prognostication for veterinary patients with seizures. PMID:24070679

  13. Integrating electrodermal biofeedback into pharmacologic treatment of grand mal seizures

    PubMed Central

    Scrimali, Tullio; Tomasello, Damiana; Sciuto, Massimo

    2015-01-01

    Electrodermal activity (EDA) and electrodermal biofeedback, when integrated with pharmacologic treatments, indicate promising methods for the treatment of grand mal seizures. They can be used to monitor patient arousal and help patients learn new strategies to better cope with stress and anxiety. Our proposed method can possibly reduce the number of crises for patients who are dependent on pharmacologic therapy and can improve their quality of life. This article describes the scientific background of electrodermal monitoring and electrodermal biofeedback for patients affected by grand mal seizures. In this study, we have reported a clinical case study. The patient was treated for 2 years with electrodermal biofeedback to augment pharmacologic treatments. The trial has been designed in accordance with “n = 1 case study research”. Our results have shown that our methods could achieve a significant reduction in grand mal seizures and sympathetic arousal when applied. The patient under consideration was also relaxed and exhibited greater competency to cope with stress. Additionally, the patient’s sense of mastery and self-efficacy was enhanced. PMID:26029078

  14. Absence epileptic activity changing effects of non-adenosine nucleoside inosine, guanosine and uridine in Wistar Albino Glaxo Rijswijk rats.

    PubMed

    Kovács, Z; Kékesi, K A; Dobolyi, Á; Lakatos, R; Juhász, G

    2015-08-01

    Adenosine (Ado) and non-adenosine (non-Ado) nucleosides such as inosine (Ino), guanosine (Guo) and uridine (Urd) may have regionally different roles in the regulation of physiological and pathophysiological processes in the central nervous system (CNS) such as epilepsy. It was demonstrated previously that Ino and Guo decreased quinolinic acid (QA)-induced seizures and Urd reduced penicillin-, bicuculline- and pentylenetetrazole (PTZ)-induced seizures. It has also been demonstrated that Ino and Urd may exert their effects through GABAergic system by altering the function of GABAA type of gamma-aminobutyric acid receptors (GABAA receptors) whereas Guo decreases glutamate-induced excitability through glutamatergic system, which systems (GABAergic and glutamatergic) are involved in pathomechanisms of absence epilepsy. Thus, we hypothesized that Ino and Guo, similarly to the previously described effect of Urd, might also decrease absence epileptic activity. We investigated in the present study whether intraperitoneal (i.p.) application of Ino (500 and 1000mg/kg), Guo (20 and 50mg/kg), Urd (500 and 1000mg/kg), GABAA receptor agonist muscimol (1 and 3mg/kg), GABAA receptor antagonist bicuculline (2 and 4mg/kg), non-selective Ado receptor antagonist theophylline (5 and 10mg/kg) and non-competitive N-methyl-d-aspartate (NMDA) receptor antagonist (+)-5-methyl-10,11-dihydro-5H-dibenzo (a,d) cyclohepten-5,10-imine maleate (MK-801, 0.0625 and 0.1250mg/kg) alone and in combination have modulatory effects on absence epileptic activity in Wistar Albino Glaxo Rijswijk (WAG/Rij) rats. We found that Guo decreased the number of spike-wave discharges (SWDs) whereas Ino increased it dose-dependently. We strengthened that Urd can decrease absence epileptic activity. Our results suggest that Guo, Urd and their analogs could be potentially effective drugs for treatment of human absence epilepsy. PMID:26037802

  15. Cognitive impairments and neuronal injury in different brain regions of a genetic rat model of absence epilepsy.

    PubMed

    Jafarian, M; Karimzadeh, F; Alipour, F; Attari, F; Lotfinia, A A; Speckmann, E-J; Zarrindast, M-R; Gorji, A

    2015-07-01

    Growing numbers of evidence indicate that cognitive impairments are part of clinical profile of childhood absence epilepsy. Little is known on neuropathological changes accompanied by cognitive deficits in absence epilepsy. The aim of the present study was to investigate age-dependent neuropathological changes accompanied by learning and memory impairments in Wistar Albino Glaxo from Rijswijk (WAG/Rij) rat model of absence epilepsy. Experimental groups were divided into four groups of six rats of both WAG/Rij and Wistar strains with 2 and 6months of age. The learning and memory performances were assessed using passive avoidance paradigm and neuropathological alterations were investigated by the evaluation of the number of dark neurons and apoptotic cells as well as the expression of caspase-3 in the neocortex, the hippocampus, and different regions of the thalamus. Results revealed a decline in learning and spatial memory of 6-month-old WAG/Rij rats compared to age-matched Wistar rats as well as 2-month-old WAG/Rij and Wistar rats. The mean number of dark neurons was significantly higher in the hippocampal CA1 and CA3 areas as well as in the laterodorsal, centromedial, and reticular thalamic nuclei and the somatosensory cortex of 6-month-old WAG/Rij rats. In addition, a higher number of apoptotic cells as well as a higher expression of caspase-3 was observed in the hippocampal CA1 and CA3 regions, the laterodorsal thalamic nucleus, and the somatosensory cortex of 6-month-old WAG/Rij rats compared to other animal groups. These results indicate significant enhancement of neuronal damage and cell death accompanied by memory deficits after seizure attacks in a rat model of absence epilepsy. Seizure-induced neuronal injury and death may underlie cognitive impairments in absence epilepsy. PMID:25907443

  16. [Lipid pneumonia and pleural-pulmonary atypical mycobacteriosis].

    PubMed

    Dorion, I; Mayeux, I; François, Y; Remond, A; Gontier, M F; Jounieaux, V

    2000-06-01

    We report a case of fat deposit pneumonia extending to the parietal pleura with a granulomatous reaction centered on the fat vaculoles. This case was complicated by an atypical and fatal mycobacterial infection caused by Mycobacterium chelonae. The severity of Mycobacterium chelonae infection in fat deposit pneumonia warrants early empirical antibiotic therapy. PMID:10951968

  17. Default Clustering in Large Portfolios: Typical and Atypical Events

    Microsoft Academic Search

    Kay Giesecke; Konstantinos Spiliopoulos; Richard B. Sowers

    2011-01-01

    We develop a dynamic point process model of correlated default timing in a portfolio of firms, and analyze typical and atypical default profiles in the limit as the size of the pool grows. In our model, a name defaults at a stochastic intensity that is influenced by an idiosyncratic risk process, a systematic risk process common to all names, and

  18. Clozapine in bipolar disorder: treatment implications for other atypical antipsychotics

    Microsoft Academic Search

    Mark A Frye; Terence A Ketter; Lori L Altshuler; Kirk Denicoff; Robert T Dunn; Timothy A Kimbrell; Gabriela Corá-Locatelli; Robert M Post

    1998-01-01

    Traditional neuroleptics are often utilized clinically for the management of bipolar disorder. Although effective as antimanic agents, their mood stabilizing properties are less clear. Additionally, their acute clinical side effect profile and long term risk of tardive dyskinesia, particularly in mood disorder patients, portend significant liability. This review focuses on the use of atypical antipsychotics in the treatment of bipolar

  19. Atypical pneumonia associated with a Mycoplasma isolate in a kitten

    PubMed Central

    Bongrand, Yannick; Blais, Marie-Claude; Alexander, Kate

    2012-01-01

    An atypical case of Mycoplasma pneumonia with an unusual radiographic and computed tomographic pattern was diagnosed in a Siamese kitten. The cat showed no response to broad-spectrum antibiotic therapy including enrofloxacin. The administration of doxycycline led to a dramatic clinical and radiographic improvement. PMID:23543932

  20. Atypical basic movement kinematics in autism spectrum conditions.

    PubMed

    Cook, Jennifer L; Blakemore, Sarah-Jayne; Press, Clare

    2013-09-01

    Individuals with autism spectrum conditions have difficulties in understanding and responding appropriately to others. Additionally, they demonstrate impaired perception of biological motion and problems with motor control. Here we investigated whether individuals with autism move with an atypical kinematic profile, which might help to explain perceptual and motor impairments, and in principle may contribute to some of their higher level social problems. We recorded trajectory, velocity, acceleration and jerk while adult participants with autism and a matched control group conducted horizontal sinusoidal arm movements. Additionally, participants with autism took part in a biological motion perception task in which they classified observed movements as 'natural' or 'unnatural'. Results show that individuals with autism moved with atypical kinematics; they did not minimize jerk to the same extent as the matched typical control group, and moved with greater acceleration and velocity. The degree to which kinematics were atypical was correlated with a bias towards perceiving biological motion as 'unnatural' and with the severity of autism symptoms as measured by the Autism Diagnostic Observation Schedule. We suggest that fundamental differences in movement kinematics in autism might help to explain their problems with motor control. Additionally, developmental experience of their own atypical kinematic profiles may lead to disrupted perception of others' actions. PMID:23983031