Sample records for atypical absence seizures

  1. Atypical EEG pattern in children with absence seizures.

    PubMed

    Silva, D F; Lima, M M; Anghinah, R; Zanoteli, E; Lima, J G

    1995-06-01

    We studied four children with diagnosis of absence seizures (generalized primary epilepsy), and with a generalized delta activity on the EEG during clinical attacks provoked by hyperventilation. The lack of ictal generalized spike-and-wave discharges with a frequency of 3 Hz in our patients, makes this an atypical pattern. All children had complete control of their seizures and disappearance of the EEG changes with valproate. We concluded that generalized delta activity observed on EEG during the hyperventilation in children should not always be considered as a normal finding for age, since it could be an ictal event of an absence seizure. PMID:7487533

  2. Galactosemia and phantom absence seizures

    PubMed Central

    Aydin-Özemir, Zeynep; Tektürk, P?nar; Uyguner, Zehra Oya; Baykan, Betül

    2014-01-01

    Generalized and focal seizures can rarely be seen in galactosemia patients, but absence seizures were not reported previously. An 18-year-old male was diagnosed as galactosemia at the age of 8 months. No family history of epilepsy was present. His absence seizures realized at the age of 9 years. Generalized 3-4 Hz spike-wave discharges were identified in his electroencephalography. Homozygous mutation at exon 6 c. 563A > G was identified. The electroencephalogram of his sibling was unremarkable. Our aim was to present the long-term follow-up of a patient diagnosed with galactosemia, who had phantom absence seizures and typical 3-4 Hz spike-wave discharges in his electroencephalogram to draw attention to this rare association. PMID:25624930

  3. ABSENCE SEIZURES AS RESETTING MECHANISMS OF BRAIN DYNAMICS1

    PubMed Central

    Nair, S.P.; Jukkola, P.I.; Quigley, M.; Wilberger, A.; Shiau, D.S.; Sackellares, J.C.; Pardalos, P.M.; Kelly, K.M.

    2009-01-01

    To understand the increase in age-related incidence and frequency of absence seizures in the rat brain, we investigated the effect of these seizures on brain dynamics. This paper puts forward the hypothesis that age-related differences in the expression of absence seizures are associated with the ability of the seizures to reset brain dynamics. PMID:19763248

  4. Neck myoclonia with absence seizures in an Indian girl.

    PubMed

    Jain, Puneet; Sharma, Suvasini; Aneja, Satinder

    2014-11-01

    Absence seizures associated with myoclonic phenomena have been associated with 4 seizure types. Recently, a new seizure type of neck myoclonia with absences was described. We present a case of 9-year-old girl who presented with abnormal head shaking and vacant stare for the past 5 months with an ictal electroencephalograph (EEG) record showing 3-Hz spike-and-wave discharges. The seizures were easily controlled with valproate and clobazam. Neck myoclonia with absences might be a new idiopathic generalized epilepsy syndrome in development. PMID:24556548

  5. Dynamical intrinsic functional architecture of the brain during absence seizures.

    PubMed

    Liao, Wei; Zhang, Zhiqiang; Mantini, Dante; Xu, Qiang; Ji, Gong-Jun; Zhang, Han; Wang, Jue; Wang, Zhengge; Chen, Guanghui; Tian, Lei; Jiao, Qing; Zang, Yu-Feng; Lu, Guangming

    2014-11-01

    Epilepsy is characterized by recurrent and temporary brain dysfunction due to discharges of interconnected groups of neurons. The brain of epilepsy patients has a dynamic bifurcation that switches between epileptic and normal states. The dysfunctional state involves large-scale brain networks. It is very important to understand the network mechanisms of seizure initiation, maintenance, and termination in epilepsy. Absence epilepsy provides a unique model for neuroimaging investigation on dynamic evolutions of brain networks over seizure repertoire. By using a dynamic functional connectivity and graph theoretical analyses to study absence seizures (AS), we aimed to obtain transition of network properties that account for seizure onset and offset. We measured resting-state functional magnetic resonance imaging and simultaneous electroencephalography (EEG) from children with AS. We used simultaneous EEG to define the preictal, ictal and postictal intervals of seizures. We measured dynamic connectivity maps of the thalamus network and the default mode network (DMN), as well as functional connectome topologies, during the three different seizure intervals. The analysis of dynamic changes of anti-correlation between the thalamus and the DMN is consistent with an inhibitory effect of seizures on the default mode of brain function, which gradually fades out after seizure onset. Also, we observed complex transitions of functional network topology, implicating adaptive reconfiguration of functional brain networks. In conclusion, our work revealed novel insights into modifications in large-scale functional connectome during AS, which may contribute to a better understanding the network mechanisms of state bifurcations in epileptogenesis. PMID:23913255

  6. Treatment of typical absence seizures and related epileptic syndromes.

    PubMed

    Panayiotopoulos, C P

    2001-01-01

    Typical absences are brief (seconds) generalised seizures of sudden onset and termination. They have 2 essential components: clinically, the impairment of consciousness (absence) and, generalised 3 to 4Hz spike/polyspike and slow wave discharges on electroencephalogram (EEG). They differ fundamentally from other seizures and are pharmacologically unique. Their clinical and EEG manifestations are syndrome-related. Impairment of consciousness may be severe, moderate, mild or inconspicuous. This is often associated with motor manifestations, automatisms and autonomic disturbances. Clonic, tonic and atonic components alone or in combination are motor symptoms; myoclonia, mainly of facial muscles, is the most common. The ictal EEG discharge may be consistently brief (2 to 5 seconds) or long (15 to 30 seconds), continuous or fragmented, with single or multiple spikes associated with the slow wave. The intradischarge frequency may be constant or may vary (2.5 to 5Hz). Typical absences are easily precipitated by hyperventilation in about 90% of untreated patients. They are usually spontaneous, but can be triggered by photic, pattern, video games stimuli, and mental or emotional factors. Typical absences usually start in childhood or adolescence. They occur in around 10 to 15% of adults with epilepsies, often combined with other generalised seizures. They may remit with age or be lifelong. Syndromic diagnosis is important for treatment strategies and prognosis. Absences may be severe and the only seizure type, as in childhood absence epilepsy. They may predominate in other syndromes or be mild and nonpredominant in syndromes such as juvenile myoclonic epilepsy where myoclonic jerks and generalised tonic clonic seizures are the main concern. Typical absence status epilepticus occurs in about 30% of patients and is more common in certain syndromes, e.g. idiopathic generalised epilepsy with perioral myoclonia or phantom absences. Typical absence seizures are often easy to diagnose and treat. Valproic acid, ethosuximide and lamotrigine, alone or in combination, are first-line therapy. Valproic acid controls absences in 75% of patients and also GTCS (70%) and myoclonic jerks (75%); however, it may be undesirable for some women. Similarly, lamotrigine may control absences and GTCS in possibly 50 to 60% of patients, but may worsen myoclonic jerks; skin rashes are common. Ethosuximide controls 70% of absences, but it is unsuitable as monotherapy if other generalised seizures coexist. A combination of any of these 3 drugs may be needed for resistant cases. Low dosages of lamotrigine added to valproic acid may have a dramatic beneficial effect. Clonazepam, particularly in absences with myoclonic components, and acetazolamide may be useful adjunctive drugs. PMID:11393330

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

    PubMed

    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

  8. 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

  9. Childhood Absence Epilepsy: Poor Attention Is More Than Seizures

    MedlinePLUS

    ... Editors David C. Spencer, MD Steven Karceski, MD Liu Lin Thio, MD, PhD Childhood absence epilepsy Poor ... 0000436060.67147.25 2013;81;e138-e139 Neurology Liu Lin Thio Childhood absence epilepsy: Poor attention is ...

  10. 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

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

    PubMed Central

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

    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 jerks of the limbs occurred in 11 patients but were not associated with the absence attacks. Eyelid myoclonus consistently occurred with absence attacks in four patients and perioral myoclonus in two patients. Absence status occurred in five patients. Absence seizures were frequently unrecognised or misdiagnosed as complex partial seizures. Satisfactory control was achieved with sodium valproate. Electroencephalography, particularly video-electroencephalography, was invaluable in the diagnosis, but focal abnormalities in seven patients might have been erroneously interpreted as indicating partial seizures. This series showed that clinical and EEG manifestations are often syndrome-related and that there are more epileptic syndromes with typical absences than those presently recognised. Images PMID:1469393

  12. 5% CO? inhalation suppresses hyperventilation-induced absence seizures in children.

    PubMed

    Yang, Xiao-Fan; Shi, Xiu-Yu; Ju, Jun; Zhang, Wei-Na; Liu, Yu-Jie; Li, Xiao-Yan; Zou, Li-Ping

    2014-02-01

    Hyperventilation can cause respiratory alkalosis by exhaling CO2, and is often used to confirm diagnosis of absence epilepsy. CO2 has long been known for its anticonvulsant properties since the 1920s. In this pilot study, we aimed to determine whether inhaling medical carbogen containing 5% CO2 and 95% O2 can suppress hyperventilation-induced absence seizures and spike-and-wave discharges (SWDs). We examined 12 patients whose absence seizures were induced by hyperventilation using video electroencephalographic recording for at least 4h. The patients were asked to hyperventilate for 3 min while breathing the following gases: (1) room air (12 patients); (2) carbogen (12 patients); and (3) 100% O2 (8 patients). Eight out of twelve patients were also examined in room air through pretreatment with carbogen for 3 min before the 3 min hyperventilation. Compared with hyperventilation in room air, hyperventilation supplemented with 5% CO2 had the following effects: (a) decrease in the number and duration of seizures; (b) prolonged appearance of epileptic discharges; and (c) reduction in the number and duration of SWDs (P<0.001). However, pretreatment with 5% CO2 and 100% O2 supplement did not yield similar effects. We demonstrated that 5% CO2 could suppress hyperventilation-induced absence seizures and SWDs, supporting the claim that 5% CO2 is an effective anticonvulsant agent. Our pilot study provides clinical basis that 5% CO2 inhalation could be a therapeutic approach for hyperventilation-related seizures. PMID:24315664

  13. T-type calcium channel blockers that attenuate thalamic burst firing and suppress absence seizures.

    PubMed

    Tringham, Elizabeth; Powell, Kim L; Cain, Stuart M; Kuplast, Kristy; Mezeyova, Janette; Weerapura, Manjula; Eduljee, Cyrus; Jiang, Xinpo; Smith, Paula; Morrison, Jerrie-Lynn; Jones, Nigel C; Braine, Emma; Rind, Gil; Fee-Maki, Molly; Parker, David; Pajouhesh, Hassan; Parmar, Manjeet; O'Brien, Terence J; Snutch, Terrance P

    2012-02-15

    Absence seizures are a common seizure type in children with genetic generalized epilepsy and are characterized by a temporary loss of awareness, arrest of physical activity, and accompanying spike-and-wave discharges on an electroencephalogram. They arise from abnormal, hypersynchronous neuronal firing in brain thalamocortical circuits. Currently available therapeutic agents are only partially effective and act on multiple molecular targets, including ?-aminobutyric acid (GABA) transaminase, sodium channels, and calcium (Ca(2+)) channels. We sought to develop high-affinity T-type specific Ca(2+) channel antagonists and to assess their efficacy against absence seizures in the Genetic Absence Epilepsy Rats from Strasbourg (GAERS) model. Using a rational drug design strategy that used knowledge from a previous N-type Ca(2+) channel pharmacophore and a high-throughput fluorometric Ca(2+) influx assay, we identified the T-type Ca(2+) channel blockers Z941 and Z944 as candidate agents and showed in thalamic slices that they attenuated burst firing of thalamic reticular nucleus neurons in GAERS. Upon administration to GAERS animals, Z941 and Z944 potently suppressed absence seizures by 85 to 90% via a mechanism distinct from the effects of ethosuximide and valproate, two first-line clinical drugs for absence seizures. The ability of the T-type Ca(2+) channel antagonists to inhibit absence seizures and to reduce the duration and cycle frequency of spike-and-wave discharges suggests that these agents have a unique mechanism of action on pathological thalamocortical oscillatory activity distinct from current drugs used in clinical practice. PMID:22344687

  14. Seizures

    MedlinePLUS

    PATIENT / FAMILY TEACHING SHEET Seizures What is a seizure? A seizure is a sudden surge of electrical activity in the brain that affects how a person feels or acts for a short time. On rare occasions, a seizure ...

  15. Cardiorespiratory Analysis on Children Suffering from Absence and Complex Partial Seizures

    E-print Network

    change on the cardio-respiratory control of the autonomic nervous system[1]. As mentioned above episodes, while absence seizures do not seem to alter the cardio-respiratory control in any signif- icant, these effects are studied and the cardio-respiratory control of children suf- fering from complex

  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. Neurochemical and Behavioral Features in Genetic Absence Epilepsy and in Acutely Induced Absence Seizures

    PubMed Central

    Bazyan, A. S.; van Luijtelaar, G.

    2013-01-01

    The absence epilepsy typical electroencephalographic pattern of sharp spikes and slow waves (SWDs) is considered to be due to an interaction of an initiation site in the cortex and a resonant circuit in the thalamus. The hyperpolarization-activated cyclic nucleotide-gated cationic Ih pacemaker channels (HCN) play an important role in the enhanced cortical excitability. The role of thalamic HCN in SWD occurrence is less clear. Absence epilepsy in the WAG/Rij strain is accompanied by deficiency of the activity of dopaminergic system, which weakens the formation of an emotional positive state, causes depression-like symptoms, and counteracts learning and memory processes. It also enhances GABAA receptor activity in the striatum, globus pallidus, and reticular thalamic nucleus, causing a rise of SWD activity in the cortico-thalamo-cortical networks. One of the reasons for the occurrence of absences is that several genes coding of GABAA receptors are mutated. The question arises: what the role of DA receptors is. Two mechanisms that cause an infringement of the function of DA receptors in this genetic absence epilepsy model are proposed. PMID:23738145

  18. Seizures

    MedlinePLUS

    ... a seizure before might have ingested any poisons, medications, etc. If your child has previously had seizures, call 911 if the seizure lasts more than 5 minutes or is for some reason very alarming to you and you're worried for your child's safety. If your child is breathing normally and the ...

  19. 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

  20. A patient with altered mental status and possible seizure reveals an atypical aortic dissection upon workup.

    PubMed

    Lawal, Olufolahan J; Dhindsa, Harinder S; Loyd, Joshua W

    2014-05-01

    Aortic dissection occurs when a tear occurs in the inner muscle wall lining of the aorta, allowing blood to split the muscle layers of the aortic wall apart. It is classically characterized by pain that starts in the upper chest, which then radiates to the upper back and is tearing or ripping in quality. Our objective is to present a case followed by a brief literature review of aortic dissection and uncommon but important features that may be demonstrated. In this report, we present the case of a 57-year-old woman who was transported to the emergency department with an acute episode of altered mental status, presenting as a possible stroke with possible seizures. The patient's only complaint was mild low back pain. Physical examination revealed disorientation to time with no other neurologic deficits or abnormal findings. Results from initial noncontrast head computed tomography, chest radiograph, and laboratory studies were all normal, except for an elevated D-dimer and serum creatinine. Chest computed tomography with contrast demonstrated a type A aortic dissection. The patient was taken emergently to the operating room where the aortic valve and a portion of the ascending aorta were replaced. The patient did well and was discharged from the hospital 5 days later without any permanent sequalae. Aortic dissection is both rare and life threatening and may present with atypical signs. It is important to note that patients may show no signs of typical features or may even display other symptoms based on other branches from the aorta that have been occluded. PMID:24360026

  1. Neural network of structures in which GABAB receptors regulate absence seizures in the lethargic (lh/lh) mouse model.

    PubMed

    Hosford, D A; Lin, F H; Kraemer, D L; Cao, Z; Wang, Y; Wilson, J T

    1995-11-01

    In previous work we have shown that GABAB receptors are required for expression of absence seizures in the lethargic (lh/lh) mouse model; that lh/lh mice have increased numbers of GABAB binding sites compared to nonepileptic littermates (designated +/+); and that the magnitude of the increased number of GABAB receptors in lh/lh mice correlated positively with the frequency of absence seizures. We performed this study to delineate the neural network in which GABAB receptors regulate absence seizures in lh/lh mice. We designed three successive screens which had to be passed by a candidate neuronal population before it could be considered a member of the neural network in which GABAB receptors regulate absence seizures. First, the neuronal populations in lh/lh mice had to have enriched GABAB binding sites compared to homologous populations in matched nonepileptic controls; baclofen-displaceable 3H-GABA binding was measured in autoradiograms for this screen. Second, the candidate populations had to generate spike-wave discharges (SWDs) during absence seizures in lh/lh mice; bipolar recording electrodes implanted into candidate neuronal structures were used in this screen. Third, the candidate populations had to demonstrate GABAB receptor-mediated regulation of absence seizures in lh/lh mice; microinjections of a GABAB agonist [(-)-baclofen] and antagonist (CGP 35348) were used for this screen. In this study we found that anterior ventral lateral thalamic nucleus (VLa), nucleus reticularis thalami (NRT), nucleus reuniens (RE) passed all three screens, and hence are members of the neural network in which GABAB receptors regulate absence seizures in lh/lh mice. PMID:7472490

  2. Absence of retromandibular vein associated with atypical formation of external jugular vein in the parotid region.

    PubMed

    Patil, Jyothsna; Kumar, Naveen; Swamy, Ravindra S; D'Souza, Melanie R; Guru, Anitha; Nayak, Satheesha B

    2014-06-01

    Veins of the head and neck exhibiting anatomical variations or malformations are clinically significant. Anatomical variation in the external jugular vein is very common. However, anatomical variation in the retromandibular vein is rare. In this paper, we report a rare case of complete absence of the retromandibular vein. In the absence of the retromandibular vein, the maxillary vein divided into anterior and posterior divisions. The posterior division joined the superficial temporal vein to form an atypical external jugular vein, and the anterior division joined the facial vein to form an anonymous vein. In clinical practice, radiologists and surgeons use the retromandibular vein as a guide to expose the branches of the facial nerve during superficial parotidectomy. Therefore, absence of the retromandibular vein is a hurdle during this procedure and may affect the venous drainage pattern from the head and neck. PMID:24987551

  3. ?-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

  4. 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

  5. ?-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

  6. 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

  7. A Critical Evaluation of the Gamma-Hydroxybutyrate (GHB) Model of Absence Seizures

    PubMed Central

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

    2015-01-01

    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

  8. Persistence of Cortical Sensory Processing during Absence Seizures in Human and an Animal Model: Evidence from EEG and Intracellular Recordings

    PubMed Central

    Chipaux, Mathilde; Vercueil, Laurent; Kaminska, Anna

    2013-01-01

    Absence seizures are caused by brief periods of abnormal synchronized oscillations in the thalamocortical loops, resulting in widespread spike-and-wave discharges (SWDs) in the electroencephalogram (EEG). SWDs are concomitant with a complete or partial impairment of consciousness, notably expressed by an interruption of ongoing behaviour together with a lack of conscious perception of external stimuli. It is largely considered that the paroxysmal synchronizations during the epileptic episode transiently render the thalamocortical system incapable of transmitting primary sensory information to the cortex. Here, we examined in young patients and in the Genetic Absence Epilepsy Rats from Strasbourg (GAERS), a well-established genetic model of absence epilepsy, how sensory inputs are processed in the related cortical areas during SWDs. In epileptic patients, visual event-related potentials (ERPs) were still present in the occipital EEG when the stimuli were delivered during seizures, with a significant increase in amplitude compared to interictal periods and a decrease in latency compared to that measured from non-epileptic subjects. Using simultaneous in vivo EEG and intracellular recordings from the primary somatosensory cortex of GAERS and non-epileptic rats, we found that ERPs and firing responses of related pyramidal neurons to whisker deflection were not significantly modified during SWDs. However, the intracellular subthreshold synaptic responses in somatosensory cortical neurons during seizures had larger amplitude compared to quiescent situations. These convergent findings from human patients and a rodent genetic model show the persistence of cortical responses to sensory stimulations during SWDs, indicating that the brain can still process external stimuli during absence seizures. They also demonstrate that the disruption of conscious perception during absences is not due to an obliteration of information transfer in the thalamocortical system. The possible mechanisms rendering the cortical operation ineffective for conscious perception are discussed, but their definite elucidation will require further investigations. PMID:23483991

  9. mTOR inhibition modulates epileptogenesis, seizures and depressive behavior in a genetic rat model of absence epilepsy.

    PubMed

    Russo, Emilio; Citraro, Rita; Donato, Giuseppe; Camastra, Caterina; Iuliano, Rodolfo; Cuzzocrea, Salvatore; Constanti, Andrew; De Sarro, Giovambattista

    2013-06-01

    Several signaling pathways are believed to be involved in the epileptogenic process that triggers the subsequent changes in the brain causing epilepsy. The mammalian target of rapamycin (mTOR) is a serine/threonine kinase that in the brain, regulates several important physiological functions such as neuronal development and synaptic plasticity, and also seems to be involved in many pathologies, including epilepsy and psychiatric disorders. Previous work in animal models of both genetic and acquired generalized convulsive epilepsies, has suggested that modulators of the mTOR signaling pathway may have beneficial neuroprotective and antiepileptogenic effects. Here, we investigated for the first time, the effect of some treatment schedules (i.e. early chronic, sub-chronic and acute) with the specific mTOR inhibitor rapamycin, on the development of absence seizures and seizure parameters as well as depressive-like behavior in WAG/Rij rats, a genetic model of absence epilepsy, epileptogenesis and mild-depression comorbidity. In addition, we studied the possible interaction between rapamycin treatment and the effects of bacterial lipopolysaccharide (LPS) endotoxin administration, which is known to aggravate absence seizures through generation of increased neuroinflammatory responses. We found that rapamycin (early chronic treatment for 17 weeks, starting at P45) exhibited clear antiepileptogenic properties also in this animal epilepsy model; however, this effect was accompanied by unexpected prodepressant effects. Both acute and sub-chronic (7 day) treatments also had anti-absence properties, but the sub-chronic treatment produced contrasting antidepressant properties in the WAG/Rij rats that were not seen in control Wistar rats. The rapamycin/LPS co-administration studies showed that rapamycin blocked or prevented the LPS-dependent increase in absence seizures, suggesting an anti-inflammatory-like protective action. In conclusion, we have demonstrated a novel antiepileptogenic effect of rapamycin in a well-established animal model of absence epilepsy, and we suggest that this effect may be mediated by the inhibition of inflammatory processes that are developed in the brain of these specific animals during epileptogenesis and during seizures. Our experiments here suggest new insights into this intriguing field, which deserves to be further explored. This article is part of the Special Issue entitled 'New Targets and Approaches to the Treatment of Epilepsy'. PMID:23092918

  10. GABAB receptors as a common target for hypothermia and spike and wave seizures: intersecting mechanisms of thermoregulation and absence epilepsy.

    PubMed

    Ostoji?, Z S; Ili?, T V; Veskovi?, S M; Andjus, P R

    2013-05-15

    In the current study the link among the ?-hydroxybutyrate (GHB)/pentylenetetrazole (PTZ)-induced absence-like seizures and concomitant decreases in the core temperature, as well as electroencephalographic (EEG) activity during rewarming from deep hypothermia produced by a drug-free protocol were investigated. During the rewarming period after deep cooling, most Wistar rats suffered from bilaterally synchronous spike and waves with no or mild behavioral correlates. Spike and wave seizures were temperature-dependent and were initially registered when body temperature (Tb) reached 25-27°C, but mostly during the mild hypothermia of 0.3-1.3°C (Tb of 36.3-37.3°C). In chemical absence models, spike and wave discharges were also closely accompanied by mild systemic hypothermia, as both PTZ- and GHB-induced temperature decreases ranged from about 1-1.4°C respectively, together with EEG markers of absence activity. Thus, throughout the different experimental designs, the occurrence of spike and wave discharges was always related to a mild (0.3-1.4°C) decrease of Tb. Benzodiazepine diazepam as the GABAA-positive allosteric modulator and CGP 62349 as the selective antagonist of GABAB receptors were used to determine if their well-known anticonvulsant properties also affect hypothermia elicited by these drugs. Finally, during the course of spontaneous rewarming from deep hypothermia, another selective GABAB-blocking agent, CGP 35348, was used to elucidate if GABAB inhibitory system could be critically implicated in the generation of hypothermia-dependent spike and waves. Diazepam prevented both the PTZ-induced hypothermia and electrographic absence seizures, but these two beneficial effects did not occur in the GHB model. Even though diazepam delayed GHB-induced maximal temperature decrease, the GHB effects remained highly significant. The GABAB antagonist CGP 62349 completely prevented hypothermia as well as absence seizures in both chemical models. Likewise, spike and wave discharges, registered during the spontaneous rewarming from deep hypothermia, were completely prevented by CGP 35348. These findings show that systemic hypothermia should definitely be regarded as a marker of GABAB receptor activation. Moreover, the results of this study clearly show that initial mild temperature decrease should be considered as strong absence-provoking factor. Hypothermia-induced nonconvulsive seizures also highlight the importance of continuous EEG monitoring in children undergoing therapeutic hypothermia after cardiac arrest. Since every change in peripheral or systemic temperature ultimately must be perceived by preoptic region of the anterior hypothalamus as the primary thermoregulatory and sleep-inducing center, the preoptic thermosensitive neurons in general and warm-sensitive neurons in particular, simply have to be regarded as the most probable candidate for connected thermoregulatory and absence generating mechanisms. Therefore, additional studies are needed to confirm their potential role in the generation and propagation of absence seizures. PMID:23415784

  11. 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 (10mg/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

  12. The ontogeny of [3H]gamma-hydroxybutyrate and [3H]GABAB binding sites: relation to the development of experimental absence seizures.

    PubMed

    Snead, O C

    1994-10-01

    gamma-Hydroxybutyric acid (GHB) is a naturally occurring compound which has the ability to induce generalized absence seizures when given to animals. There is growing evidence that both gamma-aminobutyric acid (GABA)B- and GHB-mediated mechanisms are involved in the pathogenesis of this phenomenon. Because of the fact that absence seizures are a disorder of children the ontogeny of [3H]GHB and [3H]GABAB binding and the developmental appearance of absence seizures in the GHB model of absence was ascertained and compared in developing rats. [3H]GABAB binding was present within the first 3 days of postnatal life and rose to levels which exceeded those found in adults, peaking between the 3rd and 5th postnatal week. [3H]GHB binding on the other hand did not appear until postnatal day 17 when it was detectable in the CA1 region of the hippocampus. There was a steady increase in [3H]GHB binding until adult levels were reached by postnatal day 40. Comparison of [3H]GABAB and [3H]GHB binding revealed that both sites were common to layer I-III of cortex, but otherwise differed in their regional distribution. There was an absolute concordance of the ontogeny of GHB-induced absence seizures with the developmental appearance of [3H]GHB binding in the superficial laminae of cortex; both appeared at postnatal day 18. These data support the hypotheses that the [3H]GHB and [3H]GABAB binding sites are separate from one another and suggest that maturational events in thalamus and cortex in the 3rd postnatal week are involved in the expression of GHB-induced absence seizures. PMID:7820656

  13. Long-Term Valproate Treatment Increases Brain Neuropeptide Y Expression and Decreases Seizure Expression in a Genetic Rat Model of Absence Epilepsy

    PubMed Central

    van Raay, Leena; Dedeurwaerdere, Stefanie; O’Brien, Terence J.; Morris, Margaret J.

    2013-01-01

    The mechanisms by which valproate, one of the most widely prescribed anti-epileptic drugs, suppresses seizures have not been fully elucidated but may involve up-regulation of neuropeptide Y (NPY). We investigated the effects of valproate treatment in Genetic Absence Epilepsy Rats from Strasbourg (GAERS) on brain NPY mRNA expression and seizure control. GAERS were administered either valproate (42 mg.kg?1 hr?1) or saline continuously for 5 days. Electroencephalograms were recorded for 24 hrs on treatment days 1, 3 and 5 and the percentage of time spent in seizure activity was analysed. NPY mRNA expression was measured in different brain regions using qPCR. Valproate treatment suppressed seizures by 80% in GAERS (p<0.05) and increased NPY mRNA expression in the thalamus (p<0.05) compared to saline treatment. These results demonstrate that long-term valproate treatment results in an upregulation of thalamic expression of NPY implicating this as a potential contributor to the mechanism by which valproate suppresses absence seizures. PMID:24039965

  14. From sleep spindles of natural sleep to spike and wave discharges of typical absence seizures: is the hypothesis still valid?

    PubMed

    Leresche, Nathalie; Lambert, Régis C; Errington, Adam C; Crunelli, Vincenzo

    2012-01-01

    The temporal coincidence of sleep spindles and spike-and-wave discharges (SWDs) in patients with idiopathic generalized epilepsies, together with the transformation of spindles into SWDs following intramuscular injection of the weak GABAA receptor (GABAAR) antagonist, penicillin, in an experimental model, brought about the view that SWDs may represent 'perverted' sleep spindles. Over the last 20 years, this hypothesis has received considerable support, in particular by in vitro studies of thalamic oscillations following pharmacological/genetic manipulations of GABAARs. However, from a critical appraisal of the evidence in absence epilepsy patients and well-established models of absence epilepsy it emerges that SWDs can occur as frequently during wakefulness as during sleep, with their preferential occurrence in either one of these behavioural states often being patient dependent. Moreover, whereas the EEG expression of both SWDs and sleep spindles requires the integrity of the entire cortico-thalamo-cortical network, SWDs initiates in cortex while sleep spindles in thalamus. Furthermore, the hypothesis of a reduction in GABAAR function across the entire cortico-thalamo-cortical network as the basis for the transformation of sleep spindles into SWDs is no longer tenable. In fact, while a decreased GABAAR function may be present in some cortical layers and in the reticular thalamic nucleus, both phasic and tonic GABAAR inhibitions of thalamo-cortical neurons are either unchanged or increased in this epileptic phenotype. In summary, these differences between SWDs and sleep spindles question the view that the EEG hallmark of absence seizures results from a transformation of this EEG oscillation of natural sleep. PMID:21861061

  15. 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

  16. A case of atypical benign partial epilepsy with action myoclonus.

    PubMed

    Kobayashi, Satoru; Inui, Takehiko; Wakusawa, Keisuke; Tanaka, Soichiro; Nakayama, Tojo; Uematsu, Mitsugu; Takayanagi, Masaru; Yamamoto, Toshiyuki; Haginoya, Kazuhiro

    2013-04-01

    We describe a boy, 3 years and 6 months old, who experienced a rolandic seizure accompanied by a cluster of atypical absence seizures, the EEGs for which corresponded to those of atypical benign partial epilepsy (ABPE). Of note, this patient suffered from developmental delay beginning in infancy and exhibited giant middle-latency somatosensory evoked potentials with action myoclonus. With the exceptions of ethosuximide, acetazolamide, and adrenocorticotropic hormone, which have been reported to be effective in ABPE, the atypical absence seizures were intractable despite extensive treatment with various anticonvulsants. The drugs that were effective led to a remarkable reduction in seizure frequency and EEG improvement, but the efficacy was temporary. The patient demonstrated moderate mental retardation without regression and could not walk with support or speak any meaningful words at the age of 3 years and 6 months. Based on thorough differential diagnosis, although further studies will be necessary, we propose that this boy may present a new phenotype of ABPE: ABPE with action myoclonus. PMID:23280272

  17. Comparative profiles of sodium valproate and ethosuximide on electro-behavioural correlates in gamma-hydroxybutyrate and pentylenetetrazol induced absence seizures in rats.

    PubMed

    Kumaresan, S; David, J; Joseph, T

    2000-10-01

    Sodium valproate (VPA) and ethosuximide (ESM) were compared on behavioural and EEG changes in gamma-hydroxybutyrate (GHB) and pentylenetetrazole (PTZ) rat models of Absence Seizures (AS). Both GHB, 100 mg/kg i.p. and PTZ, 20 mg/kg i.p., produced repetitive episodes of staring and immobility with concomitant 6 to 9 Hz spike and wave discharges (SWDs) in the EEG. The parameters used for drug evaluation were the number and duration of SWDs/hour. Though the number of SWDs/hour produced by GHB and PTZ were not significantly different, the duration of SWDs was significantly longer in GHB treated rats (P < 0.001) VPA and ESM, at 200 mg/kg i.p., reduced SWD number and duration in GHB pretreated rats, whereas ESM, 50 mg/kg i.p., was four times more effective than VPA, 200 mg/kg i.p., in the PTZ model. Phenytoin (PHY) 20 and Carbamazepine (CBZ) 10 mg/kg i.p., worsened AS, a feature which has also been reported clinically. Both rat models of experimental AS can be used to defect potential anti-absence activity in new chemical entities. PMID:11214495

  18. Induction of atypical EAE mediated by transgenic production of IL-6 in astrocytes in the absence of systemic IL-6.

    PubMed

    Giralt, Mercedes; Ramos, Raquel; Quintana, Albert; Ferrer, Beatriz; Erta, Maria; Castro-Freire, Marco; Comes, Gemma; Sanz, Elisenda; Unzeta, Mercedes; Pifarré, Paula; García, Agustina; Campbell, Iain L; Hidalgo, Juan

    2013-04-01

    Interleukin (IL)-6 is crucial for the induction of many murine models of autoimmunity including experimental autoimmune encephalomyelitis (EAE), an animal model of multiple sclerosis. While IL-6-deficient mice (IL-6 KO) are resistant to EAE, we showed previously that in transgenic mice with astrocyte-targeted production of IL-6-restricted to the cerebellum (GFAP-IL6), EAE induced with MOG(35-55) was redirected away from the spinal cord to the cerebellum. To further establish the importance of IL-6 produced in the central nervous system, we have generated mice producing IL-6 essentially only in the brain by crossing the GFAP-IL6 mice with IL-6 KO mice. Interestingly, GFAP-IL6-IL-6 KO mice showed a milder but almost identical phenotype as the GFAP-IL6 mice, which correlated with a lower load of inflammatory cells and decreased microglial reactivity. These results indicate that not only is cerebellar IL-6 production and eventual leakage into the peripheral compartment the dominating factor controlling this type of EAE but that it can also facilitate induction of autoimmunity in the absence of normal systemic IL-6 production. PMID:23322593

  19. Atypical pneumonia

    MedlinePLUS

    Walking pneumonia; Chlamydophila pneumoniae; Community-acquired pneumonia - atypical ... Mycoplasma pneumonia is a type of atypical pneumonia. It is caused by the bacteria M. pneumoniae . It typically affects ...

  20. Febrile Seizures

    MedlinePLUS

    ... term impact that febrile seizures might have on intelligence, behavior, school achievement, and the development of epilepsy. ... and especially very long seizures, on measures of intelligence and on the development of epilepsy. In particular ...

  1. Atypical Fibroxanthoma

    PubMed Central

    Sakamoto, Akio

    2008-01-01

    Atypical fibroxanthoma (AFX) is a nodular dermal ulcerative lesion with a favorable prognosis. AFX most commonly occurs on sun-exposed skin in elderly individuals. AFX is characterized by its association with ultraviolet radiation, not only from a clinical aspect, but also from a molecular aspect. Making a diagnosis of AFX is challenging, and it is important to differentiate it from squamous cell carcinoma and malignant melanoma. Histological features and combined immunohistochemical markers are necessary for a definitive diagnosis (i.e., an absence of immunostaining for cytokeratins, S100 and HMB45 in AFX is helpful for excluding both squamous cell carcinoma and malignant melanoma). AFX, as well as MFH (malignant fibrous histiocytoma), is a fibrohistiocytic lesion with myofibroblastic differentiation. AFX is considered to be a different lesion from MFH. AFX and MFH might share the same pathway which determines their morphology. However, they may have different pathways in development which determine their biological behavior. PMID:21892274

  2. Neuron, Vol. 31, 37, July 19, 2001, Copyright 2001 by Cell Press absence-like seizures in GAERS rats, while antagonistsIt Takes T to Tango

    E-print Network

    Huguenard, John R.

    and relay zures and spindle oscillations, which occur normallycell bursting in absences. during slow-wave). In the feline penicillin model, spike-wave activity requires both cortical and thalamic structures

  3. Seizure termination.

    PubMed

    Zubler, Frédéric; Steimer, Andreas; Gast, Heidemarie; Schindler, Kaspar A

    2014-01-01

    A better understanding of the mechanisms by which most focal epileptic seizures stop spontaneously within a few minutes would be of highest importance, because they could potentially help to improve existing and develop novel therapeutic measures for seizure control. Studies devoted to unraveling mechanisms of seizure termination often take one of the two following approaches. The first approach focuses on metabolic mechanisms such as ionic concentrations, acidity, or neuromodulator release, studying how they are dependent on, and in turn affect changes of neuronal activity. The second approach uses quantitative tools to derive functional networks from electrophysiological recordings and analyzes these networks with mathematical methods, without focusing on actual details of cell biology. In this chapter, we summarize key results obtained by both of these approaches and attempt to show that they are complementary and equally necessary in our aim to gain a better understanding of seizure termination. PMID:25078503

  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. Ezogabine treatment of childhood absence epilepsy.

    PubMed

    Vossler, David G; Yilmaz, Ugur

    2014-03-01

    Generalised-onset absence seizures can be resistant to treatment with currently available antiepileptic drugs. Ezogabine (retigabine), a potassium channel opener, is approved for the treatment of focal-onset seizures. This is a case report of an adult with childhood absence epilepsy whose daily absence seizures ceased with adjunctive ezogabine. A 59-year-old woman, with a history of typical absence seizures since the age of 6 years, had multiple seizures daily despite trials of over 11 antiepileptic drugs. While taking lamotrigine and zonisamide, ezogabine at 50 mg daily was added. The dose was slowly increased and once a total dose of only 200 mg/day was reached, she became seizure-free for three months. After subsequently discontinuing zonisamide, absence seizures returned. Further increasing the ezogabine to 400 mg/day, in addition to lamotrigine, did not restore seizure freedom, but adding back zonisamide at half dose again reduced their frequency. Ezogabine at low dose, added to lamotrigine and zonisamide, led to sustained absence seizure freedom. The return of seizures after zonisamide discontinuation suggests that the seizure freedom may have been the result of the different mechanisms of action of the antiepileptic drugs. PMID:24659629

  6. Atypical craniocerebral eumycetoma: A case report and review of literature

    PubMed Central

    Rao, Kommu Venkateswara; Praveen, Ankathi; Megha, Santhavir; Sundaram, Challa; Purohith, Anirudh Kumar

    2015-01-01

    Craniocerebral eumycetomas are rare. They usually present with scalp swelling and discharging sinuses. Radiologically, they present as space-occupying lesions. We report a case of eumycetoma involving the left parietal cortex, bone, and subcutaneous tissue in a young male, farm laborer, who presented with seizures and blurring of vision. Imaging showed a dural based lesions enhancing moderately on contrast. To the best of our knowledge and belief, ours is the first published case in the English Literature where a eumycetoma has presented as a mass lesion without discharging sinuses. It is imperative to keep such atypical features of an infective etiology in mind because they may be one of differentials of “dural” based lesions where only a biopsy may suffice in the absence of significant mass effect to prove the diagnosis.

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

    PubMed

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

    2013-08-14

    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

  8. Controlling Seizures

    ERIC Educational Resources Information Center

    Henderson, Nancy

    2008-01-01

    This article describes how an implantable device could greatly improve the quality of life for people with epilepsy. Gabe Anderson was diagnosed with bilateral heterotopia, a congenital condition that can lead to the onset of complex partial seizures stemming from both hemispheres of the brain. In early 2004, Gabe became one of the first 35…

  9. 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

  10. Atypical ulcers.

    PubMed

    Hoffman, Mark D

    2013-01-01

    Atypical ulcers of the skin challenge the dermatologist with respect to recognition, diagnosis, management, and treatment. The entire gamut of pathogenic categories including vascular, inflammatory, neoplastic, genetic, medication-related, and infectious processes may give rise to atypical ulcers. By definition, these ulcers are unusual, and accurate diagnosis may ultimately require the clinician to violate the dictum that "common things are common." Atypical ulcers may present with features that the clinician has not previously encountered, or may present with seemingly typical features that actually mislead due to phenotypic mimicry. Because skin ulcers are inherently tissue-destructive, and may reflect an underlying systemic disease process, there is heightened urgency to achieving an accurate diagnosis and initiating appropriate therapy. PMID:23742283

  11. Positron emission tomography in generalized seizures

    SciTech Connect

    Theodore, W.H.; Brooks, R.; Margolin, R.; Patronas, N.; Sato, S.; Porter, R.J.; Mansi, L.; Bairamian, D.; DiChiro, G.

    1985-05-01

    The authors used /sup 18/F-fluorodeoxyglucose (FDG) positron emission tomography (PET) to study nine patients with clinical absence or generalized seizures. One patient had only absence seizures, two had only generalized tonic-clonic seizures, and six had both seizure types. Interictal scans in eight failed to reveal focal or lateralized hypometabolism. No apparent abnormalities were noted. Two patients had PET scans after isotope injection during hyperventilation-induced generalized spike-wave discharges. Diffusely increased metabolic rates were found in one compared with an interictal scan, and in another compared with control values. Another patient had FDG injected during absence status: EEG showed generalized spike-wave discharges (during which she was unresponsive) intermixed with slow activity accompanied by confusion. Metabolic rates were decreased, compared with the interictal scan, throughout both cortical and subcortical structures. Interictal PET did not detect specific anatomic regions responsible for absence seizure onset in any patient, but the results of the ictal scans did suggest that pathophysiologic differences exist between absence status and single absence attacks.

  12. Seizures and Teens: Stress, Sleep, & Seizures

    ERIC Educational Resources Information Center

    Shafer, Patricia Osborne

    2007-01-01

    Most parents are used to erratic sleep patterns and mood swings in their teenagers. When these occur in an adolescent with seizures, however, the parent may wonder if sleep and mood problems are related to seizures. Sorting out the cause and effects of sleep in an adolescent with seizures can be confusing. Since stress can be a contributor to both…

  13. Atypical fibroxanthoma†.

    PubMed

    Zogbi, Luciano; Juliano, Camila; Neutzling, Aluísio

    2015-01-01

    Atypical fibroxanthoma (AFX) is a rare skin neoplasm of low-grade malignancy and fibroblastic origin. AFX is a curable cutaneous disease and the diagnosis depends on knowledge of its clinical and histological features and combined immunohistochemistry markers. This study presents a case of a male patient, aged 90 years, presented with painless skin lesion in his ear. The lesion had been growing progressively for 2 months, measured ?1.5 cm, ulcerated, fixed and firm. After a biopsy, the patient underwent a complete resection with adequate surgical margins and showed favorable evolution without complications or recurrence. The histopathological evaluation showed a poorly circumscribed ulcerated dermal nodule, mesenchymal proliferation, with pleomorphic spindle cells. There was infiltration of the deep dermis and subcutis, showing malignant features, but there was no invasion of cartilage. The immunohistochemical analysis confirmed the diagnosis of AFX. PMID:25742967

  14. Atypical fibroxanthoma†

    PubMed Central

    Zogbi, Luciano; Juliano, Camila; Neutzling, Aluísio

    2015-01-01

    Atypical fibroxanthoma (AFX) is a rare skin neoplasm of low-grade malignancy and fibroblastic origin. AFX is a curable cutaneous disease and the diagnosis depends on knowledge of its clinical and histological features and combined immunohistochemistry markers. This study presents a case of a male patient, aged 90 years, presented with painless skin lesion in his ear. The lesion had been growing progressively for 2 months, measured ?1.5 cm, ulcerated, fixed and firm. After a biopsy, the patient underwent a complete resection with adequate surgical margins and showed favorable evolution without complications or recurrence. The histopathological evaluation showed a poorly circumscribed ulcerated dermal nodule, mesenchymal proliferation, with pleomorphic spindle cells. There was infiltration of the deep dermis and subcutis, showing malignant features, but there was no invasion of cartilage. The immunohistochemical analysis confirmed the diagnosis of AFX.

  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. 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

  17. 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

  18. A unifying explanation of primary generalized seizures through nonlinear brain modeling and bifurcation analysis

    E-print Network

    periodic spike and slow-wave shape which slows only slightly during the seizure but does not significantly predictions with regards to seizure phenomena. We show that mapping the structure of the nonlinear bifurcation, absence seizures have a brief on-off quality, similar pre- and post-ictal EEG and a well structured

  19. Generalized tonic-clonic seizure

    MedlinePLUS

    ... tonic-clonic seizures have vision, taste, smell, or sensory changes, hallucinations, or dizziness before the seizure. This ... lasts for 1 hour or longer Loss of memory (amnesia) about the seizure episode Headache Weakness of ...

  20. Genes, Seizures & Epilepsy

    ERIC Educational Resources Information Center

    Goldman, Alica M.

    2006-01-01

    The chance that someone will develop any disease is influenced by heredity and environment. Epilepsy is not an exception. Everybody inherits a unique degree of susceptibility to seizures. About 3 percent of the United States population is prone to seizures and will get epilepsy at some point of their lives (1). Two thirds of the people with…

  1. Vagus nerve stimulation: predictors of seizure freedom

    PubMed Central

    Janszky, J; Hoppe, M; Behne, F; Tuxhorn, I; Pannek, H; Ebner, A

    2005-01-01

    Objectives: To identify predictive factors for the seizure-free outcome of vagus nerve stimulation (VNS). Methods: All 47 patients who had undergone VNS implantation at one centre and had at least one year of follow up were studied. They underwent complete presurgical evaluation including detailed clinical history, magnetic resonance imaging, and long term video-EEG with ictal and interictal recordings. After implantation, adjustment of stimulation parameters and concomitant antiepileptic drugs were at the discretion of the treating physician. Results: Mean (SD) age of the patients was 22.7 (11.6) years (range 7 to 53). Six patients (13%) became seizure-free after the VNS implantation. Only two variables showed a significant association with the seizure-free outcome: absence of bilateral interictal epileptiform discharges (IED) and presence of malformation of cortical development (MCD). Epilepsy duration showed a non-significant trend towards a negative association with outcome. By logistic regression analysis, only absence of bilateral IED correlated independently with successful VNS treatment (p<0.01, odds ratio = 29.2 (95% confidence interval, 2.4 to 353)). Bilateral IED (independent or bilateral synchronous) was found in one of six seizure-free patients and in 33 of 41 non-seizure-free patients. When bilateral IED were absent, the sensitivity for seizure-free outcome was 0.83 (0.44 to 0.97), and the specificity was 0.80 (0.66 to 0.90). Conclusions: Bilateral IED was independently associated with the outcome of VNS. These results are preliminary because they were based on a small patient population. They may facilitate prospective VNS studies enrolling larger numbers of patients to confirm the results. PMID:15716532

  2. Prediction of epileptic seizures.

    PubMed

    Litt, Brian; Echauz, Javier

    2002-05-01

    For almost 40 years, neuroscientists thought that epileptic seizures began abruptly, just a few seconds before clinical attacks. There is now mounting evidence that seizures develop minutes to hours before clinical onset. This change in thinking is based on quantitative studies of long digital intracranial electroencephalographic (EEG) recordings from patients being evaluated for epilepsy surgery. Evidence that seizures can be predicted is spread over diverse sources in medical, engineering, and patent publications. Techniques used to forecast seizures include frequency-based methods, statistical analysis of EEG signals, non-linear dynamics (chaos), and intelligent engineered systems. Advances in seizure prediction promise to give rise to implantable devices able to warn of impending seizures and to trigger therapy to prevent clinical epileptic attacks. Treatments such as electrical stimulation or focal drug infusion could be given on demand and might eliminate side-effects in some patients taking antiepileptic drugs long term. Whether closed-loop seizure-prediction and treatment devices will have the profound clinical effect of their cardiological predecessors will depend on our ability to perfect these techniques. Their clinical efficacy must be validated in large-scale, prospective, controlled trials. PMID:12849542

  3. Plasticity-modulated seizure dynamics for seizure termination in realistic neuronal models.

    PubMed

    Koppert, M M J; Kalitzin, S; Lopes da Silva, F H; Viergever, M A

    2011-08-01

    In previous studies we showed that autonomous absence seizure generation and termination can be explained by realistic neuronal models eliciting bi-stable dynamics. In these models epileptic seizures are triggered either by external stimuli (reflex epilepsies) or by internal fluctuations. This scenario predicts exponential distributions of the duration of the seizures and of the inter-ictal intervals. These predictions were validated in rat models of absence epilepsy, as well as in a few human cases. Nonetheless, deviations from the predictions with respect to seizure duration distributions remained unexplained. The objective of the present work is to implement a simple but realistic computational model of a neuronal network including synaptic plasticity and ionic current dynamics and to explore the dynamics of the model with special emphasis on the distributions of seizure and inter-ictal period durations. We use as a basis our lumped model of cortical neuronal circuits. Here we introduce 'activity dependent' parameters, namely post-synaptic voltage-dependent plasticity, as well as a voltage-dependent hyperpolarization-activated current driven by slow and fast activation conductances. We examine the distributions of the durations of the seizure-like model activity and the normal activity, described respectively by the limit cycle and the steady state in the dynamics. We use a parametric ?-distribution fit as a quantifier. Our results show that autonomous, activity-dependent membrane processes can account for experimentally obtained statistical distributions of seizure durations, which were not explainable using the previous model. The activity-dependent membrane processes that display the strongest effect in accounting for these distributions are the hyperpolarization-dependent cationic (I(h)) current and the GABAa plastic dynamics. Plastic synapses (NMDA-type) in the interneuron population show only a minor effect. The inter-ictal statistics retain their consistency with the experimental data and the previous model. PMID:21730748

  4. Plasticity-modulated seizure dynamics for seizure termination in realistic neuronal models

    NASA Astrophysics Data System (ADS)

    Koppert, M. M. J.; Kalitzin, S.; Lopes da Silva, F. H.; Viergever, M. A.

    2011-08-01

    In previous studies we showed that autonomous absence seizure generation and termination can be explained by realistic neuronal models eliciting bi-stable dynamics. In these models epileptic seizures are triggered either by external stimuli (reflex epilepsies) or by internal fluctuations. This scenario predicts exponential distributions of the duration of the seizures and of the inter-ictal intervals. These predictions were validated in rat models of absence epilepsy, as well as in a few human cases. Nonetheless, deviations from the predictions with respect to seizure duration distributions remained unexplained. The objective of the present work is to implement a simple but realistic computational model of a neuronal network including synaptic plasticity and ionic current dynamics and to explore the dynamics of the model with special emphasis on the distributions of seizure and inter-ictal period durations. We use as a basis our lumped model of cortical neuronal circuits. Here we introduce 'activity dependent' parameters, namely post-synaptic voltage-dependent plasticity, as well as a voltage-dependent hyperpolarization-activated current driven by slow and fast activation conductances. We examine the distributions of the durations of the seizure-like model activity and the normal activity, described respectively by the limit cycle and the steady state in the dynamics. We use a parametric ?-distribution fit as a quantifier. Our results show that autonomous, activity-dependent membrane processes can account for experimentally obtained statistical distributions of seizure durations, which were not explainable using the previous model. The activity-dependent membrane processes that display the strongest effect in accounting for these distributions are the hyperpolarization-dependent cationic (Ih) current and the GABAa plastic dynamics. Plastic synapses (NMDA-type) in the interneuron population show only a minor effect. The inter-ictal statistics retain their consistency with the experimental data and the previous model.

  5. Seizure and encephalopathy associated with thyroid storm in children.

    PubMed

    Lee, Hae Sang; Hwang, Jin Soon

    2011-04-01

    Thyroid storm with seizures is very rare in children. The authors report 3 children with thyroid storm who had a seizure in the absence of a history of neurologic disease. Acute medical management with propylthiouracil, Lugol's iodine solution, hydrocortisone, and propranolol led to a complete resolution of the symptoms. Patients with thyroid storm may be predisposed to the development of neuropsychiatric change. Early recognition and treatment of thyroid storm are essential to reduce morbidity and mortality from this disorder. PMID:21325127

  6. Genetics Home Reference: Seizures

    MedlinePLUS

    ... U.S. National Library of Medicine® Home Conditions Genes Chromosomes Handbook Glossary Resources Conditions > Seizures Related topics on Genetics Home Reference: 15q13.3 microdeletion Alpers-Huttenlocher syndrome aminoacylase 1 deficiency aspartylglucosaminuria ...

  7. Characterization of Atypical Language Activation Patterns in Focal Epilepsy

    PubMed Central

    Berl, Madison M.; Zimmaro, Lauren A.; Khan, Omar I.; Dustin, Irene; Ritzl, Eva; Duke, Elizabeth S.; Sepeta, Leigh N.; Sato, Susumu; Theodore, William H.; Gaillard, William D.

    2014-01-01

    Objective Functional magnetic resonance imaging is sensitive to the variation in language network patterns. Large populations are needed to rigorously assess atypical patterns, which, even in neurological populations, are a minority. Methods We studied 220 patients with focal epilepsy and 118 healthy volunteers who performed an auditory description decision task. We compared a data-driven hierarchical clustering approach to the commonly used a priori laterality index (LI) threshold (LI < 0.20 as atypical) to classify language patterns within frontal and temporal regions of interest. We explored (n = 128) whether IQ varied with different language activation patterns. Results The rate of atypical language among healthy volunteers (2.5%) and patients (24.5%) agreed with previous studies; however, we found 6 patterns of atypical language: a symmetrically bilateral, 2 unilaterally crossed, and 3 right dominant patterns. There was high agreement between classification methods, yet the cluster analysis revealed novel correlations with clinical features. Beyond the established association of left-handedness, early seizure onset, and vascular pathology with atypical language, cluster analysis identified an association of handedness with frontal lateralization, early seizure onset with temporal lateralization, and left hemisphere focus with a unilateral right pattern. Intelligence quotient was not significantly different among patterns. Interpretation Language dominance is a continuum; however, our results demonstrate meaningful thresholds in classifying laterality. Atypical language patterns are less frequent but more variable than typical language patterns, posing challenges for accurate presurgical planning. Language dominance should be assessed on a regional rather than hemispheric basis, and clinical characteristics should inform evaluation of atypical language dominance. Reorganization of language is not uniformly detrimental to language functioning. PMID:24038442

  8. Atypical clinical and electroencephalographic pattern in a patient with subacute sclerosing panencephalitis.

    PubMed

    Silva, D F; Lima, M M; Anghinah, R; Zanoteli, E; Lima, J G

    1995-06-01

    We describe an atypical clinical and electroencephalographic (EEG) pattern observed during the course of subacute sclerosing panencephalitis in a 14 year-old boy. In this patient with a two weeks history of partial complex seizures, the atypical EEG pattern was characterized by an initial left temporal focus which evolved to periodic lateralized epileptiform discharges (PLEDs) and, only during the 3rd and 4th weeks the typical bilateral and generalized periodic complexes appeared. PMID:7487538

  9. The Current State of Absence Epilepsy: Can We Have Your Attention?

    PubMed Central

    Tenney, Jeffrey R.; Glauser, Tracy A.

    2013-01-01

    Absence seizures are common within many different epilepsies and span all the ages. Even though absence seizures were described more than three centuries ago advances associated with its classification, pathophysiology, genetics, treatment, prognosis, and associated co-morbidities continue to be made. PMID:23840175

  10. 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…

  11. 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.

  12. 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

  13. 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

  14. Sickness absence.

    PubMed

    2014-10-30

    NHS Employers has launched a free online tool to improve the management of staff sick leave in the NHS. The tool is designed to help managers adopt a confident and consistent approach, and provides step-by-step information about what to do when staff call in sick, practical advice on some of the common reasons for sickness absence, and information on what to do if staff are off sick frequently or are on long-term sick leave. It also has information about managing return to work and how to prevent sickness absence. Visit the microsite at www.nhsemployers.org/sickness. PMID:25355120

  15. 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

  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. Clozapine-Related EEG Changes and Seizures: Dose and Plasma-Level Relationships

    PubMed Central

    Varma, Seema; Bishara, Delia; Besag, Frank M. C.; Taylor, David

    2011-01-01

    Clozapine is a widely used atypical antipsychotic with a unique effectiveness in treatment-resistant schizophrenia. An important adverse effect is seizures, which have been observed at all stages of clozapine treatment. Valproate has traditionally been considered the drug of choice for the prophylaxis of clozapine seizures, however it may not be the most suitable choice for all patients. There is disagreement as to the best point to prescribe valproate or a suitable antiepileptic: as seizure prophylaxis at a certain clozapine dose or level, or only as remedial treatment. In this review, we examine the relevant literature with an aim to evaluate the following relationships: clozapine dose and electroencephalogram (EEG) abnormalities, plasma levels and EEG abnormalities, dose and occurrence of seizures and plasma levels and occurrence of seizures. Weighted linear regression models were fitted to investigate these relationships. There was a strong relationship between clozapine dose and plasma level and occurrence of clozapine-induced EEG abnormalities. However, a statistically significant relationship between dose and occurrence of seizures was not found. A relationship between clozapine plasma level and occurrence of seizures was not established because of the scarcity of useful data although our review found three case reports which suggested that there is a very substantial risk of seizures with clozapine plasma levels exceeding 1300 ?g/l. Seizures are more common during the initiation phase of clozapine treatment, suggesting a slow titration to target plasma levels is desirable. An antiepileptic drug should be considered when the clozapine plasma level exceeds 500 ?g/l, if the EEG shows clear epileptiform discharges, if seizures, myoclonic jerks or speech difficulties occur and when there is concurrent use of epileptogenic medication. The antiepileptics of choice for the treatment and prophylaxis of clozapine-induced seizures are valproate (particularly where there is mood disturbance) and lamotrigine (where there is resistance to clozapine). PMID:23983927

  18. High-Frequency Oscillations and Seizure Generation in Neocortical Epilepsy

    ERIC Educational Resources Information Center

    Worrell, Greg A.; Parish, Landi; Cranstoun, Stephen D.; Jonas, Rachel; Baltuch, Gordon; Litt, Brian

    2004-01-01

    Neocortical seizures are often poorly localized, explosive and widespread at onset, making them poorly amenable to epilepsy surgery in the absence of associated focal brain lesions. We describe, for the first time in an unselected group of patients with neocortical epilepsy, the finding that high-frequency (60--100 Hz) epileptiform oscillations…

  19. Chemical–genetic attenuation of focal neocortical seizures

    PubMed Central

    Kätzel, Dennis; Nicholson, Elizabeth; Schorge, Stephanie; Walker, Matthew C.; Kullmann, Dimitri M.

    2014-01-01

    Focal epilepsy is commonly pharmacoresistant, and resective surgery is often contraindicated by proximity to eloquent cortex. Many patients have no effective treatment options. Gene therapy allows cell-type specific inhibition of neuronal excitability, but on-demand seizure suppression has only been achieved with optogenetics, which requires invasive light delivery. Here we test a combined chemical–genetic approach to achieve localized suppression of neuronal excitability in a seizure focus, using viral expression of the modified muscarinic receptor hM4Di. hM4Di has no effect in the absence of its selective, normally inactive and orally bioavailable agonist clozapine-N-oxide (CNO). Systemic administration of CNO suppresses focal seizures evoked by two different chemoconvulsants, pilocarpine and picrotoxin. CNO also has a robust anti-seizure effect in a chronic model of focal neocortical epilepsy. Chemical–genetic seizure attenuation holds promise as a novel approach to treat intractable focal epilepsy while minimizing disruption of normal circuit function in untransduced brain regions or in the absence of the specific ligand. PMID:24866701

  20. Inflammatory pathways of seizure disorders

    PubMed Central

    Marchi, Nicola; Granata, Tiziana; Janigro, Damir

    2014-01-01

    Epilepsy refers to a cluster of neurological disease characterized by seizures. While many forms of epilepsy have a well-defined immune etiology, in other forms of epilepsy an altered immune response is only suspected. In general, the hypothesis that inflammation contributes to seizures is supported by experimental results. Additionally, antiepileptic maneuvers may act as immunomodulators and anti-inflammatory therapies can treat seizures. Triggers of seizure include a bidirectional communication between the nervous system and organs of immunity. Thus, a crucial cellular interface protecting from immunological seizures is the blood-brain barrier. Here, we summarize recent advances in the understanding and treatment of epileptic seizures which derive from a non-neurocentric viewpoint and suggest key avenues for future research. PMID:24355813

  1. Atypical Hemolytic Uremic Syndrome

    PubMed Central

    Kavanagh, David; Goodship, Tim H.; Richards, Anna

    2013-01-01

    Summary Hemolytic uremic syndrome (HUS) is a triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. The atypical form of HUS is a disease characterized by complement overactivation. Inherited defects in complement genes and acquired autoantibodies against complement regulatory proteins have been described. Incomplete penetrance of mutations in all predisposing genes is reported, suggesting that a precipitating event or trigger is required to unmask the complement regulatory deficiency. The underlying genetic defect predicts the prognosis both in native kidneys and after renal transplantation. The successful trials of the complement inhibitor eculizumab in the treatment of atypical HUS will revolutionize disease management. PMID:24161037

  2. Subacute Sclerosing Panencephalitis in a Child with Recurrent Febrile Seizures

    PubMed Central

    Kartal, Ay?e; Ç?tak Kurt, Ay?egül Ne?e; Hirfano?lu, Tu?ba; Ayd?n, Kür?ad; Serdaro?lu, Ay?e

    2015-01-01

    Subacute sclerosing panencephalitis (SSPE) is a devastating disease of the central nervous system (CNS) caused by persistent mutant measles virus infection. The diagnosis of SSPE is based on characteristic clinical and EEG findings and demonstration of elevated antibody titres against measles in cerebrospinal fluid. Subacute sclerosing panencephalitis can have atypical clinical features at the onset. Herein, we report an unusual case of subacute sclerosing panencephalitis in a child with recurrent febrile seizures. The disease progressed with an appearance of myoclonic jerks, periodic high amplitude generalized complexes on EEG, and elevated titers of measles antibodies in cerebrospinal fluid leading to the final diagnosis of subacute sclerosing panencephalitis.

  3. Seizure outcomes after resective surgery for extra-temporal lobe epilepsy in pediatric patients.

    PubMed

    Englot, Dario J; Breshears, Jonathan D; Sun, Peter P; Chang, Edward F; Auguste, Kurtis I

    2013-08-01

    While temporal lobe epilepsy (TLE) is the most common epilepsy syndrome in adults, seizures in children are more often extratemporal in origin. Extra-temporal lobe epilepsy (ETLE) in pediatric patients is often medically refractory, leading to significantly diminished quality of life. Seizure outcomes after resective surgery for pediatric ETLE vary tremendously in the literature, given diverse patient and epilepsy characteristics and small sample sizes. The authors performed a systematic review and meta-analysis of studies including 10 or more pediatric patients (age ? 19 years) published over the last 20 years examining seizure outcomes after resective surgery for ETLE, excluding hemispherectomy. Thirty-six studies were examined. These 36 studies included 1259 pediatric patients who underwent resective surgery for ETLE. Seizure freedom (Engel Class I outcome) was achieved in 704 (56%) of these 1259 patients postoperatively, and 555 patients (44%) continued to have seizures (Engel Class II-IV outcome). Shorter epilepsy duration (? 7 years, the median value in this study) was more predictive of seizure freedom than longer (> 7 years) seizure history (odds ratio [OR] 1.52, 95% confidence interval [CI] 1.07-2.14), suggesting that earlier intervention may be beneficial. Also, lesional epilepsy was associated with better seizure outcomes than nonlesional epilepsy (OR 1.34, 95% CI 1.19-1.49). Other predictors of seizure freedom included an absence of generalized seizures (OR 1.61, 95% CI 1.18-2.35) and localizing ictal electroencephalographic findings (OR 1.55, 95% CI 1.24-1.93). In conclusion, seizure outcomes after resective surgery for pediatric ETLE are less favorable than those associated with temporal lobectomy, but seizure freedom may be more common with earlier intervention and lesional epilepsy etiology. Children with continued debilitating seizures despite failure of multiple medication trials should be referred to a comprehensive pediatric epilepsy center for further medical and surgical evaluation. PMID:23768201

  4. Brain Tumors and ICU Seizures

    Microsoft Academic Search

    Efstathios Papavassiliou; Panayiotis Varelas

    \\u000a Seizures are a common presentation of brain neoplasms. Both primary brain tumors and metastases can present with seizures,\\u000a which are more commonly focal depending on the location and the pathology of the lesion. In general, more benign tumors have\\u000a higher incidence of seizures than more malignant ones. These patients are admitted to an intensive care unit (ICU) either\\u000a for preoperative

  5. Febrile Seizures and Epilepsy: Possible Outcomes

    MedlinePLUS

    ... more complex features. WHAT IS THE CONNECTION BETWEEN FE- BRILE SEIZURES AND LATER DEVELOPMENT OF EPILEPSY? Overall, ... more febrile seizures. WHAT IS THE CONNECTION BETWEEN FE- BRILE SEIZURES AND LATER DEVELOPMENT OF SPECIFIC TYPES ...

  6. Analyzing autonomic activity in neonatal seizures

    E-print Network

    Ramaswamy, Priya, M. Eng. Massachusetts Institute of Technology

    2011-01-01

    Recent studies suggest that seizures in the newborn occur more often than previously appreciated. The effect of neonatal seizures remain unclear, however. Do seizures in the newborn cause brain injury, are they a consequence ...

  7. Palatal atypical histiocytic granuloma

    Microsoft Academic Search

    Eugenia Alonso-Alejandro; Jose-Luis Gutierrez-Perez; Daniel Torres-Lagares

    A clinical entity called atypical histiocytic granuloma (AHG), consists of ulceroproliferative lesions which clinically simulate a squamous cell carcinoma or with specific granulomatous lesions, and which histologically show a histiocytic proliferation and with specific mitotic activity, which could be confused with malignant processes of lymphoid origin. There are few cases reported in the literature and an adequate knowledge of the

  8. Atypical Charles Bonnet Syndrome

    PubMed Central

    Arun, Priti; Jain, Rajan; Tripathi, Vaibhav

    2013-01-01

    Charles Bonnet syndrome (CBS) is not uncommon disorder. It may not present with all typical symptoms and intact insight. Here, a case of atypical CBS is reported where antipsychotics were not effective. Patient improved completely after restoration of vision. PMID:24379505

  9. Seizures and Teens: Using Technology to Develop Seizure Preparedness

    ERIC Educational Resources Information Center

    Shafer, Patricia O.; Schachter, Steven C.

    2007-01-01

    Most people learn about seizures from their doctors, but others know only what they have seen on television. Unfortunately, visits to doctor's office aren't long enough to learn all that is needed, and often times, doctors and nurses aren't available to teach this information. Seizures are often represented inaccurately and too dramatically on…

  10. Seizures and Teens: The Practical Aspects of Managing Seizure Medications

    ERIC Educational Resources Information Center

    Shafer, Patricia Osborne; Israel, Beth

    2007-01-01

    Medications are the primary treatment for epilepsy, yet many teens and their families have problems managing seizure medicines. Fear of side effects, difficulties remembering to take medicines and figuring out how to take them are common challenges. Unfortunately, not taking medicine as prescribed can lead to breakthrough seizures, which in turn…

  11. 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.

  12. 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

  13. Neonatal Cocaine-Related Seizures

    Microsoft Academic Search

    Lynn D. Kramer; George E. Locke; Abayomi Ogunyemi; Lowell Nelson

    1990-01-01

    Cocaine abuse is associated with a variety of severe acute neurologic complications typically occurring in the abusers themselves. These include ischemic stroke, subarachnoid and intraparenchymal hemorrhage, headaches, syncope, seizures, and death. Sixteen pediatric patients with presumed cocaine-related seizures secondary to maternal consumption are reported. They were evaluated only because of requests for neurologic consultation. All were seen during the 1987

  14. Asystole following complex partial seizures.

    PubMed

    Stokes, Michael B; Palmer, Sonny; Moneghetti, Kegan J; Mariani, Justin A; Wilson, Andrew M

    2013-02-01

    A case is presented of a patient with a long history of epilepsy who presents with recurrent seizures and develops a period of asystole. The case highlights the need to consider the potential arrhythmic complications of seizures and the clinical characteristics that may be present in those with epilepsy that may warrant evaluation for arrhythmias. PMID:22877730

  15. 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

  16. 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

  17. 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

  18. Ameliorating effects of aripiprazole on cognitive functions and depressive-like behavior in a genetic rat model of absence epilepsy and mild-depression comorbidity.

    PubMed

    Russo, Emilio; Citraro, Rita; Davoli, Alessandro; Gallelli, Luca; Di Paola, Eugenio Donato; De Sarro, Giovambattista

    2013-01-01

    Aripiprazole (APZ) is regarded as a first-line atypical antipsychotic used for the treatment of first and multiple episodes of schizophrenia to improve positive- and negative-symptoms. Its therapeutic indications were extended to acute manic and mixed episodes associated with bipolar disorder. In addition, APZ was approved as an adjunct therapy for major depressive disorder in 2007. Compared to other antipsychotic drugs, APZ has a unique pharmacological profile. It is a partial agonist at D? dopamine receptors and serotonin 5-HT(1A) and 5-HT? receptors, whereas it is an antagonist at serotonin 5-HT(2A) and 5-HT? receptors. Since epilepsy is often accompanied with neurological comorbidities such as depression, anxiety and cognitive deficits caused by both the disease and/or drug treatment, we wished to examine the effects of a sub-chronic treatment (>14 consecutive days) with APZ (0.3, 1 and 3 mg/kg; i.p.) on both absence seizures and WAG/Rij rat's behavior using different standard paradigms: Open field (OF) test, elevated plus maze (EPM) test, forced swimming (FS) test, sucrose consumption (SC) test and Morris water maze (MWM). WAG/Rij rats represent a validated genetic animal model of absence epilepsy with mild-depression comorbidity, also including other behavioral alterations. APZ treatment showed some anti-absence properties and regarding the behavioral comorbidity in this rat strain, we observed that APZ possesses clear antidepressant effects in the FS and SC tests also increasing memory/learning function in the Morris water maze test. In the two anxiety models used, APZ showed only minor effects. In conclusion, our results indicate that APZ might actually have a potential in treating absence seizures or as add-on therapy but more interestingly, these effect might be accompanied by positive modulatory actions on depression, anxiety and memory which might be also beneficial in other epileptic syndromes. This article is part of a Special Issue entitled 'Cognitive Enhancers'. PMID:22766393

  19. First seizure: EEG and neuroimaging following an epileptic seizure.

    PubMed

    Pohlmann-Eden, Bernd; Newton, Mark

    2008-01-01

    An early EEG (within 48 h) and high-resolution magnetic resonance imaging (hr_MRI) are the methods of choice for an accurate diagnosis after a first seizure presentation. Together with a careful history and examination, they will allow definition of the epilepsy syndrome in two-thirds of patients and help assess the individual risk for seizure recurrence, which is determined by the specific syndrome and is highest with focal epileptiform activity on EEG. Despite the heterogeneity of first seizure studies, EEG and etiology are consistently found to be the best predictors for seizure recurrence and prognosis. The additional yield of sleep-deprived EEG and sleep EEG is uncertain; yet MRI is essential for detecting brain tumors and other structural bases for new epilepsy. The rate occurrence of remote symptomatic seizures increases significantly with age and the most common etiology in the elderly with a first seizure is stroke; however, its exact relevance to epileptogenicity is yet to be defined. There is a striking lack of systematic studies using early EEG and hr_MRI in order to better characterize epileptogenic areas and elucidate the mechanisms of seizure provocation. PMID:18184150

  20. Bupropion seizure proportion among new-onset generalized seizures and drug related seizures presenting to an emergency department

    Microsoft Academic Search

    Gene R Pesola; Jagannadha Avasarala

    2002-01-01

    Bupropion is a relatively new and popular medication with seizures as its major side effect. This drug can produce seizures with an overdose. The purpose of this investigation was to determine the relative importance of this medication as the etiology of new-onset seizures relative to other drugs and new-onset seizures in general. The study design was a retrospective case series.

  1. [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

  2. What is a seizure focus?

    PubMed

    Nadler, J Victor; Spencer, Dennis D

    2014-01-01

    The seizure focus is the site in the brain from which the seizure originated and is most likely equivalent to the epileptogenic zone, defined as the area of cerebral cortex indispensable for the generation of clinical seizures. The boundaries of this region cannot be defined at present by any diagnostic test. Imaging and EEG recording can define regions of functional deficit during the interictal period, regions that generate interictal spikes, regions responsible for the ictal symptoms, regions from which the seizure is triggered, and regions of structural damage. However, these regions define the epileptogenic zone only when they are spatially concordant. The frequent discrepancies suggest the essential involvement of synaptically connected regions, that is a distributive focus, in the origination of most seizures. Here we review supporting evidence from animal studies and studies of persons undergoing surgical resection for medically-intractable epilepsy. We conclude that very few of the common seizures are truly local, but rather depend on nodal interactions that permit spontaneous network excitability and behavioral expression. Recognition of the distributive focus underlying most seizures has motivated many surgical programs to upgrade their intracranial studies to capture activity in as much of the network as possible. PMID:25012366

  3. Redistribution of GABAB(1) protein and atypical GABAB responses in GABAB(2)-deficient mice.

    PubMed

    Gassmann, Martin; Shaban, Hamdy; Vigot, Réjan; Sansig, Gilles; Haller, Corinne; Barbieri, Samuel; Humeau, Yann; Schuler, Valérie; Müller, Matthias; Kinzel, Bernd; Klebs, Klaus; Schmutz, Markus; Froestl, Wolfgang; Heid, Jakob; Kelly, Peter H; Gentry, Clive; Jaton, Anne-Lise; Van der Putten, Herman; Mombereau, Cédric; Lecourtier, Lucas; Mosbacher, Johannes; Cryan, John F; Fritschy, Jean-Marc; Lüthi, Andreas; Kaupmann, Klemens; Bettler, Bernhard

    2004-07-01

    GABAB receptors mediate slow synaptic inhibition in the nervous system. In transfected cells, functional GABAB receptors are usually only observed after coexpression of GABAB(1) and GABAB(2) subunits, which established the concept of heteromerization for G-protein-coupled receptors. In the heteromeric receptor, GABAB(1) is responsible for binding of GABA, whereas GABAB(2) is necessary for surface trafficking and G-protein coupling. Consistent with these in vitro observations, the GABAB(1) subunit is also essential for all GABAB signaling in vivo. Mice lacking the GABAB(1) subunit do not exhibit detectable electrophysiological, biochemical, or behavioral responses to GABAB agonists. However, GABAB(1) exhibits a broader cellular expression pattern than GABAB(2), suggesting that GABAB(1) could be functional in the absence of GABAB(2). We now generated GABAB(2)-deficient mice to analyze whether GABAB(1) has the potential to signal without GABAB(2) in neurons. We show that GABAB(2)-/- mice suffer from spontaneous seizures, hyperalgesia, hyperlocomotor activity, and severe memory impairment, analogous to GABAB(1)-/- mice. This clearly demonstrates that the lack of heteromeric GABAB(1,2) receptors underlies these phenotypes. To our surprise and in contrast to GABAB(1)-/- mice, we still detect atypical electrophysiological GABAB responses in hippocampal slices of GABAB(2)-/- mice. Furthermore, in the absence of GABAB(2), the GABAB(1) protein relocates from distal neuronal sites to the soma and proximal dendrites. Our data suggest that association of GABAB(2) with GABAB(1) is essential for receptor localization in distal processes but is not absolutely necessary for signaling. It is therefore possible that functional GABAB receptors exist in neurons that naturally lack GABAB(2) subunits. PMID:15240800

  4. A Child's Guide to Seizure Disorders.

    ERIC Educational Resources Information Center

    Epilepsy Foundation of America, Landover, MD.

    Intended for young children suffering from seizure disorders, the booklet explains what a seizure disorder is, encourages the asking of questions, provides a simple explanation of how seizures happen and what effects they have, describes various kinds of seizures, and stresses the importance of taking prescribed medication regularly. Also stressed…

  5. Epileptic Seizures at the Onset of Stroke

    Microsoft Academic Search

    A. Dávalos; E. de Cendra; A. Molins; M. Ferrandiz; S. Lopez-Pousa; D. Genís

    1992-01-01

    Controversies exist concerning the frequency of early epileptic seizures in different types of stroke. The aim of this work was to analyze the incidence of epileptic seizures at the onset of stroke, the factors related to seizures, and the prognosis of such seizures. A total of 1,000 patients included in a prospective data bank of cerebrovascular diseases in Girona were

  6. Atypical odontalgia--an update.

    PubMed

    Patel, Seena B; Boros, Audrey L; Kumar, Satish K S

    2012-09-01

    Atypical odontalgia is a commonly misdiagnosed condition that frequently leads to unnecessary dental treatments such as extraction and endodontic therapy. These treatments often worsen the pain. Despite greater recognition and understanding of this condition, proper diagnosis and treatment remains a challenge. It is believed that atypical odontalgia is a neuropathic condition. This article updates the current understanding of the etiology and pathophysiology of atypical odontalgia, and provides appropriate diagnostic and management approaches for this condition. PMID:23097829

  7. Game-related seizures presenting with two types of clinical features.

    PubMed

    Chuang, Yao-Chung; Chang, Wen-Neng; Lin, Tsu-Kung; Lu, Cheng-Hsien; Chen, Shang-Der; Huang, Chi-Ren

    2006-03-01

    We evaluated 22 patients with epileptic seizures in which the seizures were triggered by various games or game-related materials. Based on whether spontaneous seizure coexisted or not, these 22 patients were divided into two groups. Ten patients who experienced seizures exclusively while playing or watching specific games were referred to as Group I, while 12 patients that had both game-induced and spontaneous seizures were classified as Group II. The patients in Group I had a middle-age onset (39.1 years) with a male predominance (90%). The electroencephalogram (EEG) or brain magnetic resonance imaging revealed non-specific abnormalities in 60%, and the partial onset seizure was recognized in 30% of patients. Antiepileptic drugs had uncertain benefits in this group. In Group II, patients had a male predominance (67%), with onset during adolescence (16.3 years). Most of them had generalized tonic-clonic seizures, myoclonic seizures, and absences, and 42% showed epileptiform discharge on EEG. These 12 patients were categorized into idiopathic generalized epilepsies. Although photosensitivity was an important factor, higher mental activity seemed to be significant precipitants of seizures in Group II. Antiepileptic drugs were necessary and valproic acid alone or combined with clonazepam was effective in this group. The results showed that game-related seizures are not a unique and homogeneous syndrome and may consist of different mechanisms. Teenage onset, coexistent spontaneous seizure, and associated idiopathic generalized epilepsies were crucial factors in the determination of antiepileptic drug therapy. Moreover, avoiding the related games altogether may be a more productive preventive measure. PMID:16406611

  8. [Atypical mycobacteriosis in immunosuppression].

    PubMed

    Schäfer, U; Nilles, M; Schill, W B; Schütterle, G

    1993-02-01

    We report on a 50-year-old patient with bluish swellings on the forearms and hands. These symptoms were accompanied by arthralgia. The patient treated himself with about 120 mg methylprednisolone daily, which initially resulted in only slight improvement. Microbiological investigations from cutaneous abscesses demonstrated an atypical mycobacterium (Mycobacterium chelonae). Occurrence of these bacteria is ubiquitous. In immunodeficient states infections are possible, which may be followed by dissemination of the mycobacteria in traumatic skin lesions. In the patient under discussion, dissemination was probably enhanced by the misuse of steroids. Despite chemotherapy, the patient died, perhaps as a consequence of dissemination. PMID:8449690

  9. 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

  10. Atypical causes of cholestasis

    PubMed Central

    Nguyen, Ken D; Sundaram, Vinay; Ayoub, Walid S

    2014-01-01

    Cholestatic liver disease consists of a variety of disorders. Primary sclerosing cholangitis and primary biliary cirrhosis are the most commonly recognized cholestatic liver disease in the adult population, while biliary atresia and Alagille syndrome are commonly recognized in the pediatric population. In infants, the causes are usually congenital or inherited. Even though jaundice is a hallmark of cholestasis, it is not always seen in adult patients with chronic liver disease. Patients can have “silent” progressive cholestatic liver disease for years prior to development of symptoms such as jaundice and pruritus. In this review, we will discuss some of the atypical causes of cholestatic liver disease such as benign recurrent intrahepatic cholestasis, progressive familial intrahepatic cholestasis, Alagille Syndrome, biliary atresia, total parenteral nutrition induced cholestasis and cholestasis secondary to drug induced liver injury. PMID:25071336

  11. A typically atypical tenosynovitis.

    PubMed

    Sahinbegovic, Enijad; Arco, Gunther; Cavallaro, Alexander; Söder, Stephan; Schörner, Christoph; Schett, Georg; Harrer, Thomas; Zwerina, Jochen

    2013-03-01

    A 68-year-old woman developed tenosynovitis of the right second digit without a history of injury or animal bites. Apart from high titer anti-nuclear antibodies, serological studies were unremarkable. Tuberculin test and interferon gamma release assay were both negative. Several immunosuppressive therapies led only to partial relief of symptoms. Of note, clinical symptoms worsened significantly after introduction of adalimumab therapy. Tenosynovectomy was performed revealing a granulomatous inflammatory process. Seven weeks later, Mycobacterium malmoense could be cultured from the surgical specimen. A four drug antibiotic regimen was started and immunosuppressive therapy discontinued resulting in complete clinical remission. Our case highlights non-tuberculous mycobacterial (NTM) tenosynovitis as an important differential diagnosis of atypical arthritis. A negative tuberculin skin test as well as negative Ziehl-Neelsen stain does not argue against NTM infection. In fact, mycobacterial culture for extended periods remains the gold standard for diagnosis. PMID:20582608

  12. 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

  13. A Smell That Causes Seizure

    PubMed Central

    Nguyen, Minh Q.; Ryba, Nicholas J. P.

    2012-01-01

    In mammals, odorants are detected by a large family of receptors that are each expressed in just a small subset of olfactory sensory neurons (OSNs). Here we describe a strain of transgenic mice engineered to express an octanal receptor in almost all OSNs. Remarkably, octanal triggered a striking and involuntary phenotype in these animals, with passive exposure regularly inducing seizures. Octanal exposure invariably resulted in widespread activation of OSNs but interestingly seizures only occurred in 30–40% of trials. We hypothesized that this reflects the need for the olfactory system to filter strong but slowly-changing backgrounds from salient signals. Therefore we used an olfactometer to control octanal delivery and demonstrated suppression of responses whenever this odorant is delivered slowly. By contrast, rapid exposure of the mice to octanal induced seizure in every trial. Our results expose new details of olfactory processing and provide a robust and non-invasive platform for studying epilepsy. PMID:22848650

  14. 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

  15. Preliminary open-label experience with topiramate in primary generalized seizures.

    PubMed

    Biton, V

    1997-01-01

    Preliminary data concerning the effectiveness of topiramate (TPM) in the management of resistant primary generalized seizures were obtained from the open-label extension of a double-blind, placebo-controlled trial of TPM. The controlled trial enrolled patients experiencing three or more primary generalized tonic-clonic seizures (PGTCS) during an 8-week baseline period. Twelve of 13 patients who completed double-blind treatment elected to receive extended open therapy with TPM and were followed for periods ranging from 2 to 11 months. Of the 12 patients, 11 (92%) experienced a 50% or greater reduction in tonic-clonic seizures during their last 2 months of open-label TPM therapy compared to their pre-double-blind baseline period, and 7 (58%) were seizure-free during the open extension. Of five patients reporting absence seizures at baseline, four (80%) demonstrated a 50% or greater reduction in seizures. In seven of the 12 patients, a concomitant antiepileptic drug (AED) was discontinued or its dosage was reduced during open TPM treatment. The most common adverse events observed in the open study extension were weight reduction (five patients), weight increase (two patients), and drowsiness (two patients). The results of controlled trials are needed to determine the efficacy of TPM in primary generalized seizures. However, these preliminary findings are encouraging. PMID:9092959

  16. 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

  17. Atypical Presentation of Cytomegalovirus Infection in a Liver Transplant Patient

    PubMed Central

    Bansal, Naresh; Arora, Anil; Kumaran, Vinay; Mehta, Naimish; Varma, Vibha; Sharma, Praveen; Tyagi, Pankaj; Sachdeva, Munish; Kumar, Ashish

    2012-01-01

    Cytomegalovirus (CMV) is the most common viral infection in solid organ transplant recipients. Symptomatic infection usually presents with fever, pneumonia, colitis, or cytopenia. We describe a case of symptomatic CMV infection in a liver transplant recipient presenting with atypical symptoms of only persistent nausea and vomiting, in the absence of classical symptoms and signs; thus, highlighting the importance of high index of suspicion of CMV in immunocompromised patients, keeping in mind the high morbidity and mortality associated with this disease.

  18. Veterinary Seizure Detector Report Number 1

    E-print Network

    Levi, Anthony F. J.

    and transient memory lapse. When an animal suffering from seizures arrives at an emergency center, it can. Abstract Animal hospitals receive on average 1-2 seizure patients weekly. Seizures in animals occur for the same reason in animals as they do in humans, with causes ranging from epilepsy to low blood sugar

  19. 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…

  20. 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

  1. Absence, Leave of 26 Absences 26

    E-print Network

    Dyer, Bill

    Architecture Program 71 Canadian Undergraduates 14 College of Business 80 Early 15 Former Students 16 Freshmen, College of Courses Graduate Program Associated Students of MSU ASMSU Athletics Audiovisual Media ServicesMOM Absence, Leave of 26 Absences 26 Absentia Registration 35, 138 College of Graduate Studies 138

  2. Atypical Headbanging Presentation of Idiopathic Sleep Related Rhythmic Movement Disorder: Three Cases with Video-Polysomnographic Documentation

    PubMed Central

    Yeh, Shih-Bin; Schenck, Carlos H.

    2012-01-01

    Study Objectives: To describe three cases of sleep related, idiopathic rhythmic movement disorder (RMD) with atypical headbanging, consisting of head punching and head slapping. Methods: Three consecutive patients (2 males [11 and 13 years old) and one female [22 years old]) presented with atypical headbanging of 6 years, 7 years, and 17 years duration. In 2 cases, typical rhythmic headbanging (with use of the head) shifted after 3-4 years to atypical headbanging, with frontal head punching that was quasi-rhythmic. In one case, atypical headbanging (head-slapping) was the initial and only RMD. There was no injury from the headbanging. Prenatal, perinatal, developmental, behavioral-psychological, medical-neurological, and family histories were negative. Clinical evaluations and nocturnal video-polysomnography with seizure montage were performed on all patients. Results: Atypical headbanging was documented in all 3 cases; episodes always emerged late in the sleep cycle: from N2 sleep in 11 episodes, from REM sleep in 4 episodes, and from N1 sleep in 1 episode. Epileptiform activity was not detected. Clonazepam therapy was substantially effective in 1 case but not effective in 2 cases. Conclusions: These 3 cases of idiopathic atypical headbanging expand the literature on this RMD variant, as to our knowledge only one previously documented case has been reported. Citation: Yeh SB; Schenck CH. Atypical headbanging presentation of idiopathic sleep related rhythmic movement disorder: three cases with video-polysomnographic documentation. J Clin Sleep Med 2012;8(4):403-411. PMID:22893771

  3. Nonlinear analysis of EEG for epileptic seizures

    SciTech Connect

    Hively, L.M.; Clapp, N.E.; Daw, C.S.; Lawkins, W.F. [Oak Ridge National Lab., TN (United States); Eisenstadt, M.L. [Knoxville Neurology Clinic, St. Mary`s Medical Center, Knoxville, TN (United States)

    1995-04-01

    We apply chaotic time series analysis (CTSA) to human electroencephalogram (EEG) data. Three epoches were examined: epileptic seizure, non-seizure, and transition from non-seizure to seizure. The CTSA tools were applied to four forms of these data: raw EEG data (e-data), artifact data (f-data) via application of a quadratic zero-phase filter of the raw data, artifact-filtered data (g- data) and that was the residual after subtracting f-data from e-data, and a low-pass-filtered version (h-data) of g-data. Two different seizures were analyzed for the same patient. Several nonlinear measures uniquely indicate an epileptic seizure in both cases, including an abrupt decrease in the time per wave cycle in f-data, an abrupt increase in the Kolmogorov entropy and in the correlation dimension for e-h data, and an abrupt increase in the correlation dimension for e-h data. The transition from normal to seizure state also is characterized by distinctly different trends in the nonlinear measures for each seizure and may be potential seizure predictors for this patient. Surrogate analysis of e-data shows that statistically significant nonlinear structure is present during the non-seizure, transition , and seizure epoches.

  4. 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.

  5. Atypical hemolytic uremic syndrome

    PubMed Central

    2011-01-01

    Hemolytic uremic syndrome (HUS) is defined by the triad of mechanical hemolytic anemia, thrombocytopenia and renal impairment. Atypical HUS (aHUS) defines non Shiga-toxin-HUS and even if some authors include secondary aHUS due to Streptococcus pneumoniae or other causes, aHUS designates a primary disease due to a disorder in complement alternative pathway regulation. Atypical HUS represents 5 -10% of HUS in children, but the majority of HUS in adults. The incidence of complement-aHUS is not known precisely. However, more than 1000 aHUS patients investigated for complement abnormalities have been reported. Onset is from the neonatal period to the adult age. Most patients present with hemolytic anemia, thrombocytopenia and renal failure and 20% have extra renal manifestations. Two to 10% die and one third progress to end-stage renal failure at first episode. Half of patients have relapses. Mutations in the genes encoding complement regulatory proteins factor H, membrane cofactor protein (MCP), factor I or thrombomodulin have been demonstrated in 20-30%, 5-15%, 4-10% and 3-5% of patients respectively, and mutations in the genes of C3 convertase proteins, C3 and factor B, in 2-10% and 1-4%. In addition, 6-10% of patients have anti-factor H antibodies. Diagnosis of aHUS relies on 1) No associated disease 2) No criteria for Shigatoxin-HUS (stool culture and PCR for Shiga-toxins; serology for anti-lipopolysaccharides antibodies) 3) No criteria for thrombotic thrombocytopenic purpura (serum ADAMTS 13 activity > 10%). Investigation of the complement system is required (C3, C4, factor H and factor I plasma concentration, MCP expression on leukocytes and anti-factor H antibodies; genetic screening to identify risk factors). The disease is familial in approximately 20% of pedigrees, with an autosomal recessive or dominant mode of transmission. As penetrance of the disease is 50%, genetic counseling is difficult. Plasmatherapy has been first line treatment until presently, without unquestionable demonstration of efficiency. There is a high risk of post-transplant recurrence, except in MCP-HUS. Case reports and two phase II trials show an impressive efficacy of the complement C5 blocker eculizumab, suggesting it will be the next standard of care. Except for patients treated by intensive plasmatherapy or eculizumab, the worst prognosis is in factor H-HUS, as mortality can reach 20% and 50% of survivors do not recover renal function. Half of factor I-HUS progress to end-stage renal failure. Conversely, most patients with MCP-HUS have preserved renal function. Anti-factor H antibodies-HUS has favourable outcome if treated early. PMID:21902819

  6. Evaluation of sphingolipids changes in brain tissues of rats with pentylenetetrazol-induced kindled seizures using MALDI-TOF-MS

    Microsoft Academic Search

    Xiaoqiong Ma; Guangyi Liu; Shuang Wang; Zhong Chen; Maode Lai; Ziyang Liu; Jun Yang

    2007-01-01

    Abnormal lipid metabolism has been implicated in the pathogenesis of many neural system diseases, including epilepsy. Pentylenetetrazol (PTZ)-induced kindling in rodents is considered a model of human absence epilepsy and myoclonic, generalized tonic-clonic seizure. In an effort to further understand the mechanism for PTZ-induced seizure, we analyzed crude lipids and sphingolipids in the cortex, hippocampus, and brain stem of normal

  7. Palatal tremor, focal seizures, repeated miscarriages and elevated anti-thyroid antibodies

    Microsoft Academic Search

    Rechdi Ahdab; Drouet Thomas

    2008-01-01

    Neurological manifestations of thyroid autoimmunity are heterogeneous and nonspecific. The most frequently adopted name for this entity is Hashimoto's encephalopathy although this eponym has been recently contested. In the absence of specific clinical features, diagnosis is suggested by the presence of elevated levels of anti-thyroid antibodies in the appropriate clinical context. We describe a patient with recurrent focal seizures, palatal

  8. 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

  9. Patterns of human local cerebral glucose metabolism during epileptic seizures

    SciTech Connect

    Engel, J. Jr.; Kuhl, D.E.; Phelps, M.E.

    1982-10-01

    Ictal patterns of local cerebral metabolic rate have been studied in epileptic patients by positron computed tomography with /sup 18/F-labeled 2-fluoro-2-deoxy-D-glucose. Partial seizures were associated with activation of anatomic structures unique to each patient studied. Ictal increases and decreases in local cerebral metabolism were observed. Scans performed during generalized convulsions induced by electroshock demonstrated a diffuse ictal increase and postictal decrease in cerebral metabolism. Petit mal absences were associated with a diffuse increase in cerebral metabolic rate. The ictal fluorodeoxyglucose patterns obtained from patients do not resemble autoradiographic patterns obtained from common experimental animal models of epilepsy.

  10. 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

  11. 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

  12. Clozapine versus other atypical antipsychotics for schizophrenia

    PubMed Central

    Asenjo Lobos, Claudia; Komossa, Katja; Rummel-Kluge, Christine; Hunger, Heike; Schmid, Franziska; Schwarz, Sandra; Leucht, Stefan

    2014-01-01

    Background Clozapine is an atypical antipsychotic demonstrated to be superior in the treatment of refractory schizophrenia which causes fewer movement disorders. Clozapine, however, entails a significant risk of serious blood disorders such as agranulocytosis which could be potentially fatal. Currently there are a number of newer antipsychotics which have been developed with the purpose to find both a better tolerability profile and a superior effectiveness. Objectives To compare the clinical effects of clozapine with other atypical antipsychotics (such as amisulpride, aripiprazole, olanzapine, quetiapine, risperidone, sertindole, ziprasidone and zotepine) in the treatment of schizophrenia and schizophrenia-like psychoses. Search methods We searched the Cochrane Schizophrenia Groups Register (June 2007) and reference lists of all included randomised controlled trials. We also manually searched appropriate journals and conference proceedings relating to clozapine combination strategies and contacted relevant pharmaceutical companies. Selection criteria All relevant randomised, at least single-blind trials, comparing clozapine with other atypical antipsychotics, any dose and oral formulations, for people with schizophrenia or related disorders. Data collection and analysis We selected trials and extracted data independently. For dichotomous data we calculated relative risks (RR) and their 95% confidence intervals (CI) based on a random-effects model. We calculated numbers needed to treat/harm (NNT/NNH) where appropriate. For continuous data, we calculated mean differences (MD) again based on a random-effects model. Main results The review currently includes 27 blinded randomised controlled trials, which involved 3099 participants. Twelve randomised control trials compared clozapine with olanzapine, five with quetiapine, nine with risperidone, one with ziprasidone and two with zotepine. Attrition from these studies was high (overall 30.1%), leaving the interpretation of results problematic. Clozapine had a higher attrition rate due to adverse effects than olanzapine (9 RCTs, n=1674, RR 1.60 CI 1.07 to 2.40, NNT 25 CI 15 to 73) and risperidone (6 RCTs, n=627, RR 1.88 CI 1.11 to 3.21, NNT 16 CI 9 to 59). Fewer participants in the clozapine groups left the trials early due to inefficacy than risperidone (6 RCTs, n=627, RR 0.40 CI 0.23 to 0.70, NNT 11 CI 7 to 21), suggesting a certain higher efficacy of clozapine. Clozapine was more efficacious than zotepine in improving the participants general mental state (BPRS total score: 1 RCT, n=59, MD ?6.00 CI ?9.83 to ?2.17), but not consistently more than olanzapine, quetiapine, risperidone and ziprasidone. There was no significant difference between clozapine and olanzapine or risperidone in terms of positive or negative symptoms of schizophrenia. According to two studies from China quetiapine was more efficacious for negative symptoms than clozapine (2 RCTs, n=142, MD 2.23 CI 0.99 to 3.48). Clozapine produced somewhat fewer extrapyramidal side-effects than risperidone (use of antiparkinson medication: 6 RCTs, n=304, RR 0.39 CI 0.22 to 0.68, NNT 7 CI 5 to 18) and zotepine (n=59, RR 0.05 CI 0.00 to 0.86, NNT 3 CI 2 to 5). More participants in the clozapine group showed decreased white blood cells than those taking olanzapine, more hypersalivation and sedation than those on olanzapine, risperidone and quetiapine and more seizures than people on olanzapine and risperidone. Also clozapine produced an important weight gain not seen with risperidone. Other differences in adverse effects were less documented and should be replicated, for example, clozapine did not alter prolactin levels whereas olanzapine, risperidone and zotepine did; compared with quetiapine, clozapine produced a higher incidence of electrocardiogram (ECG) alterations; and compared with quetiapine and risperidone clozapine produced a higher increase of triglyceride levels. Other findings that should be replicated were: clozapine improved social functioning less than risperidone and fewer participants

  13. Comparison of classifications of seizures: A preliminary study with 28 participants and 48 seizures

    Microsoft Academic Search

    Betül Baykan; Nalan Kayrak Ertas; Mustafa Ertas; Berrin Aktekin; Serap Saygi; Aysen Gokyigit

    2005-01-01

    PurposeOur aim was to compare three available seizure classifications (SCs), namely, the international classification of epileptic seizures published in 1981 (ICES; Epilepsia 1981;22:489–50); the semiological seizure classification (SSC) by H. Lüders, J. Acharya, C. Baumgartner, et al. (Epilepsia 1998;39:1006–13; Acta Neurol Scand 1999;99:137–41); and the proposal of a new diagnostic scheme for seizures (PDSS) by J. Engel, Jr. (Epilepsia 2001;42:796–803)

  14. Absence epilepsy in apathetic, a spontaneous mutant mouse lacking the h channel subunit, HCN2

    PubMed Central

    Chung, Wendy K.; Shin, Minyoung; Jaramillo, Thomas C.; Leibel, Rudolph L.; LeDuc, Charles A.; Fischer, Stuart G.; Tzilianos, Efthia; Gheith, Ayman A.; Lewis, Alan S.; Chetkovich, Dane M.

    2008-01-01

    Analysis of naturally occurring mutations that cause seizures in rodents has advanced understanding of the molecular mechanisms underlying epilepsy. Abnormalities of Ih and h channel expression have been found in many animal models of absence epilepsy. We characterized a novel spontaneous mutant mouse, apathetic (ap/ap), and identified the ap mutation as a 4 base pair insertion within the coding region of Hcn2, the gene encoding the h channel subunit 2 (HCN2). We demonstrated that Hcn2ap mRNA is reduced by 90% compared to wild type, and the predicted truncated HCN2ap protein is absent from the brain tissue of mice carrying the ap allele. ap/ap mice exhibited ataxia, generalized spike-wave absence seizures, and rare generalized tonic-clonic seizures. ap/+ mice had a normal gait, occasional absence seizures and an increased severity of chemoconvulsant-induced seizures. These findings help elucidate basic mechanisms of absence epilepsy and suggest HCN2 may be a target for therapeutic intervention. PMID:19150498

  15. 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

  16. Importance of cardiological evaluation for first seizures

    PubMed Central

    Choong, Ho; Hanna, Ibrahim; Beran, Roy

    2015-01-01

    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

  17. Early sonographic prenatal diagnosis of seizures.

    PubMed

    Sheizaf, B; Mazor, M; Landau, D; Burstein, E; Bashiri, A; Hershkovitz, R

    2007-12-01

    Fetal seizures are an unusual phenomenon. When diagnosed by ultrasonography, they are frequently associated with malformations and carry a poor prognosis. We describe first trimester seizures in two siblings with arthrogryposis multiplex congenita. In both cases, convulsions appeared before other sonographic signs of the disease. Review of the literature revealed 11 other cases of fetal seizures diagnosed by ultrasound, all later in gestation. Fetal seizures may be the first manifestation of defective neural and motor development. Therefore, in pregnancies at high risk for neuromuscular disease, early sonographic evaluation of fetal motility, in addition to the anatomical survey, is advised. PMID:17948231

  18. Reactive astrogliosis causes the development of spontaneous seizures.

    PubMed

    Robel, Stefanie; Buckingham, Susan C; Boni, Jessica L; Campbell, Susan L; Danbolt, Niels C; Riedemann, Therese; Sutor, Bernd; Sontheimer, Harald

    2015-02-25

    Epilepsy is one of the most common chronic neurologic diseases, yet approximately one-third of affected patients do not respond to anticonvulsive drugs that target neurons or neuronal circuits. Reactive astrocytes are commonly found in putative epileptic foci and have been hypothesized to be disease contributors because they lose essential homeostatic capabilities. However, since brain pathology induces astrocytes to become reactive, it is difficult to distinguish whether astrogliosis is a cause or a consequence of epileptogenesis. We now present a mouse model of genetically induced, widespread chronic astrogliosis after conditional deletion of ?1-integrin (Itg?1). In these mice, astrogliosis occurs in the absence of other pathologies and without BBB breach or significant inflammation. Electroencephalography with simultaneous video recording revealed that these mice develop spontaneous seizures during the first six postnatal weeks of life and brain slices show neuronal hyperexcitability. This was not observed in mice with neuronal-targeted ?1-integrin deletion, supporting the hypothesis that astrogliosis is sufficient to induce epileptic seizures. Whole-cell patch-clamp recordings from astrocytes further suggest that the heightened excitability was associated with impaired astrocytic glutamate uptake. Moreover, the relative expression of the cation-chloride cotransporters (CCC) NKCC1 (Slc12a2) and KCC2 (Slc12a5), which are responsible for establishing the neuronal Cl(-) gradient that governs GABAergic inhibition were altered and the NKCC1 inhibitor bumetanide eliminated seizures in a subgroup of mice. These data suggest that a shift in the relative expression of neuronal NKCC1 and KCC2, similar to that observed in immature neurons during development, may contribute to astrogliosis-associated seizures. PMID:25716834

  19. 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

  20. Soy Infant Formula and Seizures in Children with Autism: A Retrospective Study

    PubMed Central

    Westmark, Cara J.

    2014-01-01

    Seizures are a common phenotype in many neurodevelopmental disorders including fragile X syndrome, Down syndrome and autism. We hypothesized that phytoestrogens in soy-based infant formula were contributing to lower seizure threshold in these disorders. Herein, we evaluated the dependence of seizure incidence on infant formula in a population of autistic children. Medical record data were obtained on 1,949 autistic children from the SFARI Simplex Collection. An autism diagnosis was determined by scores on the ADI-R and ADOS exams. The database included data on infant formula use, seizure incidence, the specific type of seizure exhibited and IQ. Soy-based formula was utilized in 17.5% of the study population. Females comprised 13.4% of the subjects. There was a 2.6-fold higher rate of febrile seizures [4.2% versus 1.6%, OR?=?2.6, 95% CI?=?1.3–5.3], a 2.1-fold higher rate of epilepsy comorbidity [3.6% versus 1.7%, OR?=?2.2, 95% CI?=?1.1–4.7] and a 4-fold higher rate of simple partial seizures [1.2% versus 0.3%, OR?=?4.8, 95% CI?=?1.0–23] in the autistic children fed soy-based formula. No statistically significant associations were found with other outcomes including: IQ, age of seizure onset, infantile spasms and atonic, generalized tonic clonic, absence and complex partial seizures. Limitations of the study included: infant formula and seizure data were based on parental recall, there were significantly less female subjects, and there was lack of data regarding critical confounders such as the reasons the subjects used soy formula, age at which soy formula was initiated and the length of time on soy formula. Despite these limitations, our results suggest that the use of soy-based infant formula may be associated with febrile seizures in both genders and with a diagnosis of epilepsy in males in autistic children. Given the lack of data on critical confounders and the retrospective nature of the study, a prospective study is required to confirm the association. PMID:24622158

  1. Local disruption of glial adenosine homeostasis in mice associates with focal electrographic seizures: a first step in epileptogenesis?

    PubMed

    Li, Tianfu; Lytle, Nikki; Lan, Jing-Quan; Sandau, Ursula S; Boison, Detlev

    2012-01-01

    Astrogliosis and associated dysfunction of adenosine homeostasis are pathological hallmarks of the epileptic brain and thought to contribute to seizure generation in epilepsy. The authors hypothesized that astrogliosis-an early component of the epileptogenic cascade-might be linked to focal seizure onset. To isolate the contribution of astrogliosis to ictogenesis from other pathological events involved in epilepsy, the authors used a minimalistic model of epileptogenesis in mice, based on a focal onset status epilepticus triggered by intra-amygdaloid injection of kainic acid. The authors demonstrate acute neuronal cell loss restricted to the injected amygdala and ipsilateral CA3, followed 3 weeks later by focal astrogliosis and overexpression of the adenosine-metabolizing enzyme adenosine kinase (ADK). Using synchronous electroencephalographic recordings from multiple depth electrodes, the authors identify the KA-injected amygdala and ipsilateral CA3 as two independent foci for the initiation of non-synchronized electrographic subclinical seizures. Importantly, seizures remained focal and restricted to areas of ADK overexpression. However, after systemic application of a non-convulsive dose of an adenosine A(1) -receptor antagonist, seizures in amygdala and CA3 immediately synchronized and spread throughout the cortex, leading to convulsive seizures. This focal seizure phenotype remained stable over at least several weeks. We conclude that astrogliosis via disruption of adenosine homeostasis per se and in the absence of any other overt pathology, is associated with the emergence of spontaneous recurrent subclinical seizures, which remain stable over space and time. A secondary event, here mimicked by brain-wide disruption of adenosine signaling, is likely required to turn pre-existing subclinical seizures into a clinical seizure phenotype. PMID:21964979

  2. 19 CFR 162.63 - Arrests and seizures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 2 2014-04-01 2014-04-01 false Arrests and seizures. 162.63 Section 162.63 Customs...Substances, Narcotics, and Marihuana § 162.63 Arrests and seizures. Arrests and seizures under the Controlled Substances...

  3. 19 CFR 162.63 - Arrests and seizures.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 2 2013-04-01 2013-04-01 false Arrests and seizures. 162.63 Section 162.63 Customs...Substances, Narcotics, and Marihuana § 162.63 Arrests and seizures. Arrests and seizures under the Controlled Substances...

  4. 19 CFR 162.63 - Arrests and seizures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 2 2012-04-01 2012-04-01 false Arrests and seizures. 162.63 Section 162.63 Customs...Substances, Narcotics, and Marihuana § 162.63 Arrests and seizures. Arrests and seizures under the Controlled Substances...

  5. 19 CFR 162.63 - Arrests and seizures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...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 Stat. 1242, 21...

  6. 19 CFR 162.63 - Arrests and seizures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...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 Stat. 1242, 21...

  7. Nonepileptic seizures treatment workshop summary.

    PubMed

    LaFrance, W Curt; Alper, Kenneth; Babcock, Debra; Barry, John J; Benbadis, Selim; Caplan, Rochelle; Gates, John; Jacobs, Margaret; Kanner, Andres; Martin, Roy; Rundhaugen, Lynn; Stewart, Randy; Vert, Christina

    2006-05-01

    In May 2005, an international, interdisciplinary group of researchers gathered in Bethesda, MD, USA, for a workshop to discuss the development of treatments for patients with nonepileptic seizures (NES). Specific subgroup topics that were covered included: pediatric NES; presenting the diagnosis of NES, outcome measures for NES trials; classification of NES subtypes; and pharmacological treatment approaches and psychotherapies. The intent was to develop specific research strategies that can be expanded to involve a large segment of the epilepsy and psychiatric treatment communities. Various projects have resulted from the workshop, including the initial development of a prospective randomized clinical trial for NES. PMID:16540377

  8. 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

  9. 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…

  10. Increased seizure severity and seizure-related death in mice lacking HCN1 channels

    PubMed Central

    Santoro, Bina; Lee, Janet Y.; Englot, Dario J.; Gildersleeve, Sandra; Piskorowski, Rebecca A.; Siegelbaum, Steven A.; Winawer, Melodie R.; Blumenfeld, Hal

    2010-01-01

    Summary Persistent down-regulation in the expression of the hyperpolarization-activated HCN1 cation channel, a key determinant of intrinsic neuronal excitability, has been observed in febrile seizure, temporal lobe epilepsy and generalized epilepsy animal models, as well as patients with epilepsy. However, the role and importance of HCN1 downregulation for seizure activity is unclear. To address this question we determined the susceptibility of mice with either a general or forebrain-restricted deletion of HCN1 to limbic seizure induction by amygdala kindling or pilocarpine administration. Loss of HCN1 expression in both mouse lines is associated with higher seizure severity and higher seizure-related mortality, independent of the seizure induction method used. Thus, downregulation of HCN1 associated with human epilepsy and rodent models may be a contributing factor to seizure behavior. PMID:20384728

  11. Search and Seizure in the Public Schools.

    ERIC Educational Resources Information Center

    Rossow, Lawrence F.

    This monograph attempts to provide clear understanding of the standards presented by the Supreme Court in "New Jersey v. T.L.O." relative to search and seizure in public schools, and suggests practical ways of applying search and seizure law to situations in the school setting. ("T.L.O." are the initials of the anonymous student.) After an…

  12. Search and Seizure in the Schools

    ERIC Educational Resources Information Center

    Staros, Kari; Williams, Charles F.

    2007-01-01

    The Fourth Amendment to the U.S. Constitution protects the people of the United States from unreasonable searches and seizures. On first reading, these protections seem clearly defined. The amendment was meant to protect Americans from the kinds of random searches and seizures that the colonists experienced under British colonial rule. Under…

  13. Seizure or syncope: Lessons over time

    Microsoft Academic Search

    Volney L. Sheen

    A 25-year-old woman with recurrent syncopal episodes presented with a first time generalized tonic clonic (GTC) seizure. She had experienced two prior fainting spells lasting seconds and associated with diet pills and dehydration. She had another similar spell prior to falling, sustaining a laceration to the right posterior occiput, and having a witnessed GTC seizure. Her scalp electroencephalography (EEG) showed

  14. The many etiologies of neonatal hypocalcemic seizures.

    PubMed

    Levy-Shraga, Yael; Dallalzadeh, Keren; Stern, Keren; Paret, Gideon; Pinhas-Hamiel, Orit

    2015-03-01

    Seizures during the neonatal period have a broad differential diagnosis. Unlike in developing countries where hypovitaminosis D and hypocalcemia constitutes a major cause of infantile seizures, the number of neonatal seizures attributed to hypocalcemia in developed countries has decreased dramatically due to the improvement of infant formulas and vitamin D supplementation. In these countries, most infants that present with hypocalcemic seizures have underlying endocrinological etiologies rather than dietary insufficiencies. Here, we describe 3 cases of neonatal seizures due to hypocalcemia. Although the symptoms and calcium concentrations at presentation were similar in all 3 cases, the course of the disease and the final diagnosis for each were distinct. The cases are presented along with a brief review of the pathophysiology, differential diagnosis, and treatment of neonatal hypocalcemia. PMID:25738238

  15. Seizures

    MedlinePLUS

    ... is involved. Symptoms occur suddenly and may include: Brief blackout followed by a period of confusion (the person cannot remember for a short time) Changes in behavior such as picking at one's ...

  16. 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

  17. Atypical centrioles during sexual reproduction

    PubMed Central

    Avidor-Reiss, Tomer; Khire, Atul; Fishman, Emily L.; Jo, Kyoung H.

    2015-01-01

    Centrioles are conserved, self-replicating, microtubule-based, 9-fold symmetric subcellular organelles that are essential for proper cell division and function. Most cells have two centrioles and maintaining this number of centrioles is important for animal development and physiology. However, how animals gain their first two centrioles during reproduction is only partially understood. It is well established that in most animals, the centrioles are contributed to the zygote by the sperm. However, in humans and many animals, the sperm centrioles are modified in their structure and protein composition, or they appear to be missing altogether. In these animals, the origin of the first centrioles is not clear. Here, we review various hypotheses on how centrioles are gained during reproduction and describe specialized functions of the zygotic centrioles. In particular, we discuss a new and atypical centriole found in sperm and zygote, called the proximal centriole-like structure (PCL). We also discuss another type of atypical centriole, the “zombie” centriole, which is degenerated but functional. Together, the presence of centrioles, PCL, and zombie centrioles suggests a universal mechanism of centriole inheritance among animals and new causes of infertility. Since the atypical centrioles of sperm and zygote share similar functions with typical centrioles in somatic cells, they can provide unmatched insight into centriole biology.

  18. Tolerance to seizure induced by kainic acid is produced in a specific period of zebrafish development.

    PubMed

    Menezes, Fabiano Peres; Rico, Eduardo Pacheco; Da Silva, Rosane Souza

    2014-12-01

    During brain development, the electrical disturbance promoted by a seizure can have several consequences, because it can disturb a set of steps extremely regulated needed to the correct brain maturation. Animal modeling of seizure is invaluable to contribute to the mechanistic understanding of punctual seizure event, and those that triggered in an immature neural network could alter the mature brain physiology. In the present study we observed that the exposure to kainic acid diluted directly in water of zebrafish decreased the locomotor activity at 7 days post-fertilization (dpf) animals and increased at 15 dpf, despite the absence of more specific seizure features. Pre-exposure to kainic acid (500 ?M) diluted in water at 7 dpf animals reduced the susceptibility to a second exposure 2 months later by intraperitoneal injection. The current data suggest that these different responses are associated with neuronal maturation process and open a question about the window of development that are crucial to long lasting effects related to seizure in this animal model. PMID:24743104

  19. Natural course and predictors of spontaneous seizure remission in idiopathic generalized epilepsy: 7-27 years of follow-up.

    PubMed

    von Podewils, Felix; Lapp, Sabine; Wang, Z Irene; Hartmann, Ute; Herzer, Rosemarie; Kessler, Christof; Runge, Uwe

    2014-09-01

    The spontaneous course of idiopathic generalized epilepsy (IGE) is still controversial. The aim of this study was both to investigate the long-term spontaneous course and to identify factors that are predictive for epilepsy remission in a small cohort of 15 IGE patients (9 women) who refused antiepileptic drug (AED) treatment and therefore never have been treated with AED. All of them were reevaluated with a review of their medical records and direct face-to-face interview; the mean duration of follow-up was 15.3 years. Five (33.3%) of them had absence epilepsy (absence seizures, ABS), 5 had IGE with generalized tonic-clonic seizures (GTCS), and another 5 had both seizure types (IGE with ABS/GTCS). Rate of epilepsy remission was 53.3% with a mean time of seizure freedom of 13.1 years; rate of remission was highest among absence epilepsy patients (80%), followed by IGE with GTCS (60%) and IGE with ABS/GTCS (20%). The frequency of spontaneous generalized interictal epileptiform discharges in electroencephalography is not associated with the long-term seizure outcome (p=0.201) and per se does not require AED treatment. Furthermore, the occurrence of photoparoxysmal responses (p=0.020) as well as the occurrence of more than 3 GTCS during the course (p=0.029) were identified as significant predictors for a poor long-term seizure outcome which makes AED treatment indispensable in these patients. This study underlines the heterogenity of the group of IGE. AED treatment has no impact on the spontaneous course of IGE with ABS and/or GTCS. Several predictors for the long-term seizure outcome in patients with IGE were identified in this study. PMID:24907182

  20. Increased number of GABAB receptors in the lethargic (lh/lh) mouse model of absence epilepsy.

    PubMed

    Lin, F H; Cao, Z; Hosford, D A

    1993-04-01

    This study begins to explore possible mechanisms underlying the role of GABAB receptors in absence seizures in lethargic (lh/lh) mice. To test the hypothesis that alterations intrinsic to the GABAB receptor underlie enhanced synaptic activation of these receptors in absence seizures, we measured GABA-displaceable [3H]baclofen binding to neocortical plasma membranes prepared from lh/lh and wild (+/+) age-matched congenic mice. The number (Bmax) of binding sites was significantly greater (20%) in lh/lh (4.2 pmol/mg protein, n = 43 pairs, P < 0.02) than in +/+ mice (3.3 pmol/mg protein) in an age-independent manner. Interestingly, the subset of lh/lh mice with greater seizure frequency (40-70 seizures/15 min, measured by bipolar electrodes implanted into neocortex; n = 11) had a significantly greater Bmax (P < 0.003) than the subset with lower seizure frequency (1-10 seizures/15 min; n = 11). The equilibrium dissociation constant (Kd) was unchanged (60 nM in both). The Kd of both strains was inhibited to an equal degree by the nonhydrolysable GTP analogue 5'-guanylimido-diphosphate [Gpp(NH)p]. The increased number of GABAB binding sites was selective, because binding to NMDA sites ([3H]glutamate binding) and to GABAA sites ([3H]muscimol binding) was not significantly different in the two strains. These data suggest that the increased number of GABAB receptors in lh/lh mice underlies enhanced synaptic activation of these receptors. Together with evidence that GABAB receptor activation can produce disinhibition, our data support a role for GABAB receptors in the expression of absence seizures in lh/lh mice. PMID:8388308

  1. 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

  2. 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

  3. 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

    2014-07-17

    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

  4. Acute Seizures Predict Epilepsy After Childhood Stroke

    PubMed Central

    Fox, Christine K.; Glass, Hannah C.; Sidney, Stephen; Lowenstein, Daniel H.; Fullerton, Heather J.

    2013-01-01

    Objective To determine incidence rates and predictors of epilepsy after childhood stroke and compare these to published estimates of 3–5% cumulative epilepsy incidence by five years post-stroke in adults. Methods In a retrospective population-based study of children with stroke (29 days?19 years) in an integrated health care system (1993–2007), post-stroke seizures were identified through electronic searches and confirmed by chart review. Stroke and seizure characteristics were abstracted from medical records. Survival analysis was used to determine rates and predictors of remote seizures and active epilepsy (anti-convulsant treatment for remote seizure within prior 6 months) at last follow-up. Results From a population of 2.5 million children, we identified 305 stroke cases. Over a median follow-up of 4.1 years (interquartile range 1.8–6.8), 49 children had a first unprovoked remote seizure. The average annual incidence rate of first remote seizure was 4.4% (95% confidence interval [CI] 3.3, 5.8) with a cumulative risk of 16% (CI 12%, 21%) at 5 years and 33% (CI 23%, 46%) at 10 years post-stroke. The cumulative risk of active epilepsy was 13% (CI 9%, 18%) at five years and 30% (CI 20%, 44%) at 10 years. Acute seizures at the time of stroke predicted development of active epilepsy (hazard ratio [HR] 4.2, CI 2.2, 8.1). At last follow-up, one-third of the children with active epilepsy had a recent breakthrough seizure despite anti-convulsant usage. Interpretation Unlike adults, children are uniquely vulnerable to epilepsy after stroke. Children with acute seizures at the time of stroke are at particularly high risk. PMID:23613472

  5. Laugh-induced seizure: a case report

    PubMed Central

    2013-01-01

    Introduction A laugh-induced seizure is an unrecognized condition and to the best of our knowledge no case has been reported in the medical literature until now. We present an interesting and extremely rare case in which laughing generated the seizure activity that was recorded and confirmed by video electroencephalography. Case presentation A 43-year-old obese Caucasian man with history of bipolar disorder and chronic headache presented with multiple episodes of seizures, all induced by laughter while watching comedy shows. Each episode lasted approximately five seconds. In each instance, he started laughing, then his arms started shaking and he felt like ‘his consciousness was being vacuumed away’. A physical examination revealed normal findings. He had been maintained on valproic acid for bipolar disorder and topiramate for his chronic headache, but this did not control his symptoms. His sleep-deprived electroencephalography and brain magnetic resonance imaging were normal except for an arachnoid cyst measuring 4.2 × 2.1cm in the anterior right middle cranial fossa. His video electroencephalography demonstrated laugh-induced seizure activities. He was then placed on carbamazepine. Following treatment, he had two episodes of mild staring but no frank seizures, and his seizures have remained well controlled on this regimen for more than a year. Conclusions Laugh-induced seizure is a most unusual clinical entity without any previous case report. Confirmatory diagnosis can be made by video electroencephalography recording of seizure activities provoked by laughing. As in gelastic seizure without hypothalamic hamartoma, our case responded well to polytherapy with topiramate and carbamazepine on top of laugh-provocation avoidance. Further study is required to establish the standard treatment of this condition. PMID:23668718

  6. 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

  7. Information Display System for Atypical Flight Phase

    NASA Technical Reports Server (NTRS)

    Statler, Irving C. (Inventor); Ferryman, Thomas A. (Inventor); Amidan, Brett G. (Inventor); Whitney, Paul D. (Inventor); White, Amanda M. (Inventor); Willse, Alan R. (Inventor); Cooley, Scott K. (Inventor); Jay, Joseph Griffith (Inventor); Lawrence, Robert E. (Inventor); Mosbrucker, Chris J. (Inventor); Rosenthal, Loren J. (Inventor); Lynch, Robert E. (Inventor); Chidester, Thomas R. (Inventor); Prothero, Gary L. (Inventor); Andrei, Adi (Inventor); Romanowski, Timothy P. (Inventor); Robin, Daniel E. (Inventor); Prothero, Jason W. (Inventor)

    2007-01-01

    Method and system for displaying information on one or more aircraft flights, where at least one flight is determined to have at least one atypical flight phase according to specified criteria. A flight parameter trace for an atypical phase is displayed and compared graphically with a group of traces, for the corresponding flight phase and corresponding flight parameter, for flights that do not manifest atypicality in that phase.

  8. Ambroxol-induced focal epileptic seizure.

    PubMed

    Lapenta, Leonardo; Morano, Alessandra; Fattouch, Jinane; Casciato, Sara; Fanella, Martina; Giallonardo, Anna Teresa; Di Bonaventura, Carlo

    2014-01-01

    It is well known that in epileptic patients some compounds and different drugs used for the treatment of comorbidities can facilitate or provoke seizures, this evidence regarding a wide spectrum of pharmacological categories. The potential facilitating factors usually include direct toxic effects or pharmacological interactions of either active ingredients or excipients. We report the case of a patient with drug-resistant epilepsy who experienced focal epileptic seizures, easily and constantly reproducible, after each administration of a cough syrup. This is, to our knowledge, the first electroencephalogram-documented case of focal epileptic seizures induced by cough syrup containing ambroxol as active ingredient. PMID:24824664

  9. 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.

  10. 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…

  11. Comparative proteomic approach in rat model of absence epilepsy.

    PubMed

    Gürol, Gönül; Demiralp, Duygu Özel; Y?lmaz, Ayça Kasapo?lu; Akman, Özlem; Ate?, Nurbay; Karson, Ay?e

    2015-03-01

    The aim of this study was to investigate cellular proteins in the pathogenesis of the genetic rat model of absence epilepsy. Protein spots were identified with peptide mass fingerprinting analysis using matrix-assisted laser desorption ionization time of flight mass spectrometry. Data were gathered from the frontoparietal cortex and thalamus of Wistar Albino Glaxo/Rij (WAG/Rij) and Wistar by using two-dimensional gel electrophoresis (2D-PAGE). Six proteins (Clathrin light chain-A protein, Transmembrane EMP24 Domain-Containing Protein, Stathmin-4, Myosin Light Chain4, Rheb, phosphoserine phosphatase) were found to be differentially expressed in the frontoparietal cortex of WAG/Rij and Wistar rats in both age groups. Another set of six proteins (Protein FAM89A and Oasl1, Gemin2, NuDEL1, Pur-beta, 3-alpha HSD) were found to be differentially expressed in the thalamus of WAG/Rij and Wistar rats. Findings from the frontoparietal cortex suggest the presence of altered serine metabolism and increased vesicular trafficking in the frontoparietal cortex of WAG/Rij rats compared with Wistar rats. These differences in the protein levels might reflect the crucial role of these proteins and related pathways in the generation of absence seizures. In the thalamic specimens, age-dependent changes in protein expression were remarkable, suggesting that this phenomenon may be a precursor or a consequence of absence seizures. Our findings further highlight the potential role of the mTOR signaling pathway in absence epilepsy. PMID:25323782

  12. Amyloid ?-Related Central Nervous System Angiitis Presenting With an Isolated Seizure.

    PubMed

    Ishii, Makoto; Lavi, Ehud; Kamel, Hooman; Gupta, Ajay; Iadecola, Costantino; Navi, Babak B

    2014-04-01

    Amyloid beta-related angiitis (ABRA) of the central nervous system (CNS) is a very rare inflammatory disorder that causes destruction of CNS arteries and subsequent neuronal injury. Most patients with ABRA are old and present with cognitive dysfunction and stroke; however, some patients may present atypically. In this article, we report a 44-year-old man who presented with a first-time seizure but was otherwise neurologically intact and denied any headache. Brain MRI showed right hemispheric and bilateral medial frontal lobe hyperintensities and microhemorrhages that were most suspicious for a mass lesion. An extensive diagnostic evaluation including CSF analysis and catheter angiography was unremarkable. A brain biopsy with specific stains for amyloid surprisingly demonstrated ABRA and led to immunosuppressive treatment. The patient has remained neurologically intact and seizure-free 1 year after presentation. This case demonstrates that ABRA can occur in young patients without headache or neurologic deficits, and should be considered in patients with new-onset seizures and mass lesions. It also reinforces the need to consider a brain biopsy in patients with idiopathic brain lesions and negative non-invasive testing, as it is virtually impossible to confirm the diagnosis of ABRA otherwise. PMID:24707337

  13. 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

  14. 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

  15. Patient-specific seizure onset detection

    E-print Network

    Shoeb, Ali Hossam, 1981-

    2003-01-01

    Approximately one percent of the world's population exhibits symptoms of epilepsy, a serious disorder of the central nervous system that predisposes those affected to experiencing recurrent seizures. The risk of injury ...

  16. Decreased subcortical cholinergic arousal in focal seizures.

    PubMed

    Motelow, Joshua E; Li, Wei; Zhan, Qiong; Mishra, Asht M; Sachdev, Robert N S; Liu, Geoffrey; Gummadavelli, Abhijeet; Zayyad, Zaina; Lee, Hyun Seung; Chu, Victoria; Andrews, John P; Englot, Dario J; Herman, Peter; Sanganahalli, Basavaraju G; Hyder, Fahmeed; Blumenfeld, Hal

    2015-02-01

    Impaired consciousness in temporal lobe seizures has a major negative impact on quality of life. The prevailing view holds that this disorder impairs consciousness by seizure spread to the bilateral temporal lobes. We propose instead that seizures invade subcortical regions and depress arousal, causing impairment through decreases rather than through increases in activity. Using functional magnetic resonance imaging in a rodent model, we found increased activity in regions known to depress cortical function, including lateral septum and anterior hypothalamus. Importantly, we found suppression of intralaminar thalamic and brainstem arousal systems and suppression of the cortex. At a cellular level, we found reduced firing of identified cholinergic neurons in the brainstem pedunculopontine tegmental nucleus and basal forebrain. Finally, we used enzyme-based amperometry to demonstrate reduced cholinergic neurotransmission in both cortex and thalamus. Decreased subcortical arousal is a critical mechanism for loss of consciousness in focal temporal lobe seizures. PMID:25654258

  17. If I Had - My First Seizure

    MedlinePLUS Videos and Cool Tools

    ... relate to problems that can occur in the brain. Have you been having headaches recently? Fevers? Did ... A history of encephalitis? Anything that can affect brain function, might be related to having a seizure. ...

  18. Duration of Nocturnal Hypoglycemia Before Seizures

    PubMed Central

    Buckingham, Bruce; Wilson, Darrell M.; Lecher, Todd; Hanas, Ragnar; Kaiserman, Kevin; Cameron, Fergus

    2008-01-01

    OBJECTIVE—Despite a high incidence of nocturnal hypoglycemia documented by the use of continuous glucose monitoring (CGM), there are no reports in the literature of nocturnal hypoglycemic seizures while a patient is wearing a CGM device. RESEARCH DESIGN AND METHODS—In this article, we describe four such cases and assess the duration of nocturnal hypoglycemia before the seizure. RESULTS—In the cases where patients had a nocturnal hypoglycemic seizure while wearing a CGM device, sensor hypoglycemia (<60 mg/dl) was documented on the CGM record for 2.25–4 h before seizure activity. CONCLUSIONS—Even with a subcutaneous glucose lag of 18 min when compared with blood glucose measurements, glucose sensors have time to provide clinically meaningful alarms. Current nocturnal hypoglycemic alarms need to be improved, however, since patients can sleep through the current alarm systems. PMID:18694975

  19. Seizures in Adults (Beyond the Basics)

    MedlinePLUS

    ... an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of ... E, Bourgeois B, et al. ILAE treatment guidelines: evidence-based analysis of antiepileptic drug efficacy and effectiveness as ...

  20. Analysis of Epileptic Seizures with Complex Network

    PubMed Central

    Ni, Yan; Wang, Yinghua; Yu, Tao; Li, Xiaoli

    2014-01-01

    Epilepsy is a disease of abnormal neural activities involving large area of brain networks. Until now the nature of functional brain network associated with epilepsy is still unclear. Recent researches indicate that the small world or scale-free attributes and the occurrence of highly clustered connection patterns could represent a general organizational principle in the human brain functional network. In this paper, we seek to find whether the small world or scale-free property of brain network is correlated with epilepsy seizure formation. A mass neural model was adopted to generate multiple channel EEG recordings based on regular, small world, random, and scale-free network models. Whether the connection patterns of cortical networks are directly associated with the epileptic seizures was investigated. The results showed that small world and scale-free cortical networks are highly correlated with the occurrence of epileptic seizures. In particular, the property of small world network is more significant during the epileptic seizures. PMID:25147576

  1. 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.

  2. Hemispheric venous dysgenesis in a woman presenting with seizures, weakness and parkinsonism

    PubMed Central

    Das, Deep; Tanaka, Michihiro; Roy, Biman Kanti; Singh, Vineeta

    2013-01-01

    This report describes an unusual case of a woman who developed progressive hemiparesis, seizures and hemiparkinsonism associated with MRI and angiographic evidence of chronic venous hypertension in the contralateral cerebrum and cerebellum. In the absence of inflammatory or veno-occlusive disorders, the patient's clinical and neuroradiological findings point to a developmental disorder, such as a hemispheric venous dysgenesis, as the underlying lesion. PMID:23608872

  3. 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

  4. Febrile Seizure: Demographic Features and Causative Factors

    PubMed Central

    ESMAILI GOURABI, Hamed; BIDABADI, Elham; CHERAGHALIPOUR, Fatemeh; AARABI, Yasaman; SALAMAT, Fatemeh

    2012-01-01

    Objective Because of geographical and periodical variation, we prompted to determine the demographic features and causative factors for febrile seizure in Rasht. Materials & Methods In this cross-sectional study, all 6–month- to 6-year-old children with the diagnosis of febrile seizure admitted to 17 Shahrivar hospital in Rasht, from August, 2009 to August, 2010 were studied. Age, sex, family history of the disease, seizure types, body temperature upon admission and infectious causes of the fever were recorded. All statistical analysis was performed with SPSS software, version 16. Results Of the 214 children (mean age, 25.24±15.40 months), 124 were boys and 109 had a positive family history. Complex seizures were seen in 39 cases. In patients with a complex febrile seizure, 59% had the repetitive type, 20.5% had the focal type and 20.5% had more than 15 minutes duration of seizures. Most of the repetitive seizures (78.3%) occurred in patients under 2 years old; the difference between under and over 2-year-old patients was statistically significant. Study results did not show significant differences between the two genders for simple or complex seizures. The mean body temperature upon admission was 38.2±1.32?C (38.31±0.82 degrees in boys and 38.04±1.78 in girls). Upper respiratory infections were seen in most patients (74.29%). All cases of lower respiratory infections were boys. There was a statistically significant difference between boys and girls in causes of fever. Conclusion Most of the children had a positive family history and the most common causative factor was upper respiratory infection. PMID:24665278

  5. Infantile Spasms: Little Seizures, BIG Consequences

    PubMed Central

    Shields, W Donald

    2006-01-01

    Infantile spasms is one of the “catastrophic childhood epilepsies” because of the difficulty in controlling seizures and the association with mental retardation. However, early recognition, a careful diagnostic evaluation, and proper treatment may allow some children to attain seizure control and to achieve a normal, or at least much improved, level of development. Thus, there is the opportunity to have an important impact in the lives of these unfortunate children and their families. PMID:16761063

  6. Seizure or syncope: lessons over time.

    PubMed

    Sheen, Volney L

    2012-03-01

    A 25-year-old woman with recurrent syncopal episodes presented with a first time generalized tonic clonic (GTC) seizure. She had experienced two prior fainting spells lasting seconds and associated with diet pills and dehydration. She had another similar spell prior to falling, sustaining a laceration to the right posterior occiput, and having a witnessed GTC seizure. Her scalp electroencephalography (EEG) showed left temporal slowing with sharp features. T1-weighted and T2-weighted MRI revealed two moderately enhancing focal lesions within the left frontal and temporal regions. These findings raised the possibility of an underlying seizure focus. Repeat imaging studies of this patient 1 month later, however, demonstrated resolution of these findings and an area of encephalomalacia, consistent with a traumatic coup contrecoup injury. A repeat EEG was normal. Therefore, the cause of the loss of consciousness was due to syncope with the consequent head injury giving rise to an isolated seizure. Understanding the underlying cause of a seizure is important in dictating treatment. In this setting the patient was not initiated on seizure medication and has done well. PMID:22245277

  7. Atypical and Typical Antipsychotics in the Schools

    ERIC Educational Resources Information Center

    Noggle, Chad A.; Dean, Raymond S.

    2009-01-01

    The use of antipsychotic medications within the school-age population is rapidly increasing. Although typical antipsychotics may be used in rare cases, this influx is largely secondary to the availability of the atypical antipsychotics. Reduction of possible adverse effects and increased efficacy represent the primary basis for the atypical

  8. [Atypical echocardiographic aspects of cardiac amylosis].

    PubMed

    Gallimard, J F; Poupet, J Y; Chaix, A F; Coisne, D C; Allal, J; Gouet, D; Barraine, R

    1986-01-01

    Echographic abnormalities of cardiac amylosis are now well known and quite useful to the diagnosis. Forms that are morphologically atypical are rare. From three observations (2 hypertrophic, asymmetrical and obstructive forms, and 1 hypertrophic and dilated form) and a review from the literature, we study the nosological, diagnostic and therapeutic problems presented by these atypical echographic of cardiac amylosis. PMID:3800280

  9. 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.

  10. Correlation between shaking behaviors and seizure severity in five animal models of convulsive seizures

    Microsoft Academic Search

    Marcelo Cairrăo Araújo Rodrigues; Franco Rossetti; Maira Licia Foresti; Gabriel Maisonnave Arisi; Márcio Araújo Furtado; Maria Luiza Cleto Dal-Cól; Poliana Bertti; Artur Fernandes; Francisco Leite Santos; Flávio Del Vecchio; Norberto Garcia-Cairasco

    2005-01-01

    Wet dog shakes (WDS) and head shakes (HS) are associated with experimentally induced convulsive seizures. We sought to determine whether these behaviors are correlated or not with major (status epilepticus (SE) or fully kindled animals) or minor (non-SE or partially kindled animals) seizure severity. WDS are directly correlated with SE induced by intracerebral star fruit extract (Averrhoa carambola) injection and

  11. Demographic and Seizure Variables, But Not Hypnotizability or Dissociation, Differentiated Psychogenic from Organic Seizures

    Microsoft Academic Search

    Richard Litwin; Etzel Cardeńa

    2001-01-01

    Early detection and differential diagnosis of psychogenic non-epileptic seizures (PNES) and epileptic seizures (ES) is a major clinical issue in comprehensive epilepsy centers. Using blind conditions with patients with PNES (N= 10) and ES (N= 31) before diagnosis, we tested the hypotheses that individuals with PNES would exhibit significantly greater dissociativity, hypnotizability, absorption, and history of early abuse than ES

  12. A Feature Set for EEG Seizure Detection in the Newborn based on Seizure and Background Charactersitics

    Microsoft Academic Search

    N. Stevenson; M. Mesbah; B. Boashash

    2007-01-01

    This paper presents a set of four features to be used in the detection of seizure in the electroencephalograms (EEGs) of newborns. The features are designed with the aid of recent advances in modelling of the newborn EEG. The performance of the features is analysed with a database of 500 epochs of newborn EEG (250 background\\/250 seizure). The covariance of

  13. Seizures and Teens: Surgery for Seizures--What's It All About?

    ERIC Educational Resources Information Center

    Duchowny, Michael S.; Dean, Patricia

    2006-01-01

    Nearly 1 out of 2 children and teens with seizures may need to take medications throughout their lives. At least 25% will develop a condition called refractory epilepsy--meaning that their seizures do not respond to medical therapy. For these children and teens, non-drug therapies such as brain surgery are available that may offer a chance to…

  14. 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…

  15. Letting a typical mouse judge whether mouse social interactions are atypical

    PubMed Central

    Shah, Charisma R.; Forsberg, Carl Gunnar; Kang, Jing-Qiong; Veenstra-VanderWeele, Jeremy

    2013-01-01

    LAY ABSTRACT Diagnosis of an autism spectrum disorder (ASD) requires a qualitative assessment of social aptitude: one person judging whether another person interacts in a ‘typical’ way. Quantitative or computerized assessment of social aptitude cannot substitute for this subjective judgment. We hypothesized that mice could be used to make a similar judgment if they prefer ‘typical’ over ‘atypical’ social interactions with mouse models relevant to ASD. We used typical C57BL/6 (B6) mice as ‘judges’ and evaluated their preference for a chamber containing a ‘typical’ or an ‘atypical’ mouse. For our atypical mice, we chose two strains with well-documented social phenotypes, as well a mutant line with abnormal social behavior and seizures. Overall, we observed a characteristic pattern of behavior over the course of 30 minutes, with the judges preferring the typical mouse chamber to the atypical mouse chamber during the last 10 minutes of the test. When we evaluated the individual stimulus pairings, two of the three showed a similar pattern as the overall results, and the other stimulus comparison showed a trend for a preference for the typical mouse chamber across the entire test. We repeated the experiments using the 129S6 strain of typical mice as judges and found a much less strong preference pattern across time. These data suggest that a characteristic pattern of exploration in B6 mice can distinguish some socially atypical animals from controls. SCIENTIFIC ABSTRACT Diagnosis of an autism spectrum disorder (ASD) requires a qualitative assessment of social aptitude: one person judging whether another person interacts in a ‘typical’ way. We hypothesized that mice could be used to make a similar judgment if they prefer ‘typical’ over ‘atypical’ social interactions with mouse models relevant to ASD. We used wildtype C57BL/6 (B6) mice as ‘judges’ and evaluated their preference for a chamber containing a ‘typical’ (B6 or 129S6) or an ‘atypical’ mouse. For our atypical mouse stimuli, we chose two inbred strains with well-documented social phenotypes (BTBR and BALB/c), as well a mutant line with abnormal social behavior and seizures (Gabrb3 +/?). Overall, we observed a stimulus by time interaction (P < 0.0001), with B6 mice preferring the typical mouse chamber during the last 10 minutes of the 30-minute test. For two of the individual stimulus pairings, we observed a similar chamber by time interaction (BALB/c vs. 129S6, P = 0.0007; Gabrb3 +/? vs. 129S6, P = 0.033). For the third stimulus pairing, we found a trend for preference of the typical mouse across time (BTBR vs. B6, P = 0.051). We repeated the experiments using 129S6 mice as judges and found a significant overall interaction (P = 0.034), but only one stimulus pairing reached significance on its own (BALB/c vs. 129S6, P = 0.0021). These data suggest that a characteristic pattern of exploration in B6 mice can distinguish some socially atypical animals from controls. PMID:23436806

  16. Does the seizure frequency increase in Ramadan?

    PubMed

    Gomceli, Yasemin B; Kutlu, Gulnihal; Cavdar, Leyla; Inan, Levent E

    2008-12-01

    During Ramadan, the ninth month of the Islamic lunar calendar, adult Muslims are required to refrain from taking any food, beverages, or oral drugs, as well as from sexual intercourse between dawn and sunset. In this study, we aimed at discovering alterations in drug regimens and the seizure frequency of epileptic patients during Ramadan (15 October 2004-13 November 2004). In the 3 months following Ramadan in the year 2004, 114 patients with epilepsy who were fasting during Ramadan were examined at our Epilepsy Department. Of the 114 patients who were included in the study, 38 patients had seizures and one of these patients developed status epilepticus during Ramadan. When the seizure frequency of these patients during Ramadan was compared to that in the last 1 year and last 3 months period just prior to Ramadan, a statistically significant increase was observed (p<0.001). Moreover, there was an important increase in the risk of having seizures in the patients who changed their drug regimens compared with those who did not (p<0.05). In the patients who received monotherapy or polytherapy, no difference in the frequency of seizures during Ramadan was seen (p>0.05). During Ramadan, an increase in the seizure frequency of patients with epilepsy was observed. The most important reason for this situation was the alteration in the pharmacokinetics and pharmacodynamics of drugs, and consequently, in their efficacy. We believe that in the patients who received monotherapy and who did not change their drug regimes, the increase in seizure frequency may have been related to the changes in their daily rhythms, emotional stress, tiredness and their day-long fasting. PMID:18468459

  17. Atypical thyroid cancers on sonography.

    PubMed

    Klang, Kendra; Kamaya, Aya; Tahvildari, Ali M; Jeffrey, R Brooke; Desser, Terry S

    2015-03-01

    The management of thyroid nodules is a common clinical problem. Thyroid nodules are present in up to 50% of the adult population. However, thyroid malignancy is rare, occurring in only 5% to 15% of nodules. Although certain specific patterns on imaging are almost always indicative of benignity, there is considerable overlap between the sonographic appearances of benign and malignant nodules. Radiologists should be wary of applying pattern recognition approaches too liberally as some malignant nodules may exhibit sonographic features more commonly associated with benign nodules such as cystic change, comet-tail artifact, smooth margins, echogenic echotexture, hypoechoic halos, or peripheral calcifications. This article illustrates atypical imaging appearances of thyroid malignancies and reviews recent literature in an attempt to clarify nuances in the diagnosis of malignancy in benign-appearing nodules. PMID:25706368

  18. 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

  19. Neurogenetic disorders and treatment of associated seizures.

    PubMed

    Faulkner, Michele A; Singh, Sanjay P

    2013-03-01

    Seizures are a frequent complication associated with several neurogenetic disorders. Antiepileptic medications remain the mainstay of treatment in these patients. We summarized the available data associated with various antiepileptic therapies used to treat patients with neurogenetic disorders who experienced recurrent seizures. A MEDLINE search was conducted to identify articles and abstracts describing the use of antiepileptic therapy for the treatment of various neurogenetic syndromes. Of all the neurogenetic syndromes, only autism spectrum disorders, Angelman syndrome, Rett syndrome, Dravet syndrome, and tuberous sclerosis complex were identified as having sufficient published information to evaluate therapy. Some efficacy trends were identified, including frequent successes with valproic acid with clonazepam for epilepsy with Angelman syndrome; valproic acid, stiripentol, and clobazam (triple combination therapy) for epilepsy with Dravet syndrome; and vigabatrin for infantile spasms associated with tuberous sclerosis complex. Due to a paucity of information regarding the mechanisms by which seizures are generated in the various disorders, approach to seizure control is primarily based on clinical experience and a limited amount of study data exploring patient outcomes. Although exposure of the developing brain to antiepileptic medications is of some concern, the control of epileptic activity is an important undertaking in these individuals, as the severity of eventual developmental delay often appears to correlate with the severity of seizures. As such, early aggressive therapy is warranted. PMID:23400943

  20. Concepts of brain oxygen sufficiency during seizures.

    PubMed

    Kreisman, N R; Sick, T J; Rosenthal, M

    1984-01-01

    To resolve conflicting evidence of oxygen sufficiency or insufficiency during seizures, signals of metabolic and circulatory function were monitored in rat cerebral cortex during recurrent seizures. Early seizures were accompanied by increased blood volume, increased tPO2, and oxidative shifts of cytochrome a,a3, indicative of oxygen sufficiency. Later seizures were accompanied by a smaller increment in blood volume, a fall in tPO2, and shifts toward reduction of cytochrome a,a3, suggesting that cerebral oxygen supply became insufficient to meet demand. Responses suggesting oxygen insufficiency occurred during short duration ictal bursts, interictal spikes or electrocortical stimulation at times when longer duration ictal episodes still were accompanied by responses signalling oxygen sufficiency. These data indicate that there is a progressive dissociation of the normally tight couple between neuronal activity, energy demand, and cerebral blood flow during status epilepticus. Systemic derrangements that often accompanied recurrent seizures also contributed to decreased cerebral oxygenation. These factors may cause the neuronal damage reported to follow prolonged status epilepticus. PMID:6099961

  1. Ethosuximide-induced conversion of typical childhood absence to Rolandic spikes.

    PubMed

    Anyanwu, Chinekwu; Ghavami, Forough; Schuelein, Marianne; Motamedi, Gholam K

    2013-01-01

    Coexistence of 2 idiopathic epilepsy syndromes (ie, childhood absence and Rolandic epilepsy), as evidenced by electroencephalographic (EEG) findings with or without clinical features of the 2 conditions, is uncommon and remains controversial. Few case reports support this coexistence either as a continuum or drug-induced conversion, whereas a large sample case review did not find such co-occurrence. The authors report a case of conversion of typical absence to Rolandic spikes after treatment with ethosuximide. An 11-year-old girl was diagnosed with typical childhood absence epilepsy at the age of 6 years with classic clinical and EEG features. She became seizure-free on ethosuximide but her follow-up EEGs consistently recorded right centrotemporal and centroparietal spikes without associated clinical seizures. This case may suggest simultaneous presence of these 2 common childhood idiopathic epilepsies either as a continuum or a drug-induced conversion. PMID:22467741

  2. 77 FR 12360 - Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-29

    ...Exemption Applications; Epilepsy and Seizure Disorders AGENCY: Federal Motor Carrier Safety...enable these individuals with seizure disorders to operate CMVs in interstate commerce...UPS. He was diagnosed with a seizure disorder and given anti-seizure...

  3. Is there a clustering effect on electroencephalographic seizure localization?

    PubMed

    Kim, Wonsuk; Miller, John W; Drane, Daniel L; Oakley, John C

    2014-05-01

    Long-term video-EEG monitoring (LTM) is the gold standard for initial lateralization and localization of seizures in the workup for neurosurgical treatment of medically intractable epilepsy. Previous studies have yielded contradictory results as to whether seizures that occur in clusters tend to arise from the same brain region and may lead to the incorrect conclusion that seizures arise from a single focus. To determine whether seizure clustering affects localization in an LTM setting, the authors performed an observational study over 6 years at a large regional epilepsy center on those undergoing LTM for seizure diagnosis, characterization, or presurgical workup. Excluding repeat studies and LTMs with generalized or nonepileptic seizures resulted in 479 monitorings with 2774 focal seizures for analysis. Sequential pairs of consecutive focal seizures were classed as "concordant", "discordant," or "other," based on EEG localization. ANOVA analysis on the logarithm of the interseizure interval (LISI) among the three seizure pair groups showed no significant difference, p=0.47, nor did analysis defining concordance as lateralization to the same hemisphere (p=0.34). Analyses on subgroups with multifocal seizures, bilateral seizures, and extratemporal seizures all failed to show a significant difference. In conclusion, seizures have the same localizing value whether occurring in a cluster over a few hours or sporadically over a few days. This could potentially lead to shorter monitoring times. PMID:24559839

  4. Prenatal exposure to ionizing radiation and subsequent development of seizures

    SciTech Connect

    Dunn, K.; Yoshimaru, H.; Otake, M.; Annegers, J.F.; Schull, W.J. (Radiation Effects Research Foundation, Hiroshima (Japan))

    1990-01-01

    Seizures are a frequent sequela of impaired brain development and can be expected to affect more children with radiation-related brain damage than children without such damage. This report deals with the incidence and type of seizures among survivors prenatally exposed to the atomic bombing of Hiroshima and Nagasaki, and their association with specific stages of prenatal development at the time of irradiation. Fetal radiation dose was assumed to be equal to the dose to the maternal uterus. Seizures here include all references in the clinical record to seizure, epilepsy, or convulsion. Histories of seizures were obtained at biennial routine clinical examinations starting at about the age of 2 years. These clinical records were used to classify seizures as febrile or unprovoked (without precipitating cause). No seizures were ascertained among subjects exposed 0-7 weeks after fertilization at doses higher than 0.10 Gy. The incidence of seizures was highest with irradiation at the eighth through the 15th week after fertilization among subjects with doses exceeding 0.10 Gy and was linearly related to the level of fetal exposure. This obtains for all seizures without regard to the presence of fever or precipitating causes, and for unprovoked seizures. When the 22 cases of severe mental retardation were excluded, the increase in seizures was only suggestively significant and only for unprovoked seizures. After exposure at later stages of development, there was no increase in recorded seizures.

  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. Seizure Reduction with Fluoxetine in Dravet Syndrome.

    PubMed

    Meador, Kimford J

    2014-01-01

    An adult woman with Dravet syndrome (documented SCN1A mutation) experienced a marked reduction in seizures when treated with the selective serotonin reuptake inhibitor (SSRI) fluoxetine. The seizure reduction may be partly to reductions associated with aging in Dravet patients, but it appears to be due at least in part to the fluoxetine. A prior preliminary study reported that fenfluramine reduces seizures in patients with Dravet syndrome. Fenfluramine may produce this effect by increasing serotonin brain levels, and SSRIs have been found to possess antiepileptic properties in animal models of epilepsy. Given the known cardiac risks of fenfluramine, consideration of randomized clinical trials with SSRIs should be considered in Dravet syndrome and other epilepsies. PMID:24955329

  7. Continuous assessment of epileptic seizures with wrist-worn biosensors

    E-print Network

    Poh, Ming-Zher

    2011-01-01

    Epilepsy is a neurological disorder characterized predominantly by an enduring predisposition to generate epileptic seizures. The apprehension about injury, or even death, resulting from a seizure often overshadows the ...

  8. 27 CFR 478.152 - Seizure and forfeiture.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...EXPLOSIVES, DEPARTMENT OF JUSTICE FIREARMS AND AMMUNITION COMMERCE IN FIREARMS AND AMMUNITION Exemptions, Seizures, and Forfeitures...Seizure and forfeiture. (a) Any firearm or ammunition involved in or used in any knowing...

  9. 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 ... seizures and epilepsy Antiepileptic drugs: Mechanism of action, pharmacology, and adverse effects Treatment of neonatal seizures Overview ...

  10. 19 CFR 12.101 - Seizure of prohibited switchblade knives.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...false Seizure of prohibited switchblade knives. 12.101 Section 12.101 Customs...SPECIAL CLASSES OF MERCHANDISE Switchblade Knives § 12.101 Seizure of prohibited switchblade knives. (a) Importations contrary to...

  11. 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.

  12. A Unifying Explanation of Primary Generalized Seizures Through Nonlinear

    E-print Network

    Breakspear, Michael

    , and a well- structured periodic spike and slow-wave shape that slows only slightly during the seizure- dictions with regards to seizure phenomena. We show that mapping the structure of the nonlinear bifurcation

  13. 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

  14. Monitoring Seizure Duration During Electroconvulsive Therapy.

    PubMed

    Couture, Lawrence J.; Lucas, Linda F.; Lippmann, Steven B.; Shaltout, Taher; Paloheimo, Markku P. J.; Edmonds, Harvey L.

    1988-01-01

    Three alternative monitoring methods for assessing the duration of seizures during electroconvulsive therapy were studied. The mean integrated amplitude of the electroencephalogram, facial muscle electromyogram, and "cuff method" were compared with the reference single-channel unprocessed electroencephalogram in 78 sessions with 17 patients. The measures of seizure duration differed significantly (p < 0.001). The mean integrated electroence phalographic amplitude differences were small and an artifact of the sampling procedure. Larger, but clinically unimportant, discrepancies were obtained with the facial electromyogram amplitude. In contrast, there were marked differences between the electroencephalogram and the "cuff method," which suggest that the latter technique may be of limited usefulness. PMID:11940966

  15. 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

  16. Atypical Hemolytic Uremic Syndrome: Update on the Complement System and What Is New

    Microsoft Academic Search

    Patricia Hirt-Minkowski; Michael Dickenmann; Jürg A. Schifferli

    2010-01-01

    Atypical hemolytic uremic syndrome (aHUS) is a rare disease of microangiopathic hemolytic anemia, thrombocytopenia, and predominant renal impairment. It is characterized by the absence of Shiga toxin-producing bacteria as a triggering factor. During the last decade, aHUS has been demonstrated to be a disorder of the complement alternative pathway dysregulation, as there is a growing list of mutations and polymorphisms

  17. Recurrent atypical fibroxanthoma of the limbus

    PubMed Central

    Ullrich, Katja; Wells, Jane; Brennan, Catriona; Craig, Jamie

    2013-01-01

    We report an unusual presentation of recurrent atypical fibroxanthoma of the limbus. Clinical and histological appearances, as well as management are discussed and the current literature is reviewed. PMID:23505280

  18. Cognitive bedside assessment in atypical parkinsonian syndromes

    Microsoft Academic Search

    T H Bak; T T Rogers; L M Crawford; V C Hearn; P S Mathuranath; J R Hodges

    2005-01-01

    Background: Despite the growing recognition of the importance of cognitive symptoms for the diagnosis and management of atypical parkinsonian syndromes, the cognitive assessment of the patients in clinical practice often remains very limited.Objectives: To examine the ability of a brief and simple cognitive screening test to detect cognitive deficits in atypical parkinsonian syndromes.Methods: Addenbrooke’s cognitive examination (ACE), the mini-mental state

  19. Symptoms of Psychopathology in Adults with Intellectual Disability and Seizures

    ERIC Educational Resources Information Center

    Fitzgerald, Mary E.; Matson, Johnny L.; Barker, Alyse

    2011-01-01

    Seizures are more common in individuals with intellectual disabilities than in the general population. As a result, differences in functioning for individuals with intellectual disability with and without seizures have been evaluated. Research on differences in psychopathology for individuals with intellectual disability with and without seizures

  20. Rapidly Learned Identification of Epileptic Seizures from Sonified EEG

    PubMed Central

    Loui, Psyche; Koplin-Green, Matan; Frick, Mark; Massone, Michael

    2014-01-01

    Sonification refers to a process by which data are converted into sound, providing an auditory alternative to visual display. Currently, the prevalent method for diagnosing seizures in epilepsy is by visually reading a patient’s electroencephalogram (EEG). However, sonification of the EEG data provides certain advantages due to the nature of human auditory perception. We hypothesized that human listeners will be able to identify seizures from EEGs using the auditory modality alone, and that accuracy of seizure identification will increase after a short training session. Here, we describe an algorithm that we have used to sonify EEGs of both seizure and non-seizure activity, followed by a training study in which subjects listened to short clips of sonified EEGs and determined whether each clip was of seizure or normal activity, both before and after a short training session. Results show that before training subjects performed at chance level in differentiating seizures from non-seizures, but there was a significant improvement of accuracy after the training session. After training, subjects successfully distinguished seizures from non-seizures using the auditory modality alone. Further analyses using signal detection theory demonstrated improvement in sensitivity and reduction in response bias as a result of training. This study demonstrates the potential of sonified EEGs to be used for the detection of seizures. Future studies will attempt to increase accuracy using novel training and sonification modifications, with the goals of managing, predicting, and ultimately controlling seizures using sonification as a possible biofeedback-based intervention for epilepsy. PMID:25352802

  1. A unifying concept of seizure onset and termination

    Microsoft Academic Search

    Glenn Doman; Ralph Pelligra

    2004-01-01

    Recent discoveries in molecular biology and human genetics have contributed greatly to an understanding of the nature of seizure (ictal) activity. However, two questions of fundamental clinical importance continue to resist scientific inquiry: when and why does a seizure begin; and when and why does a seizure end?This paper cites evidence from the medical literature in support of two counterintuitive

  2. Seizures in patients with cerebral hemiatrophy: A prognostic evaluation

    PubMed Central

    Jaiswal, Anupam; Garg, Ravindra Kumar; Malhotra, Hardeep Singh; Verma, Rajesh; Singh, Maneesh Kumar

    2015-01-01

    Purpose: Cerebral hemiatrophy is a common childhood disease. It clinically manifests with seizures, hemiparesis and mental retardation. Materials and Methods: In this prospective study, previously untreated patients with seizures and cerebral hemiatrophy were recruited. Cerebral hemiatrophy was diagnosed on the basis of hemispheric ratio. Patients with acquired hemiconvulsion, hemiplegia, and epilepsy (HHE) syndrome were included in group A. Group B included patients with congenital HHE syndrome. Patients were followed up for 6 months for seizure recurrence. Results: Out of 42 patients 26 were in group A and 16 were in group B. After 6 months, there was significant reduction in seizure frequency (P < 0.0001) in both the groups. At least 50% reduction in seizure frequency was noted in all the patients. Complete seizure freedom was observed in 15 (35.7%) patients. Seizure recurrences were significantly higher (P = 0.008) in group A. On univariate analysis, predictors of seizure recurrences were history of febrile seizures (P = 0.013), hippocampal sclerosis (P = 0.001), thalamic atrophy (P = 0.001), basal ganglia atrophy (P = 0.001), cerebellar atrophy (P = 0.01), ventricular dilatation (P = 0.001), epileptiform discharges at presentation (P = 0.023), complex partial seizures (P = 0.006) and status epilepticus (P = 0.02). On multivariate analysis, hemispheric ratio was the only significant factor for seizure recurrence. Conclusion: Patients with congenital hemiatrophy had better seizure control than that in patients with HHE syndrome. PMID:25745309

  3. Repeated seizures induce prefrontal growth disturbance in frontal lobe epilepsy

    Microsoft Academic Search

    Hideaki Kanemura; Fumikazu Sano; Tomoko Tando; Kanji Sugita; Masao Aihara

    BackgroundThe possible consequences of seizures in the immature brain have been the subject of much conjecture. We prospectively measured frontal and prefrontal lobe volumes using three-dimensional (3D) magnetic resonance imaging (MRI)-based volumetry in patients with frontal lobe epilepsy (FLE) presenting with the same seizure semiology. The pathogenesis of repeated seizure-induced brain damage is discussed herein.

  4. Rapidly learned identification of epileptic seizures from sonified EEG.

    PubMed

    Loui, Psyche; Koplin-Green, Matan; Frick, Mark; Massone, Michael

    2014-01-01

    Sonification refers to a process by which data are converted into sound, providing an auditory alternative to visual display. Currently, the prevalent method for diagnosing seizures in epilepsy is by visually reading a patient's electroencephalogram (EEG). However, sonification of the EEG data provides certain advantages due to the nature of human auditory perception. We hypothesized that human listeners will be able to identify seizures from EEGs using the auditory modality alone, and that accuracy of seizure identification will increase after a short training session. Here, we describe an algorithm that we have used to sonify EEGs of both seizure and non-seizure activity, followed by a training study in which subjects listened to short clips of sonified EEGs and determined whether each clip was of seizure or normal activity, both before and after a short training session. Results show that before training subjects performed at chance level in differentiating seizures from non-seizures, but there was a significant improvement of accuracy after the training session. After training, subjects successfully distinguished seizures from non-seizures using the auditory modality alone. Further analyses using signal detection theory demonstrated improvement in sensitivity and reduction in response bias as a result of training. This study demonstrates the potential of sonified EEGs to be used for the detection of seizures. Future studies will attempt to increase accuracy using novel training and sonification modifications, with the goals of managing, predicting, and ultimately controlling seizures using sonification as a possible biofeedback-based intervention for epilepsy. PMID:25352802

  5. Seizure associated with clozapine: incidence, etiology, and management.

    PubMed

    Williams, Andrew M; Park, Susie H

    2015-02-01

    Seizures are a known adverse effect of clozapine therapy. The literature varies on incidence rates of seizures, secondary to varying time frames in which each seizure occurred. Tonic-clonic seizures comprise the majority of seizures experienced secondary to clozapine use, but it is imperative to recognize the potential variety of seizure presentation. The exact etiology of clozapine-induced seizure is unknown. Conflicting reports regarding total oral dose, serum concentration, dose titration, and concomitant medications make it difficult to identify a single cause contributing to seizure risk. Following seizure occurrence, it may be in the best interests of the patient to continue clozapine treatment. In this clinical situation, the use of an antiepileptic drug (AED) for seizure prophylaxis may be required. The AED of choice appears to be valproate, but several successful case reports also support the use of lamotrigine, gabapentin and topiramate. Well-designed clinical trials regarding clozapine seizure prophylaxis are lacking. Given clozapine's strong evidence for efficacy in the treatment of schizophrenia and schizoaffective disorder, every attempt to manage side effects, including seizure, should be implemented to allow for therapeutic continuation. PMID:25537107

  6. Seizure Termination by Acidosis Depends on ASIC1a

    PubMed Central

    Ziemann, Adam E.; Schnizler, Mikael K.; Albert, Gregory W.; Severson, Meryl A.; Howard, Matthew A.; Welsh, Michael J.; Wemmie, John A.

    2008-01-01

    SUMMARY Most seizures stop spontaneously. However, the molecular mechanisms remain unknown. Earlier observations that seizures reduce brain pH and that acidosis inhibits seizures indicated that acidosis halts epileptic activity. Because acid–sensing ion channel–1a (ASIC1a) shows exquisite sensitivity to extracellular pH and regulates neuron excitability, we hypothesized that acidosis might activate ASIC1a to terminate seizures. Disrupting mouse ASIC1a increased the severity of chemoconvulsant–induced seizures, whereas overexpressing ASIC1a had the opposite effect. ASIC1a did not affect seizure threshold or onset, but shortened seizure duration and prevented progression. CO2 inhalation, long known to lower brain pH and inhibit seizures, also required ASIC1a to interrupt tonic–clonic seizures. Acidosis activated inhibitory interneurons through ASIC1a, suggesting that ASIC1a might limit seizures by increasing inhibitory tone. These findings identify ASIC1a as a key element in seizure termination when brain pH falls. The results suggest a molecular mechanism for how the brain stops seizures and suggest new therapeutic strategies. PMID:18536711

  7. A case of organophosphate poisoning presenting with seizure and unavailable history of parenteral suicide attempt

    PubMed Central

    Pandit, Vinay; Seshadri, Shubha; Rao, S N; Samarasinghe, Charmaine; Kumar, Ashwini; Valsalan, Rohith

    2011-01-01

    Organophosphate (OP) poisoning is common in India. Only few case reports of parenteral OP poisoning have been described. We report a case of self-injected methyl parathion poisoning, presenting after four days with seizure, altered sensorium, and respiratory distress which posed a diagnostic and therapeutic dilemma. Despite nonavailability of history of OP poisoning, he was treated based on suspicion and showed a good clinical response to treatment trial with atropine and pralidoxime, and had a successful recovery. Atypical presentations may be encountered following parenteral administration of OP poison, and even a slight suspicion of this warrants proper investigations and treatment for a favorable outcome. Persistently low plasma cholinesterase level is a useful marker for making the diagnosis. PMID:21633583

  8. Proteomic analysis of c-butyrolactone-treated mouse thalamus reveals dysregulated proteins upon absence seizure

    E-print Network

    Kim, Daesoo

    and Myeong-Hee Yu* *Functional Proteomics Center, Korea Institute of Science and Technology, Seoul, South Korea Life Sciences Division, Korea Institute of Science and Technology, Seoul, South Korea àSchool of Life Sciences and Biotechnology, Korea University, Seoul, South Korea §Department of Biological

  9. Recognizing, Differentiating, and Referring Students with Absence Seizures: What Factors Affect Preservice Teachers' Decision Making?

    ERIC Educational Resources Information Center

    Nasewicz, Nicole

    2009-01-01

    Attention-Deficit/Hyperactivity Disorder (ADHD) and epilepsy are common pediatric disorders that often occur co-morbidly. Both disorders predispose children to a wide range of school-related problems, some of which are the same and others vastly different. Fortunately, with early diagnosis and comprehensive disease management, the long-term…

  10. Evidence of Absence software

    USGS Publications Warehouse

    Dalthorp, Daniel; Huso, Manuela M. P.; Dail, David; Kenyon, Jessica

    2014-01-01

    Evidence of Absence software (EoA) is a user-friendly application used for estimating bird and bat fatalities at wind farms and designing search protocols. The software is particularly useful in addressing whether the number of fatalities has exceeded a given threshold and what search parameters are needed to give assurance that thresholds were not exceeded. The software is applicable even when zero carcasses have been found in searches. Depending on the effectiveness of the searches, such an absence of evidence of mortality may or may not be strong evidence that few fatalities occurred. Under a search protocol in which carcasses are detected with nearly 100 percent certainty, finding zero carcasses would be convincing evidence that overall mortality rate was near zero. By contrast, with a less effective search protocol with low probability of detecting a carcass, finding zero carcasses does not rule out the possibility that large numbers of animals were killed but not detected in the searches. EoA uses information about the search process and scavenging rates to estimate detection probabilities to determine a maximum credible number of fatalities, even when zero or few carcasses are observed.

  11. 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 3-4Hz 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 (7-8Hz) and human (3-4Hz) spike-wave discharges. To examine the possible contributions of these differences, we developed a ferret model that exhibits 3-4Hz 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 3-4Hz 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

  12. Biopsychosocial Aspects of Atypical Odontalgia

    PubMed Central

    Ciaramella, A.; Paroli, M.; Lonia, L.; Bosco, M.; Poli, P.

    2013-01-01

    Background. A few studies have found somatosensory abnormalities in atypical odontalgia (AO) patients. The aim of the study is to explore the presence of specific abnormalities in facial pain patients that can be considered as psychophysical factors predisposing to AO. Materials and Methods. The AO subjects (n = 18) have been compared to pain-free (n = 14), trigeminal neuralgia (n = 16), migraine (n = 17), and temporomandibular disorder (n = 14). The neurometer current perception threshold (CPT) was used to investigate somatosensory perception. Structured clinical interviews based on the DSM-IV axis I and DSM III-R axis II criteria for psychiatric disorders and self-assessment questionnaires were used to evaluate psychopathology and aggressive behavior among subjects. Results. Subjects with AO showed a lower A?, A?, and C trigeminal fiber pain perception threshold when compared to a pain-free control group. Resentment was determined to be inversely related to A? (rho: 0.62, P < 0.05), A? (rho: 0.53, P < 0.05) and C fibers (rho: 0.54, P < 0.05), and depression was inversely related with C fiber (rho: 0.52, P < 0.05) perception threshold only in AO subjects. Conclusion. High levels of depression and resentment can be considered predictive psychophysical factors for the development of AO after dental extraction. PMID:24959561

  13. Schizophrenia - Typical and Atypical Drugs

    NSDL National Science Digital Library

    2009-04-14

    Schizophrenia and other psychotic disorders are treated principally by a class of medications called anti-psychotic drugs. These medications act principally by blocking the stimulation of dopamine receptors by the neurotransmitter dopamine. There are two main classes of anti-psychotic drugs. One is called the first generation, or typical, or conventional anti-psychotic drugs, and the second is called the second generation or atypical anti-psychotic drugs. The difference between these two, even though they both have similar properties and act as anti-psychotics, is that the newer medicines do not produce the disabling neurologic side-effects like stiffness, and slowness and tremor that the first generation drugs produced. In addition, they have a much lower affinity for dopamine receptors so they're kinder, gentler pharmacological agents as opposed to the very potent high-affinity dopamine receptor antagonist that the first generations are. And then thirdly, they may be a little better in some ways terms of their therapeutic efficacy. They alleviate symptoms better, they prevent relapse, and they may work on a broader range of the symptoms of schizophrenia.

  14. 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

  15. Automatic Seizure Detection in Rats Using Laplacian EEG and Verification with Human Seizure Signals

    PubMed Central

    Feltane, Amal; Boudreaux-Bartels, G. Faye; Besio, Walter

    2012-01-01

    Automated detection of seizures is still a challenging problem. This study presents an approach to detect seizure segments in Laplacian electroencephalography (tEEG) recorded from rats using the tripolar concentric ring electrode (TCRE) configuration. Three features, namely, median absolute deviation, approximate entropy, and maximum singular value were calculated and used as inputs into two different classifiers: support vector machines and adaptive boosting. The relative performance of the extracted features on TCRE tEEG was examined. Results are obtained with an overall accuracy between 84.81 and 96.51%. In addition to using TCRE tEEG data, the seizure detection algorithm was also applied to the recorded EEG signals from Andrzejak et al. database to show the efficiency of the proposed method for seizure detection. PMID:23073989

  16. David et al.: Seizure onset zone imaging Imaging the seizure onset zone with stereo-electroencephalography

    E-print Network

    Boyer, Edmond

    with stereo-electroencephalography Olivier David a,b,c,* , Thomas Blauwblomme d , Anne-Sophie Job e , Stéphan zone imaging 2 ABSTRACT Stereo-electroencephalography is used to localise the seizure onset

  17. St. Valentine--patron saint of epilepsy: illustrating the semiology of seizures over the course of six centuries.

    PubMed

    Kluger, Gerhard; Kudernatsch, Verena

    2009-01-01

    From the 15th century to the present day, Christian art has portrayed people who suffer from epilepsy as attributes in illustrations of Saint Valentine (SV). The objective of our study was to interpret the works of art from a modern epileptological perspective on the basis of a collection of portrayals of SV in Europe that was as comprehensive as possible. The people depicted as attributes were analyzed with respect to their age, gender, social status, and possible seizure semiology. Three hundred forty-one illustrations of SV from Austria, Belgium, Croatia, Czech Republic, France, Germany, Hungary, Ireland, Italy, Luxembourg, Poland, Scotland, Slovakia, and Switzerland were systematically analyzed. Irrespective of the age of the work of art, among the 143 pictures of people with possible epilepsy characteristics, there were more males than females from various levels of society. As far as could be interpreted, there were 17 infants, 35 children, 7 adolescents, and 84 adults. With respect to possible seizure semiology, infantile spasms (n=10), atonic seizures (n=13), tonic seizures (n=53), absences (n=2), psychogenic seizures (n=4), and postictal or undefinable states (n=61) were differentiated in a subjective assessment. Despite the fact that from a modern perspective, the 15th to 20th centuries in Europe seemed to be dominated by a rather superstitious attitude toward epilepsy, there is striking accuracy in the detail of the semiology in many of the historic portrayals, and a well-founded knowledge of epilepsy is apparent. PMID:18935981

  18. Phenotyping seizures (epilepsy)Phenotyping seizures (epilepsy) 1st ISBS Summer School1st ISBS Summer School

    E-print Network

    Kalueff, Allan V.

    Phenotyping seizures (epilepsy)Phenotyping seizures (epilepsy) 1st ISBS Summer School1st ISBS;Epilepsy · A group of CNS disorders · Associated with sudden transient seizure episodes - Abnormal motor, sensory, autonomic, and psychic activity · EEG usually normal · Different types of epilepsy - Secondary

  19. NONCONVULSIVE SEIZURES AFTER SUBARACHNOID HEMORRHAGE: MULTIMODAL DETECTION AND OUTCOMES

    PubMed Central

    Claassen, Jan; Perotte, Adler; Albers, David; Kleinberg, Samantha; Schmidt, J. Michael; Tu, Bin; Badjatia, Neeraj; Lantigua, Hector; Hirsch, Lawrence J.; Mayer, Stephan A.; Connolly, E. Sander; Hripcsak, George

    2013-01-01

    Objective Seizures have been implicated as a cause of secondary brain injury, but the systemic and cerebral physiologic effects of seizures after acute brain injury are poorly understood. Methods We analyzed intracortical EEG and multimodality physiological recordings in 48 comatose subarachnoid hemorrhage patients to better characterize the physiological response to seizures after acute brain injury. Results Intracortical seizures were seen in 38% of patients and 8% had surface seizures. Intracortical seizures were accompanied by elevated heart rate (P=0.001), blood pressure (P<0.001), and respiratory rate (P<0.001). There were trends for rising cerebral perfusion pressure (P=0.03) and intracranial pressure (P =0.06) seen after seizure onset. Intracortical seizure associated increases in global brain metabolism, partial brain tissue oxygenation, and regional cerebral blood flow (rCBF) did not reach significance, but a trend for a pronounced delayed rCBF rise was seen for surface seizures (P=0.08). Functional outcome was very poor for patients with severe background attenuation without seizures and best for those without severe attenuation or seizures (77% vs. 0% dead or severely disabled, respectively). Outcome was intermediate for those with seizures independent of the background EEG and worse for those with intracortical only seizures when compared to those with intracortical and scalp seizures (50% and 25% death or severe disability, respectively). Interpretation We replicated in humans complex physiologic processes associated with seizures after acute brain injury previously described in laboratory experiments and illustrated differences such as the delayed increase in regional cerebral blood flow. These real-world physiologic observations may permit more successful translation of laboratory research to the bedside. PMID:23813945

  20. ORIGINAL CONTRIBUTION Seizures in Alzheimer Disease

    E-print Network

    , MD; W. Allen Hauser, MD; Yaakov Stern, PhD Background: Transient symptoms in Alzheimer dis- ease (AD nonepileptic and epileptic events may be challenging. Patients with dementia may experience nonepileptic conflicting results about the prevalence of seizures in dementia and AD, with frequency ranging from 5% to 64

  1. Seizures and Epilepsy: Hope through Research

    MedlinePLUS

    ... available for many antiepileptic drugs. The chemicals in generic drugs are exactly the same as in the brand- ... check with their doctors before switching to a generic version of their medication. ... their antiepileptic drugs after 2 years have passed without a seizure. ...

  2. Prenatal cocaine: Seizure susceptibility in rat offspring

    Microsoft Academic Search

    Maria Rita De Feo; Daniele Del Priore; Oriano Mecarelli

    1995-01-01

    Proconvulsant and convulsant effects of cocaine have been described in various experimental models of epilepsy. We have studied the susceptibility to bicuculline and pentylenetetrazol-induced seizures in developing 10-, 20- and 30-day old rats, gestationally exposed to cocaine. Incidence and latency of appearance of the epileptic manifestations, their evolution toward status epilepticus and successive recovery or death, have been evaluated and

  3. [Classification of epileptic seizures and syndromes].

    PubMed

    Noachtar, S; Rémi, J

    2012-02-01

    Advances in diagnostic and therapeutic options require a revision of the current classification of seizures and epilepsies. Recently, a classification proposal was introduced which reflects the ambivalence of the Internationalen Liga gegen Epilepsie (ILAE). We suggest that epileptology should utilize the same established systematic approach used in clinical neurology. PMID:22349767

  4. Oxygen and seizure dynamics: I. Experiments.

    PubMed

    Ingram, Justin; Zhang, Chunfeng; Cressman, John R; Hazra, Anupam; Wei, Yina; Koo, Yong-Eun; Žiburkus, Jok?bas; Kopelman, Raoul; Xu, Jian; Schiff, Steven J

    2014-07-15

    We utilized a novel ratiometric nanoquantum dot fluorescence resonance energy transfer (NQD-FRET) optical sensor to quantitatively measure oxygen dynamics from single cell microdomains during hypoxic episodes as well as during 4-aminopyridine (4-AP)-induced spontaneous seizure-like events in rat hippocampal slices. Coupling oxygen sensing with electrical recordings, we found the greatest reduction in the O2 concentration ([O2]) in the densely packed cell body stratum (st.) pyramidale layer of the CA1 and differential layer-specific O2 dynamics between the st. pyramidale and st. oriens layers. These hypoxic decrements occurred up to several seconds before seizure onset could be electrically measured extracellularly. Without 4-AP, we quantified a narrow range of [O2], similar to the endogenous hypoxia found before epileptiform activity, which permits a quiescent network to enter into a seizure-like state. We demonstrated layer-specific patterns of O2 utilization accompanying layer-specific neuronal interplay in seizure. None of the oxygen overshoot artifacts seen with polarographic measurement techniques were observed. We therefore conclude that endogenously generated hypoxia may be more than just a consequence of increased cellular excitability but an influential and critical factor for orchestrating network dynamics associated with epileptiform activity. PMID:24598521

  5. Pyramidal cells accumulate chloride at seizure onset

    PubMed Central

    Lillis, Kyle P; Kramer, Mark A; Mertz, Jerome; Staley, Kevin J

    2012-01-01

    Seizures are thought to originate from a failure of inhibition to quell hyperactive neural circuits, but the nature of this failure remains unknown. Here we combine high-speed two-photon imaging with electrophysiological recordings to directly evaluate the interaction between populations of interneurons and principal cells during the onset of seizure-like activity in mouse hippocampal slices. Both calcium imaging and dual patch clamp recordings reveal that in vitro seizure-like events (SLEs) are preceded by pre-ictal bursts of activity in which interneurons predominate. Corresponding changes in intracellular chloride concentration were observed in pyramidal cells using the chloride indicator Clomeleon. These changes were measurable at SLE onset and became very large during the SLE. Pharmacological manipulation of GABAergic transmission, either by blocking GABAA receptors or by hyperpolarizing the GABAA reversal potential, converted SLEs to short interictal-like bursts. Together, our results support a model in which pre-ictal GABAA receptor-mediated chloride influx shifts EGABA to produce a positive feedback loop that contributes to the initiation of seizure activity. PMID:22677032

  6. Hyponatremia and seizures in an ultradistance triathlete

    Microsoft Academic Search

    Dale B Speedy; Ian Rogers; Shameem Safih; Bernard Foley

    2000-01-01

    Hyponatremia is being increasingly recognized as a complication of participation in ultra-endurance sports. Reported is the case of an Ironman triathlete who collapsed at the end of the race, having gained 5% in body weight. His serum sodium concentration at the finish was 116 mmol\\/L. After an Intensive Care Unit course complicated by recurrent seizures, he eventually made a complete

  7. Cognitive behavioral therapy for psychogenic nonepileptic seizures

    Microsoft Academic Search

    W. Curt LaFrance Jr.; Ivan W. Miller; Christine E. Ryan; Andrew S. Blum; David A. Solomon; Joan E. Kelley; Gabor I. Keitner

    2009-01-01

    Treatment trials for psychogenic nonepileptic seizures (PNES) are few, despite the high prevalence and disabling nature of the disorder. We evaluated the effect of cognitive behavioral therapy (CBT) on reduction of PNES. Secondary measures included psychiatric symptom scales and psychosocial variables. We conducted a prospective clinical trial assessing the frequency of PNES in outpatients treated using a CBT for PNES

  8. 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

  9. Closed-loop seizure control on epileptic rat models

    NASA Astrophysics Data System (ADS)

    Liang, Sheng-Fu; Liao, Yi-Cheng; Shaw, Fu-Zen; Chang, Da-Wei; Young, Chung-Ping; Chiueh, Herming

    2011-08-01

    In this paper numerous alternative treatments in addition to pharmacological therapy are proposed for their use in epileptic patients. Epileptic animal models can play a crucial role in the performance evaluation of new therapeutic techniques. The objective of this research is to first develop various epileptic rat models; second, develop a portable wireless closed-loop seizure controller including on-line seizure detection and real-time electrical stimulation for seizure elimination; and third, apply the developed seizure controller to the animal models to perform on-line seizure elimination. The closed-loop seizure controller was applied to three Long-Evans rats with spontaneous spike-wave discharges (non-convulsive) and three Long-Evans rats with epileptiform activities induced by pentylenetetrazol (PTZ) injection (convulsive) for evaluation. The seizure detection accuracy is greater than 92% (up to 99%), and averaged seizure detection latency is less than 0.6 s for both spontaneous non-convulsive and PTZ-induced convulsive seizures. The average false stimulation rate is 3.1%. Near 30% of PTZ-induced convulsive seizures need more than two times of 0.5 s electrical stimulation for suppression and 90% of the non-convulsive seizures can be suppressed by only one 0.5 s electrical stimulation.

  10. Ictal electroencephalograms in neonatal seizures: characteristics and associations.

    PubMed

    Nagarajan, Lakshmi; Ghosh, Soumya; Palumbo, Linda

    2011-07-01

    The characteristics of ictal electroencephalograms in 160 neonatal seizures of 43 babies were correlated with mortality and neurodevelopmental outcomes. Neonatal seizures are focal at onset, most frequently temporal, and often occur during sleep. Twenty-one percent of babies with seizures died, and 76% of survivors manifested neurodevelopmental impairment during 2-6-year follow-up. A low-amplitude ictal electroencephalogram discharge was associated with increased mortality, and a frequency of <2 Hz with increased morbidity. Status epilepticus, ictal fractions, multiple foci, and bihemispheric involvement did not influence outcomes. Of 160 seizures, 99 exhibited no associated clinical features (electrographic seizures). Neonatal seizures with clinical correlates (electroclinical seizures) exhibited a higher amplitude and frequency of ictal electroencephalogram discharge than electrographic seizures. During electroclinical seizures, the ictal electroencephalogram was more likely to involve larger areas of the brain and to cross the midline. Mortality and morbidity were similar in babies with electroclinical and electrographic seizures, emphasizing the need to diagnose and treat both types. Ictal electroencephalogram topography has implications for electrode application during limited-channel, amplitude-integrated electroencephalograms. We recommend temporal and paracentral electrodes. Video electroencephalograms are important in diagnosing neonatal seizures and providing useful information regarding ictal electroencephalogram characteristics. PMID:21723453

  11. [Gastrointestinal histoplasmosis: an atypical presentation].

    PubMed

    Barros, Roberto Augusto; Monteverde, María José; dElizalde, Santiago de; Barros, Augusto Sebastián; Barros, Roberto Federico

    2013-03-01

    Histoplasmosis is a systemic mycosis caused by Histoplasma capsulatum. It is an endemic disease in the American continent. It is spread hematogenously and any organ can be affected. It is more frequent in immunodeficient patients and the most common opportunist mycosis associated with HIV Exclusive gastrointestinal involvement is rare and invariably mortal without treatment. It is considered to be impossible to diagnose the disease based on the macroscopic aspect of lesions. We report a 43-year-old male in apparent good health status who was admitted with intermittent proctorrhagia of one year of evolution associated to burning proctalgia, without any further symptoms. A videocolonoscopy (VCC) with proctologic exam was conducted The patient was warned about the potential orificial origin of the bleeding and the importance of screening for colorectal neoplasia. The proctologic exam revealed internal congestive hemorrhoids. VCC showed during the routine exploration of the terminal ileon lesions both in that level and rectum, although of a different morphology. The colon had normal endoscopic appearance. Biopsies of both lesions identified Histoplasma. Later studies diagnosed HIV/AIDS and the patient was referred to the infectology department to complete diagnostic tests and begin treatment of both diseases. In conclusion, we present an atypical case of this mycosis because of its exclusive gastrointestinal allocation, in anasymptomatic patient, in apparent good health, with unknown HIV/AIDS, who was admitted because of a proctorrhagia of orificial origin. Endoscopic biopsies of lesions of different morphologies, located in the terminal ileon and rectum, allowed the diagnosis of this disease, that had no clinical expression. This casual endoscopic diagnosis enabled to change the life expectancy of the patient. We consider that the described endoscopic lesions in rectum are of a particular morphology and can rarely be found in other pathologies. The diffusion of these images could warn other endoscopists of these phenomena. PMID:23650831

  12. Dynamic imaging of seizure activity in pediatric epilepsy patients

    PubMed Central

    Lu, Yunfeng; Yang, Lin; Worrell, Gregory A.; Brinkmann, Benjamin; Nelson, Cindy; He, Bin

    2012-01-01

    Objective To investigate the feasibility of using noninvasive EEG source imaging approach to image continuous seizure activity in pediatric epilepsy patients. Methods Nine pediatric patients with medically intractable epilepsy were included in this study. Eight of the patients had extratemporal lobe epilepsy and one had temporal lobe epilepsy. All of the patients underwent resective surgery and seven of them underwent intracranial EEG (iEEG) monitoring. The ictal EEG was analyzed using a noninvasive dynamic seizure imaging (DSI) approach. The DSI approach separates scalp EEGs into independent components and extracts the spatio-temporal ictal features to achieve dynamic imaging of seizure sources. Surgical resection and intracranial recordings were used to validate the noninvasive imaging results. Results The DSI determined seizure onset zones (SOZs) in these patients were localized within or in close vicinity to the surgically resected region. In the seven patients with intracranial monitoring, the estimated seizure onset sources were concordant with the seizure onset zones of iEEG. The DSI also localized the multiple foci involved in the later seizure propagation, which were confirmed by the iEEG recordings. Conclusions Dynamic seizure imaging can noninvasively image the seizure activations in pediatric patients with both temporal and extratemporal lobe epilepsy. Significance EEG seizure imaging can potentially be used to noninvasively image the SOZs and aid the pre-surgical planning in pediatric epilepsy patients. PMID:22608485

  13. Characterization of Early Partial Seizure Onset: Frequency, Complexity and Entropy

    PubMed Central

    Jouny, Christophe C.; Bergey, Gregory K.

    2011-01-01

    Objective A clear classification of partial seizures onset features is not yet established. Complexity and entropy have been very widely used to describe dynamical systems, but a systematic evaluation of these measures to characterize partial seizures has never been performed. Methods Eighteen different measures including power in frequency bands up to 300Hz, Gabor atom density (GAD), Higuchi fractal dimension (HFD), Lempel-Ziv complexity, Shannon entropy, sample entropy, and permutation entropy, were selected to test sensitivity to partial seizure onset. Intracranial recordings from forty-five patients with mesial temporal, neocortical temporal and neocortical extratemporal seizure foci were included (331 partial seizures). Results GAD, Lempel-Ziv complexity, HFD, high frequency activity, and sample entropy were the most reliable measures to assess early seizure onset. Conclusions Increases in complexity and occurrence of high-frequency components appear to be commonly associated with early stages of partial seizure evolution from all regions. The type of measure (frequency-based, complexity or entropy) does not predict the efficiency of the method to detect seizure onset. Significance Differences between measures such as GAD and HFD highlight the multimodal nature of partial seizure onsets. Improved methods for early seizure detection may be achieved from a better understanding of these underlying dynamics. PMID:21872526

  14. Treatment of recurrent epileptic seizures in patients with neurological disorders

    PubMed Central

    YUAN, GUAN-QIAN; GAO, DAN-DAN; LIN, JUN; HAN, SONG; LV, BO-CHUANG

    2013-01-01

    This study aimed to investigate the clinical characteristics and the treatment principles and methods of recurrent epileptic seizures in patients with neurological disorders. A retrospective analysis was performed of the clinical data, treatment methods and results in 13 patients with recurrent epileptic seizures attending the neurosurgery department. Of the 13 patients, 10 had a history of epilepsy, 9 had organic frontal lobe brain lesions and 11 exhibited frontal lobe epilepsy. The causes of the epileptic seizure aggravation included drug withdrawal, dose reduction and dressing change (5 cases). The epileptic seizure types included partial and secondary full seizures and the seizure frequency ranged from 1 seizure/3 min to 1 seizure/several h. Following combined therapy with multiple anti-epileptic drugs (AEDs), including oral administration and injection, the epilepsy was controlled. The addition of orally administered levetiracetam improved the treatment efficiency. In cases of recurrent epileptic seizures in patients with neurological disorders, the combined administration of AEDs should be conducted with doses higher than the conventional initial dose to control the epileptic seizures as rapidly as possible. PMID:23251281

  15. SEIZURE DURATION AND RELATED ISSUES IN ECT FOR ENDOGENOUS DEPRESSION

    PubMed Central

    Andrade, Chittaranjan

    1993-01-01

    SUMMARY In a study comparing sinusoidal wave and brief-pulse ECT in endogenous depression, seizure duration was monitored by the cuff method in 29 patients over 180 treatment sessions. Mean seizure duration across all treatments was 26.5 secs, and the mean for individual patients across their ECT course ranged from a minimum of 15.7 secs to maximum of38.5 secs. Regression analysis found no variable which significantly predicted mean seizure duration. Of the 22 good responders in the study, response to ECT was associated with a mean seizure duration of secs in 1 patient, ando cs in 11 patients; as just 2 of 7poor responders to ECT had a mean seizure duration of <20 secs in 1 patients, <25 secs in 11 patients, of the 22 good responders in the study; as just 2 of 7 poor responders to ECT had a mean seizure duration of <25 secs, it appears that a cuff seizure duration of over 20 secs may suffice for the seizure to be therapeutic in depression. With (constant current) brief pulse ECT, seizure threshold significantly increased with successive ECTs; thresholds did not however differ between the good and poor responders. There was a trend for seizure duration to decrease over time; again, good and poor responders did not differ. These findings provide little support for the anticonvulsant hypothesis for the antidepressant effect of ECT, but support the literature that ECT exerts an anticonvulsant effect. PMID:21776168

  16. Inheritance of febrile seizures in sudden unexplained death in toddlers.

    PubMed

    Holm, Ingrid A; Poduri, Annapurna; Crandall, Laura; Haas, Elisabeth; Grafe, Marjorie R; Kinney, Hannah C; Krous, Henry F

    2012-04-01

    Sudden unexplained death in toddlers has been associated with febrile seizures, family history of febrile seizures, and hippocampal anomalies. We investigated the mode of inheritance for febrile seizures in these families. A three-generation pedigree was obtained from families enrolled in the San Diego Sudden Unexplained Death in Childhood Research Project, involving toddlers with sudden unexplained death, febrile seizures, and family history of febrile seizures. In our six cases, death was unwitnessed and related to sleep. The interval from last witnessed febrile seizure to death ranged from 3 weeks to 6 months. Hippocampal abnormalities were identified in one of three cases with available autopsy sections. Autosomal dominant inheritance of febrile seizures was observed in three families. A fourth demonstrated autosomal dominant inheritance with incomplete penetrance or variable expressivity. In two families, the maternal and paternal sides manifested febrile seizures. In this series, the major pattern of inheritance in toddlers with sudden unexplained death and febrile seizures was autosomal dominant. Future studies should develop markers (including genetic) to identify which patients with febrile seizures are at risk for sudden unexplained death in childhood, and to provide guidance for families and physicians. PMID:22490769

  17. Inheritance of Febrile Seizures in Sudden Unexplained Death in Toddlers

    PubMed Central

    Holm, Ingrid A.; Poduri, Annapurna; Crandall, Laura; Haas, Elisabeth; Grafe, Marjorie R.; Kinney, Hannah C.; Krous, Henry F.

    2014-01-01

    Sudden unexplained death in toddlers has been associated with febrile seizures, family history of febrile seizures, and hippocampal anomalies. We investigated the mode of inheritance for febrile seizures in these families. A three-generation pedigree was obtained from families enrolled in the San Diego Sudden Unexplained Death in Childhood Research Project, involving toddlers with sudden unexplained death, febrile seizures, and family history of febrile seizures. In our six cases, death was unwitnessed and related to sleep. The interval from last witnessed febrile seizure to death ranged from 3 weeks to 6 months. Hippocampal abnormalities were identified in one of three cases with available autopsy sections. Autosomal dominant inheritance of febrile seizures was observed in three families. A fourth demonstrated autosomal dominant inheritance with incomplete penetrance or variable expressivity. In two families, the maternal and paternal sides manifested febrile seizures. In this series, the major pattern of inheritance in toddlers with sudden unexplained death and febrile seizures was autosomal dominant. Future studies should develop markers (including genetic) to identify which patients with febrile seizures are at risk for sudden unexplained death in childhood, and to provide guidance for families and physicians. PMID:22490769

  18. An unusual cause for hyponatremia with seizures.

    PubMed

    Naha, Kushal; Vivek, G; Dasari, Sowjanya; Manthappa, M; Dias, Lorraine; Acharya, Raviraja

    2012-01-01

    A 50-year-old Asian Indian female with known hypertension presented with persistent vomiting but no other symptoms of meningism. Clinical examination and basic laboratory parameters were entirely normal except for significant hyponatremia. Further investigation was suggestive of the syndrome of inappropriate antidiuretic hormone (SIADH) secretion. Subsequently, despite steady correction of hyponatremia, the patient developed generalised seizures. Cerebrospinal fluid (CSF) analysis performed was inconclusive. Screening for a chronic meningitis underlying SIADH, yielded positive blood and CSF titres for venereal disease research laboratory (VDRL), which were confirmed by Treponema pallidum haemagglutination (TPHA). The patient was treated for neurosyphilis and made a complete recovery. Hyponatremia resolved and she had no further episodes of seizures. She was tested for HIV infection which was negative. On follow-up, she remained TPHA positive but VDRL titres became negative. PMID:22605698

  19. An unusual cause for hyponatremia with seizures

    PubMed Central

    Naha, Kushal; Vivek, G; Dasari, Sowjanya; Manthappa, M; Dias, Lorraine; Acharya, Raviraja

    2012-01-01

    A 50-year-old Asian Indian female with known hypertension presented with persistent vomiting but no other symptoms of meningism. Clinical examination and basic laboratory parameters were entirely normal except for significant hyponatremia. Further investigation was suggestive of the syndrome of inappropriate antidiuretic hormone (SIADH) secretion. Subsequently, despite steady correction of hyponatremia, the patient developed generalised seizures. Cerebrospinal fluid (CSF) analysis performed was inconclusive. Screening for a chronic meningitis underlying SIADH, yielded positive blood and CSF titres for venereal disease research laboratory (VDRL), which were confirmed by Treponema pallidum haemagglutination (TPHA). The patient was treated for neurosyphilis and made a complete recovery. Hyponatremia resolved and she had no further episodes of seizures. She was tested for HIV infection which was negative. On follow-up, she remained TPHA positive but VDRL titres became negative. PMID:22605698

  20. Local cerebral metabolism during partial seizures

    SciTech Connect

    Engel, J. Jr.; Kuhl, D.E.; Phelps, M.E.; Rausch, R.; Nuwer, M.

    1983-04-01

    Interictal and ictal fluorodeoxyglucose scans were obtained with positron CT from four patients with spontaneous recurrent partial seizures, one with epilepsia partialis continua, and one with a single partial seizure induced by electrical stimulation of the hippocampus. Ictal metabolic patterns were different for each patient studied. Focal and generalized increased and decreased metabolism were observed. Ictal hypermetabolism may exceed six times the interictal rate and could represent activation of excitatory or inhibitory synapses in the epileptogenic region and its projection fields. Hypometabolism seen on ictal scans most likely reflects postictal depression and may indicate projection fields of inhibited neurons. No quantitative relationship between alterations in metabolism and EEG or behavioral measurements of ictal events could be demonstrated.

  1. 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

  2. Ischemia-modified albumin levels in children having seizure.

    PubMed

    Inci, Asli; Gencpinar, Pinar; Orhan, Demet; Uzun, Gulbahar; Ozdem, Sebahat; Samur, An?l Akta?; Haspolat, Senay; Duman, Ozgür

    2013-10-01

    Convulsions are one of the frequently seen problems for a neurologist in the daily routine. It is difficult to distinguish the seizure from pseudo-seizure because of lack of conclusive tests. The aim of this study is to investigate the relationship between seizure types and seizure periods by studying IMA serum levels in children having seizure. Two groups were included (patients and control) in our study. The patient group consisted of the children admitted to Pediatric Emergency Care during January 2008-January 2010 with seizure and the control group consisted of healthy children. Serum Ischemia modified albumin (IMA) level in the group having seizures was 99.7 and 83.2U/ml in the control group. In the comparison of the patient and control groups, significant differences were found between their IMA values (p=0.000). There was a significant difference between IMA values of the group having generalized tonic-clonic seizures and those of the control group (p=0.001). In comparison of the IMA values of the group having febrile convulsions and those of the control group, a significant difference was determined (p=0.011). It has been shown that if the seizure was prolonged over 5 min, IMA level increased, and there was a significant difference between the groups experiencing over 5 min of seizures and the groups experiencing less than 5 min of seizures (p=0.001). An increase in IMA levels in febrile convulsion supports the hypoxia development in the brain during the seizure. Serum IMA levels increased with the elongation of the seizure period and may be an indicator for status epilepticus. PMID:23291221

  3. Intermittent clobazam therapy in febrile seizures

    Microsoft Academic Search

    Winsley Rose; Chellam Kirubakaran; Julius Xavier Scott

    2005-01-01

    Objective: To evaluate the efficacy of intermittent clobazam therapy in preventing the recurrence of febrile seizures and to assess\\u000a its safety.Methods: The study was a prospective, randomized, double-blind placebo-controlled trial conducted in the Department of Child Health,\\u000a Christian Medical College Hospital, Vellore between July 2001 and September 2002. Neurologically normal children between 6\\u000a months and 3 years of age with

  4. 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.

  5. Psychiatric disorders, trauma, and MMPI profile in a Spanish sample of nonepileptic seizure patients.

    PubMed

    Baillés, Eva; Pintor, Luis; Fernandez-Egea, Emili; Torres, Xavier; Matrai, Silvia; De Pablo, Joan; Arroyo, Santiago

    2004-01-01

    The aim of this study was to examine clinical characteristics in patients with psychogenic nonepileptic seizures and to analyze the Minnesota Multiphasic Personality Inventory (MMPI) profiles and their relation to psychopathology. Thirty patients with nonepileptic seizures confirmed through video-electroencephalography were included. A structured clinical interview (Structured Clinical Interview for DSM-III-R), a measure of personality variables (MMPI), and several structured interviews designed for collecting data on clinical and personal history were administered. Descriptive and comparative statistical methods were used. Of the sample, 67.7% met criteria for two or more simultaneous Axis I diagnoses, and 60% for an Axis II personality disorder. The most frequently elevated scales of the MMPI were Schizophrenia and Depression. There were multiple scale elevations in 12 profiles, the 91.7% of which had elevated "neurotic" and "psychotic" scales. The subgroup with personality disorders showed higher scores on the MMPI Paranoia and Hypomania scales, and the subgroup with traumatic experiences showed higher scores on the MMPI Hypomania scale. Our sample comprising patients with nonepileptic seizures showed a significant degree of psychopathology and absence of a unique character substrate. According to grades of clinical severity of pseudoseizures, several subgroups and different therapeutic implications may be defined. PMID:15234827

  6. Dentate gyrus progenitor cell proliferation after the onset of spontaneous seizures in the tetanus toxin model of temporal lobe epilepsy

    PubMed Central

    Jiruska, Premysl; Shtaya, Anan B.Y.; Bodansky, David M.S.; Chang, Wei-Chih; Gray, William P.; Jefferys, John G.R.

    2013-01-01

    Temporal lobe epilepsy alters adult neurogenesis. Existing experimental evidence is mainly from chronic models induced by an initial prolonged status epilepticus associated with substantial cell death. In these models, neurogenesis increases after status epilepticus. To test whether status epilepticus is necessary for this increase, we examined precursor cell proliferation and neurogenesis after the onset of spontaneous seizures in a model of temporal lobe epilepsy induced by unilateral intrahippocampal injection of tetanus toxin, which does not cause status or, in most cases, detectable neuronal loss. We found a 4.5 times increase in BrdU labeling (estimating precursor cells proliferating during the 2nd week after injection of toxin and surviving at least up to 7 days) in dentate gyri of both injected and contralateral hippocampi of epileptic rats. Radiotelemetry revealed that the rats experienced 112 ± 24 seizures, lasting 88 ± 11 s each, over a period of 8.6 ± 1.3 days from the first electrographic seizure. On the first day of seizures, their duration was a median of 103 s, and the median interictal period was 23 min, confirming the absence of experimentally defined status epilepticus. The total increase in cell proliferation/survival was due to significant population expansions of: radial glial-like precursor cells (type I; 7.2 ×), non-radial type II/III neural precursors in the dentate gyrus stem cell niche (5.6 ×), and doublecortin-expressing neuroblasts (5.1 ×). We conclude that repeated spontaneous brief temporal lobe seizures are sufficient to promote increased hippocampal neurogenesis in the absence of status epilepticus. PMID:23439313

  7. Rolandic epilepsy: an uncommon presentation with leg motor seizures.

    PubMed

    Fusco, Lucia; Trivisano, Marina; Specchio, Nicola; Vigevano, Federico

    2010-12-01

    Rolandic epilepsy (RE) is the most common and one of the most benign epileptic syndromes of childhood. It is typically characterized by sleep-related orofacial seizures, of brief duration, of variable frequency, in otherwise healthy children. Electroencephalography (EEG) shows typical centrotemporal spike and spike-and-wave complexes, often bilateral and asynchronous, activated by sleep. Therapy is often unnecessary and seizures spontaneously end at puberty. Apart from typical orofacial localization, arm or more diffuse clonic jerks are frequently described by parents. More rare and probably underestimated are sensorimotor seizure localized to one leg. When such seizures represent the only type of seizures in RE, the exact recognition of this benign epileptic syndrome appears difficult, leading to unnecessary investigation and therapy. We describe six children, among 230 with RE, who presented leg sensorimotor seizures as the mainly type of ictal manifestations. PMID:21204813

  8. Neuropeptide Y: potential role in recurrent developmental seizures

    PubMed Central

    Dubé, Celine

    2007-01-01

    Seizures induce profound plastic changes in the brain, including altered expression of neuropeptide Y (NPY) and its receptors. Here I discuss a potential role of NPY plasticity in the developmental brain: In a rat model of febrile seizures (FS), the most common type of seizures in infants and young children, NPY expression was up-regulated in hippocampus after experimentally-induced FS. Interestingly, NPY up-regulation was associated with an increased seizure threshold for additional (recurrent) FS, and this effect was abolished when an antagonist against NPY receptor type 2 was applied. These findings suggest that inhibitory actions of NPY, released after seizures, exert a protective effect that reduces the risk of seizure recurrence in the developing brain. PMID:17196709

  9. 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

  10. Dosing of Atypical Antipsychotics in Children and Adolescents

    Microsoft Academic Search

    Robert L. Findling

    Atypical antipsychotic medications are increasingly used to treat children and adolescents with a variety of neuropsychiatric disorders. The most common symptom for which atypical antipsychotics are prescribed to young patients is pernicious, pervasive, persistent aggression in the context of dis- ruptive behavior disorders. Unfortunately, the evidence base informing physicians about atypical anti- psychotic dosing in young people is relatively small,

  11. Atypical molluscum contagiosum accompanied by CD30-positive lymphoid infiltrates.

    PubMed

    Kim, Myoung Shin; Noh, Tai Kyung; Won, Chong Hyun; Chang, Sungeun; Lee, Mi Woo; Choi, Jee Ho; Moon, Kee Chan

    2013-01-01

    Atypical presentations of molluscum contagiosum require histophathologic examination and may show pleomorphic lymphocytic infiltrates of a reactive nature, mimicking cutaneous lymphoproliferative diseases. Serial sections of specimens or polymerase chain reactions to show T-cell receptor clonality may be helpful for differential diagnosis. We report a case of atypical molluscum contagiosum accompanied by atypical lymphocytic infiltration showing CD30 positivity. PMID:22067049

  12. Postpartum thrombotic microangiopathy revealed as atypical hemolytic uremic syndrome successfully treated with eculizumab: a case report

    PubMed Central

    2014-01-01

    Introduction Differential diagnosis of thrombotic microangiopathies can be difficult. Atypical hemolytic uremic syndrome is a rare, life-threatening disease caused by uncontrolled chronic activation of alternative complement pathway, resulting in microvascular thrombosis, organ ischemia and damage. Prognosis is poor: up to 65 percent of patients require dialysis or have kidney damage of varying severity or die despite plasma exchange/plasma infusion treatment. Case presentation We describe the case of a 23-year-old woman of Hellenic origin who, after a preeclampsia-induced premature delivery, developed thrombotic microangiopathy with renal failure, tonicoclonic seizures, anasarca edema and hypertension. Intensive plasma exchange was initiated twice daily, in parallel to dialysis for one month. Three months later, our patient was discharged with nondialysis-dependent renal failure and without signs of hemolysis. Three months after discharge our patient was readmitted with cardiomyopathy (left ventricular ejection fraction of 25 percent) and signs and symptoms of thrombotic microangiopathy. Our patient was diagnosed with atypical hemolytic uremic syndrome and was started on eculizumab (a complement inhibitor), which improved clinical and laboratory parameters. However, a transient pause in treatment resulted in thrombotic microangiopathy relapse, which was rapidly blocked with reintroduction of eculizumab treatment. During long-term eculizumab treatment, thrombotic microangiopathy manifestations were inhibited and renal and cardiac function restored, with no need for other invasive treatments. Conclusions Establishing the diagnosis of atypical hemolytic uremic syndrome in patients presenting with thrombotic microangiopathy is challenging since common symptoms are shared with other conditions like Shiga toxin-producing Escherichia coli hemolytic uremic syndrome and thrombotic thrombocytopenic purpura. The described case illustrates the complexity and importance of rapid diagnosis in a rare disease and the need for appropriate and specific treatment for best long-term outcomes. PMID:25219386

  13. Atypical hydroa vacciniforme-like epstein-barr virus associated T/NK-cell lymphoproliferative disorder.

    PubMed

    Lee, Hye Young; Baek, Jin Ok; Lee, Jong Rok; Park, Sang Hui; Jeon, In Sang; Roh, Joo Young

    2012-12-01

    Epstein-Barr virus (EBV)-associated T-cell/natural killer (NK)-cell lymphoproliferative disorders (EBV-T/NK-LPDs) accompany severe chronic active EBV infection (CAEBV) or comprise the CAEBV disease entity. The CAEBV disease entity has the common feature of lymphoproliferation of T or NK cells (primarily), and B cells (rarely), with chronic activation of EBV infection. The disease is rare and seems to be more prevalent in East Asian countries. The CAEBV disease entity encompasses heterogenous disorders, including hydroa vacciniforme (HV), hypersensitivity to mosquito bites, EBV-associated hemophagocytic syndrome, NK/T-cell lymphoma, and NK-cell leukemia. Atypical HV-like eruptions are present on sun-exposed and nonexposed areas with facial edema, fever, and hepatosplenomegaly, unlike classic HV. Recently, it has been suggested that classic HV and atypical HV-like eruptions are variants within the same disease spectrum of EBV-T/NK-LPD. We report a Korean boy with an atypical HV-like eruption and various systemic manifestations, including fever, sore throat, abdominal pain, headaches, seizures, and hematologic abnormalities for 2 years. After the initial mild eruption, which resembled a viral exanthem, ulceronecrotic skin lesions gradually developed and were associated with a high-grade fever and constitutional symptoms. He had a CAEBV infection, which showed a predominant proliferation of NK cells with high EBV DNA levels in the peripheral blood. However, in the skin lesions, there were nonneoplastic CD4 T-cell infiltrations predominantly showing a monoclonal T-cell receptor-? gene rearrangement and positive EBV in situ hybridization. PMID:23169419

  14. Atypical Gaze Following in Autism: A Comparison of Three Potential Mechanisms

    PubMed Central

    Gillespie-Lynch, K.; Elias, R.; Escudero, P.; Hutman, T.; Johnson, S. P.

    2014-01-01

    In order to evaluate the following potential mechanisms underlying atypical gaze following in autism, impaired reflexive gaze following, difficulty integrating gaze and affect, or reduced understanding of the referential significance of gaze, we administered three paradigms to young children with autism (N = 21) and chronological (N = 21) and nonverbal mental age (N = 21) matched controls. Children with autism exhibited impaired reflexive gaze following. The absence of evidence of integration of gaze and affect, regardless of diagnosis, indicates ineffective measurement of this construct. Reduced gaze following was apparent among children with autism during eye-tracking and in-person assessments. Word learning from gaze cues was better explained by developmental level than autism. Thus, gaze following may traverse an atypical, rather than just delayed, trajectory in autism. PMID:23619947

  15. Sex-specific consequences of early life seizures.

    PubMed

    Akman, Ozlem; Moshé, Solomon L; Galanopoulou, Aristea S

    2014-12-01

    Seizures are very common in the early periods of life and are often associated with poor neurologic outcome in humans. Animal studies have provided evidence that early life seizures may disrupt neuronal differentiation and connectivity, signaling pathways, and the function of various neuronal networks. There is growing experimental evidence that many signaling pathways, like GABAA receptor signaling, the cellular physiology and differentiation, or the functional maturation of certain brain regions, including those involved in seizure control, mature differently in males and females. However, most experimental studies of early life seizures have not directly investigated the importance of sex on the consequences of early life seizures. The sexual dimorphism of the developing brain raises the question that early seizures could have distinct effects in immature females and males that are subjected to seizures. We will first discuss the evidence for sex-specific features of the developing brain that could be involved in modifying the susceptibility and consequences of early life seizures. We will then review how sex-related biological factors could modify the age-specific consequences of induced seizures in the immature animals. These include signaling pathways (e.g., GABAA receptors), steroid hormones, growth factors. Overall, there are very few studies that have specifically addressed seizure outcomes in developing animals as a function of sex. The available literature indicates that a variety of outcomes (histopathological, behavioral, molecular, epileptogenesis) may be affected in a sex-, age-, region-specific manner after seizures during development. Obtaining a better understanding for the gender-related mechanisms underlying epileptogenesis and seizure comorbidities will be necessary to develop better gender and age appropriate therapies. PMID:24874547

  16. 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

  17. Global Hypoxia–Ischemia and Critical Care Seizures

    Microsoft Academic Search

    Matthew A. Koenig; Romergryko Geocadin

    \\u000a Seizures after cardiopulmonary arrest are a common problem in the intensive care unit, occurring in as many as one-third of\\u000a these patients during hospitalization. The etiology, treatment, and prognostic importance of seizures in this setting have\\u000a not been well delineated in the literature. Whether seizures exacerbate global hypoxic–ischemic brain injury in humans remains\\u000a unclear, which raises uncertainty about how aggressively

  18. Epileptic seizure prediction by non-linear methods

    DOEpatents

    Hively, Lee M. (Knoxville, TN); Clapp, Ned E. (Knoxville, TN); Daw, C. Stuart (Knoxville, TN); Lawkins, William F. (Knoxville, TN)

    1999-01-01

    Methods and apparatus for automatically predicting epileptic seizures monitor and analyze brain wave (EEG or MEG) signals. Steps include: acquiring the brain wave data from the patient; digitizing the data; obtaining nonlinear measures of the data via chaotic time series analysis tools; obtaining time serial trends in the nonlinear measures; comparison of the trend to known seizure predictors; and providing notification that a seizure is forthcoming.

  19. Epileptic seizure prediction by non-linear methods

    DOEpatents

    Hively, L.M.; Clapp, N.E.; Day, C.S.; Lawkins, W.F.

    1999-01-12

    This research discloses methods and apparatus for automatically predicting epileptic seizures monitor and analyze brain wave (EEG or MEG) signals. Steps include: acquiring the brain wave data from the patient; digitizing the data; obtaining nonlinear measures of the data via chaotic time series analysis tools; obtaining time serial trends in the nonlinear measures; comparison of the trend to known seizure predictors; and providing notification that a seizure is forthcoming. 76 figs.

  20. Surface acoustic wave probe implant for predicting epileptic seizures

    DOEpatents

    Gopalsami, Nachappa (Naperville, IL); Kulikov, Stanislav (Sarov, RU); Osorio, Ivan (Leawood, KS); Raptis, Apostolos C. (Downers Grove, IL)

    2012-04-24

    A system and method for predicting and avoiding a seizure in a patient. The system and method includes use of an implanted surface acoustic wave probe and coupled RF antenna to monitor temperature of the patient's brain, critical changes in the temperature characteristic of a precursor to the seizure. The system can activate an implanted cooling unit which can avoid or minimize a seizure in the patient.

  1. 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

  2. Clear Cell Atypical Fibroxantoma: A Rare Variant of Atypical Fibroxanthoma and Review of the Literature

    PubMed Central

    Agirbas, Sule; Sehitoglu, Ibrahim; Yurdakul, Cüneyt; Elmas, Ömer

    2014-01-01

    Atypical fibroxanthoma (AFX) is a superficial variant of pleomorphic malignant fibrous histiocytoma. Clear cell atypical fibroxanthoma (CCAFXA) is a rare variant of atypical fibroxanthoma. A 74-year-old male patient presented with a rapidly growing nodule on the shoulder, which had appeared over a 5-months period. Lesion was excised by the plastic surgeon. Microscopic examination showed an ulcerated nodule composed of pleomorphic spindled and polygonal cells with clear or vacuolated cytoplasm. The neoplastic cells were stained positively with CD68 and CD10 and were stained negative with S-100, Melan A, muscle-specific actin, or pan-cytokeratin. Final diagnosis was clear cell atypical fibroxanthoma. CCAFXA should be differentiated from other clear-cell neoplasms of the skin. Best of our knowledge only 11 cases CCAFXA of have been reported in published studies till date. Herein, we reported 12th case in literature of CCAFXA and review of the literature. PMID:25120992

  3. 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 ...

  4. 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…

  5. Atypical Antipsychotic Drug Use and Diabetes

    Microsoft Academic Search

    Jambur Ananth; Ravi Venkatesh; Karl Burgoyne; Sarath Gunatilake

    2002-01-01

    Recently, there has been increased concern about the occurrence of diabetes associated with the use of atypical antipsychotic (AAP) drugs. The relationship between diabetes, schizophrenia, and antipsychotic drugs is complex and intriguing, as untreated patients with schizophrenia are known to suffer from diabetes more often than the general population. Thirty individual case reports of clozapine-, 26 cases of olanzapine- and

  6. 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…

  7. Atypical hemolytic uremic syndrome with membranoproliferative glomerulonephritis.

    PubMed

    Mehta, Kumud; More, Vaishali; Chitale, Arun; Khubchandani, Shaila

    2013-08-01

    Atypical hemolytic uremic syndrome (aHUS) associated with membranoproliferative glomerulonephritis (MPGN) is an uncommon clinical presentation, especially in children. We report a 8-year-old-boy who presented like aHUS but the kidney biopsy showed MPGN type 1. PMID:24036644

  8. Infant Perception of Atypical Speech Signals

    ERIC Educational Resources Information Center

    Vouloumanos, Athena; Gelfand, Hanna M.

    2013-01-01

    The ability to decode atypical and degraded speech signals as intelligible is a hallmark of speech perception. Human adults can perceive sounds as speech even when they are generated by a variety of nonhuman sources including computers and parrots. We examined how infants perceive the speech-like vocalizations of a parrot. Further, we examined how…

  9. Observing Behavior and Atypically Restricted Stimulus Control

    ERIC Educational Resources Information Center

    Dube, William V.; Dickson, Chata A.; Balsamo, Lyn M.; O'Donnell, Kristin Lombard; Tomanari, Gerson Y.; Farren, Kevin M.; Wheeler, Emily E.; McIlvane, William J.

    2010-01-01

    Restricted stimulus control refers to discrimination learning with atypical limitations in the range of controlling stimuli or stimulus features. In the study reported here, 4 normally capable individuals and 10 individuals with intellectual disabilities (ID) performed two-sample delayed matching to sample. Sample-stimulus observing was recorded…

  10. Cognition, schizophrenia, and the atypical antipsychotic drugs

    E-print Network

    Park, Sohee

    Commentary Cognition, schizophrenia, and the atypical antipsychotic drugs Herbert Y. Meltzer the term to categorize a group of young psychotic patients who went on to develop dementia. A decade later impairment to schizophrenia further diminished in the 1950s, after the development of antipsy- chotic drugs

  11. Atypical Sleep in Ventilated Patients: Empirical Electroencephalography Findings and the Path Toward Revised ICU Sleep Scoring Criteria

    PubMed Central

    Watson, Paula L.; Pandharipande, Pratik; Gehlbach, Brian K.; Thompson, Jennifer L.; Shintani, Ayumi K.; Dittus, Bob S.; Bernard, Gordon R.; Malow, Beth A.; Ely, E. Wesley

    2013-01-01

    Objectives Standard sleep scoring criteria may be unreliable when applied to critically ill patients. We sought to quantify typical and atypical polysomnographic findings in critically ill patients and to begin development and reliability testing of methodology to characterize the atypical polysomnographic tracings that confound standard sleep scoring criteria. Design Prospective convenience sample. Setting Two academic, tertiary care medical centers. Patients Thirty-seven critically ill, mechanically ventilated, medical ICU patients. Interventions None. Measurements and Main Results Mechanically ventilated subjects were monitored by continuous polysomnography. After noting frequent atypical polysomnographic findings (i.e., lack of stage N2 markers, the presence of polymorphic delta, burst suppression, or isoelectric electroencephalography), attempts to use standard sleep scoring criteria alone were abandoned. Atypical polysomnographic findings were characterized and used to develop a modified scoring system. Polysomnographic data were scored manually via this revised scoring scheme. Of 37 medical ICU patients enrolled, 36 experienced atypical sleep, which accounted for 85% of all recorded data, with 5.1% normal sleep and 9.4% wake. Coupling observed patient arousal levels with polysomnographic characteristics revealed that standard polysomnographic staging criteria did not reliably determine the presence or absence of sleep. Rapid eye movement occurred in only five patients (14%). The revised scoring system incorporating frequently seen atypical characteristics yielded very high interrater reliability (weighted ? = 0.80; bootstrapped 95% CI, [0.48, 0.89]). Conclusions Analysis of polysomnographic data revealed profound deficiencies in standard scoring criteria due to a predominance of atypical polysomnographic findings in ventilated patients. The revised scoring scheme proved reliable in sleep staging and may serve as a building block in future work. PMID:23863228

  12. 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

  13. 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.

  14. Efficacy of Pregabalin in Childhood Refractory Partial Seizure

    PubMed Central

    Zamani, Gholamreza; Tavasoli, Alireza; Zare-Shahabadi, Ameneh; Rezaei, Nima; Ahmadvand, Alireza

    2014-01-01

    Objective: About one third of partial seizures are refractory to treatment. Several anticonvulsant drugs have entered the market in recent decades but concerns about intolerance, drug interactions, and the safety of the drug are notable. One of these new anticonvulsants is pregabalin, a safe drug with almost no interaction with other antiepileptic drugs. Methods: In this open label clinical trial study, pregabalin was used for evaluation of its efficacy on reducing seizure frequency in 29 children suffering from refractory partial seizures. Average daily and weekly seizure frequency of the patients was recorded during a 6-week period (baseline period). Then, during a period of 2 weeks (titration period), pregabalin was started with a dose of 25-75 mg/d, using method of flexible dose, and was brought to maximum dose of drug that was intended in this study (450 mg/d) based on clinical response of the patients and seizure frequency. Then the patients were given the drug for 12 weeks and the average frequency of daily and weekly seizures were recorded again (treatment period). Findings : Reduction in seizure frequency in this study was 36% and the responder rate or number of patients who gained more than 50% reduction in seizure frequency was 51.7%. Conclusion: This study showed that pregabalin can be used with safety and an acceptable efficacy in treatment of childhood refractory partial seizures.

  15. A microdeletion of the GABRB3 locus on 15q in a child with generalized seizures

    SciTech Connect

    Hirsch, B.; Krueger, L.; Nook, J. [Univ. of Minnesota School of Medicine, Minneapolis, MN (United States)] [and others

    1994-09-01

    A 13-month-old female presented with a history of infrequent febrile tonic-clonic seizures and recent onset of daily absence and clusters of myoclonic seizures. She had minimal developmental delays, slight frontal bossing, a wide nasal bridge and macrostomia. Initial EEG was normal as were multiple metabolic and biochemical determinations. Subsequent EEGs demonstrated normal back ground activity with frequent bursts of generalized, irregular spikes and polyspikes. The child responded favorably to a course of parenteral ACTH and at 17 months, she was maintained on valproic acid, was seizure-free and had a normal EEG. Examination was notable for prominent, socially appropriate smiling, age-appropriate speech, and significant ataxia and tremor. High resolution G-banded chromosome analysis revealed a suspected deletion of 15q11.2 and part of 15q12. FISH was performed with ONCOR probes to the D15S11, SNRPN, D15S10 and GABRB3 loci. A total of 30 metaphase cells (from two separate blood samples) were examined and revealed positive hybridization on both chromosome 15 homologues for D15S11, SNRPN, and D15S10. However, the GABRB3 probe revealed positive hybridization to only one chromosome 15 homologue, thus supporting the interpretation of a deletion of this region. FISH analyses of the patient`s parents are in progress as are methylation studies. To our knowledge, these findings represent the first report of a deletion of GAMRB3 which does not extend proximally to include all of D15S10 in a patient presenting with generalizied seizures. Careful comparison of this patient`s phenotype to that of Angelman syndrome will therefore be most informative for furthering genotype-phenotype correlations within this critical region of 15q.

  16. 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

  17. 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

  18. Anticonvulsant Effect of Guaifenesin against Pentylenetetrazol-Induced Seizure in Mice

    PubMed Central

    Keshavarz, Mojtaba; Showraki, Alireza; Emamghoreishi, Masoumeh

    2013-01-01

    Background: There have been some reports about the possible N-methyl-D-aspartate (NMDA) antagonist activity of Guaifenesin. As drugs with a similar structure to Guaifenesin (i.e. Felbamate) and those with NMDA antagonist activity have been clinically used as anticonvulsants, the aim of this study was to determine whether Guaifenesin has an anticonvulsant effect in an animal model of seizure. Methods: Anticonvulsant effect of Guaifenesin was assessed via Pentylenetetrazol (PTZ)-induced convulsion. Male albino mice received Guaifenesin (100, 200, 300, or 400 mg/kg; n=8-10) or 0.25% Tween (vehicle) intraperitoneally 30 minutes before the injection of PTZ (95 mg/kg). Diazepam (3 mg/kg; n=8) was used as a reference drug. The latency time before the onset of myoclonic, clonic, and tonic-clonic convulsions, percentage of animals exhibiting convulsion, and percentage of mortality were recorded. In addition, the effect of Guaifenesin on neuromuscular coordination was assessed using the Rotarod. Results: Guaifenesin at all the studied doses significantly increased the latency to myoclonic and clonic convulsions in a dose-dependent manner. In addition, Guaifenesin at the dose of 300 mg/kg increased the latency to tonic-clonic seizure. The ED50s of Guaifenesin for protection against PTZ-induced clonic and tonic-clonic seizures and death were 744.88 (360-1540), 256 (178-363), and 328 (262-411) mg/kg, respectively. Guaifenesin at all the investigated doses significantly reduced neuromuscular coordination, compared to the vehicle-treated group. Conclusion: These results suggest that Guaifenesin possesses muscle relaxant and anticonvulsant properties and may have a potential clinical use in absence seizure. PMID:23825891

  19. 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.

  20. HLA alleles may serve as a tool to discriminate atypical type 2 diabetic patients

    PubMed Central

    Fernández, Mariana; Fabregat, Matías; Javiel, Gerardo; Mimbacas, Adriana

    2014-01-01

    AIM: To investigate whether the presence of human leukocyte antigen (HLA) marker could add new information to discriminated atypical diabetic type 2 patients. METHODS: We analyzed 199 patients initially diagnosed as type 2 diabetes who are treated in special care diabetes clinics (3rd level). This population was classified in “atypical” (sample A) and “classic” (sample B) according to HLA typing. We consider “classic patient” when has absence of type 1 diabetes associated HLA alleles and no difficulties in their diagnosis and treatments. By the other hand, we considered “atypical patient” when show type 1 diabetes associated HLA alleles and difficulties in their diagnosis and treatments. The standard protocol Asociacion Latinoamericana de Diabetes 2006 was used for patients follow up. To analyze differences between both populations in paraclinical parameters we used unpaired t tests and contingence tables. Bivariate and multivariate analyses were carried out using the SPSS software program. In all studies we assume differences statistically significant, with a P-value < 0.05 corrected and 95%CI. RESULTS: The typing HLA in the “atypical” populations show that 92.47% patients presented at list one type 1 diabetes associated HLA alleles (DQB1*0201-0302 and DR 3-4) and 7.53% had two of its. The results showed for categorical variables (family history, presence or absence of hypertension and/or dyslipidemia, reason for initial consultation) the only difference found was at dyslipidemia (OR = 0.45, 0.243 < OD < 0.822 (P < 0.001). In relation to continuous variables we found significant differences between atypical vs classic only in cholesterol (5.07 ± 1.1 vs 5.56 ± 1.5, P < 0.05), high density lipoproteins (1.23 ± 0.3 vs 1.33 ± 0.3, P < 0.05) and low density lipoproteins (2.86 ± 0.9 vs 3.38 ± 1.7, P < 0.01). None of the variables had discriminating power when logistic regression was done. CONCLUSION: We propose an algorithm including HLA genotyping as a tool to discriminate atypical patients, complementing international treatment guidelines for complex patients. PMID:25317248

  1. 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

  2. 78 FR 41185 - Denial of Exemption Applications; Epilepsy and Seizure Disorders

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-09

    ...have experienced a seizure the same, regardless of individual medical...medication from operating a CMV in interstate...does not consider a driver's actual seizure history and time since the last seizure...The disposition of applications...

  3. 78 FR 41985 - Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-12

    ...have experienced a seizure the same, regardless of individual medical...medication from operating a CMV in interstate...does not consider a driver's actual seizure history and time since the last seizure...individualized assessments of the exemption...

  4. Atypical Glycolysis in Clostridium thermocellum

    PubMed Central

    Zhou, Jilai; Olson, Daniel G.; Argyros, D. Aaron; Deng, Yu; van Gulik, Walter M.; van Dijken, Johannes P.

    2013-01-01

    Cofactor specificities of glycolytic enzymes in Clostridium thermocellum were studied with cellobiose-grown cells from batch cultures. Intracellular glucose was phosphorylated by glucokinase using GTP rather than ATP. Although phosphofructokinase typically uses ATP as a phosphoryl donor, we found only pyrophosphate (PPi)-linked activity. Phosphoglycerate kinase used both GDP and ADP as phosphoryl acceptors. In agreement with the absence of a pyruvate kinase sequence in the C. thermocellum genome, no activity of this enzyme could be detected. Also, the annotated pyruvate phosphate dikinase (ppdk) is not crucial for the generation of pyruvate from phosphoenolpyruvate (PEP), as deletion of the ppdk gene did not substantially change cellobiose fermentation. Instead pyruvate formation is likely to proceed via a malate shunt with GDP-linked PEP carboxykinase, NADH-linked malate dehydrogenase, and NADP-linked malic enzyme. High activities of these enzymes were detected in extracts of cellobiose-grown cells. Our results thus show that GTP is consumed while both GTP and ATP are produced in glycolysis of C. thermocellum. The requirement for PPi in this pathway can be satisfied only to a small extent by biosynthetic reactions, in contrast to what is generally assumed for a PPi-dependent glycolysis in anaerobic heterotrophs. Metabolic network analysis showed that most of the required PPi must be generated via ATP or GTP hydrolysis exclusive of that which happens during biosynthesis. Experimental proof for the necessity of an alternative mechanism of PPi generation was obtained by studying the glycolysis in washed-cell suspensions in which biosynthesis was absent. Under these conditions, cells still fermented cellobiose to ethanol. PMID:23435896

  5. Atypical glycolysis in Clostridium thermocellum.

    PubMed

    Zhou, Jilai; Olson, Daniel G; Argyros, D Aaron; Deng, Yu; van Gulik, Walter M; van Dijken, Johannes P; Lynd, Lee R

    2013-05-01

    Cofactor specificities of glycolytic enzymes in Clostridium thermocellum were studied with cellobiose-grown cells from batch cultures. Intracellular glucose was phosphorylated by glucokinase using GTP rather than ATP. Although phosphofructokinase typically uses ATP as a phosphoryl donor, we found only pyrophosphate (PPi)-linked activity. Phosphoglycerate kinase used both GDP and ADP as phosphoryl acceptors. In agreement with the absence of a pyruvate kinase sequence in the C. thermocellum genome, no activity of this enzyme could be detected. Also, the annotated pyruvate phosphate dikinase (ppdk) is not crucial for the generation of pyruvate from phosphoenolpyruvate (PEP), as deletion of the ppdk gene did not substantially change cellobiose fermentation. Instead pyruvate formation is likely to proceed via a malate shunt with GDP-linked PEP carboxykinase, NADH-linked malate dehydrogenase, and NADP-linked malic enzyme. High activities of these enzymes were detected in extracts of cellobiose-grown cells. Our results thus show that GTP is consumed while both GTP and ATP are produced in glycolysis of C. thermocellum. The requirement for PPi in this pathway can be satisfied only to a small extent by biosynthetic reactions, in contrast to what is generally assumed for a PPi-dependent glycolysis in anaerobic heterotrophs. Metabolic network analysis showed that most of the required PPi must be generated via ATP or GTP hydrolysis exclusive of that which happens during biosynthesis. Experimental proof for the necessity of an alternative mechanism of PPi generation was obtained by studying the glycolysis in washed-cell suspensions in which biosynthesis was absent. Under these conditions, cells still fermented cellobiose to ethanol. PMID:23435896

  6. Unraveling Genetic Modifiers in the Gria4 Mouse Model of Absence Epilepsy

    PubMed Central

    Frankel, Wayne N.; Mahaffey, Connie L.; McGarr, Tracy C.; Beyer, Barbara J.; Letts, Verity A.

    2014-01-01

    Absence epilepsy (AE) is a common type of genetic generalized epilepsy (GGE), particularly in children. AE and GGE are complex genetic diseases with few causal variants identified to date. Gria4 deficient mice provide a model of AE, one for which the common laboratory inbred strain C3H/HeJ (HeJ) harbors a natural IAP retrotransposon insertion in Gria4 that reduces its expression 8-fold. Between C3H and non-seizing strains such as C57BL/6, genetic modifiers alter disease severity. Even C3H substrains have surprising variation in the duration and incidence of spike-wave discharges (SWD), the characteristic electroencephalographic feature of absence seizures. Here we discovered extensive IAP retrotransposition in the C3H substrain, and identified a HeJ-private IAP in the Pcnxl2 gene, which encodes a putative multi-transmembrane protein of unknown function, resulting in decreased expression. By creating new Pcnxl2 frameshift alleles using TALEN mutagenesis, we show that Pcnxl2 deficiency is responsible for mitigating the seizure phenotype – making Pcnxl2 the first known modifier gene for absence seizures in any species. This finding gave us a handle on genetic complexity between strains, directing us to use another C3H substrain to map additional modifiers including validation of a Chr 15 locus that profoundly affects the severity of SWD episodes. Together these new findings expand our knowledge of how natural variation modulates seizures, and highlights the feasibility of characterizing and validating modifiers in mouse strains and substrains in the post-genome sequence era. PMID:25010494

  7. Seizure Clustering during Drug Treatment Affects Seizure Outcome and Mortality of Childhood-Onset Epilepsy

    ERIC Educational Resources Information Center

    Sillanpaa, Matti; Schmidt, Dieter

    2008-01-01

    To provide evidence of whether seizure clustering is associated with drug resistance and increased mortality in childhood-onset epilepsy, a prospective, long-term population-based study was performed. One hundred and twenty patients who had been followed since disease onset (average age 37.0 years, SD 7.1, median 40.0, range 11-42; incident cases)…

  8. Block term decomposition for modelling epileptic seizures

    NASA Astrophysics Data System (ADS)

    Hunyadi, Borbála; Camps, Daan; Sorber, Laurent; Paesschen, Wim Van; Vos, Maarten De; Huffel, Sabine Van; Lathauwer, Lieven De

    2014-12-01

    Recordings of neural activity, such as EEG, are an inherent mixture of different ongoing brain processes as well as artefacts and are typically characterised by low signal-to-noise ratio. Moreover, EEG datasets are often inherently multidimensional, comprising information in time, along different channels, subjects, trials, etc. Additional information may be conveyed by expanding the signal into even more dimensions, e.g. incorporating spectral features applying wavelet transform. The underlying sources might show differences in each of these modes. Therefore, tensor-based blind source separation techniques which can extract the sources of interest from such multiway arrays, simultaneously exploiting the signal characteristics in all dimensions, have gained increasing interest. Canonical polyadic decomposition (CPD) has been successfully used to extract epileptic seizure activity from wavelet-transformed EEG data (Bioinformatics 23(13):i10-i18, 2007; NeuroImage 37:844-854, 2007), where each source is described by a rank-1 tensor, i.e. by the combination of one particular temporal, spectral and spatial signature. However, in certain scenarios, where the seizure pattern is nonstationary, such a trilinear signal model is insufficient. Here, we present the application of a recently introduced technique, called block term decomposition (BTD) to separate EEG tensors into rank- ( L r , L r ,1) terms, allowing to model more variability in the data than what would be possible with CPD. In a simulation study, we investigate the robustness of BTD against noise and different choices of model parameters. Furthermore, we show various real EEG recordings where BTD outperforms CPD in capturing complex seizure characteristics.

  9. Pathology Case Study: Seizures and Progressive Dementia

    NSDL National Science Digital Library

    Friese, Michael

    This is a neuropathology case study presented by the University of Pittsburgh Department of Pathology in which a 70-year-old female has seizures and progressive dementia. Visitors are given both the microscopic and gross descriptions, including images, 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 laboratory results to diagnose. It is also a helpful site for educators to use to introduce or test student learning in neuropathology.

  10. Pathology Case Study: New Onset Seizures

    NSDL National Science Digital Library

    Hamilton, Ronald

    This is a case study presented by the University of Pittsburgh Department of Pathology in which a 26-year-old nurse is experiencing headaches and seizures. Visitors are given both the microscopic and gross descriptions, including neuroimaging results, 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 neuropathology.

  11. AMPA Receptor antagonist NBQX attenuates later-life epileptic seizures and autistic-like social deficits following neonatal seizures

    PubMed Central

    Lippman-Bell, Jocelyn J.; Rakhade, Sanjay N.; Klein, Peter M.; Obeid, Makram; Jackson, Michele C.; Joseph, Annelise; Jensen, Frances E.

    2013-01-01

    Summary Purpose To determine whether AMPA receptor (AMPAR) antagonist NBQX can prevent early mTOR pathway activation and long-term sequelae following neonatal seizures in rats, including later-life spontaneous recurrent seizures, CA3 mossy fiber sprouting, and autistic-like social deficits. Methods Long-Evans rats experienced hypoxia-induced neonatal seizures (HS) at postnatal day (P)10. NBQX (20 mg/kg) was administered immediately following HS (every 12h x 4 doses). 12h post-HS, we assessed mTOR activation marker phosphorylated p70-S6 kinase (p-p70S6K) in hippocampus and cortex of vehicle (HS+V) or NBQX-treated post-HS rats (HS+N) versus littermate controls (C+V). Spontaneous seizure activity was compared between groups by epidural cortical electroencephalography (EEG) at P70-100. Aberrant mossy fiber sprouting was measured using Timm staining. Finally, we assessed behavior between P30-38. Key findings Post-seizure NBQX treatment significantly attenuated seizure-induced increases in p-P70S6K in the hippocampus (p<0.01) and cortex (p<0.001). While spontaneous recurrent seizures increased in adulthood in HS+V rats compared to controls (3.22±1seizures/hour; p=0.03), NBQX significantly attenuated later-life seizures (0.14±0.1 seizures/hour; p=0.046). HS+N rats showed less aberrant mossy fiber sprouting (115±8.0%) than vehicle-treated post-HS rats (174±10%, p=0.004), compared to controls (normalized to 100%). Finally, NBQX treatment prevented alterations in later-life social behavior; post-HS rats showed significantly decreased preference for a novel over a familiar rat (71.0±12 sec) compared to controls (99.0±15.6 sec; p<0.01), while HS+N rats showed social novelty preference similar to controls (114.3±14.1 sec). Significance Brief NBQX administration during the 48 hours post-seizure in P10 Long-Evans rats suppresses transient mTOR pathway activation and attenuates spontaneous recurrent seizures, social preference deficits and mossy fiber sprouting observed in vehicle-treated adult rats after early-life seizures. These results suggest that acute AMPAR antagonist treatment during the latent period immediately following neonatal HS can modify seizure-induced activation of mTOR, reduce the frequency of later-life seizures, and protect against CA3 mossy fiber sprouting and autistic-like social deficits. PMID:24117347

  12. Frontal Lobe Seizures: No Evidence of Self-Injury.

    ERIC Educational Resources Information Center

    Coulter, David L.

    1991-01-01

    This paper describes current neurological knowledge regarding the recognition, diagnosis, and classification of frontal lobe seizures, and then critiques a study by A. Gedye which suggested that self-injury may be involuntary and related to frontal lobe seizure activity. (JDD)

  13. Recognition Memory Is Impaired in Children after Prolonged Febrile Seizures

    ERIC Educational Resources Information Center

    Martinos, Marina M.; Yoong, Michael; Patil, Shekhar; Chin, Richard F. M.; Neville, Brian G.; Scott, Rod C.; de Haan, Michelle

    2012-01-01

    Children with a history of a prolonged febrile seizure show signs of acute hippocampal injury on magnetic resonance imaging. In addition, animal studies have shown that adult rats who suffered febrile seizures during development reveal memory impairments. Together, these lines of evidence suggest that memory impairments related to hippocampal…

  14. Epileptic seizure detection in EEG recordings using phase congruency

    Microsoft Academic Search

    Yodchanan Wongsawat

    2008-01-01

    This paper presents the use of phase congruency to robustly detect the epileptic seizure. Phase congruency is calculated from log Gabor wavelets. Numbers of spikes detected from the phase congruency of two classes of EEG data (epilepsy and seizure free) are used as the features of interest. By using only one dimensional features, the detection accuracies of the proposed method

  15. Real-Time Seizure Monitoring and Spectral Analysis Microsystem

    E-print Network

    Genov, Roman

    of an envisioned miniature implantable brain implant for automated epileptic seizure therapy. The microsystem com. INTRODUCTION Fig. 1. Architecture of the envisioned brain implant for seizure prediction. Approximately 50. For the remaining chip [7]. To date, brain activity analysis techniques have epileptics there are several existing

  16. Epileptogenic networks in seizures arising from motor systems.

    PubMed

    Bonini, Francesca; McGonigal, Aileen; Wendling, Fabrice; Régis, Jean; Scavarda, Didier; Carron, Romain; Chauvel, Patrick; Bartolomei, Fabrice

    2013-09-01

    Classification of seizures arising from the cortical motor system classically distinguishes between primary motor seizures and supplementary motor area (SMA) seizures. With the aim of better characterizing the underlying networks of motor seizures, we quantitatively studied the "epileptogenicity" of brain structures in 28 patients investigated by intracerebral recordings (stereoelectroencephalography, SEEG). Epileptogenicity of various motor regions (rolandic, SMA, pre-SMA, cingulate motor area (CMA), lateral area 6) as well as prefrontal and parietal areas, was calculated according to the "epileptogenicity index" (EI), a technique that allows mathematical quantification of rapid discharges at seizure onset. According to the maximal value of EI five groups of patients were identified: precentral, premotor/precentral, mesial premotor, lateral premotor and mesio-lateral premotor groups. Most patients disclosed a complex pattern of motor/premotor involvement, while pure mesial premotor seizures ("SMA seizures") were rare. A positive correlation between the number of structures exhibiting high EI and epilepsy duration was found, as well as a relationship between high EI values in rolandic cortex and poorer surgical outcome. Seizures arising from the motor system appear to be organized in complex electrophysiological patterns that often involve both lateral and mesial aspects of premotor areas together with precentral cortex. PMID:23726290

  17. 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…

  18. Psychogenic seizures and frontal disconnection: EEG synchronisation study

    Microsoft Academic Search

    Maria G Knyazeva; Mahdi Jalili; Richard S Frackowiak; Andrea O Rossetti

    2011-01-01

    ObjectivePsychogenic non-epileptic seizures (PNES) are paroxysmal events that, in contrast to epileptic seizures, are related to psychological causes without the presence of epileptiform EEG changes. Recent models suggest a multifactorial basis for PNES. A potentially paramount, but currently poorly understood factor is the interplay between psychiatric features and a specific vulnerability of the brain leading to a clinical picture that

  19. 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…

  20. The Effects of Tactile Stimulation on EEG Recordings and Seizures

    ERIC Educational Resources Information Center

    Ecker, Dorothy M.

    1973-01-01

    Twenty subjects between the ages of six and 12 years with a diagnosis of seizure disorder were used to investigate the relationship between therapeutically applied tactile stimulation and the incidence of seizures and changes in the electrical activity as measured by the EEG. (Editors/JA)

  1. Effects of Early Seizures on Later Behavior and Epileptogenicity

    ERIC Educational Resources Information Center

    Holmes, Gregory L.

    2004-01-01

    Both clinical and laboratory studies demonstrate that seizures early in life can result in permanent behavioral abnormalities and enhance epileptogenicity. Understanding the critical periods of vulnerability of the developing nervous system to seizure-induced changes may provide insights into parallel or divergent processes in the development of…

  2. Another Tool in the Fight against Epilepsy: Seizure Response Dogs

    ERIC Educational Resources Information Center

    Hollingsworth, Jan Carter

    2007-01-01

    Epilepsy, a chronic neurological seizure disorder, affects 2.7 million Americans, half of them children, and worldwide, it is the most common brain disorder. While there is not a cure for epilepsy, the goal of treatment is to achieve the greatest freedom from seizures that can be attained with the minimal amount of side effects. These days…

  3. Binding of specific ligand by D2- and NMDA-receptors of striatum cells in two rat strains predisposed and resistant to audiogenic seizures.

    PubMed

    Firstova, Ju Ju; Abaimov, D A; Surina, N M; Poletaeva, I I; Fedotova, I B; Kovalev, G I

    2012-12-01

    We studied parameters of specific receptor binding of D2-dopamine receptor ligand [(3)H]-sulpiride and NMDA-receptor ligand [(3)H]-MK-801 on the membranes of striatum cells in Krushinsky-Molodkina rats (predisposed to audiogenic seizures) and strain "0" selected for the absence of audiogenic seizures. No interstrain differences were observed in affinity (K(d)) of both D2- and NMDA-receptors to ligands. At the same time, significant interstrain differences in receptor density (B(max)) were found for both D2-receptors and NMDA-receptors. The reduced number of dopamine and glutamate receptors in the striatum can be associated with neurological peculiarities of Krushinsky-Molodkina rat strain (audiogenic seizures and postictal catalepsy). PMID:23330123

  4. 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.

  5. Photosensitivity, visually sensitive seizures and epilepsies.

    PubMed

    Trenité, Dorothée G A Kasteleijn-Nolst

    2006-08-01

    Although many observations in patients with this intriguing type of epilepsy have been described and detailed studies have been performed, only a few meet the current criteria of class 1 or 2 evidence-based studies. In general, the selection bias is due to studying a referral population instead of the general population, and to different age and sex distributions of the subjects under study. Comparing the various studies is often difficult, because of differences in the populations studied (single seizures, epilepsy centre population, etc.), but also because of different methods (photic stimulator, flash frequencies, eye conditions, etc.) and the terminology used. Finally, and most crucial, in many studies there is often no information on how the data were actually obtained (EEG or clinical data or both?). The popular term "photosensitive" is used widely and applied to patients with a history of visually induced seizures, with and without a photoparoxysmal response (PPR), and to those with only a PPR. An overview of the "hard" data is given with future needs for a better understanding of this type of epilepsy and for improving the endophenotype for genetic research. It is important to standardise the studies as much as possible and describe in detail the methodology of the study, taking at least the above variables into account. PMID:16814522

  6. Atypical mycobacterial infection mimicking metastatic cholangiocarcinoma

    PubMed Central

    Kanhere, Harsh A.; Trochsler, Markus I.; Pierides, John; Maddern, Guy J.

    2013-01-01

    Mycobacterial infections are rare in developed countries. Isolated involvement of the liver and biliary tree by mycobacterial infection is extremely rare. We report a case of a 45-year-old Caucasian female presenting with obstructive jaundice with a common bile duct stricture and multiple hypodense liver lesions raising suspicion of a metastatic cholangiocarcinoma. Percutaneous core biopsies of the liver lesions however suggested granulomatous process and histology at surgical excision confirmed this finding. Atypical mycobacteria (M. abcessus) sensitive to Amikacin were cultured from the surgical specimen proving the diagnosis. With the resurgence of tubercular and atypical mycobacterial infections in the developed world, it is important not to overlook these in differential diagnosis of various malignancies. PMID:24964448

  7. CASE REPORT Open Access Atypical case of Wolfram syndrome revealed

    E-print Network

    Mootha, Vamsi K.

    . The patient presented with diabetes mellitus, diffuse brain atrophy, autonomic neuropathy, optic nerve atrophy peripheral polyneuropa- thy, sensorineural deafness, optic atrophy, diabetes mel- litus, seizures, and ataxia

  8. Pharmacological Treatment of Neonatal Seizures: A Systematic Review

    PubMed Central

    Slaughter, Laurel A.; Patel, Anup D.; Slaughter, Jonathan L.

    2013-01-01

    Pharmacologic treatment options for neonatal seizures have expanded over the last two decades and there is no consensus on optimal treatment strategy. We systematically reviewed the published literature to determine which medication(s) are most effective for treating neonatal seizures, by retrieving trials and observational investigations via PubMed (through August 2011) that focused on pharmacological seizure treatment of neonates (? 28 days old) and utilized continuous or amplitude-integrated EEG to confirm seizure diagnosis and cessation. Our search identified 557 initial articles and 14 additional studies after reference reviews, with 16 meeting inclusion criteria. Two were randomized trials and only three additional investigations included comparison groups. We found limited evidence regarding the best pharmacologic treatment for neonatal seizures, but were able to devise a treatment algorithm from available data. These findings have the potential to serve both as a clinical reference and inform the design of comparative effectiveness investigations for neonatal antiepileptics. PMID:23318696

  9. Neonatal seizure detection using atomic decomposition with a novel dictionary.

    PubMed

    Nagaraj, Sunil Belur; Stevenson, Nathan J; Marnane, William P; Boylan, Geraldine B; Lightbody, Gordon

    2014-11-01

    Atomic decomposition (AD) can be used to efficiently decompose an arbitrary signal. In this paper, we present a method to detect neonatal electroencephalogram (EEG) seizure based on AD via orthogonal matching pursuit using a novel, application-specific, dictionary. The dictionary consists of pseudoperiodic Duffing oscillator atoms which are designed to be coherent with the seizure epochs. The relative structural complexity (a measure of the rate of convergence of AD) is used as the sole feature for seizure detection. The proposed feature was tested on a large clinical dataset of 826 h of EEG data from 18 full-term newborns with 1389 seizures. The seizure detection system using the proposed dictionary was able to achieve a median receiver operator characteristic area of 0.91 (IQR 0.87-0.95) across 18 neonates. PMID:25330152

  10. 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.

  11. 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

  12. 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.

  13. Historical Issues and Atypical Parkinsonian Disorders

    Microsoft Academic Search

    Christopher G. Goetz

    As shown in the above quotation from Jean-Martin Charcot’s teaching of the late 19th century, the concept of atypical Parkinsonian disorders and formes frustes of the classic disease emerged in parallel with the definition of Parkinson’s disease itself. In 1817, James Parkinson, a\\u000a London general practitioner, described resting tremor and gait impairment in the small sample of subjects whose symptoms

  14. 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.

  15. 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

  16. Atypical Presentations of Methemoglobinemia from Benzocaine Spray

    PubMed Central

    Suwantarat, Nuntra; Vierra, Joseph R; Evans, Samuel J

    2011-01-01

    Widely used for local anesthesia, especially prior to endoscopic procedures, benzocaine spray is one of the most common causes of iatrogenic methemoglobinemia. The authors report an atypical case of methemoglobinemia in a woman presenting with pale skin and severe hypoxemia, after a delayed repeat exposure to benzocaine spray. Early recognition and prompt management of methemoglobinemia is needed in order to lessen morbidity and mortality from this entity. PMID:22162610

  17. Absence of the Septum Pellucidum

    MedlinePLUS

    ... studies provides the foundation for understanding how this process can go awry and, thus, offers hope for new means to treat and prevent developmental brain disorders. NIH Patient Recruitment for Absence of the Septum Pellucidum Clinical Trials ...

  18. Histology of 8 atypical femoral fractures

    PubMed Central

    Sandberg, Olof; Isaksson, Hanna; Aspenberg, Per

    2014-01-01

    Background and purpose The pathophysiology behind bisphosphonate-associated atypical femoral fractures remains unclear. Histological findings at the fracture site itself may provide clues. Patients and methods Between 2008 and 2013, we collected bone biopsies including the fracture line from 4 complete and 4 incomplete atypical femoral fractures. 7 female patients reported continuous bisphosphonate use for 10 years on average. 1 patient was a man who was not using bisphosphonates. Dual-energy X-ray absorptiometry of the hip and spine showed no osteoporosis in 6 cases. The bone biopsies were evaluated by micro-computed tomography, infrared spectroscopy, and qualitative histology. Results Incomplete fractures involved the whole cortical thickness and showed a continuous gap with a mean width of 180 µm. The gap contained amorphous material and was devoid of living cells. In contrast, the adjacent bone contained living cells, including active osteoclasts. The fracture surfaces sometimes consisted of woven bone, which may have formed in localized defects caused by surface fragmentation or resorption. Interpretation Atypical femoral fractures show signs of attempted healing at the fracture site. The narrow width of the fracture gap and its necrotic contents are compatible with the idea that micromotion prevents healing because it leads to strains within the fracture gap that preclude cell survival. PMID:24786905

  19. Increased Cortical Extracellular Adenosine Correlates with Seizure Termination

    PubMed Central

    Van Gompel, Jamie J.; Bower, Mark R.; Worrell, Gregory A.; Stead, Matt; Chang, Su-Youne; Goerss, Stephan J.; Kim, Inyong; Bennet, Kevin E.; Meyer, Fredric B.; Marsh, W. Richard; Blaha, Charles D.; Lee, Kendall H.

    2014-01-01

    Objective Seizures are currently defined by their electrographic features. However, neuronal networks are intrinsically dependent upon neurotransmitters of which little is known regarding their peri-ictal dynamics. Evidence supports adenosine as having a prominent role in seizure termination, as its administration can terminate and reduce seizures in animal models. Further, microdialysis studies in humans suggest adenosine is elevated peri-ictally, but the relationship to the seizure is obscured by its temporal measurement limitations. Because electrochemical techniques can provide vastly superior temporal resolution, we test the hypothesis that extracellular adenosine concentrations rise during seizure termination in an animal model and humans using electrochemistry. Methods White farm swine (n=45) were used in an acute cortical model of epilepsy and 10 human epilepsy patients were studied during intraoperative electrocorticography (Ecog). Wireless Instantaneous Neurotransmitter Concentration Sensor (WINCS) based fast scan cyclic voltametry (FSCV) and fixed potential amperometry were obtained utilizing an adenosine specific triangular waveform or biosensors respectively. Results Simultaneous Ecog and electrochemistry demonstrated an average adenosine rise of 260% compared to baseline at 7.5 ± 16.9 seconds with amperometry (n=75 events) and 2.6 ± 11.2 seconds with FSCV (n=15 events) prior to electrographic seizure termination. In agreement with these animal data, adenosine elevation prior to seizure termination in a human patient utilizing FSCV was also seen. Significance Simultaneous Ecog and electrochemical recording supports the hypothesis that adenosine rises prior to seizure termination, suggesting that adenosine itself may be responsible for seizure termination. Future work using intraoperative WINCS based FSCV recording may help to elucidate the precise relationship between adenosine and seizure termination. PMID:24483230

  20. 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…

  1. 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

  2. Acute and Chronic Effects of N-acetylcysteine on Pentylenetetrazole-induced Seizure and Neuromuscular Coordination in Mice

    PubMed Central

    Zaeri, Sasan; Emamghoreishi, Masoumeh

    2015-01-01

    Background N-acetylcysteine (NAC) has been indicated against experimental seizures, but with relatively inconclusive results. This study was undertaken to evaluate whether NAC exerts a dose-dependent anticonvulsant effect and to determine NAC safe therapeutic dose range and its muscle-relaxant activity in both acute and chronic uses. Methods Following intraperitoneal (i.p.) administration of N-acetylcysteine acutely (50-300 mg/kg) or chronically for 8 days (25-300 mg/kg), mice were injected with PTZ (90 mg/kg, i.p.) and latency times to the onset of myoclonic and clonic seizures and protection against death were recorded. Changes in body weight and mortality rate were considered as parameters for drug safety. The muscle-relaxant activity of NAC was assessed by rotarod test. Results Acute and chronic treatment with NAC delayed latency times to myoclonic and clonic seizures in a dose-dependent manner, but with no significant prevention against PTZ-induced death. Chronic administration of 300 mg/kg NAC was fully lethal while lower doses (100 and 150 mg/kg) resulted in a significant weight loss and decreased stay time on rotarod. Acute treatment with NAC had no significant effect on stay time on rotarod at all studied doses. Conclusion NAC exerts a dose-dependent anticonvulsant effect in acute and chronic uses, with no muscle relaxant activity. NAC has higher efficacy in preventing seizure in chronic than acute treatment, but its chronic use at higher doses of 75 mg/kg may be associated with side effects and/or toxicity. These findings suggest that low doses of NAC may have a potential use as a prophylactic treatment for absence seizure in human.

  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. 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

  5. A case of atypical diffuse feline fibrotic lung disease.

    PubMed

    Le Boedec, Kevin; Roady, Patrick J; O'Brien, Robert T

    2014-10-01

    An 11-year-old cat presented for respiratory distress and weight loss. Thoracic radiographs were interpreted as a diffuse bronchointerstitial pattern with bronchiectasis and a mild ventral alveolar pattern on the lateral views. Computed tomography revealed a severe diffuse reticular pattern, relatively hyperattenuating in subpleural regions, with diffuse traction bronchiectasis and some degree of honeycombing. Despite the absence of basal predominance, this pattern was considered to be suggestive of usual interstitial pneumonia (UIP). Other differentials (other types of interstitial lung disease, infectious pneumonitis, neoplasia, or early edema or hemorrhage) were considered less likely based on history and other test results. The cat was discharged without any treatment, and euthanased 5 months later. Post-mortem histological analysis of the lung revealed end-stage lung, with extensive fibrosis that was more severe in subpleural regions, fibroblastic foci and honeycombing, suggestive of UIP. A probable diagnosis of idiopathic pulmonary fibrosis (IPF) was made. The diffuse distribution of the lesions was atypical compared with previous tomographic and histologic descriptions of IPF in cats. This case report suggests a heterogeneity of the pulmonary fibrotic disorders in cats that warrants further investigation for better characterization and classification. PMID:24650951

  6. Recurrent ocular involvement in pediatric atypical hemolytic uremic syndrome.

    PubMed

    Zheng, Xiaoyu; Gorovoy, Ian R; Mao, Jianhua; Jin, Ji; Chen, Xi; Cui, Qi N

    2014-01-01

    Atypical hemolytic uremic syndrome (HUS) is a subtype of thrombotic microangiopathy associated with complement alternative pathway dysregulation. It is clinically characterized by a relapsing course and a poor prognosis. Multiple organ systems are commonly affected by thrombotic microangiopathy in pediatric atypical HUS; however, ocular involvement is rarely reported. The case of an 11-year-old girl diagnosed as having atypical HUS who presented with bilateral central retinal vein occlusions with macular subhyaloid hemorrhage during her initial onset and ophthalmoplegia, diplopia, and optic disc edema during her relapsing episode 1 year later is described. All ocular manifestations occurred in the convalescence phase of atypical HUS. No other extrarenal complications were found and full recovery was achieved following typical treatment for atypical HUS (ie, plasma infusion, steroid, and supportive therapy). This is thought to be the first reported case of recurrent ocular involvement in pediatric atypical HUS. PMID:25347082

  7. Recurrent ocular involvement in pediatric atypical hemolytic uremic syndrome.

    PubMed

    Zheng, Xiaoyu; Gorovoy, Ian R; Mao, Jianhua; Jin, Ji; Chen, Xi; Cui, Qi N

    2014-01-01

    Atypical hemolytic uremic syndrome (HUS) is a subtype of thrombotic microangiopathy associated with complement alternative pathway dysregulation. It is clinically characterized by a relapsing course and a poor prognosis. Multiple organ systems are commonly affected by thrombotic microangiopathy in pediatric atypical HUS; however, ocular involvement is rarely reported. The case of an 11-year-old girl diagnosed as having atypical HUS who presented with bilateral central retinal vein occlusions with macular subhyaloid hemorrhage during her initial onset and ophthalmoplegia, diplopia, and optic disc edema during her relapsing episode 1 year later is described. All ocular manifestations occurred in the convalescence phase of atypical HUS. No other extrarenal complications were found and full recovery was achieved following typical treatment for atypical HUS (ie, plasma infusion, steroid, and supportive therapy). This is thought to be the first reported case of recurrent ocular involvement in pediatric atypical HUS. PMID:25608228

  8. Seizures as imbalanced up states: excitatory and inhibitory conductances during seizure-like events.

    PubMed

    Žiburkus, Jokubas; Cressman, John R; Schiff, Steven J

    2013-03-01

    Precisely timed and dynamically balanced excitatory (E) and inhibitory (I) conductances underlie the basis of neural network activity. Normal E/I balance is often shifted in epilepsy, resulting in neuronal network hyperexcitability and recurrent seizures. However, dynamics of the actual excitatory and inhibitory synaptic conductances (ge and gi, respectively) during seizures remain unknown. To study the dynamics of E and I network balance, we calculated ge and gi during the initiation, body, and termination of seizure-like events (SLEs) in the rat hippocampus in vitro. Repetitive emergent SLEs in 4-aminopyridine (100 ?M) and reduced extracellular magnesium (0.6 mM) were recorded in the identified CA1 pyramidal cells (PC) and oriens-lacunosum moleculare (O-LM) interneurons. Calculated ge/gi ratio dynamics showed that the initiation stage of the SLEs was dominated by inhibition in the PCs and was more balanced in the O-LM cells. During the body of the SLEs, the balance shifted toward excitation, with ge and gi peaking in both cell types at nearly the same time. In the termination phase, PCs were again dominated by inhibition, whereas O-LM cells experienced persistent excitatory synaptic barrage. In this way, increased excitability of interneurons may play roles in both seizure initiation (žiburkus J, Cressman JR, Barreto E, Schiff SJ. J Neurophysiol 95: 3948-3954, 2006) and in their termination. Overall, SLE stages can be characterized in PC and O-LM cells by dynamically distinct changes in the balance of ge and gi, where a temporal sequence of imbalance shifts with the changing firing patterns of the cellular subtypes comprising the hyperexcitable microcircuits. PMID:23221405

  9. A novel dynamic update framework for epileptic seizure prediction.

    PubMed

    Han, Min; Ge, Sunan; Wang, Minghui; Hong, Xiaojun; Han, Jie

    2014-01-01

    Epileptic seizure prediction is a difficult problem in clinical applications, and it has the potential to significantly improve the patients' daily lives whose seizures cannot be controlled by either drugs or surgery. However, most current studies of epileptic seizure prediction focus on high sensitivity and low false-positive rate only and lack the flexibility for a variety of epileptic seizures and patients' physical conditions. Therefore, a novel dynamic update framework for epileptic seizure prediction is proposed in this paper. In this framework, two basic sample pools are constructed and updated dynamically. Furthermore, the prediction model can be updated to be the most appropriate one for the prediction of seizures' arrival. Mahalanobis distance is introduced in this part to solve the problem of side information, measuring the distance between two data sets. In addition, a multichannel feature extraction method based on Hilbert-Huang transform and extreme learning machine is utilized to extract the features of a patient's preseizure state against the normal state. At last, a dynamic update epileptic seizure prediction system is built up. Simulations on Freiburg database show that the proposed system has a better performance than the one without update. The research of this paper is significantly helpful for clinical applications, especially for the exploitation of online portable devices. PMID:25050381

  10. A Novel Dynamic Update Framework for Epileptic Seizure Prediction

    PubMed Central

    Wang, Minghui; Hong, Xiaojun; Han, Jie

    2014-01-01

    Epileptic seizure prediction is a difficult problem in clinical applications, and it has the potential to significantly improve the patients' daily lives whose seizures cannot be controlled by either drugs or surgery. However, most current studies of epileptic seizure prediction focus on high sensitivity and low false-positive rate only and lack the flexibility for a variety of epileptic seizures and patients' physical conditions. Therefore, a novel dynamic update framework for epileptic seizure prediction is proposed in this paper. In this framework, two basic sample pools are constructed and updated dynamically. Furthermore, the prediction model can be updated to be the most appropriate one for the prediction of seizures' arrival. Mahalanobis distance is introduced in this part to solve the problem of side information, measuring the distance between two data sets. In addition, a multichannel feature extraction method based on Hilbert-Huang transform and extreme learning machine is utilized to extract the features of a patient's preseizure state against the normal state. At last, a dynamic update epileptic seizure prediction system is built up. Simulations on Freiburg database show that the proposed system has a better performance than the one without update. The research of this paper is significantly helpful for clinical applications, especially for the exploitation of online portable devices. PMID:25050381

  11. Seizure suppression by gain-of-function escargot mutations.

    PubMed

    Hekmat-Scafe, Daria S; Dang, Kim N; Tanouye, Mark A

    2005-03-01

    Suppressor mutations provide potentially powerful tools for examining mechanisms underlying neurological disorders and identifying novel targets for pharmacological intervention. Here we describe mutations that suppress seizures in a Drosophila model of human epilepsy. A screen utilizing the Drosophila easily shocked (eas) "epilepsy" mutant identified dominant suppressors of seizure sensitivity. Among several mutations identified, neuronal escargot (esg) reduced eas seizures almost 90%. The esg gene encodes a member of the snail family of transcription factors. Whereas esg is normally expressed in a limited number of neurons during a defined period of nervous system development, here normal esg was expressed in all neurons and throughout development. This greatly ameliorated both the electrophysiological and the behavioral epilepsy phenotypes of eas. Neuronal esg appears to act as a general seizure suppressor in the Drosophila epilepsy model as it reduces the susceptibility of several seizure-prone mutants. We observed that esg must be ectopically expressed during nervous system development to reduce seizure susceptibility in adults. Furthermore, induction of esg in a small subset of neurons (interneurons) will reduce seizure susceptibility. A combination of microarray and computational analyses revealed 100 genes that represent possible targets of neuronal esg. We anticipate that some of these genes may ultimately serve as targets for novel antiepileptic drugs. PMID:15654097

  12. 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

  13. A case of seizures induced by abstract reasoning.

    PubMed

    Tatsuzawa, Yasutaka; Yoshino, Aihide; Nomura, Soichiro

    2010-04-01

    We describe a case of reflex seizures induced by abstract reasoning but not other cognitive processes. The patient, a 46-year-old man, experienced myoclonic seizures whenever he played shogi (Japanese chess). To identify the critical thought processes responsible for inducing his seizures, we monitored his clinical seizures and epileptiform discharges while he performed comprehensive neuropsychological tests, including the Wechsler Adult Intelligence Scale-Revised (WAIS-R), spatial working memory, mental rotation, and Wisconsin Card Sorting Test (WCST) tasks. A myoclonic seizure occurred only during the WCST. Generalized 3- to 5-Hz spike-and-slow-wave bursts occurred repeatedly during the Block Design subtest of the WAIS-R and the WCST, whereas no discharges occurred during other subtests of the WAIS-R including the calculation, spatial working memory, and mental rotation tasks. These results indicate that abstract reasoning, independent of other cognitive processes, could induce the patient's epileptiform discharges, suggesting that his reflex seizures might be a distinct subtype of nonverbal thinking-induced seizures. PMID:20171146

  14. Seizure prediction using spike rate of intracranial EEG.

    PubMed

    Li, Shufang; Zhou, Weidong; Yuan, Qi; Liu, Yinxia

    2013-11-01

    Reliable prediction of forthcoming seizures will be a milestone in epilepsy research. A method capable of timely predicting the occurrence of seizures could significantly improve the quality of life for epilepsy patients and open new therapeutic approaches. Seizures are usually characterized by generalized spike wave discharges. With the advent of seizures, the variation of spike rate (SR) will have different manifestations. In this study, a seizure prediction approach based on spike rate is proposed and evaluated. Firstly, a low-pass filter is applied to remove the high frequency artifacts in electroencephalogram (EEG). Then, the morphology filter is used to detect spikes and compute SR, and SR is smoothed with an average filter. Finally, the performance of smoothed SR (SRm) in EEG during interictal, preictal, and ictal periods is analyzed and employed as an index for seizure prediction. Experiments with long-term intracranial EEGs of 21 patients show that the proposed seizure prediction approach achieves a sensitivity of 75.8% with an average false prediction rate of 0.09/h. The low computational complexity of the proposed approach enables its possibility of applications in an implantable device for epilepsy therapy. PMID:24122570

  15. Feature extraction with stacked autoencoders for epileptic seizure detection.

    PubMed

    Supratak, Akara; Ling Li; Yike Guo

    2014-01-01

    Scalp electroencephalogram (EEG), a recording of the brain's electrical activity, has been used to diagnose and detect epileptic seizures for a long time. However, most researchers have implemented seizure detectors by manually hand-engineering features from observed EEG data, and used them in seizure detection, which might not scale well to new patterns of seizures. In this paper, we investigate the possibility of utilising unsupervised feature learning, the recent development of deep learning, to automatically learn features from raw, unlabelled EEG data that are representative enough to be used in seizure detection. We develop patient-specific seizure detectors by using stacked autoencoders and logistic classifiers. A two-step training consisting of the greedy layer-wise and the global fine-tuning was used to train our detectors. The evaluation was performed by using labelled dataset from the CHB-MIT database, and the results showed that all of the test seizures were detected with a mean latency of 3.36 seconds, and a low false detection rate. PMID:25570914

  16. Body Packing: From Seizures to Laparotomy

    PubMed Central

    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.

  17. 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.

  18. Mortality in Late Post-Traumatic Seizures

    PubMed Central

    Englander, Jeffrey; Bushnik, Tamara; Wright, Jerry M.; Jamison, Laura; Duong, Thao T.

    2009-01-01

    Abstract The objective of this study was to examine the mortality rates in individuals with traumatic brain injury (TBI) who were classified as having experienced late post-traumatic seizures (LPTS) in the first 2 years post-TBI compared to those who were seizure-free (non-LPTS). Participants were a pooled sample (n?=?508) from two studies which enrolled individuals with TBI who were injured between March 31, 1992 and December 20, 1999. The first sample was made up of individuals enrolled in a study of risk factors for LPTS development; the second sample was composed of individuals enrolled in the TBI National Database from a single rehabilitation center. Seventy-one (14%) participants had LPTS, of which 27% had died at 8–15 years post-injury, as compared to 10% of non-LPTS participants. Individuals with LPTS died at a younger age (54.1 versus 67.7 years; p?=?0.01), but there were no statistically significant differences in either time from date of injury to death or highest GCS score in the first 24?h. Causes of death were variable and not specifically related to epilepsy. Of those with LPTS, risk factors for death include advanced age at time of injury and presence of subdural hematoma. The higher mortality rate and death at younger age with variable causes in TBI individuals with LPTS warrant close medical evaluation and monitoring of these individuals, particularly accessibility and compliance with ongoing general medical care, and education of primary care colleagues of the unique needs of this at-risk population. PMID:19508123

  19. A Computational Study of Stimulus Driven Epileptic Seizure Abatement

    PubMed Central

    Goodfellow, Marc; Dauwels, Justin; Moeller, Friederike; Stephani, Ulrich; Baier, Gerold

    2014-01-01

    Active brain stimulation to abate epileptic seizures has shown mixed success. In spike-wave (SW) seizures, where the seizure and background state were proposed to coexist, single-pulse stimulations have been suggested to be able to terminate the seizure prematurely. However, several factors can impact success in such a bistable setting. The factors contributing to this have not been fully investigated on a theoretical and mechanistic basis. Our aim is to elucidate mechanisms that influence the success of single-pulse stimulation in noise-induced SW seizures. In this work, we study a neural population model of SW seizures that allows the reconstruction of the basin of attraction of the background activity as a four dimensional geometric object. For the deterministic (noise-free) case, we show how the success of response to stimuli depends on the amplitude and phase of the SW cycle, in addition to the direction of the stimulus in state space. In the case of spontaneous noise-induced seizures, the basin becomes probabilistic introducing some degree of uncertainty to the stimulation outcome while maintaining qualitative features of the noise-free case. Additionally, due to the different time scales involved in SW generation, there is substantial variation between SW cycles, implying that there may not be a fixed set of optimal stimulation parameters for SW seizures. In contrast, the model suggests an adaptive approach to find optimal stimulation parameters patient-specifically, based on real-time estimation of the position in state space. We discuss how the modelling work can be exploited to rationally design a successful stimulation protocol for the abatement of SW seizures using real-time SW detection. PMID:25531883

  20. 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

  1. Experimental febrile seizures are precipitated by a hyperthermia-induced respiratory alkalosis

    Microsoft Academic Search

    Sebastian Schuchmann; Dietmar Schmitz; Claudio Rivera; Sampsa Vanhatalo; Benedikt Salmen; Ken Mackie; Sampsa T Sipilä; Juha Voipio; Kai Kaila

    2006-01-01

    Febrile seizures are frequent during early childhood, and prolonged (complex) febrile seizures are associated with an increased susceptibility to temporal lobe epilepsy. The pathophysiological consequences of febrile seizures have been extensively studied in rat pups exposed to hyperthermia. The mechanisms that trigger these seizures are unknown, however. A rise in brain pH is known to enhance neuronal excitability. Here we

  2. 78 FR 77774 - Qualification of Drivers; Exemption Applications; Epilepsy and Seizure Disorders

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-24

    ...not be certified. Drivers with a history of a single provoked seizure with low...which provide that ``drivers with a history of epilepsy/seizures off anti-seizure...commerce. Interstate drivers with a history of a single unprovoked seizure may...

  3. Seizure Risk in Patients with Attention-Deficit-Hyperactivity Disorder Treated with Atomoxetine

    ERIC Educational Resources Information Center

    Wernicke, Joachim F.; Holdridge, Karen Chilcott; Jin, Ling; Edison, Timothy; Zhang, Shuyu; Bangs, Mark E.; Allen, Albert J.; Ball, Susan; Dunn, David

    2007-01-01

    The comorbidity of seizures, epilepsy, and attention-deficit-hyperactivity disorder (ADHD) prompted the examination of whether atomoxetine use for ADHD is associated with an increased risk of seizures. Seizures and seizure-related symptoms were reviewed from two independent Eli Lilly and Company databases: the atomoxetine clinical trials database…

  4. The influence of the full moon on seizure frequency: myth or reality?

    Microsoft Academic Search

    Selim R. Benbadis; Stanley Chang; Joel Hunter; Wei Wang

    2004-01-01

    To investigate a possible relationship between seizure frequency and the lunar cycle, we reviewed the occurrence of seizures recorded in our epilepsy monitoring unit over a 3-year period. Analysis of the total number of seizures (epileptic plus nonepileptic) showed no significant association. A separate analysis revealed that for nonepileptic seizures, there was an increase at the full moon, and for

  5. 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

  6. 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

  7. Atypical Bourneville sclerosis without epilepsy and mental retardation: case report and literature review.

    PubMed

    Ciobanu, Adela Magdalena; Lisievici, Mihai Gheorghe; Coman, Teodora Camelia; Ciurea, Jean; Popa, Mihaela Camelia

    2014-01-01

    Twenty-four-year-old woman without familiar detected signs of Bourneville's disease or tuberous sclerosis complex (TSC) was diagnosed with this disease by casual discovery on cerebral magnetic resonance imaging (MRI) of an intraventricular tumor, after symptoms consist in headache, equilibrium disturbances, and progressive loss of vision. MRI shows an intracranial mass, 33÷24÷30 mm in size, localized at the level of third ventricle and lateral ventricles, with irregular shape, interesting the foramen of Monroe. There are also nodular areas of calcification and a supratentorial hydrocephalus involving the lateral ventricles and the posterior part of the third ventricle. The patients present facial angiofibromas, but from the classical triad of the disease, the epilepsy and mental retardation were absent, the patient never presented seizures. The total removal of the tumor (peace to peace) was performed surgically, the macroscopic features of resected tumor (20/10/10 mm) was of white-gray color, elastic consistency, localized in the both lateral ventricles (left>right) and into the third ventricle, traversing the foramen Monroe. The histopatological examination associated with specific localization of tumor and the facial angiofibromas are very suggestive for subependimar giant cell astrocytoma (SEGA). We have a rare case of atypical or incomplete TSC in which the epileptic seizures and the mental retardation are absent, the intelligence is normal, but occur some psychical symptoms: anxiety, sleeplessness, and autism or behavior disturbances. The evolution of this case was marked by complications because of postoperative hydrocephalus and multiple shunt insertions and revisions were performed after the tumor resection. PMID:24969994

  8. Trisomy 18 with unilateral atypical ectrodactyly

    SciTech Connect

    Rogers, R.C. [Greenwood Genetic Center, SC (United States)

    1994-01-01

    Becerra et al. recently reported on an infant with multiple congenital anomalies who had trisomy 18. This preterm infant presented with bilateral ectrodactyly of feet, small cleft palate, esophageal atresia with associated tracheoesophageal fistula, congenital heart disease and other anomalies. The authors referenced article by Castle and Bernstein, in which they reported a male with trisomy 18 and cleft foot as well as a review of the literature which showed 2 other infants with trisomy 18 and ectrodactyly of the feet. An additional case of trisomy 18 associated with multiple congenital anomalies, including unilaterial, atypical ectrodactyly of the left foot.

  9. 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)

  10. Congenital Absence of the Pericardium

    PubMed Central

    Kim, Hyun-Jin; Cho, Goo-Yeong; Choi, Sang Il

    2014-01-01

    Congenital absence of the pericardium is a rare cardiac malformation and is most often asymptomatic. It is usually discovered as an incidental finding. Physical examination, chest radiography, and electrocardiogram are often unremarkable. Echocardiography provides valuable information, and sometimes computed tomography or magnetic resonance imaging is needed for subsequent confirmation. PMID:24753808

  11. Joining the benefits: Combining epileptic seizure prediction methods

    E-print Network

    Timmer, Jens

    methods for seizure prediction so far have shown statistical significance but insufficient performance'' and ``OR'' combinations. Results: Used independently, either method resulted in a statistically significant for clinical applications, we investigated pos- sible improvements by combining algorithms capturing different

  12. 27 CFR 555.186 - Seizure or forfeiture.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... COMMERCE IN EXPLOSIVES Marking of Plastic Explosives § 555.186 Seizure or forfeiture. Any plastic explosive that does not contain...regulations on summary destruction of plastic explosives that do not contain a...

  13. 27 CFR 555.186 - Seizure or forfeiture.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... COMMERCE IN EXPLOSIVES Marking of Plastic Explosives § 555.186 Seizure or forfeiture. Any plastic explosive that does not contain...regulations on summary destruction of plastic explosives that do not contain a...

  14. 27 CFR 555.186 - Seizure or forfeiture.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... COMMERCE IN EXPLOSIVES Marking of Plastic Explosives § 555.186 Seizure or forfeiture. Any plastic explosive that does not contain...regulations on summary destruction of plastic explosives that do not contain a...

  15. Investigation of cardiac dysfunction and hypoxaemia during epileptic seizures 

    E-print Network

    Brotherstone, Ruth Elizabeth

    2012-06-30

    Epileptic seizures are often un-witnessed and can result in hypoxic brain damage or can be fatal due to injuries, status epilepticus or sudden unexpected death in epilepsy (SUDEP). The first aim of this thesis was ...

  16. Similarity-Index Early Seizure Detector VLSI Architecture

    E-print Network

    Genov, Roman

    nature of seizures is a major reason for the morbid nature of this disease, causing extensive emotional trauma to the patients and their families, as the risk of premature death in epileptic patients is two

  17. Ontology and Knowledge Management System on Epilepsy and Epileptic Seizures

    E-print Network

    Almeida, Pedro; Sales, Francisco; Nogueira, Ana; Dourado, António

    2010-01-01

    A Knowledge Management System developed for supporting creation, capture, storage and dissemination of information about Epilepsy and Epileptic Seizures is presented. We present an Ontology on Epilepsy and a Web-based prototype that together create the KMS.

  18. Nonlinear nonstationary Wiener model of infant EEG seizures.

    PubMed

    Celka, P; Colditz, P

    2002-06-01

    This paper presents the estimation of a nonstationary nonlinear model of seizures in infants based on parallel Wiener structures. The model comprises two parts and is partly derived from the Roessgen et al. seizure model. The first part consists of a nonlinear Wiener model of the pure background activity, and the second part in a nonlinear Wiener model of the pure seizure activity with a time-varying deterministic input signal. The two parts are then combined in a parallel structure. The Wiener model consists of an autoregressive moving average filter followed by a nonlinear shaping function to take into account the non-Gaussian statistical behavior of the data. Model estimation was performed on 64 infants of whom four showed signs of clinical and electrical seizures. Model validation is performed using time-frequency-based entropy distance and shows an averaged improvement of 50% in modeling performance compared with the Roessgen model. PMID:12046701

  19. Tardive Seizure with Postictal Aphasia: A Case Report

    PubMed Central

    Felkel, W. Carson; Wagner, Gerhardt; Kimball, James; Rosenquist, Peter; McCall, W. Vaughn; Arias, Lorraine

    2012-01-01

    Electroconvulsive therapy (ECT) is a highly effective treatment for certain psychiatric disorders with relatively few serious side effects or complications. Tardive seizures are one of these rare, but potentially fatal complications. Recognizing and treating tardive seizures is essential to prevent prolonged postictal confusion, progression to status epilepticus and associated soft tissue injury, anoxia, aspiration and death. Currently there is an unknown prevalence of their occurrence and an overall lack of clinical description of their phenomenology. We describe a case in which a patient develops a tardive seizure followed by a receptive and expressive aphasia, thought to be a variant of Todd’s postictal paralysis. This case is further unique in that there was a lateralization of a motor seizure presumably to the hemisphere contralateral to the RUL electrode placement. PMID:22573186

  20. 27 CFR 555.186 - Seizure or forfeiture.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... COMMERCE IN EXPLOSIVES Marking of Plastic Explosives § 555.186 Seizure or forfeiture. Any plastic explosive that does not contain...regulations on summary destruction of plastic explosives that do not contain a...

  1. 27 CFR 555.186 - Seizure or forfeiture.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... COMMERCE IN EXPLOSIVES Marking of Plastic Explosives § 555.186 Seizure or forfeiture. Any plastic explosive that does not contain...regulations on summary destruction of plastic explosives that do not contain a...

  2. The approach to patients with "non-epileptic seizures"

    PubMed Central

    Mellers, J

    2005-01-01

    Up to one fifth of patients who present to specialist clinics with seizures do not have epilepsy. The majority of such patients suffer from psychologically mediated episodes; dissociative seizures, often referred to as "non-epileptic seizures". This paper describes the diagnostic evaluation of seizure disorders, including clinical assessment and the role of special investigations. The organic and psychiatric imitators of epilepsy are outlined and findings on psychiatric assessment are reviewed. This group of patients often proves difficult to engage in appropriate treatment and an approach to explaining the diagnosis is described. As yet there are no controlled trials of treatment in this disorder but preliminary evidence suggests cognitive behavioural therapy is both a rational and promising way forward. PMID:16085740

  3. Moonstruck? The effect of the lunar cycle on seizures.

    PubMed

    Baxendale, Sallie; Fisher, Jennifer

    2008-10-01

    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 a significant negative correlation between the mean number of seizures and the fraction of the moon illuminated by the sun (rho=-0.09, P<0.05) in 1571 seizures recorded in a dedicated epilepsy inpatient unit over 341 days. This correlation disappeared when we controlled for the local clarity of the night sky, suggesting that it is the brightness of the night and the contribution the moon phase makes to nocturnal luminance, rather than the moon phase per se, that may influence the occurrence of epileptic seizures. PMID:18602495

  4. Evidence of an inhibitory restraint of seizure activity in humans

    PubMed Central

    Schevon, Catherine A.; Weiss, Shennan A.; McKhann, Guy; Goodman, Robert R.; Yuste, Rafael; Emerson, Ronald G.; Trevelyan, Andrew J.

    2012-01-01

    The location and trajectory of seizure activity is of great importance, yet our ability to map such activity remains primitive. Recently, the development of multi-electrode arrays for use in humans has provided new levels of temporal and spatial resolution for recording seizures. Here, we show that there is a sharp delineation between areas showing intense, hypersynchronous firing indicative of recruitment to the seizure, and adjacent territories where there is only low-level, unstructured firing. Thus, there is a core territory of recruited neurons and a surrounding 'ictal penumbra'. The defining feature of the 'ictal penumbra' is the contrast between the large amplitude EEG signals and the low-level firing there. Our human recordings bear striking similarities with animal studies of an inhibitory restraint, indicating that they can be readily understood in terms of this mechanism. These findings have important implications for how we localize seizure activity and map its spread. PMID:22968706

  5. 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

  6. Rescue of easily shocked Mutant Seizure Sensitivity in Drosophila Adults

    PubMed Central

    Kroll, Jason R.; Tanouye, Mark A.

    2014-01-01

    Genetic factors that influence seizure susceptibility can act transiently during the development of neural circuits or might be necessary for the proper functioning of existing circuits. We provide evidence that the Drosophila seizure-sensitive mutant easily shocked (eas) represents a neurological disorder in which abnormal functioning of existing neural circuits leads to seizure sensitivity. The eas+ gene encodes for the protein Ethanolamine Kinase, involved in phospholipid biosynthesis. We show that induction of eas+ in adult mutant flies rescues them from seizure sensitivity despite previously known developmental defects in brain morphology. Additionally, through cell-type-specific rescue, our results suggest a specific role for eas+ in excitatory rather than inhibitory neural transmission. Overall, our findings emphasize an important role for proper phospholipid metabolism in normal brain function and suggest that certain classes of epilepsy syndromes could have the potential to be treated with gene therapy techniques. PMID:23682034

  7. Acute renal failure and seizures associated with chlorambucil overdose.

    PubMed

    Blank, D W; Nanji, A A; Schreiber, D H; Hudman, C; Sanders, H D

    1983-06-01

    A case of chlorambucil overdose is presented. The clinical manifestations were acute renal failure and seizures. We are not aware of this combination of clinical features being previously reported with chlorambucil overdose. PMID:6655776

  8. Rescue of easily shocked mutant seizure sensitivity in Drosophila adults.

    PubMed

    Kroll, Jason R; Tanouye, Mark A

    2013-10-15

    Genetic factors that influence seizure susceptibility can act transiently during the development of neural circuits or might be necessary for the proper functioning of existing circuits. We provide evidence that the Drosophila seizure-sensitive mutant easily shocked (eas) represents a neurological disorder in which abnormal functioning of existing neural circuits leads to seizure sensitivity. The eas(+) gene encodes for the protein Ethanolamine Kinase, involved in phospholipid biosynthesis. We show that induction of eas(+) in adult mutant flies rescues them from seizure sensitivity despite previously known developmental defects in brain morphology. Additionally, through cell-type-specific rescue, our results suggest a specific role for eas(+) in excitatory rather than inhibitory neural transmission. Overall, our findings emphasize an important role for proper phospholipid metabolism in normal brain function and suggest that certain classes of epilepsy syndromes could have the potential to be treated with gene therapy techniques. PMID:23682034

  9. 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

  10. Genetic heterogeneity for autosomal recessive pyridoxine-dependent seizures

    Microsoft Academic Search

    C. L. Bennett; H. M. Huynh; P. F. Chance; I. A. Glass; S. M. Gospe

    2005-01-01

    Pyridoxine-dependent seizure (PDS) is a rare autosomal recessive intractable seizure disorder only controlled by a daily supplementation\\u000a of pharmacological doses of pyridoxine (Vitamin B6). Although glutamate decarboxylase utilizes pyridoxal phosphate as a cofactor\\u000a during conversion of the excitatory amino acid, glutamate, to the inhibitory neurotransmitter, ?-amino butyric acid (GABA),\\u000a several studies have failed to demonstrate a linkage to either of

  11. Atypical Celiac Disease: From Recognizing to Managing

    PubMed Central

    Admou, B.; Essaadouni, L.; Krati, K.; Zaher, K.; Sbihi, M.; Chabaa, L.; Belaabidia, B.; Alaoui-Yazidi, A.

    2012-01-01

    The nonclassic clinical presentation of celiac disease (CD) becomes increasingly common in physician's daily practice, which requires an awareness of its many clinical faces with atypical, silent, and latent forms. Besides the common genetic background (HLA DQ2/DQ8) of the disease, other non-HLA genes are now notably reported with a probable association to atypical forms. The availability of high-sensitive and specific serologic tests such as antitissue transglutuminase, antiendomysium, and more recent antideamidated, gliadin peptide antibodies permits to efficiently uncover a large portion of the submerged CD iceberg, including individuals having conditions associated with a high risk of developing CD (type 1 diabetes, autoimmune diseases, Down syndrome, family history of CD, etc.), biologic abnormalities (iron deficiency anemia, abnormal transaminase levels, etc.), and extraintestinal symptoms (short stature, neuropsychiatric disorders, alopecia, dental enamel hypoplasia, recurrent aphtous stomatitis, etc.). Despite the therapeutic alternatives currently in developing, the strict adherence to a GFD remains the only effective and safe therapy for CD. PMID:22811701

  12. Heterogeneity of atypical haemolytic uraemic syndromes

    PubMed Central

    Neuhaus, T.; Calonder, S.; Leumann, E.

    1997-01-01

    Accepted 20 February 1997? Atypical, non-diarrhoea associated haemolytic uraemic syndrome (D?HUS) is a heterogeneous disorder with a generally poor outcome, although this view has now been questioned. The clinical and laboratory features of 23 children with D?HUS, representing a third of all patients with HUS seen during the last 26 years, were examined. The median age was 4.9 years (range 3 days-13.8 years). Twenty one children (91%) survived the initial phase. All patients except six infants aged <18 months required dialysis (74%). Hypertension (43%), cardiomyopathy (43%), and cerebral convulsions (48%) were common. Nineteen (83%) children were followed up for a median period of 5.5 years (range 0.5-23.4). Only five (26%) patients, among them four infants, recovered completely. Six (32%) patients had one to 10 recurrences, including two siblings with neonatal onset, and eight (42%) developed end stage renal failure. Five children underwent cadaveric renal transplantation, with recurrence and subsequent graft failure in two. Four children died, resulting in an overall mortality of 26%. Atypical HUS is heterogeneous with regard to epidemiology, pathophysiology, and outcome. Children with a recurrent, familial, or neonatal course have worse outcomes; in contrast, infants not requiring dialysis in the acute phase have a better prognosis.?? PMID:9245850

  13. Proteasome-mediated degradation of integral inner nuclear membrane protein emerin in fibroblasts lacking A-type lamins

    SciTech Connect

    Muchir, Antoine [Departments of Medicine and Anatomy and Cell Biology, College of Physicians and Surgeons, Columbia University, New York, NY 10032 (United States); Massart, Catherine [Inserm, U582, Institut de Myologie, Paris F-75013 (France); Universite Pierre et Marie Curie-Paris6, UMR S582, IFR14, Paris F-75013 (France); Engelen, Baziel G. van [Neuromuscular Centre Nijmegen, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Lammens, Martin [Neuromuscular Centre Nijmegen, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Bonne, Gisele [Inserm, U582, Institut de Myologie, Paris F-75013 (France); Universite Pierre et Marie Curie-Paris6, UMR S582, IFR14, Paris F-75013 (France); AP-HP, Groupe Hospitalier Pitie-Salpetriere, U.F. Myogenetique et Cardiogenetique, Service de Biochimie B, Paris F-75013 (France); Worman, Howard J. [Departments of Medicine and Anatomy and Cell Biology, College of Physicians and Surgeons, Columbia University, New York, NY 10032 (United States)]. E-mail: hjw14@columbia.edu

    2006-12-29

    We previously identified and characterized a homozygous LMNA nonsense mutation leading to the absence of A-type lamins in a premature neonate who died at birth. We show here that the absence of A-type lamins is due to degradation of the aberrant mRNA transcript with a premature termination codon. In cultured fibroblasts from the subject with the homozygous LMNA nonsense mutation, there was a decreased steady-state expression of the integral inner nuclear membrane proteins emerin and nesprin-1{alpha} associated with their mislocalization to the bulk endoplasmic reticulum and a hyperphosphorylation of emerin. To determine if decreased emerin expression occurred post-translationally, we treated cells with a selective proteasome inhibitor and observed an increase in expression. Our results show that mislocalization of integral inner nuclear membrane proteins to the endoplasmic reticulum in human cells lacking A-type lamins leads to their degradation and provides the first evidence that their degradation is mediated by the proteasome.

  14. Rett syndrome, classical and atypical: genealogical support for common origin

    Microsoft Academic Search

    H O Akesson; B Hagberg; J Wahlström

    1996-01-01

    AIMS OF THE STUDY: By using genealogical methods in atypical females with Rett syndrome (RS) we looked for support for the assumption that atypical RS cases are true variants of classical RS. SUBJECTS: We selected from the Swedish national RS series the \\

  15. 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 ...

  16. Animal behavior models of the mechanisms underlying antipsychotic atypicality

    Microsoft Academic Search

    Mark A. Geyer; Bart Ellenbroek

    2003-01-01

    This review describes the animal behavior models that provide insight into the mechanisms underlying the critical differences between the actions of typical vs. atypical antipsychotic drugs. Although many of these models are capable of differentiating between antipsychotic and other psychotropic drugs, only a few seem to be able to differentiate between typical and atypical antipsychotics, such as the paw test

  17. Typical and Atypical Dementia Family Caregivers: Systematic and Objective Comparisons

    ERIC Educational Resources Information Center

    Nichols, Linda O.; Martindale-Adams, Jennifer; Burns, Robert; Graney, Marshall J.; Zuber, Jeffrey

    2011-01-01

    This systematic, objective comparison of typical (spouse, children) and atypical (in-law, sibling, nephew/niece, grandchild) dementia family caregivers examined demographic, caregiving and clinical variables. Analysis was of 1,476 caregivers, of whom 125 were atypical, from the Resources for Enhancing Alzheimer's Caregivers Health (REACH I and II)…

  18. 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.

  19. 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

  20. Proposed pathogenesis for atypical femoral fractures: Lessons from materials research

    E-print Network

    Ritchie, Robert

    -term bisphosphonate (BP) use to the occurrence of a rare but catastrophic failure (fracture) of the femur -- termedCommentary Proposed pathogenesis for atypical femoral fractures: Lessons from materials research B online 16 February 2013 Edited by: Thomas Einhorn Keywords: Atypical femoral fractures Bisphosphonates

  1. A Physiology-Based Seizure Detection System for Multichannel EEG

    PubMed Central

    Shen, Chia-Ping; Liu, Shih-Ting; Zhou, Wei-Zhi; Lin, Feng-Seng; Lam, Andy Yan-Yu; Sung, Hsiao-Ya; Chen, Wei; Lin, Jeng-Wei; Chiu, Ming-Jang; Pan, Ming-Kai; Kao, Jui-Hung; Wu, Jin-Ming; Lai, Feipei

    2013-01-01

    Background Epilepsy is a common chronic neurological disorder characterized by recurrent unprovoked seizures. Electroencephalogram (EEG) signals play a critical role in the diagnosis of epilepsy. Multichannel EEGs contain more information than do single-channel EEGs. Automatic detection algorithms for spikes or seizures have traditionally been implemented on single-channel EEG, and algorithms for multichannel EEG are unavailable. Methodology This study proposes a physiology-based detection system for epileptic seizures that uses multichannel EEG signals. The proposed technique was tested on two EEG data sets acquired from 18 patients. Both unipolar and bipolar EEG signals were analyzed. We employed sample entropy (SampEn), statistical values, and concepts used in clinical neurophysiology (e.g., phase reversals and potential fields of a bipolar EEG) to extract the features. We further tested the performance of a genetic algorithm cascaded with a support vector machine and post-classification spike matching. Principal Findings We obtained 86.69% spike detection and 99.77% seizure detection for Data Set I. The detection system was further validated using the model trained by Data Set I on Data Set II. The system again showed high performance, with 91.18% detection of spikes and 99.22% seizure detection. Conclusion We report a de novo EEG classification system for seizure and spike detection on multichannel EEG that includes physiology-based knowledge to enhance the performance of this type of system. PMID:23799053

  2. Combination anticonvulsant treatment of soman-induced seizures.

    PubMed

    Koplovitz, I; Schulz, S; Shutz, M; Railer, R; Macalalag, R; Schons, M; McDonough, J

    2001-12-01

    These studies investigated the effectiveness of combination treatment with a benzodiazepine and an anticholinergic drug against soman-induced seizures. The anticholinergic drugs considered were biperiden, scopolamine, trihexaphenidyl, and procyclidine; the benzodiazepines were diazepam and midazolam. Male guinea pigs were implanted surgically with cortical screw electrodes. Electrocorticograms were displayed continually and recorded on a computerized electroencephalographic system. Pyridostigmine (0.026 mg x kg(-1), i.m.) was injected as a pretreatment to inhibit red blood cell acetylcholinesterase by 30-40%. Thirty minutes after pyridostigmine, 2 x LD50 (56 microg x kg(-1)) of soman was injected s.c., followed 1 min later by i.m. treatment with atropine (2 mg x kg(-1)) + 2-PAM (25 mg x kg(-1)). Electrographic seizures occurred in all animals. Anticonvulsant treatment combinations were administered i.m. at 5 or 40 min after seizure onset. Treatment consisted of diazepam or midazolam plus one of the above-mentioned anticholinergic drugs. All doses of the treatment compounds exhibited little or no antiseizure efficacy when given individually. The combination of a benzodiazepine and an anticholinergic drug was effective in terminating soman-induced seizure, whether given 5 or 40 min after seizure onset. The results suggest a strong synergistic effect of combining benzodiazepines with centrally active anticholinergic drugs and support the concept of using an adjunct to supplement diazepam for the treatment of nerve-agent-induced seizures. PMID:11920921

  3. Tranexamic acid concentrations associated with human seizures inhibit glycine receptors.

    PubMed

    Lecker, Irene; Wang, Dian-Shi; Romaschin, Alexander D; Peterson, Mark; Mazer, C David; Orser, Beverley A

    2012-12-01

    Antifibrinolytic drugs are widely used to reduce blood loss during surgery. One serious adverse effect of these drugs is convulsive seizures; however, the mechanisms underlying such seizures remain poorly understood. The antifibrinolytic drugs tranexamic acid (TXA) and ?-aminocaproic acid (EACA) are structurally similar to the inhibitory neurotransmitter glycine. Since reduced function of glycine receptors causes seizures, we hypothesized that TXA and EACA inhibit the activity of glycine receptors. Here we demonstrate that TXA and EACA are competitive antagonists of glycine receptors in mice. We also showed that the general anesthetic isoflurane, and to a lesser extent propofol, reverses TXA inhibition of glycine receptor-mediated current, suggesting that these drugs could potentially be used to treat TXA-induced seizures. Finally, we measured the concentration of TXA in the cerebrospinal fluid (CSF) of patients undergoing major cardiovascular surgery. Surprisingly, peak TXA concentration in the CSF occurred after termination of drug infusion and in one patient coincided with the onset of seizures. Collectively, these results show that concentrations of TXA equivalent to those measured in the CSF of patients inhibited glycine receptors. Furthermore, isoflurane or propofol may prevent or reverse TXA-induced seizures. PMID:23187124

  4. Neonatal hypocalcemic seizures due to excessive maternal calcium ingestion.

    PubMed

    Borkenhagen, Jenna F; Connor, Ellen L; Stafstrom, Carl E

    2013-06-01

    Hypocalcemia is a common, treatable cause of neonatal seizures. A term girl neonate with no apparent risk factors developed seizures on day 5 of life, consisting of rhythmic twitching of all extremities in a migrating pattern. Physical examination was normal except for jitteriness. Laboratory evaluation was unremarkable except for decreased total and ionized serum calcium levels and an elevated serum phosphorus level. The mother had ingested 3-6 g of calcium carbonate daily during the final 4 months of pregnancy to control morning sickness. The baby's electroencephalogram showed multifocal interictal sharp waves and intermittent electrographic seizures consisting of focal spikes in the left hemisphere accompanied by rhythmic jerking of the right arm and leg. Treatment with intravenous calcium gluconate over several days resulted in cessation of seizures and normalization of serum calcium. The child has remained seizure free and is normal developmentally at 9 years of age. Hypocalcemic seizures in this newborn were likely secondary to excessive maternal calcium ingestion, which led to transient neonatal hypoparathyroidism and hypocalcemia. Inquiry about perinatal maternal medication use should include a search for over-the-counter agents that might not be thought of as "drugs," as in this case, antacids. PMID:23668874

  5. Decursin attenuates kainic acid-induced seizures in mice.

    PubMed

    Lee, Jong-Keun; Jeong, Ji Woon; Jang, Taeik; Lee, Go-Woon; Han, Hogyu; Kang, Jae-Seon; Kim, Ik-Hwan

    2014-11-12

    Epilepsy is a neurological disorder with recurrent unprovoked seizures as the main symptom. Of the coumarin derivatives in Angelica gigas, decursin, a major coumarin component, was reported to exhibit significant protective activity against glutamate-induced neurotoxicity when added to primary cultures of rat cortical cells. This study served to investigate the effects of decursin on a kainic acid (KA)-induced status epilepticus model. Thirty minutes after intraperitoneal injections of decursin (20?mg/kg) in male 7-week-old C57BL/6 mice, the animals were treated with KA (30?mg/kg, intraperitoneally) and then examined for behavioral seizure score, electroencephalogram, seizure-related expressed protein levels, neuronal cell loss, neurodegeneration, and astrogliosis. KA injections significantly enhanced neurodegenerative conditions but treatment with decursin 30?min before KA injection reduced the detrimental effects of KA in mice. The decursin-treated KA-injected group showed significantly decreased behavioral seizure activity and remarkably attenuated intense and high-frequency seizure discharges in the parietal cortex for 2?h compared with the group treated only with KA. Furthermore, in-vivo results indicated that decursin strongly inhibits selective neuronal death, astrogliosis, and oxidative stress induced by KA administration. Therefore decursin is able to attenuate KA-induced seizures and could have potential as an antiepileptic drug. PMID:25171200

  6. Seizure characterisation using frequency-dependent multivariate dynamics.

    PubMed

    Conlon, T; Ruskin, H J; Crane, M

    2009-09-01

    The characterisation of epileptic seizures assists in the design of targeted pharmaceutical seizure prevention techniques and pre-surgical evaluations. In this paper, we expand on the recent use of multivariate techniques to study the cross-correlation dynamics between electroencephalographic (EEG) channels. The maximum overlap discrete wavelet transform (MODWT) is applied in order to separate the EEG channels into their underlying frequencies. The dynamics of the cross-correlation matrix between channels, at each frequency, are then analysed in terms of the eigenspectrum. By examination of the eigenspectrum, we show that it is possible to identify frequency-dependent changes in the correlation structure between channels which may be indicative of seizure activity. The technique is applied to EEG epileptiform data and the results indicate that the correlation dynamics vary over time and frequency, with larger correlations between channels at high frequencies. Additionally, a redistribution of wavelet energy is found, with increased fractional energy demonstrating the relative importance of high frequencies during seizures. Dynamical changes also occur in both correlation and energy at lower frequencies during seizures, suggesting that monitoring frequency-dependent correlation structure can characterise changes in EEG signals during these. Future work will involve the study of other large eigenvalues and inter-frequency correlations to determine additional seizure characteristics. PMID:19580962

  7. 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

  8. STEP Regulation of Seizure Thresholds in the Hippocampus

    PubMed Central

    Aaron, Gloster; Briggs, Stephen; Walker, Jeffrey; Asik, Kemal; Lombroso, Paul; Naegele, Janice

    2010-01-01

    Summary Purpose To investigate whether STriatal Enriched protein tyrosine Phosphatase (STEP) influences ictogenesis. Methods STEP knockout mice were compared to wild-type (WT) mice in pilocarpine-induced seizures. Hippocampal slices were also prepared from these two mouse populations, allowing the examination of ictal-like stimulation in these slices using calcium imaging and electrophysiological recordings. Results To examine seizure thresholds, increasing doses of pilocarpine were administered to adult mice and seizures were scored behaviorally. Significantly fewer STEP knockout mice developed seizures that progressed to the stage of status epilepticus compared to WT mice. To examine potential differences in neural circuits that might account for this finding, seizure-like activity was induced in hippocampal slices. Electrical stimulation of the hippocampal-entorhinal cortex pathway in STEP knockout mice resulted in less activation of the dentate granule cell layer, but greater activation of the hilus in STEP knockouts, compared with heterozygous slices. Conclusions STEP deficiency is associated with higher seizure thresholds. The locus of these effects appears to include the dentate gyrus granule cell layer and hilus. PMID:21204826

  9. Antisense Reduction of Tau in Adult Mice Protects against Seizures

    PubMed Central

    DeVos, Sarah L.; Goncharoff, Dustin K.; Chen, Guo; Kebodeaux, Carey S.; Yamada, Kaoru; Stewart, Floy R.; Schuler, Dorothy R.; Maloney, Susan E.; Wozniak, David F.; Rigo, Frank; Bennett, C. Frank; Cirrito, John R.; Holtzman, David M.

    2013-01-01

    Tau, a microtubule-associated protein, is implicated in the pathogenesis of Alzheimer's Disease (AD) in regard to both neurofibrillary tangle formation and neuronal network hyperexcitability. The genetic ablation of tau substantially reduces hyperexcitability in AD mouse lines, induced seizure models, and genetic in vivo models of epilepsy. These data demonstrate that tau is an important regulator of network excitability. However, developmental compensation in the genetic tau knock-out line may account for the protective effect against seizures. To test the efficacy of a tau reducing therapy for disorders with a detrimental hyperexcitability profile in adult animals, we identified antisense oligonucleotides that selectively decrease endogenous tau expression throughout the entire mouse CNS—brain and spinal cord tissue, interstitial fluid, and CSF—while having no effect on baseline motor or cognitive behavior. In two chemically induced seizure models, mice with reduced tau protein had less severe seizures than control mice. Total tau protein levels and seizure severity were highly correlated, such that those mice with the most severe seizures also had the highest levels of tau. Our results demonstrate that endogenous tau is integral for regulating neuronal hyperexcitability in adult animals and suggest that an antisense oligonucleotide reduction of tau could benefit those with epilepsy and perhaps other disorders associated with tau-mediated neuronal hyperexcitability. PMID:23904623

  10. Treatment of epileptic seizures in brain tumors: a critical review.

    PubMed

    Bauer, R; Ortler, M; Seiz-Rosenhagen, M; Maier, R; Anton, J V; Unterberger, I

    2014-07-01

    Epileptic seizures represent a common signal of intracranial tumors, frequently the presenting symptom and the main factor influencing quality of life. Treatment of tumors concentrates on survival; antiepileptic drug (AED) treatment frequently is prescribed in a stereotyped way. A differentiated approach according to epileptic syndromes can improve seizure control and minimize unwarranted AED effects. Prophylactic use of AEDs is to be discouraged in patients without seizures. Acutely provoked seizures do not need long-term medication except for patients with high recurrence risk indicated by distinct EEG patterns, auras, and several other parameters. With chronically repeated seizures (epilepsies), long-term AED treatment is indicated. Non-enzyme-inducing AEDs might be preferred. Valproic acid exerts effects against progression of gliomatous tumors. In low-grade astrocytomas with epilepsy, a comprehensive presurgical epilepsy work-up including EEG-video monitoring is advisable; in static non-progressive tumors, it is mandatory. In these cases, the neurosurgical approach has to include the removal of the seizure-onset zone frequently located outside the lesion. PMID:24760366

  11. A history of the concept of atypical depression.

    PubMed

    Davidson, Jonathan R T

    2007-01-01

    The term atypical depression as a preferentially monoamine oxidase inhibitor (MAOI)-responsive state was first introduced by West and Dally in 1959. Further characterization of this syndrome and its responsiveness to antidepressants came to occupy the attention of many psychopharmacologists for the next 30 years. Different portrayals of atypical depression have emerged, for example, nonendogenous depression, phobic anxiety with secondary depression, vegetative reversal, rejection-sensitivity, and depression with severe chronic pain. Consistency across or within types has been unimpressive, and no coherent single type of depression can yet be said to be "atypical." In successfully demonstrating superiority of MAOI drugs to tricyclics, the Columbia (or DSM-IV) criteria have established their utility and become widely adopted, but other criteria have also passed this test. In this "post-MAOI" era, no novel compound or group of drugs has been clearly shown to have good efficacy in atypical depression, leaving the treatment of atypical depression as an unmet need. PMID:17348762

  12. New directions in the treatment of atypical depression.

    PubMed

    Thase, Michael E

    2006-12-01

    Atypical depression, one of the 4 historically important ways of subdividing depression, was first used by West and Dally to describe a patient subgroup that was nonresponsive to imipramine but responsive to iproniazid. The definition was later refined to include reverse vegetative and hysteroid dysphoria symptoms, presaging adoption of the current DSM definition in 1984. However, focusing on hysteroid dysphoria symptoms drew attention away from anxiety symptoms, some of which are more strongly linked to atypical depression. Studies that have attempted to validate atypical depression have reinforced reverse vegetative symptoms criteria and have shown that atypical depression is probably more common than melancholia. Studies suggest that atypical depression is not preferentially responsive to monoamine oxidase inhibitors, but rather less responsive to tricyclic antidepressants. PMID:17201029

  13. 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.

  14. Leaky Ca2+ release channel/ryanodine receptor 2 causes seizures and sudden cardiac death in mice

    PubMed Central

    Lehnart, Stephan E.; Mongillo, Marco; Bellinger, Andrew; Lindegger, Nicolas; Chen, Bi-Xing; Hsueh, William; Reiken, Steven; Wronska, Anetta; Drew, Liam J.; Ward, Chris W.; Lederer, W.J.; Kass, Robert S.; Morley, Gregory; Marks, Andrew R.

    2008-01-01

    The Ca2+ release channel ryanodine receptor 2 (RyR2) is required for excitation-contraction coupling in the heart and is also present in the brain. Mutations in RyR2 have been linked to exercise-induced sudden cardiac death (catecholaminergic polymorphic ventricular tachycardia [CPVT]). CPVT-associated RyR2 mutations result in “leaky” RyR2 channels due to the decreased binding of the calstabin2 (FKBP12.6) subunit, which stabilizes the closed state of the channel. We found that mice heterozygous for the R2474S mutation in Ryr2 (Ryr2-R2474S mice) exhibited spontaneous generalized tonic-clonic seizures (which occurred in the absence of cardiac arrhythmias), exercise-induced ventricular arrhythmias, and sudden cardiac death. Treatment with a novel RyR2-specific compound (S107) that enhances the binding of calstabin2 to the mutant Ryr2-R2474S channel inhibited the channel leak and prevented cardiac arrhythmias and raised the seizure threshold. Thus, CPVT-associated mutant leaky Ryr2-R2474S channels in the brain can cause seizures in mice, independent of cardiac arrhythmias. Based on these data, we propose that CPVT is a combined neurocardiac disorder in which leaky RyR2 channels in the brain cause epilepsy, and the same leaky channels in the heart cause exercise-induced sudden cardiac death. PMID:18483626

  15. Long-term safety of perampanel and seizure outcomes in refractory partial-onset seizures and secondarily generalized seizures: Results from phase III extension study 307

    PubMed Central

    Krauss, Gregory L; Perucca, Emilio; Ben-Menachem, Elinor; Kwan, Patrick; Shih, Jerry J; Clément, Jean-François; Wang, Xuefeng; Bagul, Makarand; Gee, Michelle; Zhu, Jin; Squillacote, David

    2014-01-01

    Objective To evaluate safety, tolerability, seizure frequency, and regional variations in treatment responses with the AMPA antagonist, perampanel, in a large extension study during up to 3 years of treatment. Methods Patients ?12 years old with partial-onset seizures despite treatment with 1–3 antiepileptic drugs at baseline completed a perampanel phase III trial and entered extension study 307 (NCT00735397). Patients were titrated to 12 mg/day (or their individual maximum tolerated dose) during the blinded conversion period, followed by open-label maintenance. Exposure, safety (adverse events [AEs], vital signs, weight, electrocardiography [ECG], laboratory values) and seizure outcomes were analyzed; key measures were assessed by geographic regions. Results Among 1,216 patients, median exposure was 1.5 years (range 1 week to 3.3 years), with >300 patients treated for >2 years. Treatment retention was 58.5% at cutoff. AEs reported in ?10% of patients were dizziness, somnolence, headache, fatigue, irritability, and weight increase. Only dizziness and irritability caused discontinuation in >1% of patients (3.9% and 1.3%, respectively). The only serious AEs reported in >1% of patients were epilepsy-related (convulsion, 3.0%; status epilepticus, 1.1%). No clinically relevant changes in vital signs, ECG or laboratory parameters were seen. After titration/conversion, responder rate and median percentage change from baseline in seizure frequency were stable: 46% for both measures at 9 months (in 980 patients with ?9 months' exposure) and 58% and 60%, respectively, at 2 years (in the 337 patients with 2 years' exposure). Median percentage reduction in frequency of secondarily generalized (SG) seizures ranged from 77% at 9 months (N = 422) to 90% at 2 years (N = 141). Among the 694 patients with maintenance data ?1 year, 5.3% were seizure-free for the entire year. Significance No new safety signals emerged during up to 3 years of perampanel exposure in 39 countries. Seizure responses remained stable, with marked reductions, particularly in SG seizures. PMID:24867391

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

    PubMed

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

    2014-02-01

    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

  17. 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

  18. Wireless system for long-term EEG monitoring of absence epilepsy

    NASA Astrophysics Data System (ADS)

    Whitchurch, Ashwin K.; Ashok, B. H.; Kumaar, R. V.; Saurkesi, K.; Varadan, Vijay K.

    2002-11-01

    Absence epilepsy is a form of epilepsy common mostly in children. The most common manifestations of Absence epilepsy are staring and transient loss of responsiveness. Also, subtle motor activities may occur. Due to the subtle nature of these symptoms, episodes of absence epilepsy may often go unrecognized for long periods of time or be mistakenly attributed to attention deficit disorder or daydreaming. Spells of absence epilepsy may last about 10 seconds and occur hundreds of times each day. Patients have no recollections of the events that occurred during those seizures and will resume normal activity without any postictal symptoms. The EEG during such episodes of Absence epilepsy shows intermittent activity of 3 Hz generalized spike and wave complexes. As EEG is the only way of detecting such symptoms, it is required to monitor the EEG of the patient for a long time and thus remain only in bed. So, effectively the EEG is being monitored only when the patient is stationary. The wireless monitoring sys tem described in this paper aims at eliminating this constraint and enables the physicial to monitor the EEG when the patient resumes his normal activities. This approach could even help the doctor identify possible triggers of absence epilepsy.

  19. Muscarinic M1 receptor and cannabinoid CB1 receptor do not modulate paraoxon-induced seizures

    PubMed Central

    Kow, Rebecca L; Cheng, Eugene M; Jiang, Kelly; Le, Joshua H; Stella, Nephi; Nathanson, Neil M

    2015-01-01

    One of the major signs of severe organophosphate poisoning is seizures. Previous studies have shown that both muscarinic agonist- and organophosphate-induced seizures require activation of muscarinic acetylcholine receptors in the central nervous system. Seizures induced by the muscarinic agonist pilocarpine require the M1 receptor and are modulated by cannabinoid CB1 receptors. In this study, we determined whether M1 and CB1 receptors also regulated seizures induced by the organophosphate paraoxon. We found no differences in seizures induced by paraoxon in wild-type (WT) and M1 knockout (KO) mice, indicating that in contrast to pilocarpine seizures, M1 receptors are not required for paraoxon seizures. Furthermore, we found that pilocarpine administration resulted in seizure-independent activation of ERK in the hippocampus in a M1 receptor-dependent manner, while paraoxon did not induce seizure-independent activation of ERK in the mouse hippocampus. This shows that pilocarpine and paraoxon activated M1 receptors in the hippocampus to different extents. There were no differences in seizures induced by paraoxon in WT and CB1 KO mice, and neither CB1 agonist nor antagonist administration had significant effects on paraoxon seizures, indicating that, in contrast to pilocarpine seizures, paraoxon seizures are not modulated by CB1 receptors. These results demonstrate that there are fundamental molecular differences in the regulation of seizures induced by pilocarpine and paraoxon. PMID:25692018

  20. Updated ILAE evidence review of antiepileptic drug efficacy and effectiveness as initial monotherapy for epileptic seizures and syndromes.

    PubMed

    Glauser, Tracy; Ben-Menachem, Elinor; Bourgeois, Blaise; Cnaan, Avital; Guerreiro, Carlos; Kälviäinen, Reetta; Mattson, Richard; French, Jacqueline A; Perucca, Emilio; Tomson, Torbjorn

    2013-03-01

    The purpose of this report was to update the 2006 International League Against Epilepsy (ILAE) report and identify the level of evidence for long-term efficacy or effectiveness for antiepileptic drugs (AEDs) as initial monotherapy for patients with newly diagnosed or untreated epilepsy. All applicable articles from July 2005 until March 2012 were identified, evaluated, and combined with the previous analysis (Glauser et al., 2006) to provide a comprehensive update. The prior analysis methodology was utilized with three modifications: (1) the detectable noninferiority boundary approach was dropped and both failed superiority studies and prespecified noninferiority studies were analyzed using a noninferiority approach, (2) the definition of an adequate comparator was clarified and now includes an absolute minimum point estimate for efficacy/effectiveness, and (3) the relationship table between clinical trial ratings, level of evidence, and conclusions no longer includes a recommendation column to reinforce that this review of efficacy/evidence for specific seizure types does not imply treatment recommendations. This evidence review contains one clarification: The commission has determined that class I superiority studies can be designed to detect up to a 20% absolute (rather than relative) difference in the point estimate of efficacy/effectiveness between study treatment and comparator using an intent-to-treat analysis. Since July, 2005, three class I randomized controlled trials (RCT) and 11 class III RCTs have been published. The combined analysis (1940-2012) now includes a total of 64 RCTs (7 with class I evidence, 2 with class II evidence) and 11 meta-analyses. New efficacy/effectiveness findings include the following: levetiracetam and zonisamide have level A evidence in adults with partial onset seizures and both ethosuximide and valproic acid have level A evidence in children with childhood absence epilepsy. There are no major changes in the level of evidence for any other subgroup. Levetiracetam and zonisamide join carbamazepine and phenytoin with level A efficacy/effectiveness evidence as initial monotherapy for adults with partial onset seizures. Although ethosuximide and valproic acid now have level A efficacy/effectiveness evidence as initial monotherapy for children with absence seizures, there continues to be an alarming lack of well designed, properly conducted epilepsy RCTs for patients with generalized seizures/epilepsies and in children in general. These findings reinforce the need for multicenter, multinational efforts to design, conduct, and analyze future clinically relevant adequately designed RCTs. When selecting a patient's AED, all relevant variables and not just efficacy and effectiveness should be considered. PMID:23350722

  1. APPENDIX TO MINUTE 157 SICKNESS ABSENCE POLICY

    E-print Network

    Levi, Ran

    from his/her General Practitioner to their Head of Department/Section for periods of absence exceeding. It is intended to support staff during periods of absence whilst ensuring the efficient and effective running. Absence of 1- 3 days duration For a period of absence of 3 days or less, the Head of Department

  2. 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

  3. Refractory Rheumatic Disorder: Atypical Postpregnancy Osteoporosis

    PubMed Central

    Mourgues, Cindy; Malochet-Guinamand, Sandrine; Soubrier, Martin

    2015-01-01

    This is a case report on a young patient with severe osteoporosis that was initially revealed when she presented with polyarthralgia during her second pregnancy. Postpartum, the pain increased and her X-ray did not show any abnormalities. A bone scintigraphy was performed. It indicated an inflammatory rheumatic disorder. Six months after partum, an investigation of right coxalgia revealed a spontaneous basicervical fracture. Given the persistent polyarthralgia, the patient underwent a new scintigraphy, which revealed areas of what looked to be old rib and L1 fractures. A subsequent full body magnetic resonance imaging (MRI) scan revealed signal abnormalities that could indicate multiple lower limb bone fractures. Despite exhaustive biological, radiological, and histological testing, no secondary cause for the osteoporosis was found. The patient was started on teriparatide. We finally concluded that, despite the atypical presentation, the patient was suffering from postpregnancy osteoporosis. It is possible that the frequency of occurrence of this still poorly understood disease is underestimated.

  4. Therapeutic drug monitoring of atypical antipsychotic drugs.

    PubMed

    Grundmann, Milan; Kacirova, Ivana; Urinovska, Romana

    2014-12-01

    Schizophrenia is a severe psychiatric disorder often associated with cognitive impairment and affective, mainly depressive, symptoms. Antipsychotic medication is the primary intervention for stabilization of acute psychotic episodes and prevention of recurrences and relapses in patients with schizophrenia. Typical antipsychotics, the older class of antipsychotic agents, are currently used much less frequently than newer atypical antipsychotics. Therapeutic drug monitoring (TDM) of antipsychotic drugs is the specific method of clinical pharmacology, which involves measurement of drug serum concentrations followed by interpretation and good cooperation with the clinician. TDM is a powerful tool that allows tailor-made treatment for the specific needs of individual patients. It can help in monitoring adherence, dose adjustment, minimizing the risk of toxicity and in cost-effectiveness in the treatment of psychiatric disorders. The review provides complex knowledge indispensable to clinical pharmacologists, pharmacists and clinicians for interpretation of TDM results. PMID:25531781

  5. Statistical Detection of Atypical Aircraft Flights

    NASA Technical Reports Server (NTRS)

    Statler, Irving; Chidester, Thomas; Shafto, Michael; Ferryman, Thomas; Amidan, Brett; Whitney, Paul; White, Amanda; Willse, Alan; Cooley, Scott; Jay, Joseph; Rosenthal, Loren; Swickard, Andrea; Bates, Derrick; Scherrer, Chad; Webb, Bobbie-Jo; Lawrence, Robert; Mosbrucker, Chris; Prothero, Gary; Andrei, Adi; Romanowski, Tim; Robin, Daniel; Prothero, Jason; Lynch, Robert; Lowe, Michael

    2006-01-01

    A computational method and software to implement the method have been developed to sift through vast quantities of digital flight data to alert human analysts to aircraft flights that are statistically atypical in ways that signify that safety may be adversely affected. On a typical day, there are tens of thousands of flights in the United States and several times that number throughout the world. Depending on the specific aircraft design, the volume of data collected by sensors and flight recorders can range from a few dozen to several thousand parameters per second during a flight. Whereas these data have long been utilized in investigating crashes, the present method is oriented toward helping to prevent crashes by enabling routine monitoring of flight operations to identify portions of flights that may be of interest with respect to safety issues.

  6. Atypical regions in large genomic DNA sequences

    SciTech Connect

    Scherer, S. [Lawrence Berkeley Lab., CA (United States)]|[Univ. of Minnesota, Minneapolis, MN (United States); McPeek, M.S.; Speed, T.P. [Univ. of California, Berkeley, CA (United States)

    1994-07-19

    Large genomic DNA sequences contain regions with distinctive patterns of sequence organization. The authors describe a method using logarithms of probabilities based on seventh-order Markov chains to rapidly identify genomic sequences that do not resemble models of genome organization built from compilations of octanucleotide usage. Data bases have been constructed from Escherichia coli and Saccharomyces cerevisiae DNA sequences of >1000 nt and human sequences of >10,000 nt. Atypical genes and clusters of genes have been located in bacteriophage, yeast, and primate DNA sequences. The authors consider criteria for statistical significance of the results, offer possible explanations for the observed variation in genome organization, and give additional applications of these methods in DNA sequence analysis.

  7. 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

  8. Melanoma risk factors and atypical moles.

    PubMed Central

    Williams, M L; Sagebiel, R W

    1994-01-01

    Despite important advances in the treatment of melanoma, the prognosis for advanced disease remains discouraging. This fact, in combination with a worldwide epidemic of melanoma among persons of white skin type, has focused attention on identifying melanoma in its early, surgically curable stages. Attention has also been directed toward pinpointing which persons are at increased risk for melanoma to reduce risk where possible and to aid early diagnosis. Essentially all epidemiologic studies have identified an increased number of melanocytic nevi as an important risk factor in the development of melanoma, but controversy has arisen concerning the risk associated with certain types of nevi, particularly "dysplastic" nevi. We review melanoma risk factors and examine the relationship between melanocytic nevi and melanoma to clarify for primary care physicians what is "known" (non-controversial) and what is "unknown" (controversial). We propose a working definition of an atypical mole phenotype and outline an approach to managing high-risk patients. Images PMID:8023484

  9. Presurgical connectome and postsurgical seizure control in temporal lobe epilepsy

    PubMed Central

    Helpern, Joseph A.; Sainju, Rup; Nesland, Travis; Edwards, Jonathan C.; Glazier, Steven S.; Tabesh, Ali

    2013-01-01

    Objectives: The objective of this study was to evaluate whether patients with surgically refractory medial temporal lobe epilepsy (MTLE) exhibit a distinct pattern of structural network organization involving the temporal lobes and extratemporal regions. Methods: We retrospectively studied 18 healthy controls and 20 patients with medication refractory unilateral MTLE who underwent anterior temporal lobectomy for treatment of seizures. Patients were classified as seizure-free or not seizure-free at least 1 year after surgery. The presurgical brain connectome was calculated through probabilistic connectivity from MRI–diffusion tensor imaging from 83 anatomically defined regions of interest encompassing the whole brain. The connectivity patterns were analyzed regarding group differences in regional connectivity and network graph properties. Results: Compared with controls, patients exhibited a decrease in connectivity involving ipsilateral thalamocortical regions, with a pathologic increase in ipsilateral medial temporal lobe, insular, and frontal connectivity. Among patients, those not seizure-free exhibited a higher connectivity between structures in 1) the ipsilateral medial and lateral temporal lobe, 2) the ipsilateral medial temporal and parietal lobe, and 3) the contralateral temporal pole and parietal lobe. Patients not seizure-free also exhibited lower small-worldness in the subnetwork within the ipsilateral temporal lobe, with higher subnetwork integration at the expense of segregation. Conclusions: MTLE is associated with network rearrangement within, but not restricted to, the temporal lobe ipsilateral to the onset of seizures. Networks involving key components of the medial temporal lobe and structures traditionally not removed during surgery may be associated with seizure control after surgical treatment of MTLE. PMID:24107863

  10. A case of atypical progressive supranuclear palsy

    PubMed Central

    Spaccavento, Simona; Del Prete, Marina; Craca, Angela; Loverre, Anna

    2014-01-01

    Background Progressive supranuclear palsy (PSP) is a neurodegenerative extrapyramidal syndrome. Studies have demonstrated that PSP can present clinically as an atypical dementing syndrome dominated by a progressive apraxia of speech (AOS) and aphasia. Aim We aimed to investigate the clinical presentation of PSP, using a comprehensive multidimensional evaluation, and the disease response to various pharmacological treatments. Methods A 72-year-old right-handed male, with 17 years education, who first presented with aphasia, AOS, depression, apathy, and postural instability at 69 years; a complete neuropsychological evaluation, tapping the different cognitive domains, was performed. Results Testing revealed a moderate global cognitive deficit (Mini-Mental State Examination test score =20), low memory test scores (story recall, Rey’s 15-word Immediate and Delayed Recall), and poor phonemic and semantic fluency. The patient’s language was characterized by AOS, with slow speech rate, prolonged intervals between syllables and words, decreased articulatory accuracy, sound distortions, and anomia. Behavioral changes, such as depression, anxiety, apathy, and irritability, were reported. The neurological examination revealed supranuclear vertical gaze palsy, poor face miming, and a mild balance deficit. Magnetic resonance imaging showed only widespread cortical atrophy. Single photon emission computed tomography demonstrated left > right frontotemporal cortical abnormalities. After 6 months, a further neuropsychological assessment showed a progression in cognitive deficits, with additional attention deficits. The patient reported frequent falls, but the neurological deficits remained unchanged. Neuroimaging tests showed the same brain involvement. Conclusion Our case highlights the heterogeneity of the clinical features in this syndrome, demonstrating that atypical PSP can present as AOS and aphasia, without the classical features or involvement of the subcortical gray and brainstem region, commonly affected in typical PSP. PMID:24368882

  11. The use of atypical antipsychotics in Bipolar Spectrum disorders.

    PubMed

    Grünze, H; Möller, H J

    2003-01-01

    Viewed in the context of ever-expanding conceptual boundaries for the diagnosis of bipolar disorder including the spectrum concept of DSM-IV, or even beyond (Akiskal and Pinto, 1999), it becomes obvious that lithium is the treatment of choice in a minority' of patients only (Bowden et al, 2000). This article reviews what additional benefit atypical antipsychotics may provide in patients with bipolar disorder.Due both to tradition and to the regulatory requirements in the USA (FDA) and European Union (EMEA), the main target of clinical trials with atypical antipsychotics has been typical manic disorder. More recently, a significant subgroup of atypical patients, e.g., with mixed states, marked psychosis, or rapid cycling, have participated in these studies to allow an estimation of the value of atypical antipsychotics in these conditions. For the purposes of filing applications for registration with the regulatory agencies, the existing evidence is probably weak, however; from a clinical perspective, it is important that most atypical antipsychotics have also been tested in combination treatments. Finally, first data are now available on long-term prophylactic efficacy of atypical antipsychotics. These combined efficacy data definitely support the use of atypical antipsychotics in bipolar disorder, and it is now the time to collect more experience with these substances in severely ill patients in clinical settings. PMID:21206806

  12. 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.

  13. 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.

  14. 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.

  15. The Secret “Spice”: An Undetectable Toxic Cause of Seizure

    PubMed Central

    de Havenon, Adam; Chin, Brian; Thomas, Karen C.; Afra, Pegah

    2011-01-01

    Neurologists and emergency department physicians are frequently involved in the comprehensive evaluation of a first generalized seizure. An important aspect of this evaluation is a detailed history which can identify a provoked seizure secondary to drug toxicity and hence avoid unnecessary treatment with antiepileptic drugs. “Spice” is an umbrella term for a variety of synthetic cannabinoid products whose inhalation has been associated with an increasing number of toxic side effects resulting in emergency department visits. These side effects (including psychosis, tachyarrhythmia, and seizures) are not typically seen with marijuana (Cannabis sativa) use. We report 2 patients with no prior history of neurological disease that experienced their first generalized tonic–clonic seizure after smoking Spice. The mechanism behind the possible proconvulsant effect of synthetic cannabinoids is not known, but it may be due to their effects at the cannabinoid receptor CB1. Although the US Drug Enforcement Administration placed 5 synthetic cannabinoids into schedule 1 for a 12-month period beginning March 2011, new Spice products containing different synthetic cannabinoids continue to emerge. Because synthetic cannabinoids are not detectable on commercial drug screens it is important that neurologists and emergency department physicians consider Spice inhalation in their differential diagnosis of a first generalized seizure. PMID:23983854

  16. 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

  17. Detection of tonic epileptic seizures based on surface electromyography.

    PubMed

    Larsen, Sigge N; Conradsen, Isa; Beniczky, Sandor; Sorensen, Helge B D

    2014-08-01

    The purpose of this project was to design an algorithm for detection of tonic seizures based on surface electromyography signals from the deltoids. A successful algorithm has a future prospect of being implemented in a wearable device as part of an alarm system. This has already been done for generalized tonic-clonic seizures, and the hypothesis was that some of the same characteristics could be found for tonic seizures. The signals were pre-processed by a high-pass filter to remove low frequency noise such as movement artifacts. Several different features were investigated, including kurtosis, median frequency, zero crossing rate and approximate entropy. These features were used as input in the random forest classifier to decide if a data segment was from a seizure or not. The goal was to develop a generic algorithm for all tonic seizures, but better results were achieved when certain parameters were adapted specifically for each patient. With patient specific parameters the algorithm obtained a sensitivity of 100% for four of six patients with false detection rates between 0.08 and 7.90 per hour. PMID:25570115

  18. Non-LTE studies of A-type supergiants

    NASA Astrophysics Data System (ADS)

    Przybilla, N.; Butler, K.; Firnstein, M.

    2014-11-01

    The tenuous atmospheres of A-type supergiants are good sources for studying non-LTE physics. We present an overview of recent achievements in quantitative analyses of high-resolution spectra of Galactic A-type supergiants at optical and near-IR wavelengths, focusing on the nature and extent of non-LTE effects. We discuss their impact on determinations of atmospheric and fundamental stellar parameters and element abundances, and draw some conclusions regarding the evolutionary status of A-type supergiants.

  19. Childhood epilepsy and school absence.

    PubMed

    Ibekwe, Roland C; Ojinnaka, Ngozi C

    2008-10-01

    Epilepsy is one of the most common diseases encountered among school children. Its effect on school attendance and academic performance is a major cause of concern to both parents and clinicians. In this communication, the absence rate and academic performance of 50 school children with epilepsy attending normal schools was compared with that of their age- and sex-matched classmates using the class attendance register and overall score of the 2001/2002 academic year. The mean and standard deviation of the number of days an epileptic child was absent in the 2001/2002 session was 15.3 + 13.8 days while that of the controls was 9.4 + 9.6 days (x2 = 3.4,df = 49, p < 0.001). There was no significant relationship between the rate of absenteeism and overall score among both epileptic children (x2 = 6.34, df = 2, p = 0.18) and the controls (x2 = 1.43, df = 2, p = 0.49). School absenteeism was therefore more common among epileptic children, though there was no observed negative effect of this increased absence on academic performance. PMID:18820208

  20. 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

  1. Interictal cardiorespiratory variability in temporal lobe and absence epilepsy in childhood.

    PubMed

    Varon, Carolina; Montalto, Alessandro; Jansen, Katrien; Lagae, Lieven; Marinazzo, Daniele; Faes, Luca; Van Huffel, Sabine

    2015-04-01

    It is well known that epilepsy has a profound effect on the autonomic nervous system, especially on the autonomic control of heart rate and respiration. This effect has been widely studied during seizure activity, but less attention has been given to interictal (i.e. seizure-free) activity. The studies that have been done on this topic, showed that heart rate and respiration can be affected individually, even without the occurrence of seizures. In this work, the interactions between these two individual physiological variables are analysed during interictal activity in temporal lobe and absence epilepsy in childhood. These interactions are assessed by decomposing the predictive information about heart rate variability, into different components like the transfer entropy, cross-entropy, self- entropy and the conditional self entropy. Each one of these components quantifies different types of shared information. However, when using the cross-entropy and the conditional self entropy, it is possible to split the information carried by the heart rate, into two main components, one related to respiration and one related to different mechanisms, like sympathetic activation. This can be done after assuming a directional link going from respiration to heart rate. After analysing all the entropy components, it is shown that in subjects with absence epilepsy the information shared by respiration and heart rate is significantly lower than for normal subjects. And a more remarkable finding indicates that this type of epilepsy seems to have a long term effect on the cardiac and respiratory control mechanisms of the autonomic nervous system. PMID:25799266

  2. Stimulus driver for epilepsy seizure suppression with adaptive loading impedance

    NASA Astrophysics Data System (ADS)

    Ker, Ming-Dou; Lin, Chun-Yu; Chen, Wei-Ling

    2011-10-01

    A stimulus driver circuit for a micro-stimulator used in an implantable device is presented in this paper. For epileptic seizure control, the target of the driver was to output 30 µA stimulus currents when the electrode impedance varied between 20 and 200 k?. The driver, which consisted of the output stage, control block and adaptor, was integrated in a single chip. The averaged power consumption of the stimulus driver was 0.24-0.56 mW at 800 Hz stimulation rate. Fabricated in a 0.35 µm 3.3 V/24 V CMOS process and applied to a closed-loop epileptic seizure monitoring and controlling system, the proposed design has been successfully verified in the experimental results of Long-Evans rats with epileptic seizures.

  3. Blast TBI Models, Neuropathology, and Implications for Seizure Risk

    PubMed Central

    Kovacs, S. Krisztian; Leonessa, Fabio; Ling, Geoffrey S. F.

    2014-01-01

    Traumatic brain injury (TBI) due to explosive blast exposure is a leading combat casualty. It is also implicated as a key contributor to war related mental health diseases. A clinically important consequence of all types of TBI is a high risk for development of seizures and epilepsy. Seizures have been reported in patients who have suffered blast injuries in the Global War on Terror but the exact prevalence is unknown. The occurrence of seizures supports the contention that explosive blast leads to both cellular and structural brain pathology. Unfortunately, the exact mechanism by which explosions cause brain injury is unclear, which complicates development of meaningful therapies and mitigation strategies. To help improve understanding, detailed neuropathological analysis is needed. For this, histopathological techniques are extremely valuable and indispensable. In the following we will review the pathological results, including those from immunohistochemical and special staining approaches, from recent preclinical explosive blast studies. PMID:24782820

  4. Unification of neuronal spikes, seizures, and spreading depression.

    PubMed

    Wei, Yina; Ullah, Ghanim; Schiff, Steven J

    2014-08-27

    The pathological phenomena of seizures and spreading depression have long been considered separate physiological events in the brain. By incorporating conservation of particles and charge, and accounting for the energy required to restore ionic gradients, we extend the classic Hodgkin-Huxley formalism to uncover a unification of neuronal membrane dynamics. By examining the dynamics as a function of potassium and oxygen, we now account for a wide range of neuronal activities, from spikes to seizures, spreading depression (whether high potassium or hypoxia induced), mixed seizure and spreading depression states, and the terminal anoxic "wave of death." Such a unified framework demonstrates that all of these dynamics lie along a continuum of the repertoire of the neuron membrane. Our results demonstrate that unified frameworks for neuronal dynamics are feasible, can be achieved using existing biological structures and universal physical conservation principles, and may be of substantial importance in enabling our understanding of brain activity and in the control of pathological states. PMID:25164668

  5. Unification of Neuronal Spikes, Seizures, and Spreading Depression

    PubMed Central

    Wei, Yina; Ullah, Ghanim

    2014-01-01

    The pathological phenomena of seizures and spreading depression have long been considered separate physiological events in the brain. By incorporating conservation of particles and charge, and accounting for the energy required to restore ionic gradients, we extend the classic Hodgkin–Huxley formalism to uncover a unification of neuronal membrane dynamics. By examining the dynamics as a function of potassium and oxygen, we now account for a wide range of neuronal activities, from spikes to seizures, spreading depression (whether high potassium or hypoxia induced), mixed seizure and spreading depression states, and the terminal anoxic “wave of death.” Such a unified framework demonstrates that all of these dynamics lie along a continuum of the repertoire of the neuron membrane. Our results demonstrate that unified frameworks for neuronal dynamics are feasible, can be achieved using existing biological structures and universal physical conservation principles, and may be of substantial importance in enabling our understanding of brain activity and in the control of pathological states. PMID:25164668

  6. Poland Syndrome: Description of an Atypical Variant

    Microsoft Academic Search

    G. A. Ferraro; A. Perrotta; F. Rossano; F. D’Andrea

    2005-01-01

    Poland syndrome comprises a unilateral absence of the large pectoral muscle, ipsilateral symbrachydactyly, and occasionally other malformations of the anterior chest wall and breast. The condition is more frequent among males, and usually occurs on the right hemithorax in the unilateral form. The syndrome is believed to be caused by a genetic disorder that reduces the embryonal circulation in the

  7. Automatic detection of seizure termination during electroconvulsive therapy using sample entropy of the electroencephalogram.

    PubMed

    Yoo, Cheol Seung; Jung, Dong Chung; Ahn, Yong Min; Kim, Yong Sik; Kim, Su-Gyeong; Yoon, Hyeri; Lim, Young Jin; Yi, Sang Hoon

    2012-01-30

    Determining the exact duration of seizure activity is an important factor for predicting the efficacy of electroconvulsive therapy (ECT). In most cases, seizure duration is estimated manually by observing the electroencephalogram (EEG) waveform. In this article, we propose a method based on sample entropy (SampEn) that automatically detects the termination time of an ECT-induced seizure. SampEn decreases during seizure activity and has its smallest value at the boundary of seizure termination. SampEn reflects not only different states of regularity and complexity in the EEG but also changes in EEG amplitude before and after seizure activity. Using SampEn, we can more precisely determine seizure termination time and total seizure duration. PMID:21831451

  8. 28 CFR 8.2 - Designation of officials having seizure authority.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...Designation of officials having seizure authority. 8.2 Section 8.2 Judicial Administration DEPARTMENT OF JUSTICE FBI FORFEITURE AUTHORITY FOR CERTAIN STATUTES § 8.2 Designation of officials having seizure authority. The Director,...

  9. 28 CFR 8.2 - Designation of officials having seizure authority.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...Designation of officials having seizure authority. 8.2 Section 8.2 Judicial Administration DEPARTMENT OF JUSTICE FBI FORFEITURE AUTHORITY FOR CERTAIN STATUTES § 8.2 Designation of officials having seizure authority. The Director,...

  10. Diverse seizure presentation of acute Mycoplasma pneumoniae encephalitis resolving with immunotherapy.

    PubMed

    Arkilo, Dimitrios; Pierce, Beth; Ritter, Frank; Doescher, Jason S; Frost, Michael

    2014-04-01

    We report 3 previously normal children that presented for evaluation of new onset seizures. Case 1, a 7-year-old female, presented with refractory left frontal lobe seizures associated with right arm simple motor seizures refractory to 6 antiepileptic medications at sufficient doses and levels. Case 2, a 15-year-old female, presented with left frontotemporal lobe seizures and nonconvulsive seizures, associated with neuropsychiatric symptoms refractory to 5 antiepileptic medications. Both patients received intravenous steroids and intravenous immunoglobulin. Case 3, an 11-year-old male, presented with a generalized tonic clonic seizure and worsening hallucinations responding to intravenous corticosteroids and 1 antiepileptic medication. All 3 patients had extensive infectious and metabolic evaluation and were found to be serum immunoglobulin M positive for mycoplasma pneumoniae. Despite their prolonged severe symptoms, all patients had virtually complete recovery with excellent seizure control after aggressive seizure management with immunotherapy and antiepileptic medication. PMID:23481447

  11. 31 CFR 406.1 - Secret Service officers authorized to make seizures of gold.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...Secret Service officers authorized to make seizures of gold. 406.1 Section 406.1 Money and Finance...DEPARTMENT OF THE TREASURY SEIZURE AND FORFEITURE OF GOLD FOR VIOLATIONS OF GOLD RESERVE ACT OF 1934 AND GOLD REGULATIONS §...

  12. 31 CFR 406.1 - Secret Service officers authorized to make seizures of gold.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...Secret Service officers authorized to make seizures of gold. 406.1 Section 406.1 Money and Finance...DEPARTMENT OF THE TREASURY SEIZURE AND FORFEITURE OF GOLD FOR VIOLATIONS OF GOLD RESERVE ACT OF 1934 AND GOLD REGULATIONS §...

  13. 31 CFR 406.1 - Secret Service officers authorized to make seizures of gold.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...Secret Service officers authorized to make seizures of gold. 406.1 Section 406.1 Money and Finance...DEPARTMENT OF THE TREASURY SEIZURE AND FORFEITURE OF GOLD FOR VIOLATIONS OF GOLD RESERVE ACT OF 1934 AND GOLD REGULATIONS §...

  14. 31 CFR 406.1 - Secret Service officers authorized to make seizures of gold.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...Secret Service officers authorized to make seizures of gold. 406.1 Section 406.1 Money and Finance...DEPARTMENT OF THE TREASURY SEIZURE AND FORFEITURE OF GOLD FOR VIOLATIONS OF GOLD RESERVE ACT OF 1934 AND GOLD REGULATIONS §...

  15. 31 CFR 406.1 - Secret Service officers authorized to make seizures of gold.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...Secret Service officers authorized to make seizures of gold. 406.1 Section 406.1 Money and Finance...DEPARTMENT OF THE TREASURY SEIZURE AND FORFEITURE OF GOLD FOR VIOLATIONS OF GOLD RESERVE ACT OF 1934 AND GOLD REGULATIONS §...

  16. Application of machine learning to epileptic seizure onset detection and treatment

    E-print Network

    Shoeb, Ali Hossam, 1981-

    2009-01-01

    Epilepsy is a chronic disorder of the central nervous system that predisposes individuals to experiencing recurrent seizures. It affects 3 million Americans and 50 million people world-wide. A seizure is a transient ...

  17. Absence seizures in C3H/HeJ and knockout mice caused by mutation of the AMPA receptor

    E-print Network

    Huguenard, John R.

    (s). This is an Open Access article distributed under the terms of the Creative Commons Attribution Non within the circuitry of the cerebral cortex and thalamus that regulates awareness. The inbred mouse channels are active in thalamocortical circuits that determine awareness state and are also potentially

  18. 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

  19. 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

  20. 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

  1. Delayed Recurrence of Atypical Pulmonary Carcinoid Cluster: A Rare Occurrence

    PubMed Central

    Surani, Saherish S.; Varon, Joseph

    2014-01-01

    Carcinoid is one of the most common tumors of the gastrointestinal tract followed by the tracheobronchial tree. Bronchial carcinoid compromises 20% of total carcinoid and accounts for 1–5% of pulmonary malignancies. Carcinoid can be typical or atypical, with atypical carcinoid compromises 10% of the carcinoid tumors. Carcinoid usually presents as peripheral lung lesion or solitary endobronchial abnormality. Rarely it can present as multiple endobronchial lesion. We hereby present a rare case of an elderly gentleman who had undergone resection of right middle and lower lobe of lung for atypical carcinoid. Seven years later he presented with cough. CT scan of chest revealed right hilar mass. Flexible bronchoscopy revealed numerous endobronchial polypoid lesions in the tracheobronchial tree. Recurrent atypical carcinoid was then confirmed on biopsy. PMID:25506019

  2. Water-drinking as ictal behavior in complex partial seizures.

    PubMed

    Rémillard, G M; Andermann, F; Gloor, P; Olivier, A; Martin, J B

    1981-02-01

    The urge to demand, pour, and drink water at the time of an attack was encountered in 20 patients who had seizures with complex partial symptomatology. Two patients were studied with bitemporal stereotaxically implanted depth electrodes. Drinking was associated with electrographic and clinical seizures starting in the amygdala, hippocampus, and parahippocampal gyrus. Sometimes, this was the only clinical manifestation of an attack, and its significance would not have been recognized without depth recording. Ictal drinking was never encountered in patients without electroencephalographic evidence of temporal epileptic abnormality, and therefore seems to have localizing significance. PMID:7193295

  3. Adjunctive perampanel for refractory partial-onset seizures

    PubMed Central

    Krauss, Gregory L.; Biton, Victor; Squillacote, David; Yang, Haichen; Laurenza, Antonio; Kumar, Dinesh; Rogawski, Michael A.; Campanille, Verónica; Floridia, Jorge; Ilari, Rita; Consalvo, Damián E.; Thomson, Alfredo; Sfaello, Ignacio; Pociecha, Juan; Nieto, Flavia; Firstenfeld, Alfredo; Zuin, Daniel; Mesri, Jacobo; Silva, Walter; Nofal, Pedro; Cristalli, Diana; Clement, Jean-Francois; Hwang, Paul; McLachlan, Richard; Pillay, Neelan; Lasso, Jorge; Peralta, Balduin Lawson; Hernandez, Marcelo Leiva; Tenhamm, Eugenio; Barroso, Noe; Milian, Albino Contreras; Morales, Sarug Reyes; Rodríguez, Ildefonso; Jain, Sanjay; Wilfong, Angus; Kalra, Arun; Renfroe, Ben; Moore, David; Flamini, J.; Klapper, Jack; Szaflarski, Jerzy; Teasley, Jean; Halford, Jonathan; Ferreira, Jose; Goodpasture, Hewitt; Sperling, Michael; Klein, Pavel; Ayala, Ricardo; Brower, Richard; Leroy, Robert; Davis, Ronald; Elterman, Roy; Enlow, Thomas; Sosa, Veronica; Puri, Vinay; Miller, John; Shneker, Bassel; Bautista, Ramon; Chung, Steve; Lesch, David; Steiner, David; Webb, Randall; Armstrong, Robert; Biton, Victor; Krauss, Gregory; Mitchell, Wendy; Hogan, Robert; Knowlton, Robert; Wheless, James; Aung-Din, Ronald; Ali, Imran; Brown, Lawrence; Gruenthal, Michael; Kankirawatana, Pongkiat; Charlet, Michael; Conry, Joan; Owen, Meriem Bensalem; Yerby, Mark; Herrman, Craig; Fessler, Albert; Modur, Pradeep; Miranda, Fernando; King-Stephens, David

    2012-01-01

    Objective: To assess efficacy and safety of once-daily 8 or 12 mg perampanel, a noncompetitive ?-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) receptor antagonist, when added to concomitant antiepileptic drugs (AEDs) in the treatment of drug-resistant partial-onset seizures. Methods: This was a multicenter, double-blind, placebo-controlled trial (ClinicalTrials.gov identifier: NCT00699972). Patients (?12 years, with ongoing seizures despite 1–3 AEDs) were randomized (1:1:1) to once-daily perampanel 8 mg, 12 mg, or placebo. Following baseline (6 weeks), patients entered a 19-week double-blind phase: 6-week titration (2 mg/week increments to target dose) followed by a 13-week maintenance period. Percent change in seizure frequency was the primary endpoint; 50% responder rate was the primary endpoint for EU registration. Results: Of 388 patients randomized and treated, 387 provided seizure frequency data. Using this intent-to-treat population over the double-blind phase, the median percent change in seizure frequency was ?21.0%, ?26.3%, and ?34.5% for placebo and perampanel 8 and 12 mg, respectively (p = 0.0261 and p = 0.0158 for 8 and 12 mg vs placebo, respectively). Fifty percent responder rates during the maintenance period were 26.4%, 37.6%, and 36.1%, respectively, for placebo, perampanel 8 mg, and perampanel 12 mg; these differences were not statistically significant for 8 mg (p = 0.0760) or 12 mg (p = 0.0914). Sixty-eight (17.5%) patients discontinued, including 40 (10.3%) for adverse events. Most frequent treatment-emergent adverse events were dizziness, somnolence, irritability, headache, fall, and ataxia. Conclusions: This trial demonstrated that once-daily, adjunctive perampanel at doses of 8 or 12 mg improved seizure control in patients with uncontrolled partial-onset seizures. Doses of perampanel 8 and 12 mg were safe, and tolerability was acceptable. Classification of evidence: This study provides Class I evidence that once-daily 8 and 12 mg doses of adjunctive perampanel are effective in patients with uncontrolled partial-onset seizures. PMID:22843280

  4. Subclinical rhythmic electrographic discharge in adults: an atypical evolution.

    PubMed

    Silva, D F; Zanoteli, E; Lima, M M; Anghinah, R; Lima, J G

    1995-06-01

    The subclinical rhythmic electrographic discharge in adults (SREDA) has been rarely reported. We describe the case of a 71 year-old man with transient ischemic attack, whose EEG showed an atypical evolution of this uncommon pattern. The computed tomography scan and cerebrospinal fluid were normal. We are not aware of any other report in the literature with this atypical evolution of SREDA. PMID:7487535

  5. An Atypical Case of Pityriasis Rosea Gigantea after Influenza Vaccination

    PubMed Central

    Papakostas, Dimitrios; Stavropoulos, Panagiotis G.; Papafragkaki, Dafni; Grigoraki, Ekaterini; Avgerinou, Georgia; Antoniou, Christina

    2014-01-01

    Pityriasis rosea is a common erythematosquamous eruption, typically presenting along the cleavage lines of the skin. A wide spectrum of atypical manifestations may challenge even the most experienced physician. Here we report a rare case of a suberythrodermic pityriasis rosea with gigantic plaques after an influenza vaccination, and we discuss the possible triggers of atypical manifestations of such a common dermatological disease in the setting of an altered immunity. PMID:24847250

  6. A-type granites: geochemical characteristics, discrimination and petrogenesis

    Microsoft Academic Search

    Joseph B. Whalen; Kenneth L. Currie; Bruce W. Chappell

    1987-01-01

    New analyses of 131 samples of A-type (alkaline or anorogenic) granites substantiate previously recognized chemical features, namely high SiO2, Na2O+K2O, Fe\\/Mg, Ga\\/Al, Zr, Nb, Ga, Y and Ce, and low CaO and Sr. Good discrimination can be obtained between A-type granites and most orogenic granites (M-, I and S-types) on plots employing Ga\\/Al, various major element ratios and Y, Ce,

  7. Atypical carcinoid of the esophagus: report of a case.

    PubMed

    Xiaogang, Zhao; Xingtao, Jiang; Huasheng, Wang; Mo, Wang

    2002-10-01

    We present a case of an atypical carcinoid in the midthoracic esophagus. Esophagectomy was performed with a three-incisional approach. Although both postoperative chemotherapy and radiation therapy were given, the patient died 11 months postoperatively of liver metastasis and cachexia. We suggest that the aggressive behavior of atypical carcinoid of the esophagus precludes the use of limited surgical resection and requires adjuvant chemoradiotherapy. PMID:12472414

  8. Atypical apocrine adenosis diagnosed on breast core biopsy: implications for management.

    PubMed

    Calhoun, Benjamin C; Booth, Christine N

    2014-10-01

    Apocrine adenosis (AA) and atypical apocrine adenosis (AAA) are uncommon findings in breast biopsies that may be misinterpreted as carcinoma. The data from long-term follow up studies of open biopsies suggest that AAA is not a high-risk or precursor lesion. The clinical significance and risk implications of AAA diagnosed on core biopsy are not well established. The goal of this study was to determine the frequency of carcinoma in excision specimens after a core biopsy diagnosis of AA or AAA. We identified 34 core biopsies of AA (22) and AAA (12) performed between 1996 and 2014. The mean age at diagnosis was 60 years. The most common indications for core biopsy were calcifications (11), a mass or density (18), and a mass or density with calcifications (3). Two cases were detected on magnetic resonance imaging (MRI) studies. Available pathology reports and slides were reviewed, and surgical excision findings were correlated with core biopsy diagnoses. Of the core biopsies with AA or AAA, 7 also contained atypical ductal or lobular hyperplasia (AH) and 4 contained ductal carcinoma in situ or invasive carcinoma. In the absence of coexisting AH or carcinoma in the initial core biopsy specimen, none of the surgical excision specimens after a diagnosis of AA (2) or AAA (7) contained ductal carcinoma in situ or invasive carcinoma. AAA by itself is an uncommon core biopsy diagnosis that may not require surgical excision. PMID:25106711

  9. [Clinical heterogeneity of atypical fractures during prolonged use of bisphosphonates--risk factors and bone turnover markers].

    PubMed

    Piazzetta, Giovana; Baracho, Filipe R; Oliveira, Larissa de; Santos, Gustavo R; Kulak, Carolina A M; Borba, Victória Z C

    2014-11-01

    We describe four cases of atypical femoral fractures treated at the Department of Endocrinology, Hospital de Clínicas, Federal University of Paraná (SEMPR) which, although characteristic of this type of fracture, presented clinical peculiarities that should be considered and serve as a warning in these patients, such as: late diagnosis with maintenance of bisphosphonates; absence of co-morbidities with excellent result; failure of fracture healing; use of anabolic medication after the fracture and the use of bone turnover markers at the follow up. PMID:25465610

  10. 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

  11. Nonparametric spectral analysis with applications to seizure characterization using EEG time series

    Microsoft Academic Search

    Li Qin; Yuedong Wang

    2008-01-01

    Understanding the seizure initiation process and its propagation pattern(s) is a critical task in epilepsy research. Characteristics of the pre-seizure electroencephalograms (EEGs) such as oscillating powers and high-frequency activities are believed to be indicative of the seizure onset and spread patterns. In this article, we analyze epileptic EEG time series using nonparametric spectral estimation methods to extract information on seizure-specific

  12. Persistent consequences of atypical early number concepts

    PubMed Central

    Mazzocco, Michčle M. M.; Murphy, Melissa M.; Brown, Ethan C.; Rinne, Luke; Herold, Katherine H.

    2013-01-01

    How does symbolic number knowledge performance help identify young children at risk for poor mathematics achievement outcomes? In research and practice, classification of mathematics learning disability (MLD, or dyscalculia) is typically based on composite scores from broad measures of mathematics achievement. These scores do predict later math achievement levels, but do not specify the nature of math difficulties likely to emerge among students at greatest risk for long-term mathematics failure. Here we report that gaps in 2nd and 3rd graders' number knowledge predict specific types of errors made on math assessments at Grade 8. Specifically, we show that early whole number misconceptions predict slower and less accurate performance, and atypical computational errors, on Grade 8 arithmetic tests. We demonstrate that basic number misconceptions can be detected by idiosyncratic responses to number knowledge items, and that when such misconceptions are evident during primary school they persist throughout the school age years, with variable manifestation throughout development. We conclude that including specific qualitative assessments of symbolic number knowledge in primary school may provide greater specificity of the types of difficulties likely to emerge among students at risk for poor mathematics outcomes. PMID:24027540

  13. Atypical alpha asymmetry in adults with ADHD*

    PubMed Central

    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 asymmetry has been associated with ADHD-like traits such as reduced reward responsiveness, a lack of inhibition toward aversive experience, and increased approach behaviors, and previous work has indicated increased rightward alpha asymmetry in children with ADHD. The current study explores whether increased rightward alpha asymmetry is also evident in adults with ADHD. Method We assessed low (8– 10 Hz) and high (10– 12 Hz) alpha asymmetry in adults with ADHD (n = 29) versus controls (n = 62) during baseline and cognitive activation conditions for nine homologous electrode pairs along the anterior–posterior axis. Result Seven results emerged (p < .05) showing increased rightward alpha asymmetry in adults with ADHD. This occurred in three specific electrode pairs across two testing conditions, and five of six results occurred in the lower alpha band. Finally, post hoc analysis indicated that increased rightward alpha asymmetry was generally associated with greater numbers of ADHD symptoms—with a possible parietal association for inattentive and a fronto-temporal association for hyperactivity symptoms. Conclusions Increased rightward alpha asymmetry previously observed in children with ADHD appears to be a developmentally persistent feature of ADHD. PMID:19467358

  14. Atypical Presentation of Traumatic Aortic Injury

    PubMed Central

    Chua, Tallie Wei-Lin; Seth, Puneet; Tan, Kenneth Boon Kiat

    2014-01-01

    Background. Blunt thoracic aorta injury (BAI) is second only to head injury as cause of mortality in blunt trauma. While most patients do not survive till arrival at the hospital, for the remainder, prompt diagnosis and treatment greatly improve outcomes. We report an atypical presentation of BAI, highlighting the diagnostic challenges of this condition in the emergency department. Case Presentation. A previously well 25-year-old male presented 15 hours after injury hemodynamically stable with delirium. There were no signs or symptoms suggestive of BAI. Sonography showed small bilateral pleural effusions. Chest radiograph showed a normal mediastinum. Eventually, CT demonstrated a contained distal aortic arch disruption. The patient underwent percutaneous endovascular thoracic aortic repair and recovered well. Conclusion. This catastrophic lesion may present with few reliable signs and symptoms; hence, a high index of suspicion is crucial for early diagnosis and definitive surgical management. This paper discusses the diagnostic utility of clinical features, injury mechanism, and radiographic modalities. Consideration of mechanism of injury, clinical features, and chest radiograph findings should prompt advanced chest imaging. PMID:25610670

  15. Observing Behavior and Atypically Restricted Stimulus Control

    PubMed Central

    Dube, William V; Dickson, Chata A; Balsamo, Lyn M; O'Donnell, Kristin Lombard; Tomanari, Gerson Y; Farren, Kevin M; Wheeler, Emily E; McIlvane, William J

    2010-01-01

    Restricted stimulus control refers to discrimination learning with atypical limitations in the range of controlling stimuli or stimulus features. In the study reported here, 4 normally capable individuals and 10 individuals with intellectual disabilities (ID) performed two-sample delayed matching to sample. Sample-stimulus observing was recorded with an eye-tracking apparatus. High accuracy scores indicated stimulus control by both sample stimuli for the 4 nondisabled participants and 4 participants with ID, and eye tracking data showed reliable observing of all stimuli. Intermediate accuracy scores indicated restricted stimulus control for the remaining 6 participants. Their eye-tracking data showed that errors were related to failures to observe sample stimuli and relatively brief observing durations. Five of these participants were then given interventions designed to improve observing behavior. For 4 participants, the interventions resulted initially in elimination of observing failures, increased observing durations, and increased accuracy. For 2 of these participants, contingencies sufficient to maintain adequate observing were not always sufficient to maintain high accuracy; subsequent procedure modifications restored it, however. For the 5th participant, initial improvements in observing were not accompanied by improved accuracy, an apparent instance of observing without attending; accuracy improved only after an additional intervention that imposed contingencies on observing behavior. Thus, interventions that control observing behavior seem necessary but may not always be sufficient for the remediation of restricted stimulus control. PMID:21541173

  16. Observing behavior and atypically restricted stimulus control.

    PubMed

    Dube, William V; Dickson, Chata A; Balsamo, Lyn M; O'Donnell, Kristin Lombard; Tomanari, Gerson Y; Farren, Kevin M; Wheeler, Emily E; McIlvane, William J

    2010-11-01

    Restricted stimulus control refers to discrimination learning with atypical limitations in the range of controlling stimuli or stimulus features. In the study reported here, 4 normally capable individuals and 10 individuals with intellectual disabilities (ID) performed two-sample delayed matching to sample. Sample-stimulus observing was recorded with an eye-tracking apparatus. High accuracy scores indicated stimulus control by both sample stimuli for the 4 nondisabled participants and 4 participants with ID, and eye tracking data showed reliable observing of all stimuli. Intermediate accuracy scores indicated restricted stimulus control for the remaining 6 participants. Their eye-tracking data showed that errors were related to failures to observe sample stimuli and relatively brief observing durations. Five of these participants were then given interventions designed to improve observing behavior. For 4 participants, the interventions resulted initially in elimination of observing failures, increased observing durations, and increased accuracy. For 2 of these participants, contingencies sufficient to maintain adequate observing were not always sufficient to maintain high accuracy; subsequent procedure modifications restored it, however. For the 5th participant, initial improvements in observing were not accompanied by improved accuracy, an apparent instance of observing without attending; accuracy improved only after an additional intervention that imposed contingencies on observing behavior. Thus, interventions that control observing behavior seem necessary but may not always be sufficient for the remediation of restricted stimulus control. PMID:21541173

  17. Epilepsy Research 72 (2006) 8081 Comment on: "Performance of a seizure warning

    E-print Network

    Timmer, Jens

    2006-01-01

    Epilepsy Research 72 (2006) 80­81 Discussion Comment on: "Performance of a seizure warning Epilepsy Center, University Hospital of Freiburg, Germany Accepted 26 June 2006 Available online 21 August device for epilepsy patients based on an in-time seizure warning. However, seizure pre- diction suffers

  18. Generalized epilepsy with febrile seizures plus. A genetic disorder with heterogeneous clinical phenotypes

    Microsoft Academic Search

    Ingrid E. Scheffer; Samuel F. Berkovic

    1997-01-01

    Summary The clinical and genetic relationships of febrile seizures myoclonic seizures, FS 1 and atonic seizures, and the most severely affected individual had myoclonic-astatic epilepsy and the generalized epilepsies are poorly understood. We ascertained a family with genealogical information in 2000 (MAE). The pattern of inheritance was autosomal dominant. The large variation in generalized epilepsy phenotypes was individuals where there

  19. 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…

  20. Febrile Seizures and Behavioural and Cognitive Outcomes in Preschool Children: An Old Issue Revisited

    ERIC Educational Resources Information Center

    Deonna, Thierry

    2012-01-01

    The possible deleterious role of febrile seizures on development is an old issue. It took a long time to realize that impaired development or occurrence of chronic epilepsy affected a very small minority of children with febrile seizures. These children either had pre-existing brain damage, specific genetic epileptic conditions, or seizure-induced…

  1. SPECT in a Patient with Postictal PLEDs: Is Hyperperfusion Evidence of Electrical Seizure?

    Microsoft Academic Search

    Murat Fani Bozkurt; Serap Saygi; Belkis Erbas

    2002-01-01

    The pathophysiological relation between periodic lateralized epileptiform discharges (PLEDs) and epileptic seizures is not known and the exact causative mechanism of PLEDs still remains unclear. In this report, the authors present a case in which the EEG displayed PLEDs after a complex partial seizure. This patient, with a long history of complex partial seizures, had previously undergone right standard anterior

  2. Favorable Seizure Outcome in Kabuki Make-up Syndrome Associated With Epilepsy

    Microsoft Academic Search

    Atsushi Ogawa; Sawa Yasumoto; Yasuko Tomoda; Masaharu Ohfu; Akihisa Mitsudome; Yoshikazu Kuroki

    2003-01-01

    Kabuki make-up syndrome is a mental retardation—malformation syndrome affecting multiple organ systems, with a broad spectrum of neuromuscular dysfunction and mental ability. The incidence of seizures associated with this syndrome ranges from 10 to 40%. However, details of the seizures in this syndrome have not been adequately reported or thoroughly evaluated. In this study, we analyzed seizure characteristics and clinical

  3. Audiogenic seizures and cochlear damage in rats after perinatal antithyroid treatment

    SciTech Connect

    Van Milllesworth, L.; Norris, C.H.

    1980-06-01

    The feeding of goitrogens during pregnancy and lactation causes the offspring of rats to be partially deaf and persistently sensitive to audiogenic seizures. The most potent goitrogen, propylthiouracil, caused severe dysfunction and disorganization of the organ of Corti. Adult seizure-susceptible rats showed increased sensitivity to audiogenic seizures when they were fed propylthiouracil.

  4. Preoperative clinical, EEG, and imaging findings do not predict seizure outcome following temporal lobectomy in childhood.

    PubMed

    Goldstein, R; Harvey, A S; Duchowny, M; Jayakar, P; Altman, N; Resnick, T; Levin, B; Dean, P; Alvarez, L

    1996-11-01

    Although certain clinical, electroencephalographic (EEG), magnetic resonance imaging (MRI), and pathologic findings in adults with intractable temporal lobe epilepsy predict seizure outcome following temporal lobectomy, predictors of seizure outcome have not been studied systematically in pediatric temporal lobectomy series. We retrospectively analyzed preoperative clinical, EEG, and neuroimaging findings with reference to seizure outcome (seizure free or non-seizure free) in 33 children (mean age, 9.3 years) who underwent tailored temporal lobe resections for intractable temporal lobe epilepsy. Trends were apparent with (1) younger age at seizure onset, younger age at surgery, shorter duration of epilepsy, localized unilateral temporal lesions on MRI, and right-sided surgery more frequently associated with a seizure-free outcome, and (2) significant prior history, daily preoperative seizures, generalized motor seizures, mental retardation, and localized unilateral temporal epileptiform EEG activity more frequently associated with a non-seizure-free outcome. However, none of these findings, alone or in combination, correlated with postoperative seizure status at a statistically significant level. Submitting the four variables generally considered to be most predictive of favorable outcome (ie, normal intelligence, unilateral ictal and interictal EEG discharges, and focal temporal MRI lesion) to a multiple-cutoff procedure did not predict seizure freedom. Our data indicate that predictors of outcome of temporal lobectomy in adults may not apply in children, perhaps due to inherent neurobiologic differences in the etiology and expression of temporal lobe epilepsy, and should therefore not be used as sole determinants of surgical candidacy in children. PMID:9120221

  5. Age of seizure onset, functional reorganization, and neuropsychological outcome in temporal lobectomy

    Microsoft Academic Search

    Stefanie Griffin; Daniel Tranel

    2007-01-01

    Patients with early onset seizure disorder tend to have less cognitive decline following surgical resection than patients with late onset seizure disorder. Differential opportunity for presurgical cerebral functional reorganization has been proposed to account for this “age of onset” effect. However, the relationships between age of seizure onset, functional organization, and neuropsychological outcome remain incompletely understood. To shed additional light

  6. 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

  7. Doctors' prediction of certified sickness absence

    Microsoft Academic Search

    Harald Reiso; Pĺl Gulbrandsen; Sören Brage

    Methods. A questionnaire survey was carried out in primary health care concerning 796 patients certified sick within 140 days after the start of absence. The episodes of absence were labelled short-standing (up to 2 weeks) and long-standing (from 3 to 20 weeks), at the time of consultation. The doctors' prediction of the patients' absence status 4 weeks ahead, diagnoses, work

  8. AFTER DIVORCE:Investigations into Father Absence

    Microsoft Academic Search

    TERRY ARENDELL

    1992-01-01

    On the basis of in-depth interviews with 75 divorced New York fathers, the phenomenon of postdivorce paternal absence is investigated. The accounts provided by the interviewees suggest that father absence is more than a literal practice: it is also a perceived option and a standard of comparison. Father absence is a strategy of action, the objective of which is to

  9. Critical evaluation of four different seizure detection systems tested on one patient with focal and generalized tonic and clonic seizures.

    PubMed

    Van de Vel, Anouk; Verhaert, Kristien; Ceulemans, Berten

    2014-08-01

    For long-term home monitoring of epileptic seizures, the measurement of extracerebral body signals such as abnormal movement is often easier and less obtrusive than monitoring intracerebral brain waves with electroencephalography (EEG). Non-EEG devices are commercially available but with little scientifically valid information and no consensus on which system works for which seizure type or patient. We evaluated four systems based on efficiency, comfort, and user-friendliness and compared them in one patient suffering from focal epilepsy with secondary generalization. The Emfit mat, Epi-Care device, and Epi-Care Free bracelet are commercially available alarm systems, while the VARIA (Video, Accelerometry, and Radar-Induced Activity recording) device is being developed by our team and requires offline analysis for seizure detection and does so by presenting the 5% or 10% (patient-specific) most abnormal movement events, irrespective of the number of seizures per night. As we chose to mimic the home situation, we did not record EEG and compared our results to the seizures reported by experienced staff that were monitoring the patient on a semicontinuous basis. This resulted in a sensitivity (sens) of 78% and false detection rate (FDR) of 0.55 per night for Emfit, sens 40% and FDR 0.41 for Epi-Care, sens 41% and FDR 0.05 for Epi-Care Free, and sens 56% and FDR 20.33 for VARIA. Good results were obtained by some of the devices, even though, as expected, nongeneralized and nonrhythmic motor seizures (involving the head only, having a tonic phase, or manifesting mainly as sound) were often missed. The Emfit mat was chosen for our patient, also based on user-friendliness (few setup steps), comfort (contactless), and possibility to adjust patient-specific settings. When in need of a seizure detection system for a patient, a thorough individual search is still required, which suggests the need for a database or overview including results of clinical trials describing the patient and their seizure types. PMID:25010322

  10. 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.

  11. Rapid Changes in Brain Benzodiazepine Receptors After Experimental Seizures

    Microsoft Academic Search

    Steven M. Paul; Phil Skolnick

    1978-01-01

    Seizures induced in the rat by electroshock or by injections of pentylenetetrazol increase the specific binding of diazepam to putative receptor sites in cerebral cortical membranes. The enhancement of diazepam binding results from a rapid increase in the number of available binding sites rather than a change in receptor affinity. The postictal increase in cortical benzodiazepine receptors suggests that the

  12. Impaired sensorimotor gating in patients with non-epileptic seizures

    Microsoft Academic Search

    Hamid R Pouretemad; Pamela J Thompson; Peter B. C Fenwick

    1998-01-01

    The aim of the study was to identify possible disturbances of sensorimotor gating and habituation of the eye blink startle response, in patients with non-epileptic seizures (NES). Prepulse inhibition (PPI) of the startle reflex, as an operational measure of sensorimotor gating and habituation was studied in 21 patients with NES and in 22 healthy control subjects. Six NES patients were

  13. Characterization of Dopamine Release in a Penicillin Model of Seizure

    E-print Network

    Collins, Gary S.

    Characterization of Dopamine Release in a Penicillin Model of Seizure Taylor C. Hood, James O References Adiguzel, Esat, Ilgaz Akdogan, S. Ender Duzcan, and A. Cevik Tufan. "Effect of Penicillin Induced Analysis of Penicillin-induced Epileptiform Activity in Anesthetized Rats." Epilepsy Research 82.1 (2008

  14. Seizure Recognition on Epilepsy Feature Tensor , Canan Aykut Bingol

    E-print Network

    Bystroff, Chris

    Seizure Recognition on Epilepsy Feature Tensor Evrim Acar , Canan Aykut Bingol , Haluk Bingol are threefold. First, we rearrange multi-channel EEG signals as a third-order tensor called an Epilepsy Feature Tensor with modes: time epochs, features and electrodes. Second, we model the Epilepsy Feature Tensor

  15. 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

  16. Adenosine dysfunction in astrogliosis: cause for seizure generation?

    PubMed

    Li, Tianfu; Quan Lan, Jing; Fredholm, Bertil B; Simon, Roger P; Boison, Detlev

    2007-11-01

    Epilepsy is characterized by both neuronal and astroglial dysfunction. The endogenous anticonvulsant adenosine, the level of which is largely controlled by astrocytes, might provide a crucial link between astrocyte and neuron dysfunction in epilepsy. Here we have studied astrogliosis, a hallmark of the epileptic brain, adenosine dysfunction and the emergence of spontaneous seizures in a comprehensive approach that includes a new mouse model of focal epileptogenesis, mutant mice with altered brain levels of adenosine, and mice lacking adenosine A1 receptors. In wild-type mice, following a focal epileptogenesis-precipitating injury, astrogliosis, upregulation of the adenosine-removing astrocytic enzyme adenosine kinase (ADK), and spontaneous seizures coincide in a spatio-temporally restricted manner. Importantly, these spontaneous seizures are mimicked by untreated transgenic mice that either overexpress ADK in brain or lack A1 receptors. Conversely, mice with reduced ADK in the forebrain do not develop either astrogliosis or spontaneous seizures. Our studies define ADK as a crucial upstream regulator of A1 receptor-mediated modulation of neuronal excitability, and support the ADK hypothesis of epileptogenesis in which upregulation of ADK during astrogliosis provides a crucial link between astrocyte and neuron dysfunction in epilepsy. These findings define ADK as rational target for therapeutic intervention. PMID:18634566

  17. Ictal Cognitive Assessment of Partial Seizures and Pseudoseizures

    Microsoft Academic Search

    William L. Bell; Yong D. Park; Elizabeth A. Thompson; Rodney A. Radtke

    1998-01-01

    Background: Previous studies suggest that responsive- ness is impaired during complex partial seizures (CPS) and pseudoseizures (PS); however, to our knowledge, there has been no systematic comparison using both re- sponse and memory testing. Objective: To compare CPS with PS using ictal cogni- tive assessment (ICA) of responsiveness and memory. Patients and Methods: We used a nonautomated method of ICA

  18. 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…

  19. Pediatric psychogenic nonepileptic seizures: A study of assessment tools

    Microsoft Academic Search

    Jay A. Salpekar; Sigita Plioplys; Prabha Siddarth; Brenda Bursch; Richard J. Shaw; Miya R. Asato; W. Curt LaFrance Jr.; Deborah M. Weisbrot; David W. Dunn; Joan K. Austin; Donald M. Olson; Rochelle Caplan

    2010-01-01

    The goal of this study was to identify assessment tools and associated behavioral domains that differentiate children with psychogenic nonepileptic seizures (PNES) from those with epilepsy. A sample of 24 children with PNES (mean age 14.0 years, 14 female), 24 children with epilepsy (mean age 13.6 years, 13 female), and their parents were recruited from five epilepsy centers in the

  20. 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